union pro or con - page 6

does your hospital have a union for the nurses? if so has it helped or not? why do nurses constantly eat each other rather than say have a more powerful labor voice when... Read More

  1. by   jadey1
    I posted another thread, describing my workplace and it's shortfalls. I forget what the title was, but if you search my posts, under my profile, you'll see it.

    I'm in Northern KY and I work Skilled LTC/Rehab.

    As for the RN, with the Master's Degree: She's already been terminated, r/t a huge med error, where an ENTIRE pre-filled syring of Byatta was injected and the patient went into cardiac arrest. She's, since, lost her license, altogether.

    I didn't mean that she was only going to be as good a NURSE as I was training her to be. I meant, she was only going to be as good a DESK NURSE as I trained her to be. Paperwork, Physicians' Orders, MD/Family communication, admissions....ANYONE can do those things. LPN or RN. I've only been doing LTC for 1.5 years. I've always worked in Dr.'s offices. Triage, med audit, PT/INR's. This is my first hands-on patient care position. I've moved up the ranks VERY quickly. I've been offered a Unit Manager position, on a non-skilled floor. Being mostly LPN's, at my facility, I don't find it fair that we have no say in anything, but a newb RN can come in an push us out of our jobs.
  2. by   daniRN65
    I think unions can have their place, but I think they can have a negative effect as well. What about being paid for additional education? In my facility fair wage is in play and sometimes that is frustrating for those with Bachelor's degrees and/or specialty ceritfication. Those of who have worked at furthering their education beyond an asscociates degree are not able to be compensated for their efforts. Also, those who show up to work to "punch the clock" and just putting their time in, are getting the same percent of pay increase as those who are dedicated to providing their patients top notch care. And i don't care what any one says, you all can instantly identify those people. They are there. The bottom line should really be the patient and the care they receive. Also, thinking that with tighter, stricter guidelines set out by CMS, Joint Commission & a competitive market, hospitals are going to be forced to step up and provide better working conditions or they won't be able to meet guidelines and be forced to either loser reimbursment, accredidation and be forced to close.
    For example, in my area , (midwest, mostly rural) within a 100 mile radius there are at least 14 Hospitals (off the top of my head), all ranging from small to a larger teaching university. Residents of this area of a large selection of where to go to receive their care. If my hospital wants to stay competitive they are going to have to be able to provide top quality care. With Press-Ganey surveys and now HCAPs which is reported publically, patients definitely have a choice.
    If your working conditions are so terrible, you may need a union, but remember there will be downsides to it also.
  3. by   RN4MERCY
    Quote from daniRN65
    I think unions can have their place, but I think they can have a negative effect as well. What about being paid for additional education? In my facility fair wage is in play and sometimes that is frustrating for those with Bachelor's degrees and/or specialty ceritfication. Those of who have worked at furthering their education beyond an asscociates degree are not able to be compensated for their efforts. Also, those who show up to work to "punch the clock" and just putting their time in, are getting the same percent of pay increase as those who are dedicated to providing their patients top notch care. And i don't care what any one says, you all can instantly identify those people. They are there. The bottom line should really be the patient and the care they receive. Also, thinking that with tighter, stricter guidelines set out by CMS, Joint Commission & a competitive market, hospitals are going to be forced to step up and provide better working conditions or they won't be able to meet guidelines and be forced to either loser reimbursment, accredidation and be forced to close.
    For example, in my area , (midwest, mostly rural) within a 100 mile radius there are at least 14 Hospitals (off the top of my head), all ranging from small to a larger teaching university. Residents of this area of a large selection of where to go to receive their care. If my hospital wants to stay competitive they are going to have to be able to provide top quality care. With Press-Ganey surveys and now HCAPs which is reported publically, patients definitely have a choice.
    If your working conditions are so terrible, you may need a union, but remember there will be downsides to it also.
    I'm not sure I understand what you believe are the downsides to union membership. Unions represent workers for the purposes of collective bargaining. A team of union members negotiates with management to achieve a contract that sets forth wages, hours, and working conditions. If, for instance, the represented nurses at your facility want to negotiate a premium wage, or some kind of bonus pay for RNs who complete additional education, and enough members are willing to stick together and support that demand, then it will be submitted as a proposal during bargaining. My hospital used to offer that; I think it amounted to an extra $50 per month for having/achieving a BSN.

    They kept that up for awhile, but then over time, they took away education pay, retirement contributions became sporadic, and they capped or eliminated raises, or gave raises based on very subjective criteria. Favoritism was rampant and in our experience, the management "yes" nurses got what raises there were, and those of us who spoke out and tried to change clinical practice to make it safer for patients were retaliated against. The "poor performers" you alluded to are most often the manager's pets in a non-union environment. Those of us who organized did so because we were fed up with such disrespectful and abusive work place practices.

    It's management's responsibility to ensure competency and compliance with specific, measurable and achievable work place behaviors. The expectations should be the same, whether the facility has union representation or not. Union representation protects workers from management's whims. Union representation insures fairness in the disciplinary process. It eliminates "at-will" employment (the employer can terminate you for any reason, at any time). I think we can agree that everyone should be entitled to due process and "just cause" discipline. Without union representation, there's no recourse or protections for a nurse who's been unfairly targeted for trying to change unsafe working conditions or to challenge inequitable treatment. Without a contract, management can change the terms, benefits, and conditions of employment at any time.

    The other part of your post had to do with patient satisfaction scores, access to care, improved patient outcomes, and choice of provider. Here's some food for thought: Is satisfaction about marketing a perception? Are patients really qualified by virtue of education, professional license, or experience to determine whether or not they've received therapeutic and appropriate care? A patient may believe they were "well treated" and yet, be discharged early and have a shortened length of stay based on their provider's bottom line, only to suffer from complications and readmission later down the road. Is choice of hospital really in the hands of the patient and their family, or is it at the discretion of their HMO, insurance company, or otherwise determined or mandated because their employer doesn't offer insurance, or they can't afford or qualify for insurance? What happens to public hospitals who don't have the funds to provide "concierge service" and luxurious hoted decor; should reimbursement really be tied to patient satisfaction? What is the relationship between customer service and therapeutic, safe care, and good health outcomes?

    In the extreme, consider the case of the hospitals where patients received heart surgery that wasn't medically indicated? In the year before the scandal broke, a news article was published that contained this quote: "Redding Medical Center was ranked by Healthgrades, a national healthcare quality solutions company, as the top-ranked hospital for cardiac care in far Northern California, and earned a five-star rating, putting RMC in the top five percent of hospitals nationwide for cardiac care. The hospital is fully accredited by the Joint Commission on the Accreditation of Healthcare Organizations, the nation's oldest and largest hospital accreditation agency." The next time you see unionized nurses who are forced to picket the hospital where they work, or stage a protest in front of an insurance company, or as advocates in front of the legislature consider this: when nurses are on the outside, there's something wrong on the inside. The public has a right to know; it's our duty to inform them. The public trusts us to be their advocates.

    The power of unions to represent the public interest is evidenced by their collective ability to support research and expose evidence of fraud and system-wide abuse that deprives the public of precious health care resources, and demand public accountability. An individual doesn't stand much of a change against wealthy corporations and their bought-off politicians. But collectively and in unity, RNs are a powerful force in advocating for change that benefits all of us.

    The United American Nurses/National Nurses Organizing Committee, is the largest collective of unionized RNs in the country. We have a national vision and an action plan to achieve universal access to a single standard of excellent health care for everyone in this country. By expanding and improving Medicare to cover all of us, we address all those issues in a publicly supported, publicly accountable system of health care delivery. Legislation, HR 676 is currently before Congress, and we are at the forefront of seeking it's passage.
  4. by   jadey1
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    Last edit by jadey1 on Apr 12, '09
  5. by   daniRN65
    Thank you for sharing. I'm not against unions. I am aware of how contracts are reached, negotiations and the work involved, on both sides. But I disagree about the low-perfomers. I was not referring to "manager's pets" in non-union positions. I was in fact alluding to RN's in patient care areas doing the same work as I am. But they sit on their butts and get up only when they "have" to and do the bare minimum to get by. I don't care where you work, they are out there. And a nurse can follow the rules and "get by" and still be a low performer. It is a frustration that those nurses will recieve the same percent wage increase as those who are busting their butts. Wages should not be based on seniority only. Skill, knowledge and ability should also be considered in this process.
    Regarding patient satisfaction scores. It doesn't matter if they should or shouldn't matter. The truth is if the patient is dissatisfied w/ their care, they don't have to come to my facility, and if patients stop coming to my facility, then what happens? More staff cuts, lay-offs? Of course. That's where that comes in to play.
    I do not disagree w/ you. I think unions have paved many wonderful roads for our profession. I do believe there are facilities who are not for the nurse and for their own bottom line, cut wages, eliminate benefits. But to say there are NO downsides to unions is a far stretch. I know there are many great things yet to come from organized labor, but I am still frustrated that "Miss-flip-through-her- magazine and ignore lights is still getting the same wage increase" & I do agree it's managements responsibility to address these issues, but like I said you can follow the rules and still "just get by".
    I really appreciate your repsonse. It has been very helpful and insightful.
  6. by   MN BigJ
    Unions have some benifits, however I too would like to see pay and raises based on performance and not on seniority. I agree with an earlier post that unions breed mediocracy (sp). Things that make a difference are union reps, management's willingness to work with the union and of course if the Union puts up with people just getting by. I don't believe the Union is there to support everyone like the claim is. It is there to support you if you have seniority but that's it. I was laid off because of the Unions rules. Not based on qualifications, but seniority, even though management tried to fight the union, but that's a whole nother story.

    I do think the Unions help with working conditions and increasing compensation in general but you have to take the good with the bad, decide what means more to you and go with it.
  7. by   momatwork
    Unions are for profit and have agendas just as any organization. There are special clauses such as super seniority, which allow pro union employees to bump other nurses with more experience. Also vacations are based on seniority. I watched a union try to organize at my hospital. Union reps called nurses at all hours, and showed up at our doors unannounced. They conducted a very dirty campaign, using intimidation of peers. Thay tried to show us CEO salaries, but neglected to mention that many of the union administrators, such as its president make more than our CEO. I don't need to pay 1% of my gross salary to a union to speak for me...I can speak for myself. Our benefits were rival with the union hospitals in the information they presented us...why did we need to pay someone else! Over 90% of us voted........and it appears they are not welcome!
  8. by   momatwork
    I have worked in both climates. I do not need another organization to answer to, such as a union. If they belong to a national union, add another organization as well. As a nurse and patient advocate, I speak for myself and my patients and do not need an intermediary, who I would pay over 1% of my gross salary to. I want to work in an organization that recognizes the contributions I make, and do not want to receive the same raise as the mediocre RN who just gets by for her paycheck.
  9. by   seablitz.llc
    Sorry, that is simply not true. Maybe in your hometown they do, but there are many places in the country where nurses can make more than physicians.


    Here is something to keep in mind. It's what Union leaders don't want you to think about and will tell you that you shouldn't care about, but if you're a nurse, then you are generous and caring by your very nature, so you won't be able to ignore it:

    If you live in an area with a low cost of living, such as upstate NY, then you are going to get paid less than someone who lives and works in Boston or Chicago. To unionize your nurses and strong-arm your hospital in to paying you a wage that is on a par with what nurses in those other cities make, then you have to be prepared to deal with the consequences. If the salaries of all the nurses go up, then hospital bills are going to skyrocket as well. One thing that Unions are good at is promoting mediocrity: you know that crappy nurse who just got fired for being absolutely incompetent and almost killing a few of her patients? If you had a Union, she'd literally have to kill someone before the hospital could get rid of her.

    I'm not saying don't unionize. I'm saying think about
    Quote from nursemedic78
    I am now working at my first non-union hospital in my eight year career and it is the most pleasant and patient-centered working environment I have ever been in.


    Selfish and uncaring people do not make good nurses. Generous and selfless people do not make good Union members. Last year, the current President of the National Education Association (teachers union) was asked his opinion on the fact that teachers salaries were getting so high in some schools that they are having to shut down band, choir, and art programs just to keep up with payroll requirements, and he said he would start worrying about their interests when they join his Union.

    Unionizing will not result in all the things you think it will and should. If working conditions at your hospital are absolutely intolerable, THEN QUIT! Maybe you haven't heard, but there are more nursing jobs then nurses right now, so it's not like that place is the only job you can ever have. If enough people start quitting, it will force the hospital to make the changes they need to make to keep people. It's called a free-market employment system and it is hated by Union leaders everywhere.


    what it means for everyone involved; think about what it means for your patients, not just for you.

    I am absolutely a union pro as well. However, as a nurse who is very much involved in hospital finances, there are many information that is not being filtered to the members when collective bargaining are being proposed. For example, since 1996, our nurses received 3% increase per year. What is neglected in the bargaining table as an information is that annually, hospital expenses increases between 6 to 8%. Since the Balanced Budget Act of 1997, hospital payment from Medicare and Medicaid decreased by approximately 12% between 1997 and 2003 alone. New regulations and federal initiatives continues to hit hospitals' bottom line across the United States. Hospitals are closing, in NY alone, 21 hospitals and 48 Nursing Homes have closed since 2000 (HANYS.org, 2008).

    In reference to the salary comparison between a nurse and a dental hygienist - it is apples and oranges because RN/LPN benefits are pretty decent and comprises 18% of hospital budget. I cannot say the same thing with dental hygienist if they are working under a private practitioner.

    The literature suggests that very few hospitals are operating with sound financial status. The whole healthcare system is in a financial mess, that is why even government implement programs to mitigate the demise of our Medicare program, which hospitals depend on heavily for revenue.
  10. by   lindarn
    Quote from seablitz.llc
    Sorry, that is simply not true. Maybe in your hometown they do, but there are many places in the country where nurses can make more than physicians.


    Here is something to keep in mind. It's what Union leaders don't want you to think about and will tell you that you shouldn't care about, but if you're a nurse, then you are generous and caring by your very nature, so you won't be able to ignore it:

    If you live in an area with a low cost of living, such as upstate NY, then you are going to get paid less than someone who lives and works in Boston or Chicago. To unionize your nurses and strong-arm your hospital in to paying you a wage that is on a par with what nurses in those other cities make, then you have to be prepared to deal with the consequences. If the salaries of all the nurses go up, then hospital bills are going to skyrocket as well. One thing that Unions are good at is promoting mediocrity: you know that crappy nurse who just got fired for being absolutely incompetent and almost killing a few of her patients? If you had a Union, she'd literally have to kill someone before the hospital could get rid of her.

    I'm not saying don't unionize. I'm saying think about


    I am absolutely a union pro as well. However, as a nurse who is very much involved in hospital finances, there are many information that is not being filtered to the members when collective bargaining are being proposed. For example, since 1996, our nurses received 3% increase per year. What is neglected in the bargaining table as an information is that annually, hospital expenses increases between 6 to 8%. Since the Balanced Budget Act of 1997, hospital payment from Medicare and Medicaid decreased by approximately 12% between 1997 and 2003 alone. New regulations and federal initiatives continues to hit hospitals' bottom line across the United States. Hospitals are closing, in NY alone, 21 hospitals and 48 Nursing Homes have closed since 2000 (HANYS.org, 2008).

    In reference to the salary comparison between a nurse and a dental hygienist - it is apples and oranges because RN/LPN benefits are pretty decent and comprises 18% of hospital budget. I cannot say the same thing with dental hygienist if they are working under a private practitioner.

    The literature suggests that very few hospitals are operating with sound financial status. The whole healthcare system is in a financial mess, that is why even government implement programs to mitigate the demise of our Medicare program, which hospitals depend on heavily for revenue.
    Your arguement would have more credibility, if it were not for the fact that these same hospitals are always coming up with the "empty pockets" routine at contract time. They have no problem, however, with giving the green light to "necessary capital expenditures". Pianos in the lobby, fancy expensive artwork, lavish lobbies, an overabundance of "paper pushing administrators", assistants to the assistants, etc, ad nauseum.

    You are obviously in administration, and truly cannot identify with the peons in the trenches. Where is their reward for all of the hard work they do, day in, and day out, year after year? Unions are proliferating in the US, (not fast enough in my book), because of the inequities of working as a nurse. We are not rewarded for our hard work, and told to bed over and take it when the workload is impossible. Then we are made to look at where the raises and benefits they should have received, are instead poured into the above expenditures, which do not benefit patient care and/or positive patient outcomes. And now we are being told that we are greedy and unrealistic?

    Keep making the excuses that nurses are asking too much to be paid for what we are worth and we contribute to positive patient outcomes. And by the way, who told you that the cost of living in Upstate NY is a bargain? You might ask my in laws who have lived in Buffalo their entire lives just how "cheap" the cost of living is in Upstate NY. NY is one of the highest taxed states in the country. JMHO and my NY $0.02.

    Lindarn, RN, BSN, CCRN
    Spokane, Washington

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