Why unions are good for nursing and good for patients

Nurses Union

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The article below is long but a good reference to support why unions are best practice.

Nursing Journal Study Shows Nurses Unions Improve Patient Outcomes in Hospitals.

Patients Treated for Heart Attacks Have Lower Mortality Rate at RN-Unionized Hospitals

Patients with heart trouble would be wise to seek care at a hospital with a nurses union according to a recent study of the impact of nurses unions and the mortality rate for patients with acute myocardial infarction (AMI, the medical terminology for heart attack). The study, which was published in the March issue of JONA (Journal of Nursing Administration), studied hospitals in California and found that hospitals with a nurse’s union had a "significantly predicted lower risk-adjusted AMI mortality."

The study’s authors, Jean Ann Seago, PhD, RN and Michael Ash, PhD, concluded that "this study demonstrates that there is a positive relationship between patient outcomes and RN unions." Editor’s Note: for a fax copy of the study, contact the MNA at 781.249.0430

"Thirty-five percent of hospitals in California have RN unions. The significant finding in this study is that hospitals in California with RN unions have 5.7% lower mortality rates for AMI after accounting for patient age, gender, type of MI, chronic diseases and several organizational characteristics. This result includes controls for number of beds, AMI-related discharges, cardiac services, staff hours and wages.

In discussing how unions impact the quality of patient care, the authors stated, "unions may impact the quality of care by negotiating increased staffing levels…that improve patient outcomes. Alternatively, unions may affect the organization nursing staff or the way nursing care is delivered in a fashion that facilitates RN-MD communication. This is the ‘voice’ function of unions…Yet another possible mechanism by which unions can improve care is by raising wages, thereby decreasing turnover, which may improve patient care."

The authors conclude, "perhaps having an RN union promotes stability in staff, autonomy, collaboration with MDs and practice decisions that have been described as having a positive influence on the work environment and on the patient outcomes."

"We at the MNA couldn’t have said it better ourselves,’ said Karen Higgins, RN, MNA President. "In fact, we have been saying this for years - a patient’s greatest advocate is a unionized nurse, because a unionized nurse has the protected right and the power to stand up for their practice and their profession. The fact that this same message is being delivered through a research study published in a journal for nursing administrators is even more telling. These are the folks who often fight tooth and nail to prevent nurses from forming a union. Perhaps now they will see the value of having a union at their facility. We know the staff nurses here in Massachusetts have seen the value."...

It was MNA that forced safe staffing contract language through collective bagaining in MPLS a few years ago. MNA is now trying to extend that protection legislatiely statewide.

One other area where MNA has positively impacted patient care is the "no mandatory OT" law. this essentially allows nurses to refuse OT d/t fatigue without reprisal. As a professional I don't want tired nurses caring for patients. There are way too many potential risks to patients when providers are tired.

I tend to think that the evidence favors unionization as a force for patient safety through both increased professionalism and safer care environments.

AFGE at my hospital has accomplished:

An emphasis on ongoing professional development.

M/S ratios of 4:1. (Occasionally 5:1 with no tele patients.)

a mutual culture of respect that puts patients first.

As for me I am a union man......

Specializes in Critical care, tele, Medical-Surgical.

Originally Posted by Woodenpug viewpost.gif

I'm sure we can all agree that staffing ratios are important to patient safety. What we seem to disagree on is whether or not unions are beneficial. Both sides, I'm sure have experiences to validate their opinions. Still, either position is only opinion, no evidence seems to be available to demonstrate that unions are good for nurses and good for patients.
Good ratios can be achieved without unions and without the threat of unions.

Originally Posted by herring_RN viewpost.gif

Do you have peer reviewed published studies to support this?

That improved staffing ratios are beneficial? Or that anyone has an opinion? The point is I did not attempt to show that I had any evidence. I made a clear statement that Im offering an opinion here. The op presented his opinion as if it were evidence. That study is clearly of little scientific value. I offer various ways where something similar to proof could be offered. The responses are simply more rhetoric and "cutesy" phrases. I do think some evidence exists or can be found one way or another. That, of course, until some such proof is found, is opinion.

Sorry. I misread your post. I thought you were stating that Good ratios can be achieved without unions and without the threat of unions.

I was asking for a study proving that.

There IS proof that unions have both contract language requiring staffing by acuity with ratios as the maximum number of patients a nurse may be assigned and in California a law requiring the same.

Organized nurses in other states are working on the same, even better.

Specializes in MPCU.
Originally Posted by Woodenpug viewpost.gif

I'm sure we can all agree that staffing ratios are important to patient safety. What we seem to disagree on is whether or not unions are beneficial. Both sides, I'm sure have experiences to validate their opinions. Still, either position is only opinion, no evidence seems to be available to demonstrate that unions are good for nurses and good for patients.
Good ratios can be achieved without unions and without the threat of unions.

Originally Posted by herring_RN viewpost.gif

Do you have peer reviewed published studies to support this?

Sorry. I misread your post. I thought you were stating that Good ratios can be achieved without unions and without the threat of unions.

I was asking for a study proving that.

There IS proof that unions have both contract language requiring staffing by acuity with ratios as the maximum number of patients a nurse may be assigned and in California a law requiring the same.

Organized nurses in other states are working on the same, even better.

A bit desperate isn't it? Do you have peer reviewed evidence that unions are the cause of good staffing ratios? Again, the thread claims to have evidence, I never claimed anything except that the evidence does not support the conclusion "unions are good for nurses and good for patients."

Is it that scary for you to work with me to develop a pilot study to provide some valid evidence to support the hypothesis "union organizations are good for patient outcomes as compared to non-union organizations?"

Specializes in Critical care, tele, Medical-Surgical.
A bit desperate isn't it? Do you have peer reviewed evidence that unions are the cause of good staffing ratios? Again, the thread claims to have evidence, I never claimed anything except that the evidence does not support the conclusion "unions are good for nurses and good for patients."

Is it that scary for you to work with me to develop a pilot study to provide some valid evidence to support the hypothesis "union organizations are good for patient outcomes as compared to non-union organizations?"

Scary? :lol2:

No. I'm not in a "publish or perish" position.

No peer reviewed study is needed to prove the fact that it was the California Nurses Association that sponsored the law, sheparded it through the legislature, wrote, called, and demonstrated to convince the governor to sign the bill into law.

Statement by the California Healthcare Association. Major opponent of the Safe Staffing Law

California's nurse staff ratio law (Statutes 1999, Chapter 945, AB 394) was passed by the California Legislature and signed into law by Governor Gray Davis in 1999. The bill's passage, which was sponsored by health care labor unions,

http://www.calhealth.org/public/press/Article%5C113%5CImplementation%20of%20CA%20Nurse%20Ratio%20Law,%20History%20of%20the%20Law.pdf

1999 article:

Four new California laws sponsored by the California Nurses Association

http://www.allbusiness.com/health-care/health-care-professionals-nurses-nursing/6716386-1.html

The resulting regulations required for all licensed acute care hospitals in the state:

http://www.cdph.ca.gov/services/DPOPP/regs/Documents/R-37-01_Regulation_Text.pdf

Specializes in MPCU.

Done. Science, logic let's dismiss the whole concept. How could I have imagined that Nursing was a science?

Specializes in Critical care, tele, Medical-Surgical.

Where is the logic in demanding a peer reviewed study to determine how a law was passed and implemented?

Specializes in MPCU.

No logic applies to demanding a peer reviewed study as to how a law is passed. I'm asking for evidence that patients are better off in a health care organization which has an RN union. The other stuff is just a red herring.

This thread has convinced me that currently, no literature exists to support the threads assertion.

Let's move on. Can we find data to support the premise?

Compare infection rates between union/nonunion hospitals hospitals

compare LOS figures

Staff/patient ratios (I have read here that the evidence is conclusive that lower ratios result in better care.)

For that matter compare BSN penetration/retention.

I am willing to bet that the union hospitals have better results on just about any metric that can be devised. We don't need to study this to death. The indirect measures can be used to infer the best evidence.

Specializes in MPCU.

Thank you.

Let's try the infection rates idea. It should be limited to hospital acquired infections, just to make the research more simple and less chance of confounding factors.

I am remaining open, in that I have done no research into this subject.

I think it is true that hospitals are required to report hospital acquired infections. Is that correct?

I think generally, I should look at hospital acquired pneumonia morbiditiy. CNA represents Kaiser hospitals.

If the rates of hospital acquired pneumonia at Kaiser hospitals is lower than it is for the overall rate of hospital acquired pneumonia, I would be convinced that unions benefit patients.

If the opposite is true, would unionist be convinced that unions do not benefit patients? I am not even asking that you agree that unions harm patients.

Specializes in ER,ICU,L+D,OR.

Good nursing care promotes better patient outcomes. Where unions represent mediocrity, I just do not see how Union hospitals could possibly be better.

That is one of the biggest fallacies about unions. They do not encourage mediocrity but they do insist on due process for employees in disciplinary matters. If anything the union moement has been one of the biggest poponents for improving productivity through advocacy of employee training programs. (After all a preceptorship relationship is an apprenticeship pogram.)

Specializes in ER,ICU,L+D,OR.

My union experiences in the past, though limited to one union. Did indeed lead me to the conclusion. I don't remember where I read it. Unions are a dictatorship of mass mediocrity. I saw this to be true. Little was offered or available to nurses who were striving to excel. Nor were they encouraged to. They were encouraged like our in school system to stay within the norm. I found this distasteful.

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