Why unions are good for nursing and good for patients

[advocateforsafety]

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."...

[Woodenpug, BSN]

Still, to be fair. Favoring collective bargaining is opposing individual bargaining. Mr. viking made the mistake of arguing against a non-argument. Iam only defined collective bargaining in vocabulary with negative connotations.

Back to the point of this thread. Can we show evidence that unions benefit patients?

[Mindful, RN]

Still, to be fair. Favoring collective bargaining is opposing individual bargaining. Mr. viking made the mistake of arguing against a non-argument. Iam only defined collective bargaining in vocabulary with negative connotations.

Back to the point of this thread. Can we show evidence that unions benefit patients?

Try this for size, my friend.... http://www.pennanurses.org/news/2008/unionized_care_better.html

[HM2VikingRN, RN]

One recent study found that hospitals with unionized registered nurses have 5.5 percent fewer deaths from heart attacks than nonunion hospitals. That mortality rate is a key statistic used to evaluate a hospital’s performance.

The study, conducted independently and without union funding, was by an economics and public policy professor at the University of Massachusetts, Amherst, and a community health professor at the University of California, San Francisco. Published in Cornell University’s “Industrial and Labor Relations Review,” the study looked at many variables that could affect quality, including how better wages might increase productivity. It concluded that the presence of unionized workers meant higher quality of care.

From Laborers link......

[HM2VikingRN, RN]

good nursing care promotes better patient outcomes. where unions represent mediocrity, i just do not see how union hospitals could possibly be better.

the available evidence does not support this assertion:

productivity

according to a recent survey of 73 independent studies on unions and productivity: "the available evidence points to a positive and statistically significant association between unions and productivity in the u.s. manufacturing and education sectors, of around 10 and 7 percent, respectively."[color=#333399][2]

some scholars have found an even larger positive relationship between unions and productivity. according to brown and medoff, "unionized establishments are about 22 percent more productive than those that are not."[color=#333399][3]

product/ service delivery and quality

according to professors michael ash and jean ann seago,[color=#333399][4] heart attack recovery rates are higher in hospitals where nurses are unionized than in non-union hospitals.

another study looked at the relationship between unionization and product quality in the auto industry.[color=#333399][5] according to a summary of this study prepared by american rights at work:

"the author examines the system of co-management created through the general motors-united auto workers partnership at the saturn corporation...the author credits the union with building a dense communications network throughout saturn's management system. compared to non-represented advisors, union advisors showed greater levels of lateral communication and coordination, which had a significant positive impact on quality performance."

training

several studies in have found a positive association between unionization and the amount and quality of workforce training. unionized establishments are more likely to offer formal training.[color=#333399][6] this is especially true for small firms. there are a number of reasons for this: less turnover among union workers, making the employer more likely to offer training; collective bargaining agreements that require employers to provide training; and finally, unions often conduct their own training.

at http://www.aflcio.org/joinaunion/why/uniondifference/uniondiff8.cfm

[Woodenpug, BSN]

From Laborers link......

Simple enough. I only need for the undecided to do her own research. You need that person to believe you and not check the facts.

No valid study has evidence to support the conclusion that Union organizations (as compared to non-union organizations) are good for patient outcomes.

The easiest way to defeat the union delusion is with the truth.

[HM2VikingRN, RN]

I don't think that union members are delusional and I think it is unfair to use that characterization. You have asked for evidence that unions support and achieve enhanced quality in health care. Safe staffing laws and language have been achieved through collective bargaining and/or legislative advocacy. Evidence exists on the clinical level to support improved patient outcomes. Evidence exists on the training level that unionized hospitals have better training programs. For that matter an argument can also be made that collective bargaining agreements tend to professionalize mnagement which also tends to improve quality of care.

[Woodenpug, BSN]

I don't think that union members are delusional and I think it is unfair to use that characterization. You have asked for evidence that unions support and achieve enhanced quality in health care. Safe staffing laws and language have been achieved through collective bargaining and/or legislative advocacy. Evidence exists on the clinical level to support improved patient outcomes. Evidence exists on the training level that unionized hospitals have better training programs. For that matter an argument can also be made that collectie bargaining agreements tend to professionalize mnagement which also tends to improve quality of care.

I don't think it's fair to use fallacies to support a position. That unions do good has not been in doubt. whether or not the union is necessary for that good is another story. Simply show that union hospitals have better patient outcomes than non-union hospitals.

Repeating a false conclusion from a poorly done research study as if it were fact, is also delusional thinking.

The study which seemed to show better patient outcomes is very dated and correlates patient outcomes with union status five years after the outcome measures.

Again, as long as undecided people do their own research the truth that no evidence exists to support the conclusion that unions are better for patient outcomes than non-union organizations.

Stating that evidence exists is also delusional when in fact you can show no study to support the conclusion.

[lindarn]

One CANNOT be a good nurse if one cannot safely advocate for their patient. One cannot advocate for their patient if you are afraid of losing your job in one of these, "wprkers paradise" "right to work" states.

This list serve contains thread after thread from nurses in the "right to work" states, concerning the horrendous working conditions, "Sentinal Events", due to short staffing, and unlicensed personnel performing what are professional duties of an RN.

Individuals who continues to support anti union, "right to work" rhetoric is in la la land. Go ahead and try to advocate for you patient in unsafe staffing situations. Go ahead and try to advocate for a patient when the surgeon who is about to perform surgery shows up in the OR drunk.

Try to advocate for higher pay, better benefits, when nurse after nurse leaves for greener pasteurs for employment, and they cannot find enough nurses to hire to improve staffing. Go ahead and try to make improvements for anything in a "right to work" state. If you think that you can accomplish any of this, you have delusions of granduer. JMHO and my NY $0.02.

Lindarn, RN, BSN, CCRN

Spokane, Washington

[Woodenpug, BSN]

One CANNOT be a good nurse if one cannot safely advocate for their patient. One cannot advocate for their patient if you are afraid of losing your job in one of these, "wprkers paradise" "right to work" states.

This list serve contains thread after thread from nurses in the "right to work" states, concerning the horrendous working conditions, "Sentinal Events", due to short staffing, and unlicensed personnel performing what are professional duties of an RN.

Individuals who continues to support anti union, "right to work" rhetoric is in la la land. Go ahead and try to advocate for you patient in unsafe staffing situations. Go ahead and try to advocate for a patient when the surgeon who is about to perform surgery shows up in the OR drunk.

Try to advocate for higher pay, better benefits, when nurse after nurse leaves for greener pasteurs for employment, and they cannot find enough nurses to hire to improve staffing. Go ahead and try to make improvements for anything in a "right to work" state. If you think that you can accomplish any of this, you have delusions of granduer. JMHO and my NY $0.02.

Lindarn, RN, BSN, CCRN

Spokane, Washington

Try and have done. You do not need a union to advocate for your patient. Thank you though for using a different classical fallacy from the usual ad hominiem, ignoratio elenchi and argumentum ad nausium. At least you've offered a change in pace to the regular rheotric found on this board.

[HM2VikingRN, RN]

FTR I did not refer to you as delusional. I did say that I thought that the use of the word delusional was pejorative and unfair. Both Linda and myself have cited concrete examples of how union members through their orgnizations have achieved improvements in patient safety and care quality through efforts on a variety of levels. Collective bargaining tends to establish an environment where problems are discussed and solutions developed, implemented and maintained.

[Woodenpug, BSN]

FTR I did not refer to you as delusional. I did say that I thought that the use of the word delusional was pejorative and unfair. Both Linda and myself have cited concrete examples of how union members through their orgnizations have achieved improvements in patient safety and care quality through efforts on a variety of levels. Collective bargaining tends to establish an environment where problems are discussed and solutions developed, implemented and maintained.

Did I refer to you as delusional? That would be an example of the straw man argument. Attribute an argument to someone who knows your facts are not supported and then disprove what you attributed to them.

The claim is that patient outcomes are better in union health care organizations. You have not supported that claim.

A review of the literature will show that no evidence supports that claim. I am still open. I suggested that we compare patient outcomes for hospital acquired pneumonia in a union hospital (Kaiser) to the general population. I have not looked into that, but since you have been unwilling to accept the idea, most likely that can not be established.

We can do a pilot review of the evidence. If it shows some promise, one way or the other, I can find resources to take the next step.

instead of making unsubstantiated claims, why not propose a way to look into the information available. If that fails, decide what information would be convincing.

Imagine, if I were playing "devils advocate" and I wanted to convince people in my area who do not support unions. Have you provided me with anything? It is simple enough to provide anti-union "evidence" of the quality I've seen presented here in favor of unions. That would be a long and tedious journey, where both sides attempt to validate opinions as facts.

Claiming to have evidence where none exists is at best delusional. I hope you are not intentionally fabricating the truth and that no pathology exists.

[Tweety, BSN, RN]

Claiming to have evidence where none exists is at best delusional. I hope you are not intentionally fabricating the truth and that no pathology exists.

Low blow. Why would anyone engage in a debate or conversation with you when you end it like that? If you can't discuss this issue without such insinuations, perhaps it's time for you to bow out. If you seriously believe the above is true, then it definitely is time for you to bow out, why debate with people you feel are lying and delusional?

Otherwise carry on, because there's some good discussion here, but call a truce to the low blows. Thanks.