Why unions are good for nursing and good for patients

Nurses Union

Published

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."...

Specializes in MPCU.
The University of Pennsylvania research was reported in the Journal of the American Medical Association (JAMA)

I'm unable to find the first article. I only have access to:

# Cardiosource Plus

# CINAHL

# Clinical Evidence(EBM Database)

# Cochrane Library (Evidence Based Reviews)

# Health Business

# InfoTrac

# Micromedex

# MDConsult

# Nursing Reference Center

# OvidWeb Databases

# PubMed

# Stat!Ref

# UpToDate

# Pubmed

and google.

Please let me know in which issue the papers were published. Again I apologize for not having time to review these articles and for my poor research skills.

I did note that the second article appears in JONA. I'm not familiar with that publication.

Thank you for bringing this research to my attention.

Specializes in Critical care, tele, Medical-Surgical.

i'm sorry. i accidentally typed "jama" when i meant "jona". (thinking about the linda aiken study.)

the study was published in industrial and labor relations review, vol. 57, no. 3 (april 2004). © by cornell university.and the article in the journal of nursing administration.

it was before the california "safe staffing by acuity of whch the ratio is the minimum" law. now all (or law abiding) california hospital staffing is safer than that of other states because of the union law.

here is the most recent study regarding that:

http://www.nationalnursesunited.org/assets/pdf/hsr_ratios_study_042010.pdf

for the entire publication please open the pdfs attached to post #105.

jonajournal of nursing administration)

volume 32, number 3, pp 143-151

©2002, lippincott williams & wilkins, inc.

registered nurse unions and

patient outcomes

jean ann seago, phd, rn

michael ash, phd

industrial and labor relations review, vol. 57, no. 3 (april 2004). © by cornell university.

the effect of registered nurses’ unions on heart-attack mortality

michael ash and jean ann seago*

this study examines the relationship between r.n. unionization and the mortality rate for acute myocardial infarction (ami), or heart attack, in acute-care hospitals in california.

after controlling for patient and hospital characteristics, the authors find that hospitals with unionized r.n.’s have 5.5% lower heartattack mortality than do non-union hospitals

for your convenience here are the authors references:

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129–38.

 

Specializes in MPCU.

Sigh, it's been so long....

I was hoping for something with more current "evidence."

Specializes in Critical care, tele, Medical-Surgical.

did you see the date on this one from post #109 that concluded that with the union sponsored california ratios, nj would 14%, pa 11% fewer deaths. ratios also boost rn retention and increase time for patient care?

 

a major new study led by one of the nation's most eminent nurse researchers provides compelling new evidence that california's landmark rn-to-patient staffing law reduces patient mortality, assures nurses more time to spend with patients, and substantially promotes retention of experienced rns.

 

cna/nnu, sponsor of law, cites major gains for patient safety, rn shortage.

 

cna/nnu, the nation's largest organization of direct care rns with 155,000 members, sponsored the california law and has fought off repeated hospital industry attempts to erode it, including a well-chronicled fight with gov. arnold schwarzenegger who sought to roll back the law in late 2004.

 

the study, published today by the influential policy journal, health services research, was conducted by university of pennsylvania researchers led by linda aiken, rn, ph.d. , director of the center for health outcomes and policy research at the university of pennsylvania school of nursing. - http://www.calnurses.org/media-center/press-releases/2010/april/the-evidence-is-in-california-rn-to-patient-ratios-save-lives.html?print=t

 

link to the study published april 20, 2010:

http://www.nursing.upenn.edu/chopr/documents/aiken.2010.californiastaffingratios.pdf

 

tens of thousands of nurses worked for years to achieve the safe staffing law. of course the union law also saves lives at non union hospitals. 

Specializes in ICU/CCU/TRAUMA/ECMO/BURN/PACU/.
Sigh, it's been so long....

I was hoping for something with more current "evidence."

Do you feel that way about the effectiveness of polio vaccine and whether or not it really prevents the disease, or whether the use of a parachute prevents injury among those who engage in the sport of skydiving?:confused:

Specializes in MPCU.

Cool, I know you both love unions. So how would this "stuff" actually convince anyone?

No evidence exist to support the original proposition. Those who follow, will find it easier to join a union. Others will think for themselves.

I directly stated why those studies were flawed and received no answer to my objections. Later the study is re-posted.

I only require anyone to look at your "evidence," to see the reality. You require that they take your word for it. Or, that the overwhelming length of the post will convince someone.

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