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]

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?

Because you dislike when or how I point out that your statements are false. Does not make them true.

Patient outcomes are not better at union hospitals. The reports presented are riddled with logical fallacies and a complete lack of evidence.

Check it out for yourself compare union and non-union hospitals by measurable standards.

You can find your own source or use this one:

http://www.hospitalcompare.hhs.gov/

[Woodenpug, BSN]

My apology tweety, I forgot to congratulate you on your clever use of the Argumentum ad Hominem. Wow! since you don't like me, I must be wrong or should stop advocating for the truth. Nicely done.:redbeathe

[NRSKarenRN, BSN, RN]

all members should read our: terms of service as it's how we moderate our bb.

debates

we promote the idea of lively debate. this means you are free to disagree with anyone on any type of subject matter as long as your criticism is constructive and polite

long term posters in this forum abide by this guideline and help to promote nursing profession. erudite commentary not the most popular on a message board.

[Tweety, BSN, RN]

My apology tweety, I forgot to congratulate you on your clever use of the Argumentum ad Hominem. Wow! since you don't like me, I must be wrong or should stop advocating for the truth. Nicely done.:redbeathe

Clever use of sarcasm on your part. Nicely done.:redbeathe

I am neither agreeing or disagreeing with anything you have debated in this forum. Please continue to debate your issues because you bring up some interesting and very good points.

I'm not smart enough to use Argumentum ad Hominem. I don't even know what that means.

It just seems more decent to say "I don't quite believe that becuase.........". "Are you sure you have your facts straight, because............" and then continue the conversation rather than bully them with name calling. It keeps the line of communication open and keeps people listening to you.

Just my opinion.

[Chico David, BSN, RN]

So here's a fairly concrete example of the postive role that unions have played in nursing and patient care: I don't have all the names dates and places at my immediate disposal, but the facts are correct and I could dig all the details out with a little effort.

A few years ago, at a major hospital in Southern California, an OB doc believed that poor women should not be having babies and so he had a fixed policy of torturing women during delivery if they were MediCal recipients. Both refusing analgesia and shoving unneeded obstrical forceps into the birth canal and manipulating them vigorously to cause a maximum of pain. Nurses complained of this to their supervisor and were told to keep quiet. One nurse had finally had enough and reported it to state authorities. The hospital (non-union) naturally responded by firing the nurse. Now, in first instance, the firing probably would not have happened in a union environment. In the second, the nurse would have had recourse through a union grievance procedure.

What did happen in this instance is that the CNA (a nurses union) got involved and wrote a bill, which it then pushed through the legislature. It is now illegal in California to fire a healthcare worker for reporting illegal conduct to the authorities. In many other states - those with few or no unions, what the hospital did remains legal and a nurse advocating for his/her patient in this way risks firing.

[Iam46yearsold]

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.

I live in a major right to work state. I have never been in the least afraid to advocate for my patient. And I have never known anyone to lose their job when advocating for a patient. Or for better pay, or more time off or whatever. You may not get what you want. But you dont get fired. Come to work drunk, yes you get fired. But that is reasonable. Ive never seen any reasonable action you might take threaten you job. Do something very stupid, that is different of course.

And I live in Texas. A strange enough place as is.

[Woodenpug, BSN]

So here's a fairly concrete example of the postive role that unions have played in nursing and patient care: I don't have all the names dates and places at my immediate disposal, but the facts are correct and I could dig all the details out with a little effort.

A few years ago, at a major hospital in Southern California, an OB doc believed that poor women should not be having babies and so he had a fixed policy of torturing women during delivery if they were MediCal recipients. Both refusing analgesia and shoving unneeded obstrical forceps into the birth canal and manipulating them vigorously to cause a maximum of pain. Nurses complained of this to their supervisor and were told to keep quiet. One nurse had finally had enough and reported it to state authorities. The hospital (non-union) naturally responded by firing the nurse. Now, in first instance, the firing probably would not have happened in a union environment. In the second, the nurse would have had recourse through a union grievance procedure.

What did happen in this instance is that the CNA (a nurses union) got involved and wrote a bill, which it then pushed through the legislature. It is now illegal in California to fire a healthcare worker for reporting illegal conduct to the authorities. In many other states - those with few or no unions, what the hospital did remains legal and a nurse advocating for his/her patient in this way risks firing.

I appreciate that you do not have all the facts. I have this problem often and can empathize. Even if the terrible events you described did occur, you are only speculating as to what would happen in a non-union environment. (if I understand your post.)

A concrete example would be a union hospital with measurably better patient outcomes than an equivalent non-union hospital.

Several tertiary articles misquoting the same questionable primary source, does not validate that source and forgive the misquotes.

Remember many newspapers reported that Dewey defeated Roosevelt. Did not make it true.

The constant reposting of those tertiary articles and misquotes is much more insulting to me than would be the vague references I made had they be directed in my direction.

Still, tit for tat is childish and I do sincerely apologize.

[Iam46yearsold]

So here's a fairly concrete example of the postive role that unions have played in nursing and patient care: I don't have all the names dates and places at my immediate disposal, but the facts are correct and I could dig all the details out with a little effort.

A few years ago, at a major hospital in Southern California, an OB doc believed that poor women should not be having babies and so he had a fixed policy of torturing women during delivery if they were MediCal recipients. Both refusing analgesia and shoving unneeded obstrical forceps into the birth canal and manipulating them vigorously to cause a maximum of pain. Nurses complained of this to their supervisor and were told to keep quiet. One nurse had finally had enough and reported it to state authorities. The hospital (non-union) naturally responded by firing the nurse. Now, in first instance, the firing probably would not have happened in a union environment. In the second, the nurse would have had recourse through a union grievance procedure.

What did happen in this instance is that the CNA (a nurses union) got involved and wrote a bill, which it then pushed through the legislature. It is now illegal in California to fire a healthcare worker for reporting illegal conduct to the authorities. In many other states - those with few or no unions, what the hospital did remains legal and a nurse advocating for his/her patient in this way risks firing.

sounds more like one of those old Urban Myths that keep popping up.

[lpnflorida]

I work in a right to work state Florida, and in a Health Care System which has no union. I beg to differ that only union facilities have good outcome for patients, or are the only places with high employee satisfaction. We do not fear advocating for our patients. I agree not all places are great to work at, but this one is. I have said in the past I worked in a union hospital in minn once upon a time, I felt it was also a good place and had good outcomes, but so does my non union hospital system.

( name of health system removed only for my own privacy )is a recipient of numerous

awards, including Solucient's 100 Top

Hospitals, Modern Healthcare's Top- 100

Integrated Healthcare Networks and Florida

Nurses Association Award of Excellence. It is

one of only four health systems in the country

to receive national recognition as an "Employer

of Choice." Hospitals & Health Networks

named the system among the nation's 100

Most Wired and Most Improved Hospitals and

Health Care Systems in the use of the latest

i n f o rmation technology.

[herring_RN, ASN, BSN]

sounds more like one of those old Urban Myths that keep popping up.

I don't have a link because I just purchased archived articles. It should ve very easy to verify.

O.C. nurse testifies in favor of state whistle-blower bill

LEGISLATION: The measure would give hospital employees who complain more protection against retaliation.

March 11, 1999

Byline: DANIEL M. WEINTRAUB

The Orange County Register

An Orange County nurse who alleges she was forced from her job after complaining about a doctor tearfully testified Wednesday in favor of legislation that would hand hospital whistle-blowers more protection against retaliation.

Pamela Douglas, who left Garden Grove Hospital and Medical Center in a dispute over the birthing practices of Dr. Witoon S. Krailas, told the Senate Health and Human Services Committee that Krailas performed rare and painful procedures on new mothers, blamed women for injuries to their babies and threatened to have her fired for reporting his behavior to superiors.

The committee then voted 6-2 to approve a measure that would increase fines and criminal penalties for hospitals that strike back at patients or workers who file complaints.

Krailas has declined to discuss the case with The Orange County Register.

The bill, carried by Senate Leader John Burton, D-San Francisco, also would shift to hospitals the burden of proving that their actions were not retaliatory if they came soon after a patient or employee filed a complaint.

"Nurses need to know they can stand up for their patients and be protected," Douglas said in an interview.

The bill is opposed by the California Health Care Association, Kaiser Permanente and the California Association of Catholic Hospitals. Lobbyists for all three said Wednesday that current law already provides sufficient whistle-blower protections and that there is no reason to single out hospitals for stricter treatment.

Story appeared in METRO section on page b7 ID: 1108104 Morning Edition

[herring_RN, ASN, BSN]

The other article:

Whistle-blower bill clears Senate

LEGISLATION: The measure makes it a crime for hospitals to retaliate against a patient or employee.

July 9, 1999

Byline: DANIEL M. WEINTRAUB

The Orange County Register

A whistle-blower protection bill for hospital workers and patients - inspired in part by the case of an Orange County nurse - cleared the state Senate on Thursday and was sent to Gov. Gray Davis, who is expected to sign it.

The measure, by Senate Leader John Burton, D-San Francisco, would make it a crime for hospitals to retaliate against a patient or employee who complained about improper practices. The bill would impose fines of up to $25,000 on hospitals that violate the law.

The legislation also would make it easier for people to sue hospitals for retaliating against them. It would in effect presume that hospitals are guilty until found innocent, forcing them to prove in court that they fired or demoted an employee for good cause and not as retaliation for reporting a problem.

"That's terrific," said Pamela Douglas, an Orange County labor-and-delivery nurse whose case helped persuade legislators to pass the law. "It's fantastic."

Douglas left Garden Grove Hospital and Medical Center in a dispute over the birthing practices of a physician she said performed rare and painful procedures on new mothers, blamed women for injuries to their babies and threatened to have her fired for reporting his behavior.

"Nurses need to have protection," Douglas said. "They are the ones who are one-to-one with the doctors. They see what's happening. If they are afraid for their jobs, with a family to support, it makes it very hard to come forward and say anything.

With this protection they will be freer."

The bill was sponsored by the California Nurses Association.

Art Sponseller, chief operating officer for the California Healthcare Association, which represents hospitals, described the bill as an invitation to "mischief. " He predicted problem employees would use it to protect themselves from being fired.

"It just isn't necessary," he said. "Whistle-blowers already have protection."

A spokesman for Davis said Thursday that the governor would sign the bill because he believes that whistle-blowers deserve more protection.

"He thinks we need to find a way to ensure that they have the comfort and confidence to be able to share the information that they have," press secretary Michael Bustamante said.

[Woodenpug, BSN]

herring_RN if you could give a full title. I searched several ways and could not find the article. I did find a metro from the san francisco bay area. It's a well known alternative magazine. But for the date listed it did not have any articles related to the story you quoted.

It still misses the point, but the unedited decade old article seems as if it would be an interesting read.