Can (do) nurses unions help improve patient care - page 2

I have heard claims from nurses' unions that they can and do help improve patient care by improving working conditions and reducing turnover, negotiating better nurse/staff ratios, eliminating... Read More

  1. by   JennieO
    Unions seem to be interested in their dues and having a closed shop. We only see them at voting time and that is to secure our vote in the "cardboard box with the slit." It is next to impossible to talk to a rep by phone because they are always in "the field". This union, the biggest and wealthiest in the world, cannot put together a website that is interactive or informative. Right now, their biggest concern with our dues is to get retail clerks at Wal-Mart insurance. How is this our concern to pay for? We are a closed shop and can't get rid of them because they are the teamsters and individually we are terrified of them. Most of us are old enough to remember Jimmy Hoffa. Keep them out if you can. They want a piece of YOUR hard earned pie!
  2. by   pickledpepperRN
    Quote from Tucson
    I have heard claims from nurses' unions that they can and do help improve patient care by improving working conditions and reducing turnover, negotiating better nurse/staff ratios, eliminating mandatory overtime and floating, and giving nurses a greater voice in patient care through staffing and nurse practice committees. Is this true? If so, can anyone provide concrete examples. Thanks.
    I just remembered this article my manager shared with me:

    Registered Nurse Unions and Patient Outcomes.


    ...The significant finding in this study is that hospitals in California with RN unions have
    5.7% (.84-the RN union coefficient from Model 4/14.8-statewide risk-adjusted AMI mortality rate average) 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.
    Although we have not necessarily identified a causal relationship, the approach in this study demonstrates
    that there is a positive relationship between patient outcomes and RN unions. ...

    http://www.jonajournal.com/pt/re/jon...856145!8091!-1

    I bought this article but it is too big to attach.
    -------------------------------------------------------

    Of course many fine nurses do not like unions.
    Some are my valued colleagues and friends.
  3. by   HM2VikingRN
    this is the best argument out there for being in a union. its from barbara ehrenreichs website at: http://www.barbaraehrenreich.com/decent_wages.htm

    center for economic and policy research
    for immediate release: tuesday, october 18, 2005
    75% of american workers don't have decent wages and benefits
    washington, dc -- only 25.2 percent of american workers have a job that pays at least $16 per hour and provides health insurance and a pension, according to a new study by the center for economic and policy research.
    the report, "how good is the economy at creating good jobs?" found that between 1979 and 2004 the share of american workers in good jobs remained unchanged at about 25 percent, despite strong economic growth over that period. (the report defines a "good job" as one that offers at least $16 per hour or $32,000 annually, employer-paid health insurance and a pension.) in the last quarter century, the u.s. workforce has become older, more experienced and better educated, but 75 percent of workers are still struggling in jobs that do not provide health insurance, a pension and solid middle-class wages.
    "the u.s. economy has failed to convert long-term economic growth into better jobs," said john schmitt, cepr economist and author of the report. "despite huge improvements in the average educational level our workforce, most american workers still don't have a job that pays a decent wage and provides health insurance and a pension."
  4. by   HM2VikingRN
    Quote from jennieo
    unions seem to be interested in their dues and having a closed shop. we only see them at voting time and that is to secure our vote in the "cardboard box with the slit."
    " it is your responsibility as a member of your local to be active, informed and demand accountability from management..." hm2
    it is next to impossible to talk to a rep by phone because they are always in "the field".
    "the business managers and stewards are supposed to be actively representing the broad interests of the bargaining unit as a whole...on the local level i would challenge you to become a steward so you can act as a knowledgeable representative of the interests of your fellow nurses.."hm2
    this union, the biggest and wealthiest in the world, cannot put together a website that is interactive or informative. right now, their biggest concern with our dues is to get retail clerks at wal-mart insurance. how is this our concern to pay for?
    "the labor movement is a means for society to achieve progress....if you as an individual want to remain a part of the middle class it most assuredly is in your economic self interest to help others achieve a higher standard of living...if we fail to aggressively advance the proposition that all members of society should have access to affordable health care and good wages we are placing our own future access to affordable benefits and good wages at risk.."hm2
    we are a closed shop and can't get rid of them because they are the teamsters and individually we are terrified of them. most of us are old enough to remember jimmy hoffa. keep them out if you can. they want a piece of your hard earned pie!
    "if you want to keep your piece of the pie it is in your best interest to advance the interests of all of your coworkers. remember united we win...divided they conquer..." hm2
  5. by   HM2VikingRN
    Quote from music

    i just hope you will keep in mind that those of us who do not want to join a union have the same passion for our profession and we have much to say also.

    through this site, you and i have found a way to share our views in a calm and professional manner. we should all be able to do that, without interference from non-nurse organizers who twist and manipulate the truth, causing friction and mistrust among nurses. when unions rise above those tactics, we will all make progress.
    best wishes for continued success in your profession.
    the real intimidators are companies and management like the following story:
    from tom paine: http://www.tompaine.com/articles/200...ning_table.php
    if we want workers to get their fair share of the benefits of a growing economy, then we have to ensure that their organizing rights are protected. under the current system for choosing unions, workers' rights are easily ignored.
    consider the case of ivo camilo. for 35 years, camilo worked at the blue diamond growers plant in sacramento, the world's largest almond processing plant. but he and his co-workers were worried about job security and felt they had no voice at work. so, in 2004, camilo joined with some of his co-workers to try to form a union. in 2005, just two weeks after camilo and 58 of his coworkers informed management of their union efforts, he was fired.
    in congressional testimony this week, camilo described blue diamond's campaign against the union. "they had put out more than 30 anti-union flyers. in group captive audience meetings and one-on-one talks, company officials and supervisors threatened that we could lose our pensions and other benefits if the union came in. they threatened that the plant would close."

    "i personally believe that a strong labor movement allows each of us as professionals the cognitive safety (which is sadly lacking in most non union shops) to be able to aggressively advocate on behalf of our clients..."
  6. by   Cynjon
    My experience with unions has been pretty negative. My first experience was back in the dark ages, at age 17. I was working as a NAi n a LTC facility. SEIU was trying unionize. They convinced the LVN who was the only nurse in the facilty from 11p to 07 to walk out when they had a strike, telling her that they would protect her. She was fired and lost her liscense. Something about patient abandonment?

    My second experience, as an LVN at a County Hospital was while another union, forget which one(it was during the Ice Age ), tried to unionize the "real" nurses. The promise was to improve staffing and increase wages. There was little discourse with staff about how they were going to accomplish this but lots of talk about going out on strike. They had a one day sick out and yelled and screamed at everyone who went to work. I didn't appreiciate being threatened, especially since I was merely an LVN and wasn't "good enough" to be in their union.

    My third experince was as a RN House Supervisor, management. I wasn't eligible to vote but had to live with the results. The union promised a 7% wage increase, staff got 3.5%. The union promised no more floating, the contract included floating. The union promised no low census days, the contract included low census days. The contract did include an "interesting" formula for figuring out floating and call offs that didn't make anyone happy. The contract did formalize many policies that were already in effect but did not change anything. What I did not notice was increased difficulty in terminating employees for wrong doing. For example, charge and staff nurses had written up a certain CNA for sleeping on the job, disappearing for hours, being rude to patients and not following simple policies like handwashing. She called in sick alot, left early and arrived late. She was not someone you wanted to work with. Despite being counciled on over 20 seperate occasions with more then 50 complaints, the union fought against her termination and won their grievence because her supervisor supposedly didn't like her.

    My most recent experience is currently ongoing as staff....sigh....We are being promised no floating, no call offs, increased pay, full control over staffing ratios, administrative staff will be fired, less expensive health care, more sick and vacation days etc ...etc....
    I don't believe that they can carry out their promises. But what really bothers me are the negative ads and fliers and outright lies that the union propagates. Example: We are opening a new unit. The union claims a "Victory" by saying that it has forced the hospital to appropriately staff the unit, provide pt supplies, a tube system, a crash cart and a medication Pxysis! Like any hospital anywhere wouyld not havew a crash cart or pt supplies or etc.....the unit hasn't opened yet but when I walk by the nurses station I see a tube system, I see a med room with a Pyxsis....Things that have obviously been in progress for a while.
    Do I think the union will improve patient care? No. I don't think anything will improve if the union is voted in except the uions budget. I think that the only thing that will happen is I will lose over 1200.00 a year in union dues ( hourly base wage x 2 per pay period plus 2%) I don't think they will improve ratios, policies, get rid of management or anything else they promise.
    Again, this has been MY expierence...and definitely not something I want to have to deal with again...
    Good luck with whatever happens where you are.
  7. by   PMHNP10
    Quote from Tucson
    I have heard claims from nurses' unions that they can and do help improve patient care by improving working conditions and reducing turnover, negotiating better nurse/staff ratios, eliminating mandatory overtime and floating, and giving nurses a greater voice in patient care through staffing and nurse practice committees. Is this true? If so, can anyone provide concrete examples. Thanks.
    I have read some studies which say unions improve pt. outcomes (I think others have mentioned them). I know union members make more money. Furthermore, some studies have concluded that higher pay = greater job satisfaction; and we all know a happy nurse is more likely to perform better at their job than a disgruntled nurse. Also, I saw a study indicating higher educated folks are more likely to join a union.

    So, yes, a union "can" do all you suggested; they "do" do all you mention as well. But then again, some unions cannot, nor do they do anything for their members. And to borrow perhaps a used cliche: nurses' unions are only as strong as their members are active.
    Last edit by PMHNP10 on Feb 10, '07
  8. by   HM2VikingRN
    from: http://www.tompaine.com/articles/200...kers_again.php
    the people who devised this ploy could not care less about how much a worker takes home, as long as it’s as little as possible. no, this is about keeping money out of the hands of unions, who might use it to influence elections. unions, you see, often back things like raising the minimum wage, workplace safety, paid family leave and other progressive measures that much of the business community despises.

    the real point is that unions and their members exist to advocate on behalf of the interests of their members and society at large. in other words nurses, their families and the clients that we are privileged to serve.
  9. by   pickledpepperRN
    Our contract does not have all of these. We do have most.
    I have been a member of the PPC committee.

    The main State Nurses Association is united for patient safety - http://www.mainenurse.org/
    Many RN unions and professional organizations are activly working to improve patient care. Working conditions and patient care are entwined.

    CNA contracts have created new standards for RNs
    and patient protection. A crucial part of quality
    patient care is reversing the trend of inadequate
    hospital staffing that is putting patients at risk and driving
    nurses out of the profession. CNA representation provides
    nurses with a voice in patient care decisions, which we can
    use to create safer healthcare facilities to protect our
    patients, our licenses, and ourselves.

    Professional Practice Committees
    CNA contracts negotiate staff RN-controlled committees with
    the authority to document unsafe practices and the power to
    make real changes. The Professional Practice Committee
    (PPC) is an elected, staff RN committee with representatives
    from every major nursing unit. The PPC meets in the hospital
    on paid time and tracks unsafe conditions through
    an independent documentation system called the
    Assignment Despite Objection (ADO).

    Staffing Ratio Protections
    ■ Ratios in contract to protect against future attacks:
    Enforced through the RN’s legal contract guarantees,
    with disputes settled by a neutral third party arbitrator.
    ■ Binding arbitration for safe staffing: Disputes between
    management and PPC may be submitted to a neutral
    arbitrator for a binding decision.
    ■ All-RN staffing: A commitment to only hire RNs into all
    open non-relief licensed positions in designated units.

    Safe Lift Policies
    Contract language to assure safer lift policies, including
    “appropriately trained and designated staff” to assist with
    patient handling available 24 hours a day.

    Technology Won’t Replace RN Judgment
    Precedent-setting language that prevents new technology
    from displacing RNs or RN professional judgment.

    Binding Arbitration for Safe Staffing
    Disputes between management and the RN-elected staffing
    committee may be submitted to a neutral arbitrator for
    a binding decision.

    Floating Policy Improvements
    Floating not required outside the RN’s clinical area.
    No floating allowed unless RN clinically competent.

    Ban on Mandatory Overtime
    Prevents nurses working when they are exhausted,
    endangering patients.

    Quality Liaisons
    Staff RNs selected by CNA who work as independent
    patient care monitors on staffing problems and structural
    concerns regarding quality of care improvements and
    nursing practice.

    Charge RN
    Not counted in the staffing matrix. Has the authority
    to increase staffing as needed.

    Paid Education Leave
    Up to 12 days per year.

    Resource RNs
    RNs who are not given a patient care assignment or
    counted in the patient acuity mix available to assist RNs
    as needed on their units.

    http://www.calnurse.org/assets/pdf/cna101.pdf

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