Nurses' Unions

Sheri257 · Mar 29, 2007

Unions are not designed with the interests of the patients in mind.

The only reason California has a ratio law was because of unions. And it benefits all nurses in California, 80 percent of whom don't belong to a union.

It also benefits patients because nurses have more time to spend on care.

:typing

HM2VikingRN, RN · Mar 30, 2007

MNA negotiated a nurse/patient ratio provision that in essence prevents unsafe staffing levels.

In MN the highest quality hospitals are unionized.

HM2VikingRN, RN · Mar 30, 2007

The Children's Health System of Atlanta is the number one ranked children's hospital to work for by Fortune. Top 10 in US News mag, and Child mag.
HS graduation rates, and the rate at which minorities are killing each other in southern Fulton County cannot be placed on the shoulder of the health-care establisment. If so, then I'd like to hear the reaction of the Minnesota Dept. of Education and the Minn. Attorney Gen.when they are told that their graduation rates and crime is a reflection of their unionized health care system.

It may well be a great hospital for staff to work at. But the real issue is access for patients the question becomes are you insured or can you pay out of pocket to use it........

I have a feeling that Minneapolis Children's hospital is equal or superior in quality of care and it is a UNION hospital

Shamira Aizza · Mar 30, 2007

It may well be a great hospital for staff to work at. But the real issue is access for patients the question becomes are you insured or can you pay out of pocket to use it........
I have a feeling that Minneapolis Children's hospital is equal or superior in quality of care and it is a UNION hospital

You like to post research, polls, and surveys, and there is nothing that suggests that MCH is even in the same league.

Opinions of convenience, perhaps?

HM2VikingRN, RN · Mar 31, 2007

most if not all of these hospitals are unionized.

http://www.healthgrades.com/consumer/index.cfm?fuseaction=mod&modtype=hospitals&modact=hospitals_search_results&prodtype=hosprat&state=mn&city=&maparea=&proc=&tabset=dhp&hgid=&useragree=yes

[color=white]hospital name/location

abbott - northwestern hospital inc, minneapolis

fairview southdale hospital, edina

www.southdale.fairview.org/

healtheast st john's hospital, maplewood

mercy hospital, coon rapids

methodist hospital, minneapolis

north memorial health care, robbinsdale

st joseph's hospital, st. paul

st lukes hospital, duluth

st mary's/duluth clinic health systems, duluth

st marys hospital, rochester

performance reports from children's hospital mpls.

http://xpedio02.childrensmn.org/stellent/groups/public/@web/@healthprof/documents/policyreferenceprocedure/085067.pdf

a telling part of this report is that they are also self critical about areas needing improvement. there is also a value that may not be reflected within the national quality data about children's hospital. children's is located within a cluster of excellent hospitals dedicated to providing high quality treatment to pediatric patients. nationally recognized centers of pediatric excellence that are nearby include the following:

http://www.child.com/child/story.jhtml;jsessionid=bdjgd3r0pjol5qfibqpr5vq?storyid=/templatedata/child/story/data/1165872619302.xml&categoryid=/templatedata/child/category/data/1131546614395.xml&page=12

38. mayo eugenio litta children's hospital at the mayo clinic in rochester, mn (part of the mayo system)

20. children's hospital of iowa in iowa city

9. children's hospital of wisconsin, milwaukee

40. children's hospital in omaha

7. st. louis children's hospital

18. children's memorial hospital in chicago

while minneapolis children's hospital was not rated in theus news top 10 the benefits of being located within the gestalt of a group of high performers would translate into a consistently high standard of care. the central issues of affordability and commitment to access also influence and promote a health care culture dedicated to patient care.

versus: http://www.healthgrades.com/consumer/index.cfm?fuseaction=mod&modtype=hospitals&modact=hospitals_search_results&prodtype=hosprat&state=ga&city=&maparea=&proc=&tabset=dhp

georgia recipients for the year 2007 [color=#ffffff]hospital name/location memorial health university medical cen,inc, savannah

northeast georgia medical center, gainesville

including:

northeast georgia medical center - lanier park campus, gainesville

piedmont hospital, atlanta

saint joseph's hospital of atlanta, atlanta

furthermore, the us news list did have a greater number of hospitals from the "blue" states which may indicate that atlanta children's was an exception rather than the norm for quality health care. the other point remains that united health's rankings were centered around the effectiveness of state health promotion efforts which are a key part of reducing the need for more intensive health care services. isn't our profession supposed to be about creating social environments that promote and maintain health rather than illness?

RN4MERCY · Apr 2, 2007

In the US, nursing unions serve two purposes; as a palliative measure to give the appearance of improving a festering underlying occupational disfunction within a facility, and in some places as a place for meek employees to "sign up" for the team-based approach of extorting benefits from an employer when the employee is too afraid or uninformed to negotiate their own.
I refuse to work at a union shop because it indicates systemic problems that have not been repaired, but have rather been "spackled over" by a union, and because a union will deny me the right and privilege to negotiate my own compensation based on my own merits and ambition.

(In case you missed it, this is a cross post from the Walter Reed thread...)

I guess we'll have to agree to disagree about unions. As opposed to the "individual mandate/mantra--"every woman (or man) for themselves", I believe in the collective, progressive point of view, " we're all in this together."

Before unions, people could be worked 10 or more hours a day, 6 days a week, in whatever kind of miserable conditions employers felt like offering. You have unions to thank for 40 hour workweeks, two days off per week, and living wages, retirement and insurance benefits. The ability, the right to bargain collectively, to meet your employer on equal terms, to enforce safe working conditions, pay and benefits over and above the minimum wage that the laws provide, to be respected as an equal, to be protected against arbitrary discrimination, all of these things are what unions are about.

Now, how about those hospital administrators vs. the direct care RNs who are really held accountable, ultimately, for what happens to the patient? (If you don't like it leave?) Mandatory overtime?, Merit pay or favoritism?, Staffing flexibility or admitting patients without adequate staffing and calling it "care", such as putting patients in the hallways or on monitors that no one is monitoring, and then billing for the "service"? Fraud or legalized neglect? Bottom line vs. genuine patient-focused care and nursing practice/patient advocacy protection? The bosses will tell you, "do the best you can" and then play "the blame game" when patients suffer complications and even death. Let's talk about fairness and justice!

Unionized direct care Registered Nurses in California, members of The California Nurses Association, called the question, collectively fought for and passed the first-in-the-nation minimum nurse to patient ratios. The law also requires hospitals to "staff up" (provide additional staffing of RNs, LVNs, NAs, Ward Clerks), based on acuity and scope of practice to meet the needs of the patient, as determined by the independent clinical judgement of the direct care registered nurses responsible for the patients. The ratio law protects patients from corporate greed/bottom line staffing schemes and improves working conditions to stop the hemorrhage of nurses from the profession.

The only reason the government does any of these things is because of union-led and supported legislation. Most of these laws - or at least their enforcement - are being undermined by "dirty money" (corporate cash exchanged for political gain)...political appointees and elected officials who look the other way as our individual rights and freedoms...free speech, freedom of association, and freedom to control our practice are encumbered or eroded to the point that they endanger patients by stifling our ability to advocate without fear of retaliation.

The reason they (Bush-its, Schwarzen-cronies, and Co.) are able to even attempt this is that unions are far weaker now than when these laws were passed - and the public is far less educated about the benefits of unions; and, the fact that most legal workplace protections wouldn't be there without unions. And, in fact, if unions disappear, so will all of those legal protections, and many others that we just take for granted these days.

Responsibility is one thing, and it's a good thing. No one would argue with that. But unions aren't just about responsibility, they're also about power - power in the good sense. The individual is no match for even a small company, much less a large corporation. Joining together in unions is the only way that individual workers can have a voice to defend pay, working conditions and benefits, whether legal or bargained. And unions, public interest groups, and government, (if the laws are enforced), are the only means to make sure that management lives up to its corporate and social responsibility not to sicken, injure, kill and exploit workers (or patients) and the community.

And when California's Gov. Schwarzenegger abused his discretionary power to suspend our ratios, the nurses and the community fought back, from a position of collective strength, united in a common cause for safe standards; we prevailed in court and the law won, the nurses won and our patients won! Just try that as an individual...and don't kid yourself.

It's always going to be a fight and someday, you're going to have to lock arms together in a righteous fight in the exclusive interest of, and for the safety of patients, be they civilians, or Veterans.

HM2VikingRN, RN · Apr 2, 2007

minnesota is just about one of the most liberal states in the usa with an alleged higher comparative percentage of insured people...i wonder if there's a correlation between that and the need to unionize the hospitals in order to make them tolerable for nurses.

interestingly, as the european union was celebrating its 50th birthday this past week, the spotlight was on germany, whose dynamic economy is enjoying an impressive recovery, with plummeting unemployment. the german federal republic incurred massive costs when it absorbed the former communist east germany. many blamed its slump on strong unions and high wages. but it turns out that this same social model produces the world's most productive workforce. germany enjoys a large trade surplus despite an expensive currency, and much greater income equality. unions as partners can be good not just for worker pay, but for the economy. in our country, unions have never been able to make that case by gentle persuasion. they make it in the old-fashioned way, organizing one worker and one legislator at a time.

http://www.prospect.org/web/page.ww?section=root&name=viewweb&articleid=12613

i think that the relative incomes of american states with strong labor movements play out in health and safety outcomes for the citizenry.

Pediatric Critical Care Columnist · Apr 2, 2007

(In case you missed it, this is a cross post from the Walter Reed thread...) I guess we'll have to agree to disagree about unions. As opposed to the "individual mandate/mantra--"every woman (or man) for themselves", I believe in the collective, progressive point of view, " we're all in this together."
It's always going to be a fight and someday, you're going to have to lock arms together in a righteous fight in the exclusive interest of, and for the safety of patients, be they civilians, or Veterans.

Well said.

Shamira Aizza · Apr 2, 2007

(In case you missed it, this is a cross post from the Walter Reed thread...)
I guess we'll have to agree to disagree about unions. As opposed to the "individual mandate/mantra--"every woman (or man) for themselves", I believe in the collective, progressive point of view, " we're all in this together."
Before unions, people could be worked 10 or more hours a day, 6 days a week, in whatever kind of miserable conditions employers felt like offering. You have unions to thank for 40 hour workweeks, two days off per week, and living wages, retirement and insurance benefits. The ability, the right to bargain collectively, to meet your employer on equal terms, to enforce safe working conditions, pay and benefits over and above the minimum wage that the laws provide, to be respected as an equal, to be protected against arbitrary discrimination, all of these things are what unions are about.
Now, how about those hospital administrators vs. the direct care RNs who are really held accountable, ultimately, for what happens to the patient? (If you don't like it leave?) Mandatory overtime?, Merit pay or favoritism?, Staffing flexibility or admitting patients without adequate staffing and calling it "care", such as putting patients in the hallways or on monitors that no one is monitoring, and then billing for the "service"? Fraud or legalized neglect? Bottom line vs. genuine patient-focused care and nursing practice/patient advocacy protection? The bosses will tell you, "do the best you can" and then play "the blame game" when patients suffer complications and even death. Let's talk about fairness and justice!
Unionized direct care Registered Nurses in California, members of The California Nurses Association, called the question, collectively fought for and passed the first-in-the-nation minimum nurse to patient ratios. The law also requires hospitals to "staff up" (provide additional staffing of RNs, LVNs, NAs, Ward Clerks), based on acuity and scope of practice to meet the needs of the patient, as determined by the independent clinical judgement of the direct care registered nurses responsible for the patients. The ratio law protects patients from corporate greed/bottom line staffing schemes and improves working conditions to stop the hemorrhage of nurses from the profession.
The only reason the government does any of these things is because of union-led and supported legislation. Most of these laws - or at least their enforcement - are being undermined by "dirty money" (corporate cash exchanged for political gain)...political appointees and elected officials who look the other way as our individual rights and freedoms...free speech, freedom of association, and freedom to control our practice are encumbered or eroded to the point that they endanger patients by stifling our ability to advocate without fear of retaliation.
The reason they (Bush-its, Schwarzen-cronies, and Co.) are able to even attempt this is that unions are far weaker now than when these laws were passed - and the public is far less educated about the benefits of unions; and, the fact that most legal workplace protections wouldn't be there without unions. And, in fact, if unions disappear, so will all of those legal protections, and many others that we just take for granted these days.
Responsibility is one thing, and it's a good thing. No one would argue with that. But unions aren't just about responsibility, they're also about power - power in the good sense. The individual is no match for even a small company, much less a large corporation. Joining together in unions is the only way that individual workers can have a voice to defend pay, working conditions and benefits, whether legal or bargained. And unions, public interest groups, and government, (if the laws are enforced), are the only means to make sure that management lives up to its corporate and social responsibility not to sicken, injure, kill and exploit workers (or patients) and the community.
And when California's Gov. Schwarzenegger abused his discretionary power to suspend our ratios, the nurses and the community fought back, from a position of collective strength, united in a common cause for safe standards; we prevailed in court and the law won, the nurses won and our patients won! Just try that as an individual...and don't kid yourself.
It's always going to be a fight and someday, you're going to have to lock arms together in a righteous fight in the exclusive interest of, and for the safety of patients, be they civilians, or Veterans.

It's not so simple as "every man for himself."

When it comes to the workplace, people should be expected to show independent personal value instead of paying someone else to extort recognition from an employer. If folks don't want to work in specific conditions as professionals, then they should walk away and let someone do it who will.

Your description of what happens in some hospitals (which you blamed on management), is not necessarily abated by unions, and it's not necessarily a union problem. It's a reflection of a systemic problem with the union-type mindset works against itself to resolve while blaming everyone else for the problem. You want to socialize the system, which will result in more people using ED's for primary care while reducing available resources (because socialized systems ration care), and reducing staff two ways; reduced reimbursements will mean less money to pay the wages that unions demand. Hospitals won't be able to hire more people because the existing staff will have a union-negotiated wage; unions can't negotiate the number of people a hospital will hire, and they can't get water from an empty well.

And the last thing a union can criticize is corruption and dirty money; there is not a union in the history of man that hasn't been involved in illegal activities of some kind.

BTW, I'm offended by the terms "Bush-its" and "Schwarzen-cronies," but I have come to accept the fact that such flavor of labels are only infractions if they are uttered by a conservative. Moderation is not so objective as they'd like to say they are.

Your statement that "unions are the only way" is simply not true. Unions certainly can do their part to improve conditions for nurses, but they are not known for improving conditions for consumers, and to categorically say that unions are the "only way" fails to recognize non-union hospitals that have superior outcomes in patient care vs. union hospitals that are further down on the list.

HM2VikingRN, RN · Apr 5, 2007

I would consider the source of the rankings. US News is only slightly to the left of the Weekly Standard. The problem with human social organizations is that they are run by humans who are subject to temptation. Making a categorical claim of "all unions are corrupt" is no more accurate than a claim that "all businesses are corrupt." The question becomes which organizational structure can be held to the highest standard of public accountability and transparency. Looking at the past 5 years I can think of rather dramatic cases of corporate corruption that resulted in real harm to the interests of the country.

Just a few examples:

Enron

Halliburton

KBR

World Com

Each of these companies have engaged in outright theft from their employees and us as taxpayers. Enron stole billions from its employees through destruction of their pension plans and price gouged california consumers. Professionalized management and clear work rules are the usual results of a unionized business environment. Your claims of rationed/reduced care and provider numbers under a universal care system are not really supported by the OECD data. On average the OECD countries have more physicians and nurses per capita. An RN in Norway makes almost exactly the same salary as an RN in MN. (Mn RNs are second in the country for average salary.) While the occasional venality of a business manager makes the news and tars the reputations of honest well run unions, on balance the presence of a strong labor movement tends to increase the average prosperity of any given state especially when you factor in the higher average wages, emphasis on good schools and a healthy populace. Investments of this type tend to result in a better educated and more productive workforce which directly benefits the business climate.

In health care the question becomes do you want a state economy where the average hospital is A-/B+ and is affordable/accessible for the population who are insured at a 92% coverage level at large or a state economy where you have one A level hospital and the rest are B-/C+ hospitals and the population is insured at a 85% level. The point of this is that social investments yield competitive business environments.

Shamira Aizza · Apr 5, 2007

I would consider the source of the rankings. US News is only slightly to the left of the Weekly Standard. The problem with human social organizations is that they are run by humans who are subject to temptation. Making a categorical claim of "all unions are corrupt" is no more accurate than a claim that "all businesses are corrupt." The question becomes which organizational structure can be held to the highest standard of public accountability and transparency. Looking at the past 5 years I can think of rather dramatic cases of corporate corruption that resulted in real harm to the interests of the country.
Just a few examples:
Enron
Halliburton
KBR
World Com
Each of these companies have engaged in outright theft from their employees and us as taxpayers. Enron stole billions from its employees through destruction of their pension plans and price gouged california consumers. Professionalized management and clear work rules are the usual results of a unionized business environment. Your claims of rationed/reduced care and provider numbers under a universal care system are not really supported by the OECD data. On average the OECD countries have more physicians and nurses per capita. An RN in Norway makes almost exactly the same salary as an RN in MN. (Mn RNs are second in the country for average salary.) While the occasional venality of a business manager makes the news and tars the reputations of honest well run unions, on balance the presence of a strong labor movement tends to increase the average prosperity of any given state especially when you factor in the higher average wages, emphasis on good schools and a healthy populace. Investments of this type tend to result in a better educated and more productive workforce which directly benefits the business climate.
In health care the question becomes do you want a state economy where the average hospital is A-/B+ and is affordable/accessible for the population who are insured at a 92% coverage level at large or a state economy where you have one A level hospital and the rest are B-/C+ hospitals and the population is insured at a 85% level. The point of this is that social investments yield competitive business environments.

1. If you can name a union, any union, it won't take long to find an instance of corruption involving that union. My statement is accurate.

2. Not sure of the point of comparing Norway to Minn. US nurses are largely the best paid nurses in the world, and it has nothing to do with unions. Regardless, the data most certainly does support the fact that socialized systems ration care, and it isn't tied to the numbers of physicians and nurses. It's tied to the policies of that country to provide for certain types of care. For example, socialized countries tend to refuse rescuscitation of preterm infants before a certain age, and deny transplants to people who are over a certain age. They place people on waiting lists for essential surgeries. You can have a 1:1 physician ratio, but it makes no difference if you won't pay for him to provide you any care.

The remainder of your claims are rhetoric...unless you can show some kind of reference that proves that unions result in good schools (and schools are one of the most unionized institutions in America and deteriorate even more every year) or result in a healthier populace. There is no data to support that.

HM2VikingRN, RN · Apr 5, 2007

the education and health outcomes data for states with a history of a strong labor movement do compare favorably when compared to "right to work" states.

i was not being an apologist for corruption in organizations i was making the point that while unions do have bad actors so do corporations. but when corporations engage in crime it tends to be much more damaging to the fabric of society. bad actors whether they are ceo's or union presidents need to be held accountable for their misdeeds after they have abused the public trust.

ultimately i think that we need to work together to reinforce and share a commitment to :

if the sense of community exists, both freedom and security exist as well. the community then takes on a life of its own, as people become free enough to share and secure enough to get along. the sense of connectedness and formation of social networks comprise what has become known as social capital.[4]
social capital is defined by robert d. putnam as "the collective value of all social networks (who people know) and the inclinations that arise from these networks to do things for each other (norms of reciprocity)." social capital in action can be seen in groups of varying formality, including neighbors keeping an eye on each others' homes.

http://en.wikipedia.org/wiki/community

mcmillan and chavis (1986) identify four elements of "sense of community": 1) membership, 2) influence, 3) integration and fulfillment of needs, and 4) shared emotional connection.

http://en.wikipedia.org/wiki/community

community by definition includes individual awareness and appreciation for common interests and working together to meet the common good. healthy communities are dedicated to building points of community networks for provision of the common good (public schools and health care are 2 prime examples)

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