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Unionizing during a Pandemic – Another story from the bedside

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SafetyNurse1968 has 20 years experience as a ADN, BSN, MSN, PhD and specializes in Oncology, Home Health, Patient Safety.

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Are nurse unions a dire need?

This is the fourth in a series of interviews that were done during the 3rd week of April 2020 in response to the global Covid-19 pandemic. This ER nurse is also spearheading an effort to unionize in her hospital – so much so that the article ended up being more about unions than about Covid-19, though Sandy pointed out that the poor response of her hospital has been driving her to continue to push for a union.

Unionizing during a Pandemic – Another story from the bedside
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I’ve changed multiple details in this article to protect the identity of the nurse I interviewed. I offered to pay her for her time, but she refused, so I made a donation to the American Nurses Foundation Coronavirus Response Fund in her honor. The fund, Coronavirus Response Fund for Nurses, focuses on:

  • Providing direct financial assistance to nurses 
  • Supporting the mental health of nurses – today and in the future
  • Ensuring nurses everywhere have access to the latest science-based information to protect themselves, prevent infection, and care for those in need
  • Driving the national advocacy focused on nurses and patients

Sandy is an ER nurse in a hospital with only 10 cases since the Covid-19 outbreak began. Her state is in the first phases of re-opening and the number of cases has doubled in the last week. I first talked to her over three weeks ago, so a few days I checked in. She told me, “not much has changed. They are setting unrealistic metrics, the census is increasing, the staff is increasingly compromised…believe it or not, it’s worse…but we’re hanging in there for the vote.”

And by “vote” she means a vote to unionize, which could happen in the next few weeks. 

Unions

Unions are a controversial topic in the U.S., and it can be tough to find unbiased information. I remember when I was a new nurse back in 2006, I was told that if you even said the word “union” you could be fired. This was in North Carolina, where I had been taught “Unions are illegal.” I discovered it is illegal to dismiss an employee for trying to organize or join a union, but it can be hard to prove that someone was fired for those reasons.

The US Bureau of Labor Statistics states that approximately 13% of Americans belong to a union (down from 20% in 1983). But, 18% of RNs belong to unions. A union is an organization of workers formed to protect and advocate for the member's interests. Nurses don’t have a single labor union. Some of the most active include National Nurses United and The American Federation of Labor and Congress of Industrial Organizations. Twenty-eight states are “right to work” and twenty-two states have mandatory union participation, including California, New York and Illinois. It is important to note that most unions are not organized or led by nurses. Dues can be as much as $90 each month, but nurses in unions are paid 20% higher than nurses in non-union facilities.

Pros to Nursing Unions

Job security, better working conditions, guaranteed wages and pay increases, seniority advantages, education reimbursement, better benefits, a guaranteed process for grievances, ability to strike, legal representation. Research has shown that hospitals with successful unionization have improved patient outcomes and better employee satisfaction.

Cons to Nursing Unions

These are cons to unions, like bad eggs -- it’s very hard to fire someone who isn’t doing a good job. In health care, with lives on the line, this can be a frightening concept. Many nurses are against the idea that an incompetent nurse can keep her job if she’s in a union. Though some sources say unions favor seniority over performance, Sandy says in the union she’s pushing for, pay raises are merit-based. Mandatory striking is another issue. If you are a member of the union, it is possible you’ll have to strike, though striking is a last resort and only occurs if the majority of the nurses decide if the strike takes place. Sandy says, “It’s a one-day strike maximum in this union.” Another issue is that union negotiations have the potential to create adversarial relationships between employees and employers. Other complaints are about union dues.

Why a Union?

When I asked Sandy about the Covid-19 situation at her hospital she said, “I feel very unsafe at work, but it’s not at all related to PPE. It has everything to do with staffing. We agreed on a 3:1 ratio with nursing administration in our high acuity pod, but now it’s crept back to 4:1.”

“An elderly patient came in for a kidney stone with a 98.7 temp. Then the temp started to spike, the pressure started to drop. She developed slurred speech and her mentation declined. She started shivering and spiked 103. We were trying to get a blood draw before she could go to pre-op, but her blood was clotting like crazy. Phlebotomy is no longer coming to the most critical pod in the ER so labs take 2 hours to come back. So you might think 14 patients in the ER seems manageable with 5 or 6 nurses, but it blows up with traumas coming in, people getting stabbed, people who are emergent. You can’t predict what will happen and we need to have staff available.” 

“There’s no one on call. There are no float nurses. How am I supposed to respond effectively and safely to 4 patients when I’ve got a status epilepticus needing intubation, a septic patient, a patient who needs intubation, and a fourth one who is waiting for a urinary stent and pulling out his IV?”

“People are quitting, and our ER is full of new graduates. One primed some antibiotics and didn’t do it correctly. Just stupid stuff. The ED is down to who can survive it. The PRN folks have been cut loose – furloughed and encouraged to take travel assignments. There is no one to cover FMLA. We’ve lost 30 nurses in 3 months due to a combination of firing and quitting.”

“Our director mandated we won’t get lunch breaks because we have low productivity in the ER. So, we don’t get paid for the 30 minutes of lunch. All the pictures you see of nurses getting free food for being heroes. Those pictures are with managers, educators and supervisors.

Work Situation

At the end of March, Sandy said she was working every other day. She was distressed because she said, “We lost another good nurse. She gave her two weeks’ notice and they told her not to come back.”  She went on to say, “I’ve been flexed a few times at 70% of my base pay. We have to use PTO to cover the other 30%. When workers have had positive exposures, there’s been no quarantine, no nothing. If someone is a PUI, and they’ve tested positive, there’s a sheet with all the names of those who have provided bedside care, but they are not told – you’d be more likely to find out in the newspaper that you were exposed, than from hospital administration." 

PPE Situation

“In the ER, we always have plenty of surgical masks, N95 not as much. We didn’t see any N95s for a while, but on March 24th they suddenly came out of hiding. That’s when the education on PPE, how to use it, scenarios, etc… really started.”

People of Interest

“When we get people with symptoms who don’t need to be hospitalized, we are sending them home and not testing. Someone is supposed to be checking on them to see if they are compromised. How would you even know if you are desatting, if you are desatting? Who has a pulse-oximeter at home? A patient went home on self-quarantine, she couldn’t breathe and by the time EMS arrived, she had died. This is not okay. We have to change what we are doing, how we are responding.”

Covid-19 is Just Reinforcing What We Already Knew About Our Hospital

Sandy says, “The need for a union is so dire. Our focus needs to be on supporting each other and taking care of our staff, but sometimes I get so angry, I want to jump ship. We have to focus on getting people to believe there is strength in numbers. You may be fine in your nursing job, you may have adequate staffing and bathroom breaks, but you have to stop thinking about yourself and think about the bigger picture.”

Would you like to be interviewed?

I'm going to continue to interview nurses on the frontlines. If you'd like to be interviewed or you have a particular area of nursing you are interested in, let me know. I've already got a few other interviews out there for you as well:

At the Bedside with Covid-19 - Stories from the Frontlines

At the Bedside with Covid-19 - Part 2: John

Methadone Clinics and Covid-19: More Stories from Nurse on the Frontlines

Dr. Kristi Miller, aka Safety Nurse is an Assistant Professor of nursing at USC-Upstate and a Certified Professional in Patient Safety. She is also a mother of four who loves to write so much that she would probably starve if her phone didn’t remind her to take a break.  Her work experiences as a hospital nurse make it easy to skip using the bathroom to get in just a few more minutes on the computer. She is obsessed with patient safety. Please read her blog, Safety Rules! on allnurses.com. She is doing research into the relationship between participation in Root Cause Analysis and patient safety attitudes (contact her if you are interested). In the guise of Safety Nurse, she is sending a young Haitian woman to nursing school and you can learn more about that adventure: gf.me/u/xzs5sa

12 Followers; 63 Articles; 20,520 Profile Views; 405 Posts

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OUxPhys has 4 years experience as a BSN, RN and specializes in Cardiology.

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Unions are needed mainly for safety, I.e. safe staffing ratios. I work for a hospital with a very weak union for nurses. Unfortunately it's true when it is said unions will go out of their way to protect the bad workers. It's true at my hospital. I wish they put as much energy into safe staffing as they did with protecting bad employees. 

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11 Followers; 3,918 Posts; 31,083 Profile Views

Our union got our PPE back after they took every single bit of it from us because we were thought to be "low risk" until we weren't. They forced the hospital to make changes to parking so employees wouldn't have to ride on over-crowded shuttles. They also got the hospital to stop making us use our vacation time for low census days. If we are able to work, willing to float and there is nothing for us to do we get paid out of special disaster bank. They also forced the hospital to add 80 hrs of ill time to be used if we had to quarantine due to exposure. Overall I'm very pleased with what they did for us. I've been at this facility for 12 years and am not aware of any bad employees that we had to keep due to the union. Several have been fired after receiving due process which I think is fair. 

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SafetyNurse1968 has 20 years experience as a ADN, BSN, MSN, PhD and specializes in Oncology, Home Health, Patient Safety.

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1 minute ago, Wuzzie said:

Our union got our PPE back after they took every single bit of it from us because we were thought to be "low risk" until we weren't. They forced the hospital to make changes to parking so employees wouldn't have to ride on over-crowded shuttles. They also got the hospital to stop making us use our vacation time for low census days. If we are able to work, willing to float and there is nothing for us to do we get paid out of special disaster bank. They also forced the hospital to add 80 hrs of ill time to be used if we had to quarantine due to exposure. Overall I'm very pleased with what they did for us. I've been at this facility for 12 years and am not aware of any bad employees that we had to keep due to the union. Several have been fired after receiving due process which I think is fair. 

That is fantastic news. Thank you for sharing!

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OUxPhys has 4 years experience as a BSN, RN and specializes in Cardiology.

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38 minutes ago, Wuzzie said:

Our union got our PPE back after they took every single bit of it from us because we were thought to be "low risk" until we weren't. They forced the hospital to make changes to parking so employees wouldn't have to ride on over-crowded shuttles. They also got the hospital to stop making us use our vacation time for low census days. If we are able to work, willing to float and there is nothing for us to do we get paid out of special disaster bank. They also forced the hospital to add 80 hrs of ill time to be used if we had to quarantine due to exposure. Overall I'm very pleased with what they did for us. I've been at this facility for 12 years and am not aware of any bad employees that we had to keep due to the union. Several have been fired after receiving due process which I think is fair. 

I wish we had a union like that but at the same time I work for a government hospital so that's probably why they aren't as successful as yours. Overall though I think nurses should be unionized, which is a complete 180 from when I first went into nursing. 

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43 minutes ago, OUxPhys said:

I wish we had a union like that but at the same time I work for a government hospital so that's probably why they aren't as successful as yours. Overall though I think nurses should be unionized, which is a complete 180 from when I first went into nursing. 

I count myself as lucky that our union functions as it does. 

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AutumnLeaves has 36 years experience as a MSN, RN, NP and specializes in acute care, icu, surgery, vasc.surgery,trauma.

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On 6/3/2020 at 9:46 AM, OUxPhys said:

I wish we had a union like that but at the same time I work for a government hospital so that's probably why they aren't as successful as yours. Overall though I think nurses should be unionized, which is a complete 180 from when I first went into nursing. 

I also work for a govt. hospital and our union is useless. They don't help us with pay, staffing or PPE.

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Serhilda is a ADN, RN and specializes in Cardiac Telemetry, ICU.

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I switched from a union hospital to a non-union hospital here in Massachusetts. Guess which one had better PPE and pay?

Needless to say, I'll never work for a union hospital again if I can avoid it. All the MNA did was write a ~strongly worded~ letter to the hospital I previously worked for. They were shaking in their boots at the union's power, I'm sure. So afraid they proceeded to cut 401k contributions a couple weeks later. Man, just wait until they read the next letter. That'll show 'em!

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Leader25 has 37 years experience as a ASN, BSN, RN and specializes in NICU.

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First of all you need the support of the community,and this is not the time.The public perception of nurses in general is very positive,do not ruin it prematurely.

You can always unionize or fight to unionize later with a long list of positives garnared during the pandemic.Usually Er nurses lead the fight but you must have all the other units behind you and many will not agree or snitch on you.Make sure it is a stong Union you are selecting,nursing associations are the weakest ,Teamsters,AFL-Seiu, are stonger.

The hospital might fight dirty...I am talking from experience.They will try to hurt you from the inside out with the help of anti union nurses--especially those that consider themselves"professionals" and too proud to join while they starve or get their benefits by *** kissing administration.

Much look to you ,hope you win and vote in a new contract.

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Leader25 has 37 years experience as a ASN, BSN, RN and specializes in NICU.

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On 6/7/2020 at 11:15 AM, Serhilda said:

Needless to say, I'll never work for a union hospital again if I can avoid it. All the MNA did was write a ~strongly worded~ letter t

Sorry but you picked the wrong union.Do your research associations like NYSNA are in bed with management or too weak to fight with you,because you must fight alongside the members not sit back and expect "the union" to do your fighting.You are the UNION,remember that for next time.Sorry it did not work out for you.

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Leader25 has 37 years experience as a ASN, BSN, RN and specializes in NICU.

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On 6/3/2020 at 8:31 AM, OUxPhys said:

It's true at my hospital. I wish they put as much energy into safe staffing as they did with protecting bad employees. 

That bad huh,did you give back the raise???

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OUxPhys has 4 years experience as a BSN, RN and specializes in Cardiology.

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4 hours ago, Leader25 said:

That bad huh,did you give back the raise???

Nope. Union had nothing to do with my cash bonus, that was all my manager. Got another one coming too. My manager also got us a retention incentive due to covid. I am re-thinking the union here though. It's not nearly as good or strong as other government hospitals in my state.

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