1. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 18 Collective Bargaining and the Professional Nurse

2. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Historical Perspectives Unions present since 1790s –Protection from wage cuts during industrialization –Strikes rare and usually peaceful Early 1800s –Increased strike activity during economic prosperity –Negotiation with employers about wages, work rules, hours, and grievances

3. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Historical Perspectives (cont.) Mid- to late 1800s: labor movement similar to today After depression: repressive management; tension high between workers and employers National Labor Relations Act (Wagner Act) –Right to form unions, bargain collectively –Creation of NLRB (see Box 18.1)

4. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Historical Perspectives (cont.) Taft-Hartley Labor Act of 1947 (retained Wagner Act provisions) –Added employee’s right to refrain from taking part in unions (see Box 18.2) –Union shop only after majority employee vote –Jurisdictional strikes, secondary boycotts, union contributions to political campaigns forbidden

5. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Historical Perspectives (cont.) Federal legislation –Fair Labor Standards Act –Occupational Safety and Health Act –Equal Employment Opportunity Act Little growth of unions in private and blue-collar sectors since peaking in 1950s

6. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Historical Perspectives and Nursing Collective bargaining slow: illegal until labor laws amended; view of nursing as service commodity Kennedy Executive Order 10988 (1962): city, county, district hospitals, health care agencies joined collective bargaining

7. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Historical Perspectives and Nursing (cont.) Amended Wagner Act (1974): extension of national labor laws to private nonprofit hospitals, nursing homes, health clinics, HMOs, other health care institutions Slow but steady increases 1962 to 1989 NLRB (1998): nurses able to form own separate bargaining units (see Table 18.1) AHA lawsuit against ANA –Ruling on hold until 1991 –Decision of 1989 upheld by Supreme Court

8. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Is the following statement true or false? In the beginning, it was illegal for health care workers to join a union.

9. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer True. Collective bargaining was slow in coming to health care. Until labor laws were amended, it was illegal for health care workers to unionize.

10. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Unions Representing Nurses Service Employees International Union (SEIU): largest in health care National Nurses United (NNU) ANA National Union of Hospital and Health Care Employees of Retail, Wholesale, and Department Store Union American Federation of Labor-Congress of Industrial Organizations (AFL-CIO)

11. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Unions Representing Nurses (cont.) United Steelworkers of America (USWA) American Federation of Government Employees, AFL-CIO American Federation of State, County and Municipal Employees, AFL-CIO International Brotherhood of Teamsters American Federation of State, County, and Municipal Employees (mostly public sector) United Auto Workers

12. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Motivation to Join Unions Increase in individual’s power Economics Communication of aims, feelings, complaints, ideas to others Elimination of discrimination Requirement of job Social need for acceptance Improvement in patient outcomes (see Box 18.3)

13. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Reasons Not to Join Distrust of unions: promote welfare state; oppose free enterprise Need for individualism, social status Promotion of mediocrity and substandard practice Values more closely align with management Identification with management viewpoint Fear of employer reprisal Fear of losing income related to strike or walkout

14. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Which of the following would be least likely to motivate a nurse to join a union? A. Increase in individual power B. Improved wages C. Social need for acceptance D. Values aligning with management Question

15. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer D. If a nurse’s values align with those of management, this would be a reason for not joining a union. Increased individual power, better wages, and a social need for acceptance are motivations to join a union.

16. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Eligibility for Union Membership Initially, only supervisors considered managers so prohibited from joining union NLRB (2006): charge nurses considered supervisors (even part-time) Administrative, court rulings of early 1990s, issue of “supervisor” Oakwood ruling

17. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Organizing a Unions & Seeking Representation Use of different tactics (see Box 18.5) Steps –Need for determining adequate levels of desire for unionization—interest cards (at least 30% by NLRB; 60% to 70% by other agents) –Election—vote on desire for unionization; 50% + 1 vote necessary before recognition of the union Rights of management and labor In health care facility: no solicitation or distribution of union literature in immediate patient care areas

18. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Is the following statement true or false? At least 50% of employees must demonstrate an interest in forming a union before an election for unionization can be held.

19. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer False. The NLRB requires that at least 30% of employees demonstrate interest before an election for unionization can be held. Most collective-bargaining agents will require 60% to 70% employee interest before beginning an organizing campaign.

20. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Labor–Management Relations Management: choice of accepting or opposing union –Union-busting techniques; subtle by attempts to discredit –Acceptance: variable along continuum –Accommodation: full acceptance; management, union show mutual respect

21. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Labor–Management Relations (cont.) Attitudes, philosophies of leaders in management, union determine type of relationship –Flexibility of managers –Avoiding ignorance of issues or overpowering –Need for rational approach to problem solving Employees with the right to participate in union organizing under the NLRA; interference by managers prohibited

22. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins ANA and Collective Bargaining Dual role of ANA –Professional organization –NLRB recognition of ANA as collective-bargaining agent –Some state nurses associations splitting away from ANA American Association of University Professors: –Professional association, collective-bargaining unit –Also fundraising arm

23. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Is the following statement true or false? Accommodation is demonstrated when management and the union show mutual respect for one another.

24. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer True. Accommodation is characterized by management’s full acceptance of the union with both union and management showing mutual respect.

25. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Nurses and Strikes 10 days’ notice of intent to strike required Critics: strike unethical; leaves patients without care providers Unions: strikes used only as last resort Both aim for same goal: safe patient care

26. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Nurses and Strikes (cont.) ANA: nurses with right to strike –But also professional responsibility, ethical duty to do so if maintaining work conditions conducive to providing high-quality care Nurse’s personal moral dilemma about decision to strike, crossing picket line

27. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins End of Presentation