Hospital nurse unionization: legal rights and workplace safety concerns

Unionization of a Hospital Staff

When union representatives come to a hospital and approach its employees -- in this case, nurses -- a decision has to be made by the nurses as to whether or not this is a good idea. But more than that, the hospital administration has to realize that the nurses have the legal right to organize, and any attempt to stifle their negotiations or block union representatives from talking to the nurses is against federal law. This paper is intended to present the facts to the CEO of the hospital, as to what rights the nurses have to organize and what management must be careful of doing in case federal law is violated.

Why would nurses want to organize and join a union? Background)

In a poll of nurses taken by the journal Nursing Management, 39% "strongly agreed" and 27% agreed with this statement: "Nurses should unionize" (Nursing Management, 2000). But what are the reasons in 2014 that nurses would want to become union members? For one thing nurse work environments have changed pretty seriously over the past few years. There is a nursing shortage and though that isn't a new problem, it presents serious situations for nurses. The Illinois Nurses Association explains that because of a shortage of nurses, "Too many nurses are spending too much time on non-nurse duties," and many nurses are having to work a lot of overtime (INA).

Also, because of the nurse shortages, not only are many nurses working overtime, which could cause fatigue and a reduction of alertness on the job, but nurses are working in conditions that "are unsafe for themselves and their patients" (INA). Hence, a union might be a good way to assure nurses that they have safe working conditions and don't have to work so many overtime hours. With a union, nurses could negotiate "enforceable contracts that spell out specific working conditions," the Illinois Nurses Association explains. With a union, the negotiations (collective bargaining) will take place and the union can put its demands on the table in order to make sure union membership is safe and not working too many hours.

For example, how many patients should one nurse be attending to at a time? The issue of nurse-patient ratios is often an important issue to be resolved. Just like teachers in a classroom with too many students (so that there is no possibility of one-on-one instruction and some students are bound to feel ignored), nurses on a ward with too many patients means that some patients might not get the attention they deserve.

And one important negotiating issue to be brought up during collective bargaining when the union meets management is pay scales. What is the average pay scale for hospital nurses in any given situation? The union leadership has the job of discovering what the average salary is for a nurse with ten years experience in the OR, and what the beginning salary should be for a nurse fresh out of school with her degree and her nursing permit. And with representation at the bargaining table the individual nurse doesn't have to fend for herself, and go it alone when she feels like she deserves a raise in compensation.

Employer interference with union organizers is a serious violation of law

Chirag Mehta and Nik Theodore are researchers with the Center for Urban Economic Development at the University of Illinois at Chicago; they have produced a narrative pointing out the many violations they discovered in their work. The results of their research is worthy of any CEO to pay close attention -- in particular when there is a movement afoot to form a union in their workplace. I recommend that you share this with top management and other leadership in this hospital.

First of all, Mehta / Theodore found out that "…more than 23,000 workers are fired or penalized for union activity" every year (Mehta, 2005). The reason companies are able to get away with this is because the labor law system is "weak" and employers have been successful at manipulating the "current process of establishing union representation" (Mehta, p. 4). They use undemocratic strategies in order to "significantly influence the outcome of union representation elections," Mehta continues.

I highly recommend that this hospital remain neutral if possible, and certainly do not conduct any activities that appear to interfere with organizers' rights. Union "busting" is a popular pastime in some states controlled by ultra conservatives that see unions as a threat to profits. But unions are not a threat to profits at all; an article in PubMed points out that nurses wages when they are unionized rise about 5%, and moreover unions have been just "…a minor contributor to hospital cost inflation" (Adamache, et al., 1982).

The situation as Mehta sees it -- and I strongly recommend you do the research and be up-to-date with the scholarship on this issue -- is that the falling rate of unionization has lowered wages, but not because "some workers no long receive higher union salaries," but also because there is "less pressure on non-union employers to raise salaries" (Mehta, p. 4). In the book Undermining the Right to Organize, the findings are stark reminders that many employers break the law when it comes to unions and the right to organize. Employer interference with union organizers is "both pervasive and effective," Mehta explains on page 5. The date that are available in that book clearly make the point that laws are not being enforced when it comes to the rights of unions to organize; the following data is available vis-a-vis employers that were faced with union organizing campaigns:

Thirty percent of those employers faced with union organizing "fired workers when they engaged in union activities;

Forty-nine percent of employers "threatened to close or relocate all or part of the business if workers…" went with a union;

Eighty-two percent of employers used high-priced consultants to "design and coordinate their anti-union campaigns";

Things have been unpleasant for union organizers over the past few years; Mehta explains that in one year, 2002, 179 petitions were filed by labor unions with the NLRB to have the right to organize in a given workplace. Of those 179 petitions, in many cases up to 80% of the workers wanted a union, but in only 31% of the 179 petitioned cases did the union succeed. And in many of those cases when workers petitioned for union representation, it turned out that "…pro-union workers lost their majority status" (Mehta, p. 5).

Moreover: a) employers have often delayed the NLRB election process, giving more time to anti-union activists to defeat the organizers; b) penalties are "too weak" to prevent misconduct on the part of employers; and c) the NLRB has "failed to regulate employer conduct that ensures fair election processes (Mehta, p. 5).

In conclusion, as your HR professional, again I recommend that you remain neutral and certainly don't become engaged in any of the activities I have outlined in this paper. Providing the nurses with the best possible working conditions, limiting their need to work many overtime hours, and listening to their concerns is the best offense you can present. No need to be defensive at all; respect the rights of your nurses and put forward your best management strategies as well.