Nurses: Supervisory Status or Union Solidarity?

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Nurses: Supervisory Status Or Union Solidarity?

As nurses take on responsibilities that are increasingly supervisory in nature, the issue of whether they can be part of a collective bargaining unit is becoming more complex.

Analysts for the Federation of Nurses and Health Professionals predict that by the year 2000, the United States will need more than 2 million registered nurses (RNs)--612,000 more than are employed today. According to Candice Owley, president of the Federation, the demand for healthcare services is "outstripping the supply of trained, qualified workers due to the growing number of senior citizens, diseases such as AIDS, advances in technology, and the decreasing number of women choosing to go into health professions." As a result, the United States is likely to face "a potentially devastating curtailment or even a `rationing' of services."

These developments, coupled with the proliferation of government regulations regarding healthcare and the move by hospitals to expand their market by developing specialty units, have radically changed the role of the professional nurse. No longer solely a caregiver, today's nursing professional is a key decision maker with increased responsibility for the hospital's strategic direction, personnel planning, and policy making. Thrust into this new role, some nurses have turned to unionization as a way of bringing their needs, interests, and concerns for today and the future into the limelight. Thus, human resources professionals in healthcare organizations would do well to understand the issues surrounding collective bargaining and nursing professionals.

Recent Developments

Controversy over what constitutes an appropriate healthcare unit where collective bargaining is concerned has lingered ever since 1974, when amendments to the Taft Hartley Act extended the Act's coverage to nonprofit medical institutions. The matter was resolved last summer when the National Labor Relations Board (NLRB) issued its final proposed rules for determining appropriate bargaining units in the healthcare industry in St. Francis II 271 NLRB 948 (1984). The rules permit a maximum of eight bargaining units in a cute care hospitals, regardless of their number of beds. (Nursing homes and psychiatric facilities are specifically excluded from the ruling's purview.) The eight units include:

1. All registered nurses.

2. All professionals other than

registered nurses and physicians.

3. Physicians.

4. Technical employees.

5. Skilled maintenance workers.

6. All business-office clerical

employees.

7. Service and other

nonprofessional employees.

8. Guards.

Although this eight-unit configuration may serve the NLRB's interest by addressing congressional concern over healthcare organizing and bargaining, it has left unanswered a number of questions. For example, should nursing care coordinators, assistant nursing care coordinators, head nurses, and charge nurses be excluded from the bargaining unit because they may possess the requisite authority to be considered supervisors, or even managers, under the National Labor Relations Act (NLRA)? This issue becomes even more complex when we take into account the increasing responsibility that nurses are assuming.

In addition, while unions seeking to organize healthcare units won approximately 50% of the elections held between 1977 and 1986, the percentage of union wins varied significantly among unit types. Craft units (which organize only along occupational, skill, and guild lines, such as electricians, carpenters, and plumbers) had the highest union victory rates (66%) according to the NLRB, with nurses and technical units both showing a 58% union victory rate. We should note that these rates are higher than the overall average union win rate, which is approximately 43%.

In its St. …