 2000 AJN Table of Contents
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Issues Update
American Journal of Nursing - August, 2000 - Volume 100, Issue 9
Come Together
Nurses representing nurses
by Cheryl L. Johnson, RN
As a newly licensed RN, Ann Converso wasn’t interested in the union when she took a staff nurse position at Veterans Hospital in Buffalo, New York, 27 years ago. “I was having the time of my life,” Converso says. “I was excited about starting my new profession, but I didn’t think I could afford the union dues.” However, she did join the union and soon began handling grievances. Before long, her commitments to her profession and her union became
Last month, Converso reached two milestones. She began her 28th year as a staff nurse at Veterans Hospital, where she chairs the local union representing 200 RNs, and she was elected vice chairperson of the United American Nurses (UAN), the labor arm of the American Nurses Association. Now she can’t imagine a life that doesn’t value providing patient care or belonging to a union that gives RNs a voice equal to management’s regarding the best way to deliver care.
“At Veterans Hospital, we demand predecisional involvement, and we get it,” says Converso. “Because we have a strong contract.”
United Nurses
Protecting nurses and giving them a voice in workplace decision making are the driving forces behind the UAN. The ANA created the national labor group last year to consolidate the existing work of its constituent member associations, which were organizing and representing RNs on issues such as staffing levels, workplace safety, and fair compensation through collective bargaining.
As the UAN chairperson, I am sometimes asked by nonunion nurses why they need a union. I always respond by asking if they work in a facility with inadequate staffing and mandatory overtime and in which they have no power over patient care. And do their facilities offer inadequate protection against workplace violence, latex allergy, and needlestick or back injuries?
The bad news is that the answer to either question is always “yes.” Mandatory overtime, inadequate staffing, health hazards on the job, and unilateral reassignment without regard to experience or training are just a few of the staff nurses’ concerns. The good news is that there’s a solution: organization. More and more U.S. nurses are realizing that securing a contract is the best way to protect patients and themselves. Through organization, nurses are part of the solution to workplace problems.
“RNs who’ve been through the megamergers are finding they have no voice in health care delivery without union representation and contracts,” says UAN director Susan Bianchi-Sand. “Therefore, organizing is our top priority. We’ve added staff and funds so we can send resources quickly when staff nurses need us.”
‘For Nurses by Nurses’
Whereas the UAN represents the most RNs nationwide, at least 10 unions affiliated with the AFL-CIO (American Federation of Labor-Congress of Industrial Organizations) are also working to organize nurses, with mixed results. These unions have discovered what we’ve known for a long time: organizing nurses is challenging work, and it’s even more difficult for unions that have competing agendas and divided interests.
“Nurses should represent nurses,” says Converso. “Another union might be able to get a contract, but we’re the ones who live with that contract. The UAN is the union for nurses by nurses.”
The conviction that nurses should be represented by nurses is echoed by Valerie Tate, RN, an organizer for the District of Columbia Nurses Association (DCNA). She attributes the labor successes of nurses in Washington, DC, to the DCNA staff and leaders’ singular focus on daily workplace concerns.
An example of the union’s success can be found at Greater Southeast Community Hospital in Washington, DC. After a year and a half of building personal contacts among nurses in the facility and compiling a list of their concerns, the DCNA presented management with a petition for representation signed by 80% of the staff nurses. The management then refused to recognize the bargaining unit.
“They never do,” says Tate. The management’s consultants swung into action with a full-blown antiunion campaign. Fortunately, the DCNA had warned the nurses to expect such tactics and the nurses soon filed a request for an election with the National Labor Relations Board.
“I tell them how hard it’s going to be, that there are risks, and how bad the final days can get before an election,” says Tate. “Most nurses find it hard to believe until they live through it.”
In many organizing campaigns, the chief nurse is fired in an effort to misdirect blame and to give a chilling warning that any worker is dispensable. The management usually follows this with the typical “union-buster” messages, delivered one-on-one by supervisors, and in mandatory meetings that convey anti-union messages:
At Greater Southeast Community Hospital, these tactics failed on election day: nearly 100% of the eligible nurses turned out, with 85% voting in favor of the union.
Rewards of Organizing
Why would nurses take on such a tough fight? Says Tate: “It can change your life. With a contract comes autonomy, the power to enforce professional standards and practices, and a voice in the hospital’s business procedures that affect patient care.”
Greater Southeast Community Hospital is a good example of how bargaining benefits RNs, patients, and the entire community. When the hospital filed for bankruptcy last year, the nurses proposed ways to cut costs without reducing the quality of patient care, lobbied for emergency funding, and helped find a suitable buyer. In the end, care of 100,000 patients was maintained, and nearly 900 jobs were saved. This, in Tate’s mind, makes all the work, pain, and effort of organizing worthwhile.
When nurses collectively speak out on behalf of patient care, they have a powerful effect. People listened, for example, when the Ohio Nurses Association (ONA), with the assistance of an ANA grant, carried out a “visibility campaign” to reach RNs and the general public.
“We had three goals,” says ONA first vice president Linda Warino, RN. “We wanted to show unorganized nurses that they belong with us, show the public that RNs are their best hope for good patient care, and put the spotlight on the problems as well as our solutions.”
Thirty-seven thousand RNs in Cleveland and Columbus were surveyed on the impact changes in their workplaces made on them professionally, physically, and emotionally. Nurses reported huge increases in patient loads and sharp decreases in the time available for direct care—working conditions that took a toll on the nurses and jeopardized patient well-being. The ONA spotlighted these problems through the release of survey results last spring that occasioned hundreds of media reports about Ohio’s health care problems.
“Most shocking to the reporters were the nurses’ answers to the question, ‘Would you put your own loved one in your hospital?’” said Warino. “Half of the nurses answered ‘no.’”
The ONA campaign pointed out dangers in the health care system and nurses’ crucial role in patient care, and it showed many nonunion nurses how solidarity could address the many threats nurses and their patients face.
Collective bargaining highlights nurses’ contributions to high-quality patient care. We know our patients, our facilities and services, and our shortcomings and strengths better than anyone, because collectively we’re on duty every hour of every day of every year. We’ve waited too long to be included in decision making and the quality of care is declining. That’s why we’re organizing and negotiating contracts. To those in management who fail to include us, we say, “it’s time for a change.”
indistinguishable.
For more information about the United American Nurses, call (877)ANA-ORGANIZE.
Cheryl Johnson, a clinical nurse III at the University of Michigan Health System, Ann Arbor, is the newly elected chairperson of the United American Nurses, Washington, DC, and vice president of the Michigan Nurses Association, Okemos, MI.
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