FOR IMMEDIATE RELEASE/February 7, 1996 CONTACT: Joan Meehan [202/651-7020]; Sara Foer [202-651-7023] ANA Applauds NLRB Ruling on RN StatusRuling means RNs can advocate for patients without fear of firingWASHINGTON, DC --A 3-1 ruling Monday by the National Labor Relations Board (NLRB) that registered nurses, including charge nurses at Providence Hospital in Anchorage, Alaska, are not statutory supervisors, and are therefore protected by federal labor law, is a victory for both nurses and patients, said the American Nurses Association. "This decision is a victory for nurses, who deserve the protections of federal labor law, and for their patients who can feel confident that nurses' professional obligation to advocate in their best interest is not undermined due to fear of firing," said ANA President Virginia Trotter Betts, JD, MSN, RN. The American Nurses Association argued as an amici (friend of the court) when the NLRB heard oral argument on the case in October 1994. This long-awaited decision could serve to remove a tactic employers have used to impede union organizing by registered nurses (RNs). The NLRB's decision in the case, Providence Hospital, recognizes that the judgment used by RNs in monitoring and assessing patients is part of their professional role, rather than part of any statutory supervision as defined by the National Labor Relations Act (NLRA). The implications of the decision are that RNs who work as professional, non-supervisory employees have the right to organize for collective bargaining purposes and to engage in other concerted activity. For example, nurses who speak out as a group regarding job conditions or management decisions that may compromise the safety and quality of patient care will be protected from firing. The issue of RNs' employment status gained national prominence following the May 1994 Supreme Court decision in NLRB v. Health Care & Retirement Corp. of America. In a 5-4 decision in NLRB v. Health Care & Retirement Corp. of America, the Supreme Court rejected the NLRB's long-held position of the use of a "patient care analysis" in determining the supervisory status of professional employees in the health care industry. In its decisions, the Court held that the Board's determination of supervisory status was to be the same from one industry to another. As a result, the Court affirmed a court of appeals conclusion that the LPNs involved were supervisors and not protected under the NLRA. The Providence case involved 700 registered nurses who were organizing for representation by the Alaska Nurses Association (AaNA). Following the Supreme Court decision, the employer, Providence Hospital, argued that any RN who ever worked as a charge nurse, even if it was as little as 5 percent of the time, was a supervisor and was ineligible for collective bargaining. "The Board correctly made the distinction between the expert judgment of professionals, including RNs, and supervisory judgment, which is what the Alaska Nurses Association, ANA and the other unions argued," said ANA General Counsel Barbara J. Sapin, who presented oral argument before the Board in October 1994. "The Board further acknowledged that a part of all nurses' professional responsibilities is to act as patient advocates -- the charge nurses, like all professional RNs, did just that." The NLRB, using traditional supervisory analyses, made the distinction between the professional judgment that nurses make as part of assessing and caring for patients, and the independent judgment made by statutory supervisors. In finding that the charge nurses did not exercise supervisory independent judgment, the Board noted that there were "institutional limits" on the general authority of the charge nurses. The Board further determined that rather than acting in a supervisory capacity, the RNs, especially the charge nurses, served "as a classic example of team leaders responsible for coordinating the team's work and for serving as a center for communication." The NLRB also ruled in a companion case, Ten Broeck Commons, that licensed practical nurses in a New York nursing home oversaw the work of certified nursing assistants in a routine manner, without using the type of independent judgment necessary to be a statutory supervisor. In a 5-4 decision in NLRB v. Health Care & Retirement Corp. of America, the Supreme Court ruled that nurses who direct the work of other employees may be found to be supervisors, and thus not covered by protections guaranteed to them under the NLRA. The Providence decision has implications for a number of other cases before the NLRB. Since the Supreme Court's decision, some hospitals have used it to fight nurses' attempts to organize for purposes of collective bargaining. Other employers have tried to decertify units or have refused to negotiate. For example, Bozeman Deaconess Hospital in Bozeman, Mont., withdrew recognition of the Montana Nurses Association as the legal bargaining agent for its RN employees, stating they were all supervisors. It was only after an administrative law judge ordered the hospital to bargain with the RNs that the new management team at Bozeman complied. ANA, through its state nurses association (SNAs), is the oldest and largest labor union for registered nurses. In the Supreme Court case, ANA filed an amicus brief in support of the NLRB. In addition, ANA and the Alaska Nurses Association presented oral argument to the NLRB in the Providence case. "With hospitals downsizing their RN staffs, some to dangerously low levels, and increasing the use of unlicensed assistive personnel, this decision is vital to protect nurses and their patients," said Betts. "ANA and the state nurses associations have long fought battles in the courts and at the bargaining table to ensure that nurses' and patients' rights are protected. It is ANA's top priority to fight for measures that focus on safety and quality, not cost-cutting, as the driving force in health care." The lack of data relating to the status of the safety and quality of care in hospitals and the impact of new, untested staffing patterns on patient care was underscored in a report issued January 18 by the Institute of Medicine's Committee on the Adequacy of Nurse Staffing. The report called for a national research agenda on hospital quality, as well as the linkages between staffing and quality. Through its "Every Patient Deserves a Nurse" campaign, ANA has alerted consumers about hospitals' increased reliance on unlicensed, assistive personnel to provide a growing range of complex patient care services. In addition, ANA has spearheaded efforts to further demonstrate the link between RN staffing and quality patient outcomes, it has promoted the need for nursing indicators in all "report card" efforts, and it has lobbied Congress to require hospitals to publicly disclose information about qualifications and levels of staffing.
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