Assignment
What happens when unionized nurses and hospital administrators do not agree? Not long ago, the California Nurses Association threatened a one-day strike against dozens of California hospitals. The union wanted to call attention to its serious concerns about hospitals' preparations for protecting nurses against the potentially deadly H1N1 swine flu. At the time, 200 people in California had died from the flu strain, and hospitals around the state were coping with an influx of patients suffering from swine flu. The union was also in the middle of negotiating a new contract for its members, seeking higher pay and higher staffing levels than specified in the previous contract, which had expired months earlier. Case 11.2 When Nurses and Hospitals Don't Agree ©sergey rusakov/ S Only days before the strike was scheduled to take place, however, it was called off as union negotiators and hospital administrators sat down with a federal mediator and worked to resolve their differences. The two sides were able to reach an agreement, and the union's members ratified the contract, which included extra safety precautions to protect nurses against swine flu. This is only one example of how complex the negotiations can be when nurses' unions and hospital management disagree.
Adding to the challenge, the U.S. health care system is currently facing two conflicting issues: a shortage of nurses and pressure to contain costs while providing proper medical care. The quality of care is, in fact, an important consideration for both sides, especially in light of research published by the National Bureau of Economic Research. Covering 50 nurses' strikes in New York state hospitals over 20 years, the study found higher mortality rates and higher readmission rates among patients hospitalized during the strikes, even when hospitals hired replacement nurses to cover for those on the picket line. Because the stakes are so high, some nurses' unions are banding together to boost their advocacy efforts. In 2009, the California Nurses Association, the Massachusetts Nurses Association, and the United American Nurses merged to create National Nurses United, a union with 150,000 members across the nation. The union's top priority is to lobby for a higher ratio of nurses to patients.
Strikes are not the only way a nurses' union can put the spotlight on their concerns. When members of the Washington State Nursing Association were unhappy with proposed contract changes that could limit rest breaks, the nurses walked an informational picket line outside the Providence Sacred Heart Medical Center. The nurses were worried about fatigue affecting the quality of care, and they wanted to ensure that they had a full ten minutes of break time every four hours to rest. Rather than call a strike, nurses carried explanatory picket signs outside the hospital before and after their regular shifts. This nurses' union also set up an informational picket line when its contract negotiations with Tacoma General Hospital were stalled over pay increases and changes to retirement programs. Sometimes nurses' unions and hospital administrators disagree on other issues. The Pennsylvania Association of Staff Nurses and Allied Professionals decided to strike Temple University Hospital in Pennsylvania after working without a contract for months.
One of the key reasons was to protest a clause preventing union leaders and members from publicly criticizing hospital administration and staff. The hospital's CEO said the "non-disparagement" clause would not prevent nurses from alerting administrators to concerns about patient care. Other issues included pay, retirement programs, and college-tuition benefits for the children of hospital workers. The hospital hired 850 temporary nurses to maintain staffing levels during the strike, which lasted for a month. At the end, union and hospital negotiators bargained for days about the issues that had divided them, reached an agreement acceptable to both sides, and the union promptly ratified the new multiyear contract.
Questions
1. Identify the major issues that have led to disagreements between nurses' unions and hospitals. Which do you think are most important for each side, and why?
2. Why would a nurses' union choose an informational picket instead of a strike when it wants to call attention to important contract issues?
3. Should U.S. lawmakers forbid nurses' unions from striking unless mediation and arbitration fail to settle their disputes with management?
The response should include a reference list. Double-space, using Times New Roman 12 pnt font, one-inch margins, and APA style of writing and citations.