Nursing unions on the verge of revolution


The other day, I was talking with a hospital executive, whom I warned that nurse unionization was developing a level of momentum I hadn't seen before in my 20 years in the business. His response was confident: "Unions aren't a part of our culture." I didn't argue with my friend, who certainly knows his institution better than I do. But somehow, I doubt that such cultures will last long in the face of what's coming in the nursing world.

Let's face it, ladies and gentlemen, given the responsibilities they carry, the hours they work and the amount of training their work requires, nurses aren't particularly well paid. Then, factor in the fact that--let's be honest here--nurse-to-patient ratios are more than a little thin at many hospitals, doubtless due to nursing shortages, but also cost-cutting; and consider that many hospitals give nurses virtually no chance to provide input into how things are done, treating them as robots rather than intelligent, skilled clinicians who can contribute much to a patient's plan of care, and you've got a recipe for revolution.

As we reported a couple of days ago, nursing unions are taking steps they've never taken before. For one thing, two powerful groups--the SEIU and CNA/NNOC--are working together on health reform, despite having had an intense rivalry before. And two other groups doing the protecting--the United American Nurses and Massachusetts Nurses Association--have agreed to merge. Expect more of such cooperation to show up in the future.

Sure, reform is driving these alliances as much as workplace issues, but the two are closely linked. Nurses seem to have hope that if reforms are enacted, things will be fairer all around (perhaps inaccurately, but that's another story). Meanwhile, they're not letting up on the workplace reforms, particularly required overtime and mandated nurse-to-patient ratios.

All told, I don't know whether you should be so confident, executive friend. I imagine nobody took the Teamsters seriously either until Jimmy Hoffa started busting noses and rousing the common man. While the nurses aren't about to clobber anyone physically, I'd watch out for their lobbyists' left hook, nonetheless. - Anne