pro

The notion of healthcare professionals unionizing, particularly registered nurses, has been a source of debate over the past few years. The issue became more pronounced as the registered nurses of Health Midwest began organizing with the American Federation of Teachers (AFT) last year. Not the first group of RNs to organize in the Kansas City area, various unions represent several private sector bargaining units in the metropolitan area. The Missouri Nurses Association (MONA) represents the nurses for purposes of collective bargaining at Humana Kansas City, Inc. and Encompass Medical Group (formerly Prime Health Medical Group).

Healthcare providers find unionization more attractive as they face the effects of managed care and cutbacks in financing and reimbursement. When healthcare corporations persistently emphasize the bottom line, individual employees lack the autonomy and control to influence the repercussions - short staffing, unskilled bedside personnel, and mandatory overtime. Economic security is a factor in unionizing. Nurses, however, typically organize to promote professionalism and safe, quality patient care. It takes a collective voice - a union - to make a change.

Those arguing unionization is not professional might think about what the term "professional" depicts - autonomy, higher education and fair compensation. In June 1999, the American Nurses Association (ANA) created an autonomous labor body, the United American Nurses (UAN), which sets labor policy for the organization and implements a progressive labor agenda. The American Medical Association (AMA) also created a union in 1999 to help organize employed physicians and residents. Unionized healthcare professionals have the dedication, compassion and professionalism associated with their credentials. However, they have the added bonus of power - power that leads to better outcomes for both provider and patient.

Karen Backus, BSN, RN, is Director of Practice and Economic and General Welfare for the Missouri Nurses Association. Phone: 573.636.4623 x 22 or e-mail: karen@monursesassociation.org

 

con

The Midwest has seen a recent increase in union organizing efforts among healthcare professionals, particularly registered nurses. Yet there is little that unions can point to as tangible achievements for healthcare professionals. Midwestern healthcare professionals don't see unions offering solutions to the problems and issues facing healthcare facilities.

There are several reasons to reject unionization:
• Patients. Healthcare professionals and employers are focused on quality care for patients. Unions, with little experience with patient care issues, can't solve two primary issues affecting quality patient care: a dramatic nurse shortage and diminishing funds from government and private insurers.
• Market Forces. Market forces already provide what unions offer healthcare professionals. To hire and retain the best employees, employers must do all they reasonably can in terms of pay, benefits and supportive employee policies.
• Economics. Most healthcare professionals don't want to pay initiation fees and dues to a union that can't improve wages, working conditions and benefits.
• Leadership. During unionization campaigns, organizers often are insufficiently prepared to address significant issues for the professionals they are trying to influence.
• Fear. Many professionals don't want increased risk of economic actions, strikes and confrontations.
• Reduced Productivity. Healthcare professionals often find that influencing a union requires hours of meetings with union advocates and management, dramatically reducing productivity.

The National Labor Relations Act guarantees employees both the right to organize and the right to refrain from organizing. Midwestern healthcare professionals have chosen to exercise their right to refrain.

David L. Wing, , a partner with the law firm of Spencer Fane Britt & Browne, LLP, works with healthcare
organizations on labor and employment issues. Phone: 816.474.8100 or e-mail: dwing@spencerfane.com