Labor decision undermines patient care
October 10, 2006
The National Labor Relations Board has just handed down a bad decision.
In a case decided Oct. 4, the board created a dangerous new precedent by denying the basic legal protections of the National Labor Relations Act to many professionals, and some blue-collar workers, as well.
The profession most directly affected is nursing, and the decision undermines nurses’ ability to advocate for quality patient care without fear of employer retaliation.
This is bad for nurses – and patients.
The NLRB based its decision on a 2001 Supreme Court case saying that nurses couldn't be union members at a community care facility in Kentucky. There, nurses coordinated patient care provided by other, less-skilled workers — as theydo throughout the health care industry.
In its decision, the NLRB found that “charge nurses” at a Michigan hospital can't be union-represented, either. These nurses, who are usually more experienced, play a key role in assessing patient needs and assembling teams of care-givers on each hospital shift. They don’t have any of the traditional powers or prerogatives of management.
According to the conservative majority on both the board and the court, not only should supervisors (as traditionally defined) be denied union contract protection, but so should millions of non-management employees who have no power to hire, fire, lay off or impose workplace discipline as real bosses do.
In hospitals with a union contract, nurses can stand up for themselves, their co-workers and the sick — all at the same time. Collectively bargained pay and benefit coverage keeps more nurses where they are needed most today — at the bedside. Plus, nurses can challenge unreasonable patient loads and forced overtime, conditions that may lead to painful complications for patients or fatal medical errors.
When nurses don’t have a union, patient advocacy gets more difficult, if not impossible. Few hospital administrators welcome complaints about patient care, even though nurses are taught that it’s part of their professional duty to engage in any necessary whistle-blowing, regardless of the career riskinvolved.
For the many nurses now wrongly reclassified as supervisors, such patient advocacy will no longer be protected by the NLRB because these nurses now fall into management. Meanwhile, organizing will continue to be bogged down in lengthy legal appeals, filed by employers, over bargaining unit eligibility questions.
This is a situation that needs to be corrected — for the benefit of all of us.
Steve Early is a lawyer and union organizer. Suzanne Gordon is the author of “Nursing Against The Odds: How Health Care Cost Cutting, Media Stereotypes, and Medical Hubris Undermine Nurses and Patient Care” (ILR Press, 2005). They can be reached at email@example.com.