Should there be a nurses' union? Yes - and here's why

This is in support of voting yes to nurses who are trying to locally organize a union in part in response to corporate decisions from Kalispell Regional Healthcare. I am a working medical health-care professional in Montana since 1983 and a past union bargaining representative.

To begin this, I would like to speak to Dr. Craig Lambrecht’s argument (June 23 Daily Inter Lake) that allowing a nurses’ union could threaten the hospital’s independence. I respectfully disagree with that rhetorical statement. Dr. Lambrecht came from one of the largest rural hospital systems in the U.S., Sanford Health (where unions exist). Sanford Health has 44 hospitals, about 1,400 physicians and $1 billion in gifts to that system.

It appears recently and in the past, that Kalispell Regional moved toward what Sanford Health has done in other areas, and that is move to customer-centric interventions, which rarely (if ever) improve the quality of care patients receive. For full review of what this means go to mnnurses.org/Sanford-health and read the article by Mathew Keller, RN, JD titled “Sanford Health Gets it Backwards.” See how patient satisfaction scores are tied to Medicare reimbursement rates and where they link nurse’s pay to patient satisfaction feedback. As Keller argues: In the first place, customer-centric interventions rarely (if ever) improve the quality of care patients receive. Rather, they merely improve patients’ perceptions of care.

This is an important article to read in understanding why nurses in the Flathead Valley want organization and a union.

Sacrificing real patient care and safety for a perception of patient care and safety are two real different things. Keller goes on to state: That’s why Sanford-Bemidjii has it all wrong in their current push to link nurse pay to patient satisfaction scores. A patient’s perception of their care has more to do with a good customer-service model than a good health care model, but Sanford continues to insist that nurse pay be linked to patient satisfaction scores.

Really? If this is being considered locally, would anyone in the Flathead support linking our nurses’ pay to customer satisfaction scores? Fancier TV’s, fancier rooms, art work in the lobbies, rooms and hallways are nice and affect perception, but do not affect real patient outcomes, including adequate staffing and care.

So what is a nurses’ union? It is a labor union also known as a trade union of organized workers formed to protect and advocate for its members’ interests. This mostly is in the form of collective bargaining aimed at improving employee wages, hours, working conditions and benefits.

Now what are the advantages?

1) This includes job security prohibiting termination without cause and to offer representation for disciplinary action to ensure fair treatment.

2) Nurses unions consistently advocate for higher nurse-to-patient ratios, better safety rules and protocols, and the elimination of mandatory overtime.

3) Guaranteed wages and pay raises. Pay increases are given automatically based on the union contract in place and the employer will not be able to lower nurse wages due to budget cuts.

4) Process for addressing grievances. Unions have a specific process for addressing complaints and grievances which protect a nurse from reprisal and actively facilitate resolutions.

5) Other benefits include a union offering educational grants, apparel and travel discounts, insurance and even special mortgage rates.

What are the disadvantages?

1) Union procedures may make it difficult to fire nurses or bad eggs for inappropriate behavior or incompetence.

2) In order to gain better working conditions, unions may go on strike. As a union member, a nurse must join the strike (without pay) or face anger and even violence from the rest of the union members.

3) Seniority over performance. While a nurse will always know when and how much his/her next raise is, it will be based on how long he/she has been employed or other measurable standards that may not represent the whole picture.

4) Union mediation for everything. Unions may create adversarial relationship between employees and their managers and complicate simple disputes with unnecessary processes.

5) Union Dues. In order to operate, unions collect initiation and membership fees which are or can be deducted from your paycheck.

Are unionized nurses better off? Various studies have been done and are inconclusive for a yes or no. Most information about nurse unions have been found to be biased. My personal experience has been that when the subject of organizing comes up there is something driving that movement.

The question needs to be: What are the local nurses striving for? What is driving the request to form a union?

The best thing to do is give them a voice and see what is driving their concerns. Think of things like short staffing, pay cuts, layoffs, perception versus real value. As integral parts of a hospital system nurses deserve a loud voice in the quality of patient care and how he/she works satisfactorily as a nurse.

Not unique locally to health-care workers is the violence that has become prevalent to nurses in the workplace, as has been reported in most major Montana newspapers. There is a reason Montana Nurses Association supports HR 1309 -The Workplace Violence Prevention for Healthcare and Social Service Workers Act. It is clear that Montana nurses need a voice in this debate and a nurse union lends a voice to the need.

Let’s say KRH wanted to sell to Sanford and the nurses here are unionized. According to the National Labor Relations Act, new owners are subject to a test called substantial continuity. New ownership may require the new owner to be forced to honor the union contract. You can look up Substantial Continuity Overview under the National Labor Relations Act. If Sanford were to purchase KRH it would likely cost them more. This may be a moot subject, but it is worth considering when looking at why anyone would object to the nurses in this community wanting to organize.

Finally, in my personal experience as a union representative and bargaining member, the disadvantages of having a union fall under the more rare occurrences. The advantages of unionized nurses? Perhaps you could ask the nurses in Missoula if they want to give up their collective bargaining power.

I have been on both sides of this equation. It is a no brainer for me. I wholeheartedly support the effort for nurses in this community to organize and be able to collectively bargain on their own behalf, and to the benefit of the local community.

Mary Jane Barrett works in Whitefish.