Training To Be An CNA Nurse

Despite such advantages, most nursing managers and academics—and even many working nurses question the appropriateness of collective bargaining in health care settings. The harshest of these critics play on nurses’ class and status anxieties and socialization in selflessness, according to Darlene and Paul Clark, Penn State University professors who’ve studied this phenomenon. Darlene teaches in the nursing school, where she tries to introduce her students to the subject of organized labor. RNs- in-training often equate unionism with being blue-collar and not really professional. “They go to nursing school to become professionals,” Clark points out. “They are taught in most schools and in most organizations that they don’t want to be seen as blue-collar, so if unions are blue-collar, then why would we want to do that?” In addition there is the concern that if you’re in a union you might have to strike, an action that many nurses view as tantamount to abandoning their patients.

According to Clark, this feeds another worry, that labor-management conflict might erode public support for nursing. As the polls show, nurses are highly trusted, far more than lawyers, businessmen, and people in most other occupations. Many in nursing believe, however, that their profession’s favorable rating is so rooted in an image of selflessness that any behavior contrary to that image would cost nurses dearly in terms of public esteem. Opponents of unionization play on such fears. They invariably depict nursing unions as strike-happy, as if some RNs were eager to spend their days shivering in the cold as they walk in front of hospitals with picket signs and no paychecks. In fact, such scenes are relatively rare and RN bargaining units have to be pushed to the brink before they walk out—in the United States at least. When they do go on strike, it’s often because working conditions or management demands—related to overtime, scheduling, or staffing—are jeopardizing patient care. As Clark notes, when the issues involved are framed and explained in terms of their impact on patients, nurses’ strikes often receive an impressive degree of public support.

The Increasing RN Work Force

This means that RNs can fulfill their ethic- 295 call obligation to be forceful patient advocates, while also having a strong collective voice that addresses workplace problems, professional issues, and public policies related to health care. In Australia, for example, the Victoria branch of the Australian Nursing Federation fought for and won the first staffing legislation implemented anywhere in the world. In Switzerland, the Swiss Nurses Association has negotiated pay equity in some Swiss cantons, thus giving nurses equal pay with that of other civil servants. In the canton of Zurich, nurses were awarded the equivalent of $200 million in back pay.14 another powerful nurses’ union is the Danish Nurses Association, which represents everyone from staff nurses to the vice president of nursing in a hospital. As a result, RNs in Denmark are some of the most powerful and best treated hospital workers in the world.

Over the past decade, nurses in the United States have become increasingly restive about the deteriorating conditions of patient care work. One expression of this trend has been a continuing series of shake-ups and splits within nursing organizations themselves. In 1967 internal tensions between nurse executives and fellow members of the American Nurses Association (ANA) whom they supervised led to formation of a separate group for managers—the American Association of Nurse Executives, which is now a subsidiary of the American Hospital Association. In the early 1990s, nurses in the California Nurses Association split off from the ANA and formed their own independent union, because they felt the national organization was still not representing the interests of working nurses as opposed to those of academics and advanced practice RNs. As managed care continued to erode nurses’ working conditions, the Massachusetts and Maine State Nurses Associations also voted to leave the ANA. Since then, the collective bargaining wing of the ANA has sought to bolster its union credentials and avert further defections by affiliating with the AFL-CIO as the United American Nurses.

In the United States, health care unionization remains controversial and limited (to 17 percent of the RN work force), in part because employer resistance is far greater here than elsewhere.15 In addition, nursing education rarely addresses the fact that legal protections in unionized workplaces allow nurses to speak up about problematic practices or unsafe working conditions and give them greater legal recourse against employer retaliation. Nurses, like most workers, believe that everyone should have due process rights on the job and the opportunity for a fair hearing when their job performance is questioned or their continued employment is at stake. What nurses usually don’t know is that, without union representation and a negotiated procedure for appealing management actions, they have no guarantee that their side of the story will ever be heard, and lite

Hope that an unfair personnel decision might be overturned. They’re also rarely aware that unionized employers, as part of their legal obligation to engage in collective bargaining, must share large amounts of useful information related to their pay and benefit costs, staffing levels, training budgets, tuition reimbursement plans, and other personnel programs. Before altering existing personnel practices, hospitals must give affected RNs advance notice and the chance to bargain about proposed changes— an opportunity for input routinely denied in nonunion workplaces, where any such management consultation with employees is completely discretionary.