| Though our nation's economy has recently lost | | | | Association (ANA) in 1903. The ANA has a |
| millions of jobs, the health care industry has | | | | federated structure: Nurses do not typically join |
| continued to add them. Not surprisingly, unions are | | | | the organization directly, but instead join their |
| eager to sign up health care workers. In the last | | | | respective state organization, which has |
| 10 years, the rate of union wins in the health care | | | | membership in the ANA. After several years of |
| industry has grown faster than the national | | | | believing the ANA was not providing them |
| average. Unions are uniting to lobby for | | | | adequate financial support to increase collective |
| labor-friendly legislation to promote increased union | | | | bargaining activity in California, the CNA broke ties |
| membership in the health care sector. | | | | with the ANA in 1995 and formed its own union, |
| In addition to traditional organizing, health care | | | | becoming the first state organization to secede |
| union organizers are using more radical corporate | | | | from the ANA. Since its break from the ANA, the |
| campaigns that target hospital donors, | | | | CNA has acquired a reputation as one of the |
| shareholders, community groups, and even | | | | most aggressive labor unions in the country. In |
| patients. The unions push these target groups to | | | | 2004, the CNA began establishing itself in other |
| put pressure on hospital owners to allow unions to | | | | states under the name National Nurses Organizing |
| organize their employees. Many critics have | | | | Committee (NNOC). The CNA voted to seek |
| argued that some of these agreements with | | | | affiliation in the AFL-CIO in 2007. CNA |
| employers have greatly limited workers' power | | | | membership has doubled over the last seven |
| and emphasized the union's cooperation with | | | | years and represents 80,000 members from all |
| management. | | | | 50 states. |
| The following article provides an overview of the | | | | UAN-NNOC |
| major unions involved in the health care industry, | | | | In February, CNA/NNOC, United American Nurses |
| as well as strategies to ensure your organization | | | | (UAN), and the Massachusetts Nurses Association |
| is prepared and remains successful. | | | | (MNA) announced the formation of another new |
| Service Employees International Union | | | | union: the United American Nurses-National Nurses |
| The Service Employees International Union (SEIU) | | | | Organizing Committee (UAN-NNOC). With a |
| began in 1921 primarily as a janitor's union and | | | | combined membership of more than 150,000 |
| branched out to include government, security, and | | | | affiliates in 19 states, it is the largest nursing union |
| health care workers. By 2000, it was the largest, | | | | in the history of the United States. |
| fastest-growing union in the United States, with | | | | National Federation of Nurses |
| much of that growth stemming from a series of | | | | The National Federation of Nurses (NFN) was |
| strategic mergers with smaller unions. In June | | | | officially launched in April at an event in Portland, |
| 2005, the SEIU and six other unions left the | | | | Oregon. The NFN represents more than 70,000 |
| American Federation of Labor and Congress of | | | | nurses in six state nurses' associations, including |
| Industrial Organizations (AFL-CIO) to form the | | | | New York, New Jersey, Ohio, Montana, Oregon, |
| Change to Win coalition. Citing the need for a | | | | and Washington. Based on a federated model |
| renewed effort to organize workers, Change to | | | | (much like the ANA), the NFN recognizes the |
| Win purports to be focused on achieving fair | | | | independence of each member organization. |
| wages, health care benefits, and secure | | | | Membership is open to state nurses' associations |
| retirement for all employees. The coalition also | | | | and other labor organizations that represent RNs. |
| encourages workers to unionize on an | | | | The NFN is tied to the ANA, which outlines |
| industry-wide basis, consolidating smaller unions | | | | standards for nursing practices, but has historically |
| within larger unions. | | | | opposed nurse unionism and includes managers in |
| SEIU Healthcare | | | | its leadership. Since nurse union leaders expect |
| In 2007, the SEIU announced plans to launch a | | | | many of the 15 unions with nurse memberships |
| new health care union to serve approximately one | | | | to flood hospitals with authorization cards if the |
| million members, such as nurses and service | | | | Employee Free Choice Act (EFCA) passes, they |
| workers at hospitals and nursing homes. SEIU | | | | want to establish their own national union to |
| Healthcare combined financial and personnel | | | | ensure nurses are organized by nurses. |
| resources from the 38 local SEIU Healthcare | | | | SEIU and CNA: From Violent Disputes to |
| unions. Of the SEIU's 1.9 million members, 900,000 | | | | Cooperative Agreements |
| work in health care. In September 2008, the SEIU | | | | The SEIU signed a neutrality agreement in March |
| reported it would begin several high-profile | | | | 2008 with an Ohio Catholic hospital to organize |
| projects to bring business leaders, health care | | | | 8,000 workers. The day before voting was |
| providers, community organizations, and elected | | | | scheduled to begin, members of the CNA |
| officials together to work on the nation's health | | | | distributed leaflets to discourage workers from |
| care system. SEIU leaders were part of a May | | | | joining the SEIU. After the workers received the |
| meeting held by President Obama to discuss a | | | | leaflets attacking SEIU and its arrangement with |
| health care overhaul. More recently, SEIU | | | | management for an election, SEIU called off the |
| members attended town hall meetings to speak | | | | vote. Then at an April 2008 conference in Detroit, |
| out in support of the proposed health care | | | | SEIU staff and members protested at a banquet |
| reform. In August, the SEIU was part of a | | | | of CNA members, resulting in violence. The two |
| group-largely funded by the pharmaceutical | | | | unions have also launched raids and counter-raids |
| industry's lobby-that launched $12 million in | | | | across the country, and both have sent mailings |
| television advertisements to support Obama's | | | | to thousands of nurses (including nurses in other |
| health care proposal. This group, the Americans | | | | unions, as well as nurses whose unions are |
| for Stable Quality Care, could spend tens of | | | | currently trying to organize) attacking each other. |
| millions more this fall. | | | | After more than a year of fighting, the SEIU and |
| SEIU and NUHW | | | | CNA signed a cooperation agreement in March. |
| The SEIU attempted to consolidate three local | | | | They will work together to bring union |
| units representing home health care workers into | | | | representation to all non-union RNs and other |
| one unit last December, taking authority away | | | | health care employees, as well as improve patient |
| from the local units. The SEIU accused the local | | | | care standards. The unions have also agreed to |
| unit officials of financial misconduct, and in | | | | refrain from raiding each other's members and will |
| response, the leaders of the local units criticized | | | | work together toward common goals, including |
| the SEIU's practice of centralizing power at its | | | | lobbying for congressional passage of the EFCA. |
| Washington headquarters and making corrupt | | | | SEIU and CNA will coordinate campaigns at the |
| deals with employers. In January, a | | | | largest health care systems and launch an |
| 150,000-member SEIU local unit in Oakland was | | | | intensive national organizing campaign. Catholic |
| put under trusteeship by the SEIU, and the local | | | | hospital chains will likely be among the first |
| officials of that unit were dismissed. The ousted | | | | targets. |
| officials formed a new union, the National Union of | | | | In June, the U.S. Conference of Catholic Bishops |
| Healthcare Workers (NUHW). | | | | and the nation's largest unions (including the SEIU |
| The NUHW announced the first workers had cast | | | | and the AFL-CIO) signed an agreement describing |
| votes in favor of representation by the new | | | | how union organizing will be conducted at Catholic |
| union in March. A majority of 350 | | | | health care facilities. (The document is similar to |
| union-represented workers at four nursing homes | | | | the one Catholic Healthcare Partners and |
| in northern California managed by North American | | | | Community Mercy Health Partners created last |
| Health Care wanted to end their labor relationship | | | | year with the SEIU before the CNA protest |
| with SEIU and join the NUHW. The day after this | | | | canceled the vote.) This agreement is significant |
| announcement, the SEIU filed unfair labor practice | | | | because Catholic health care providers represent |
| charges against the four nursing homes, charging | | | | the largest employers and providers of services in |
| that administrators of the facilities had illegally | | | | many communities. The agreement provides |
| withdrawn union recognition and colluded with a | | | | seven guidelines for management at Catholic |
| competing labor union. In that same month, a | | | | health care facilities and unions, making it easier |
| National Labor Relations Board regional director | | | | organize health care workers at these facilities. |
| ruled against the NUHW, saying that the contract | | | | What This Means for Your Organization |
| between the SEIU and the hospital chain | | | | Many experts agree that expanded unionization, |
| prevented the effort by a new labor union to | | | | along with the passage of the EFCA, will |
| represent 14,000 Catholic Healthcare West | | | | negatively impact our health care system. Both |
| workers. Despite the ruling, the founding | | | | health care providers and industry analysts fear |
| convention to formally launch the NUHW took | | | | that unionization could mean higher costs and |
| place in April 2009. According to the NUHW, | | | | more restrictive work rules, adding to the soaring |
| approximately 91,000 California health care | | | | cost of delivering health care. Hospital and health |
| workers have signed petitions filed at the labor | | | | care facilities need to be aware of these issues |
| board, stating they would like be members of the | | | | and how they can educate their supervisors and |
| new union. | | | | workers about the threat of unionization. |
| The NUHW also claims that, in response to these | | | | Communication with your employees is a critical |
| decertification drives, the SEIU has resorted to | | | | first step. Many issues are involved in the possible |
| harassment and intimidation and tactics similar to | | | | unionization of a health care facility (economic |
| union prevention. The SEIU argues that the new | | | | factors, working conditions, quality of patient care, |
| group has unfairly restrained and coerced | | | | employee satisfaction, etc.). To prepare for |
| workers, as well as complained to the National | | | | possible union activity, identify issues that are |
| Labor Relations Board. A decisive battle between | | | | relevant to your facility and address those needs |
| the two unions will come in 2010, when the | | | | publicly. Train leadership and include information |
| SEIU-UHW contract with Kaiser Permanente | | | | about your union-free policy in the employee hiring |
| expires and the opportunity for decertification | | | | and orientation procedures. Assess your wage |
| elections reopens. Kaiser, the largest health care | | | | and benefit structure, and be sure to promote |
| provider in California, has 50,000 workers that | | | | what you offer. |
| could potentially become members of NUHW. | | | | You can use brochures, meetings, video, |
| California Nurses Association/National Nurses | | | | webinars, e-mail, Web sites, or eLearning tools to |
| Organizing Committee | | | | reach your employees. The most effective |
| The California Nurses Association (CNA) began as | | | | efforts include an employee feedback system |
| a state chapter of the American Nurses | | | | that encourages two-way communication. |