Collective Bargaining UnionizationLearnin

Collective Bargaining/ Unionization
Learning Objectives
Identify major legislation that has impacted the ability of nurses
to unionize
Identify factors that influence whether nurses join unions
Describe the relationships between national economic
prosperity, the existence of nursing shortages and surpluses, and
the unionization rates of nurses
Identify the largest unions representing health-care employees
and nurses in particular
Identify the steps necessary to start a union
Debate philosophically the potential conflicts inherent in having
a professional organization also serve as a collective bargaining
agent
Reflect on whether going on strike can be viewed as an ethically
appropriate action for professional nurses
Explore labor laws regarding overtime and working conditions
present in the state in which he or she lives or will seek
employment
Explain how equal employment legislation has affected
employment and hiring practices
Describe current legislation that seeks to eliminate gender -
based differences

Identify how the Civil Rights Act, the Americans with
Disabilities Act, and the Age Discrimination and Employment
Act have attempted to reduce discrimination in the workplace
Identify the purpose of the Occupational Safety and Health Act
(OSHA)
Identify strategies for eliminating sexual harassment in the
workplace
Underlined is done!!
Collective bargaining video
https://youtu.be/5ulJqK3KxEE
Terminology associated with unions and collective bargaining
Agency shop: Also called an open shop. Employees are not
required to join the union.
Arbitration: Terminal step in the grievance procedure where a
third party reviews the grievance, completes fact finding, and
reaches a decision. Always indicates the involvement of a third
party. Arbitration may be voluntary on the part of management
and labor or imposed by the government in a compulsory
arbitration.
Collective bargaining: Relations between employers, acting
through their management representatives, and organized labor

Grievance: Perception on the part of a union member that
management has failed in some way to meet the terms of the
labor agreement
Lockout: Closing a place of business by management in the
course of a labor dispute for the purpose of forcing employees
to accept management terms
National Labor Relations Board (NLRB): Labor board formed to
implement the Wagner Act. Its two major functions are
(a) determine who should be the official bargaining unit when a
new unit is formed and who should be in the unit
(b) adjudicate unfair labor charges.
Union shop: Also called a closed shop. All employees are
required to join the union and pay dues.
What Is Collective Bargaining?
A process in which working people, through their unions,
negotiate contracts with their employers to determine their
terms of employment
Chapter 22, examines the leadership roles and management
functions necessary to create a climate in which unionization
and employment legislation are compatible with organizational
goals.
Like the video stated it including things like pay, benefits,
hours, job leave, job health and safety policies, ways to balance

work and family, and more.
When Managers are not understanding, it causes the staff to
find support in other places. Like a Unions.
Many facilities are implementing shared governance it involve
nurses in decision making. The concept of shared governance
can be a concern to unions representing nurses for purposes of
collective bargaining since collective bargaining is also thought
to be a governance model.
Legislation that led to unionization in health care.
1935: National Labor Act/Wagner Act: gave unions rights for
organizing which resulted in rapid union growth
1947: Taft-Hartley Amendment: Returned some of the power
back to management.
Resulted in more equal balance of power between unions and
management
1962: Kennedy Executive Order: Amended the Wagner Act to
allow public employees to
join unions
1974: Amendments to Wagner Act: Allowed non profit
organizations to join unions
1989: National Labor Relations Board ruling: Allowed nurses to
form their own
separate bargaining unit.

From 1962 through 1989, slow but steady increases occurred in
the numbers of nurses represented by collective bargaining
agents.
The important consequence of the decision by the National
Labor Relations Board ruling that affected nurses, was that they
were free to organize themselves and not to be organized by
existing unions
Nursing Unions
California Nurses Association (CNA)
United American Nurses (UAN)
The Service Employees International Union (SEIU)
National Nurses United (NNU)
In 1946, the American Nurses Association (ANA) House of
Delegates unanimously approved a resolution that formally
initiated the journey of RNs down the road of collective
bargaining.

In 2007, the American Nurses Association informed the UAN
and CNA that they would not be renewing their affiliation
agreement.
Following this, in 2009, the union and professional organization
of registered nurses was officially formalized. This organization
is the National Nurses United (NNU), and it is an outgrowth of
the merger of California Nurses Association, the Massachusetts
Nursing Association, and the United American Nurses (the
former UAN)
Quick Facts
The Service Employees International Union (SEIU) is a large
union in the healthcare industry representing 85,000 nurses in
21 states and an additional 900,000 LPN’s/LVN’s, doctors, lab
techs, nursing home workers and home care workers to name a
few (2016)
Unions increase during high employment time and decreases
during economic recession and layoffs
https://www.seiu.org/about
Today SEIU has 2-million members
Union Representation of Nurses
In 2012, just over 18% of the nation’s registered nurses (RNs)
belonged to unions, down from almost 20% in 2008. Not only
did the proportion of unionized nurses drop in those 4 years, so

did the actual number, despite the total number of nurses
increasing by about 70,000.
The numbers declined further in 2014, with only 17% of RNs
and 10.7% of licensed practical nurses (LPNs)/licensed
vocational nurses (LVNs) being unionized. Still, nurses are
roughly twice as likely to be in a union as are other workers.
Union-Organizing Strategies
Meetings (both group and one-on-one)
Leaflets and brochures
Pressure on the hospital corporation through media and
community contacts
Political pressure of regional legislators and local lawmakers
Corporate campaign strategies
Activism of local employees
Using lawsuits
Bringing pressure from financiers
Technology

Steps to establishing a union
Demonstrate an adequate level of desire for unionization among
the employees
NLRB requires 30% of employees to sign an interest card for an
election of unionization to occur
Most unions require 60-70% of employees to sign interest cards
Have an election where the employees such as RN’s vote on
their desire for unionization
50% of the employees plus one of the petitioned units must vote
for unionization in order to be recognized
No representation: the voters do not want the union
Decertification: 30% of eligible employees in bargaining unit
initiate a petition asking to no longer be in the union
Managers role during union organizing
NRLA provides union protections only to employees, so
supervisors (nurse managers) have no right to form or
participate in a union
Managers who are not employed in a unionized health-care
organization should anticipate that one or more unions may
attempt to organize their nurses within the next few years
Prohibited acts from managers are:
Threatening employees
Interrogating employees
Promising employees rewards for cessation of union activity
Spying on employees

Leadership Roles and Management Functions
DISPLAY 22.1 Leadership Roles and Management Functions
Associated With Collective Bargaining, Unionization, and
Employment Laws
Leadership Roles
Is self-aware regarding personal attitudes and values regarding
collective bargaining and employment laws
Recognizes and accepts reasons why people seek unionization
Creates a work environment that is sensitive to employee needs,
thereby reducing the need for unionization
Maintains an accommodating or cooperative approach when
dealing with unions and employment legislation
Is a role model for fairness
Is nondiscriminatory in all personal and professional actions
Examines the work environment periodically to ensure that it is
supportive for all members regardless of gender, race, age,
disability, or sexual orientation
Confronts and addresses immediately sexual harassment in
adopting a zero tolerance approach to the problem
Embraces the intent of laws barring discrimination and
providing equal opportunity
Management Functions
Understands and appropriately implements union contracts
Administers personnel policies fairly and consistently
Works cooperatively with the personnel department and top-
level administration when dealing with union activity
Promotes worker identification with management
Investigates immediately and fully all complaints regarding
violations of the collective bargaining contract and takes
appropriate action

Creates opportunities for subordinates to have input into
organizational decision making to discourage unionization
Is alert for discriminatory employment practices in the
workplace and intervenes immediately when problems exist
Ensures that the unit or department meets state licensing
regulations
Understands and follows labor and employment laws that relate
to the manager’s sphere of influence and organization
responsibilities
Ensures that the work environment is safe
Works closely with human resource management to assure the
organization is in compliance with employment legislation
mandates
Management perspectives of the unions
Oppose the union with union busting techniques
Have employees campaign against union
Blackmail
Discredit the union
Manager perspectives FOR the unions

First- and middle-level managers usually have little to do with
negotiating the labor contract
The middle-level manager has the greatest impact on the quality
of the relationship that develops between labor and management
Leader-managers must be able to see collective bargaining and
employment legislation from four perspectives:
The organization
The worker
General historical and societal
Personal
Managers who can gain this perspective will better understand
HOW management and employees can work together despite
unionization and employment legislation. Many industrialized
countries have adopted an attitude of acceptance and tolerance
for the difficulties that may occur in managing under these
influences. However, in the United States, many organizations
view these forces with at least some resentment.

What do you think?
Do you think management should not interfere with the right of
a union member to distribute literature? Why or why not?
Management cannot interfere with the right of employees to
unionize, but the distribution of literature in immediate patient
care areas is forbidden.
Effective Labor & Management Relations
Before the 1950s, labor–management relations were turbulent
History books are filled with battles, strikes, mass-picketing
scenes, and brutal treatment by management and employees.
Over the last 30 years, employers and unions have substantially
improved their relationships
Evidence is growing that contemporary management has come
to accept the reality that unions are here to stay
Likewise, unions have come to accept the fact that there are
times when organizations are not healthy enough to survive
aggressive union demands

Integrating Leadership Skills and Management
If the organization is not unionized, the manager must use the
leadership skills of communication, fairness, and shared
decision making to ensure that employees do not feel
unionization is necessary. The integrated leader-manager is a
role model for fairness, knows unit employees well, and
sincerely seeks to meet their needs.
When making decisions that deal with unions and employment
legislation, the effective leader-manager always seeks to do
what is just. Additionally, he or she seeks appropriate
assistance before finalizing decisions that involve sensitive
legal or contractual issues. By using these leadership skills, the
manager becomes fairer in personnel management, develops
increased self-awareness, and develops an understanding of the
average individual’s need to seek unionization and of the
necessity for employment legislation.
The effective manager maintains the required amount of staffing
and ensures a safe working environment. The rights of the
organization and the employee are protected as the manager
uses personnel policies in a nondiscriminatory and consistent
manner.
Civil Rights Act of 1964
Laid the foundation for equal employment in the United States
It prohibits discrimination based on factors unrelated to job
qualifications and it promotes employment based on ability and

merit. The areas of discrimination specifically mentioned are
race, color, religion, sex, and national origin.
In health-care organizations, when discrimination has been
found (such as unequal pay for men and women in nursing
assistant jobs), financial awards in class action suits have been
extraordinarily high.
This act was strengthened by President Lyndon Johnson’s
Executive Order 11246 in 1965 and Executive Order 11375 in
1967. These executive orders sought to correct past injustices.
Because the government believed that some groups had a long
history of being discriminated
Age Discrimination and
Employment Act
Enacted by Congress in 1967, the purpose of the Age
Discrimination in Employment Act (ADEA) was to promote the
employment of older people based on their ability rather than
age.
In early 1978, the ADEA was amended to increase the protected
age to 70 years.
In 1987, Congress voted to remove even this age restriction
except in certain job categories.
Although some people are alarmed by the removal of mandatory
age retirements, trends continue toward earlier retirement.
Some people are alarmed by the removal of mandatory age
retirements, trends continue toward earlier retirement. Reversal
of this trend may have serious consequences for some
organizations. In particular, it could have a significant impact
on organizations that are labor intensive, particularly if those
labor-intensive organizations also have demanding physical

requirements such as those in nursing.
State Health Facilities Licencing Boards
In addition to health and safety requirements, many state boards
have regulations regarding staffing requirements.
It is the ultimate responsibility of top-level management to meet
the requirements for state licensing. However, all managers are
responsible for knowing and meeting the regulations that apply
to their unit or department.
For example, if the manager of an ICU has a state staffing level
that mandates 12 hours of nursing care per patient per day and
requires that the ratio of RNs to other staff be 2:1, then the
supervisor is obligated to staff at that level or greater. If, during
times of short staffing, supervisors are unable to meet this level
of staffing, they must communicate this to the upper level
management so that there can be a joint resolution.
Eliminating Sexual Harassment in Workplace
An “unwelcome sexual advances, requests for sexual favors, and
other verbal or physical conduct of a sexual nature when
submission to or rejection of this conduct explicitly or
implicitly affects an individual’s employment; unreasonably
interferes with an individual’s work performance; or creates an

intimidating, hostile, or offensive work environment”
Indeed, health-care organizations must be alert to sexual
harassment and intervene immediately when it is suspected,
regardless of the perpetrator.
Nurses must take appropriate action when they witness the
harassment of others or when they themselves are the targets of
such offenses. When one person makes another uncomfortable
in the workplace by the use of sexual innuendos or jokes or
invades another’s personal space, this behavior should be
recognized and confronted as sexual harassment. Unfortunately,
underreporting of the problem is common
Why nurses join unions
To increase their input into organizational decision making
To eliminate discrimination and favoritism
Because of a social need to be accepted
Because they are required to do so as part of employment
(Closed shop)
Because they believe it will improve patient outcomes and
quality of care

=
Why nurses do not join unions
Belief that unions promote the welfare state and oppose the
American system of free enterprise
A need to demonstrate individualism
A belief that professional should not unionize
An identification with management’s viewpoint
Fear of employer reprisal
Fear of lost income associated with a strike or walkout
Learning Exercise
St. Chris Nurses Deserve Parental Leave, Safe Staffing.
What are your thoughts about the situations at St. Christopher’s
Hospital?
How do you think this affects the children at this hospital?

Article Link: https://www.inquirer.com/opinion/commentary/st-
christopher-hospital-nurses-hannehman-closure-20200210.html
Article: St. Chris nurses deserve parental leave, safe staffing
Article Date: 2/10/20
Amanda is a neonatal at St Christopher's hospital in
Philadelphia has been a nurse for a total of 8 years but has been
working at St. Chris for 5 years talks about how she had paid
time off to use after she has given birth to her son. Two weeks
after she gave birth to a son, her benefits were taken away from
her. Amanda said she saved 220 hours of paid time off that was
support to last her 12 weeks. Since her paid time off was taken,
her husband ( who is a firefighter) has been working extra hours
weekly to support the family. Amanda had said that ever since
this has happened, she has been worried about using any time
off because she was worried she would not be getting paid.
She has stated that Tower Health and Drexel cannot hide the
fact that they stole all the time she saved.
In 2016, a group of nurses organized PASNAP that would help
support the sick children and nurses at St. Chris, but now the
president of Tower Health and Drexel are trying to get rid of
that completely. When the group of nurses was trying to speak
with the president of Tower and Drexel, they were denied the
opportunity to talk with them, which shows that they are more
interested in money than the sick patients and nurses. The
nurses at St. Chris are working on making their voice heard of
getting this matter fixed.

Discussion Questions
Do you think it is necessary to have Collective
Bargaining/unionization in Nursing?
Do you feel like there are advantages and disadvantages of
Collective Bargaining/unionization in nursing?
When becoming a registered nurse will you join a union or
would you not join a union? Why or Why not?
Practice NCLEX Questions
The new nurse on the med surg unit is learning about collective
bargaining/ unionization from a nurse who has been working on
the unit for 15 years. Which of the following statement by the
new nurse would state she understands the teaching?
Collective Bargaining gives nurses a voice for their patients and
themselves.
Nurses have no control over Collective Bargaining.
Collective Bargaining does not give nurses a voice to advocate
for patients and themselves.
Collective Bargaining allows employers to make new rules for

nursing staff.
Answer
A)
Collective Bargaining gives nurses a voice for their patients and
themselves.
A nurse on a Med-Surg unit is debating whether or not to join a
union. What would be the BEST reason for the nurse to join a
union?
A.) To fit in with other nurses on the unit.
B.) To increase power and confidence in one's self as a nurse.
C.) To help improve one's nursing skills.
D.) To earn a pay raise

Answer
B.)
To increase power and confidence in one's self as a nurse.
What are the factors that influence nurses to unionize? (Select
all that apply)
Feeling powerless
Job stress/demands
Need to communicate complaints without fear of job loss
Low wages, work environment, job dissatisfaction
Nurse turnover, and workload issues
Answer
A, B, C, D, E

All of them are factors that influence nurses to unionize.
What are the two types of nursing collective action?
Workplace advocacy
Obtain collective bargaining agent
Collective bargaining
Need to know why nurses want collective action
Answer
A, C
The two types of nursing collective action are:
Workplace advocacy and collective bargaining
B & D are process of unionization
A leader displays which qualities?

A.) Leads by example
B.) Has a clear vision
C.) Blames others
D.) Continually grows in their learning
Answer
A,B,D
A leader leads by example, have a clear vision and continually
grows in their learning
Reference(s)
Collective Bargaining. (2017). Collective Bargaining:
Traditional (Union) and Nontraditional Approaches. clinical
gate. Retrieved from https://clinicalgate.com/collective-
bargaining-traditional-union-and-nontraditional-approaches/
Gilson, Amanda. (2020). “St. Chris Nurses Deserve Parental
Leave, Safe Staffing.” The Philadelphia Inquirer. Retrieved
from https://www.inquirer.com/opi nion/commentary/st-
christopher-hospital-nurses-hannehman-closure-20200210.html
Huston, B. L. (2017). Leadership Roles and Management

Functions in Nursing. Philadelphia: Wolters Kluwer Health.
SEIU. (2020). Service Employees International Union.
https://www.seiu.org/about

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