Healthcare - Unions Implications of Unionization Term Paper

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Healthcare - Unions

IMPLICATIONS of UNIONIZATION in the HEALTHCARE INDUSTRY Background and History of Labor Unions in the United States:

Labor unions first appeared in the United States shortly before the turn of the 20th century, coinciding with the end of the Frontier era of American history and the emerging prevalence of skilled industrial labor in the nation's economy. Still relatively rare in relation to the general workforce, they increased in number and in memberships after the end of the Great Depression in conjunction with the New Deal and a recovering national economy (Nevins & Commager 1992).

Generally, the construction, railroad, mining, and automobile manufacturing industries adopted the unionized labor model the most extensively, but infiltration by organized crime into labor unions -sometimes at the highest levels - cooled the nation's initial enthusiasm with organized labor. The unions subsequently enjoyed something of a resurgence in the 1960s and 70s, peaking in national membership in the early 1980s.

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Public servants like teachers, police, and firefighters in particular had increasingly adopted unionized labor by then (Nevins & Commager 1992). Since that period, union membership as a percentage of the national workforce has gradually declined, partly because of the collapse of the automobile and steel industries in the Midwest, but also because federal and state legislation of workers' issues have provided better vocational environments and benefits than previously available for non-unionized workers.

Term Paper on Healthcare - Unions Implications of Unionization in Assignment

Healthcare in the U.S. has never been a highly-unionized industry, but in the last several decades, healthcare workers have increasingly turned to unionized labor to increase their ability to control working conditions, benefits, and wages by negotiating for them through unionized representation. Just as in other industries and previous eras, more often than not, management has resisted this trend, primarily out of fear of losing control over work-related issues over which management has previously retained exclusive authority (Daft 2005).

On the other hand, experience with unionized labor in healthcare have generally been positive for workers in addition to increasing the quality of patient care. In many cases, beneficial results of this nature are attributable to the specific concerns of non- unionized healthcare workers over which they turned to unionization in the first place.

Nevertheless, unionized labor sometimes introduces unintended problems and must be evaluated in relation to the realistic cost-benefit analysis of non-unionized labor in the healthcare industry. Thus far, nurses have utilized unionized labor more than any other segment of healthcare workers, but their experience likely serves as a model for what other segments of healthcare workers will experience if unionized labor becomes the norm throughout the American healthcare system. The Advantages of Unionized Labor for Healthcare Workers: In general, the most obvious benefits of unionization for healthcare workers consist of greater control over their working conditions. Whereas non-unionized workers often have to choose between accepting management decisions and policies or to look for work elsewhere, unionized workers have input into many aspects of their vocational environment and conditions of employment. Through their union representatives, unionized workers have the ability to vote on policies and procedures affecting their employment in collective bargaining agreements that are binding contracts. This is particularly important in the field of nursing and medical care, because hospital administrators are often too far removed from the actual day-to-day working issues that affect workers. Unionized representation enables healthcare workers to contribute to the development of policies and procedures with which they are more familiar than administrators, especially those who are not themselves medically trained professionals.

In comparison with non-unionized healthcare workers, unionized labor forces enjoy higher average compensation and a negotiated schedule of regular pay increases, in addition to extra pay corresponding to seniority and the increasing cost of living.

Unionized healthcare workers may also have the negotiated right to minimum amounts of overtime where desired; more importantly, they are exempt from mandatory overtime that is not desired. In the area of workers' benefits, unionized workers enjoy paid time off including holidays and paid vacations, which is less commonly true of non-unionized workers. In terms of long-term disability compensation, both unionized and non-union workers receive similar benefits, but many more unionized workers receive short-term disability compensation. Medical insurance rates are comparable between unionized and non-unionized workers, but comparatively few non-unionized workers receive life insurance through their employers.

More importantly, approximately twice as many unionized workers have retirement benefits and of those who do, significantly fewer of them are defined benefit plans that guarantee a stable fixed rate of return regardless of fluctuations in the value of the company's stock value or in the value of other investments that generate those benefits. In light of the recent high-profile collapses of the retirement systems of employees at companies like Enron, this advantage may be one of the most significant benefits of unionization in the healthcare industry.

Likewise, healthcare workers unions generally prohibit the administrative reassigning of workers to fill responsibilities that differ from their specific specialty areas of training and experience, which emerged as a particular problem in certain states like California after several hospitals had adopted the practice of swapping nurses from floor to cope with budget-related staff shortages. In many cases, nurses were reassigned to cardiac floors without any appropriate training in procedures and equipment used in that area (Taylor, et al. 2005). Unlike non-unionized healthcare workers, unionized labor forces have the right to address grievances against management through union representatives and to further resolve continuing disputes through impartial third-party arbitrators. Non-unionized workers have no such opportunity and must either accept adverse decisions by management or retain private legal representation to pursue costly civil causes of action.

Furthermore, union contracts often provide benefits and rights that far exceed the rights of independent workers under state and federal labor laws (Daft 2005).

The Advantages of Unionized Labor for Hospital Management: Since nurses began unionizing in the late 1990s, several independent and unrelated studies have indicated that unionization of healthcare workers can benefit hospitals by significantly improving the quality of patient care (Swan & Harrington 2007) as well as decreasing patient mortality (Seago & Ash 2002). According to the Swan & Harrington study (2007), unionized nursing facilities reported more employee-generated complaints related to noncompliance with medically-accepted procedures and compliance with regulatory legislative requirements, indicating that monitoring and oversight within unionized healthcare vocational environments is more reliable and effective than non- unionized workplaces. That conclusion was partly attributed to the fact that while unionized healthcare facilities generated more complaints, they included significantly fewer serious violations than those reported in non-unionized healthcare facilities.

The increased vigilance of healthcare workers constitutes a very obvious advantage of unionized workforces in healthcare environments, especially in conjunction with a reduction in more serious violations. These types of benefits are the result of union representatives lobbying state legislators (as they did in California, for example), to establish safety measures in the areas of staffing requirements pertaining to the ratio of nurses to patients among other working conditions that directly impact on safety and patient care. Nursing union contracts also prohibit the extensive use of unlicensed personnel including certified nurse assistants (CAN) in capacities ordinarily filled by nurses.

In the non-unionized work environment, hospital administrators often employed non-nurses to save money to a degree that compromised patient care and safety in a manner often complained of by nursing unions seeking to end that practice. According to the study reported in the Journal of Nursing Administration (Seago & Ash 2002), empirical evidence demonstrates that the warnings that wee often ignored when expressed by non-unionized nurses were absolutely justified. The same study revealed that California hospitals with unionized nursing staffs maintained lower mortality rates than their non-unionized counterparts.

The authors concluded that in addition to better monitoring, compliance, and reporting of violations associated with unionized nursing, the lower staff-patient ratios demanded by nursing unions together with reduction in task reassignments by administration policies unrelated to patient care needs all contributed to the lower patient mortality rates identified. In a more general sense, because unionized nurses earn more, on average, and enjoy better benefits and working conditions than their non-unionized counterparts, hospitals with union nurses are able to attract better qualified nurses, which also improves patient care. Finally, employee retention is also higher among unionized workforces, which in the healthcare industry further contributes to the quality of patient care delivered by nursing staff by virtue of the collective experience and functional task synchronicity that develops among highly skilled workers. This alone is considered to reduce human error in the healthcare industry (Taylor, et al. 2005).

The Disadvantages of Unionized Labor for Healthcare Workers: Unionization of labor provides tremendous benefits to workers, but as has often been suggested by critics of labor unions, a union is only as strong as its weakest members. Just as in politics and other complex fields where many individuals rely on smaller groups of representatives to voice their collective will, labor unions are susceptible to mismanagement, oversight, fraud, and infiltration by criminal elements.

Whereas unionized employees who are represented by strong, well organized union leaders enjoy better… [END OF PREVIEW] . . . READ MORE

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