Healthcare Unions Post Strong Gains

The first six months of 2010 were very productive for the nation's healthcare unions, and there is little to indicate that the tide is turning in management's favor, at least for the next year or so.

The 35th Semi Annual Labor Activity in Healthcare Report—conducted by IRI Consultants for the American Society for Healthcare Human Resources Administration—found union win rates in healthcare representation elections have held above 70% for five straight years.

Even more impressive, in the first six months of 2010 the Service Employees International Union won 91% of its representation elections, and the newly formed National Nurses United won 100% of its elections.

Clearly, when a healthcare union targets a hospital for an organizing campaign, it's highly likely that the union will succeed.

The report's findings indicate more aggressive attitudes by healthcare unions that show no sign of abating into 2011.

For example:

• In 2009, there were a total of 220 organizing elections in the healthcare sector, and unions won 153 (70%) of them. In the first six months of 2010 there were 143 elections in the healthcare sector and unions won 105 (73%).
• SEIU accounted for 39% of all organizing petitions filed in the first six months of 2010, up from 27% in 2009. AFSCME and UFCW, both with 11%, followed by IBT, with 8%, and NNU, with 5%.
• 27% of organizing petitions filed in healthcare organizations in the first half of 2010 were withdrawn, dismissed, transferred or nullified—down from 48% in 2009.
• Unions won a staggering 89% of decertification elections in the first six months of 2010 versus 58% in 2009.
• In 2009, there were 11 strikes that idled 2,614 workers, averaging 238 workers per strike. In the first half of 2010, there were seven strikes involving 13,898 workers, averaging 1,985 workers per strike.

IRI President Jim Trivisonno says unions are at a distinct advantage for a number of reasons, including pro-labor sentiment on the National Labor Relations Board, the White House, and (at least for the next month or so) in Congress, and workers' anxiety over the economy.

In addition to expanding their rank and file, Trivisonno says healthcare unions will tap their connections in the federal and state government to push for hot-button mandates like staffing ratios.

"You will begin to see decisions coming out, we are already seeing some, that are going to further provide unions with additional protections and rights, not just to organize, but with employee discharges, the ability to strike, permanent replacements, a host of things," he says.

Trivisonno says that—if Republicans take the House next month—NRLB will be pressed "to jam as many decisions in as they can, this very liberal NLRB, between now and August," when the term of President Obama's controversial recess appointment of labor lawyer Craig Becker expires.

"It will be a much less liberal board after August of next year. I would look for that. They will overturn cases that currently exist. Clearly they will be favorable to labor unions," Trivisonno says.

Organized labor often taps into the anxiety of workers during a recession, which Trivisonno says was shown in the spike in union victories in decertification elections. "Unions won nearly 90% of the de-cert elections in the first six months of last year. That number is off the charts," he says. "It's the economy again. Employees have concerns about downsizing and benefits. They are seeing these things happening, and the union says if you have a union contract this couldn't happen. Without a union contract, the employer is free to make changes."
Trivisonno believes that nurses unions' influence might increase as the economy recovers and the nursing shortage returns as an issue.

"You will see some additional union organizing and pushes for state and federal legislation around staffing ratios," he says. "In nursing, as staffing becomes a bigger issue, nurses will seek out unions in an attempt to fix that problem for them and potentially get staffing ratios in a collective bargaining agreement."

Trivisonno says NNU has accomplished a lot since its formation last year, and he credits the effective leadership and cooperation between NNU and SEIU for much of the success.

"The arrangement is the NNU gets the nurses, the SEIU gets everyone else," he says.

Newly elected SEIU President Mary Kay Henry doesn't have jagged relations that former SEIU President Andy Stern had with rival unions, and that allows her to work with them to patch up differences.

"Her approach is going to be to increase organizing and one of the best ways to do that is to align with other unions rather than competing," Trivisonno says.

There is still some distrust and friction between NNU and some state nurses associations, but Trivisonno says that that is lessening. NNU won a lot of admirers in labor with its aggressive tactics in several nurses' strikes this year, most notably stoppages in Minnesota and Philadelphia. NNU Executive Director Rose Ann DeMoro has made it clear that the union is not afraid to strike.

While labor finds itself very much in the driver's seat, Trivisonno says hospitals aren't entirely powerless. He says the best antiunion measures require proactive communication with staff.

"You have to get ahead of it. Education is key from the board level to employees," he says. "The most important things are employee engagement. Unions don't like shared governance and (nursing) magnet status, and those are heavy engagement components. Communicate openly and honestly."

Lastly, he suggests, hospital leaders should have tools in place that can assess employees' attitudes in real time as critical issues are occurring. "A lot of people do opinion surveys once a year or ever other year. But there are periods in between those assessments where you have to constantly keep in touch with how employees are feeling," Trivisonno says. "There is always a triggering incident. Something happens that causes employees to consider having a labor union. Recognizing what that is and dealing with it quickly becomes a key piece of being prepared."