Labor Preaches Unity for Big Gains in '09

John Commins, for HealthLeaders Media, March 30, 2009

As good as 2008 was for organized labor, union leaders believe 2009 will be even better.

Monica Russo, president of the 15,000-member SEIU Healthcare Florida, says union membership will grow "a whole lot" this year with the expected passage in Democratically-controlled Congress of the Employee Free Choice Act.

EFCA, aka "card check," is seen by supporters and opponents as one of the most important pieces of pro-labor legislation in decades. "The biggest outcome of the EFCA is healthcare workers being able to more-freely join unions so we can improve the healthcare system," Russo tells HealthLeaders Media.

She says healthcare workers are flocking to unions because they're anxious about the economy and job security, but even more so because they want a greater role in delivering quality healthcare. "Economics is a huge piece of it, but I cannot overemphasize the importance in having a voice in the care they provide. That is a huge. This is a calling," Russo says.

EFCA could add an additional 5 million workers to the 16.1 million workers now unionized, who represent about 12.4% of the workforce.

The card check provision all but eliminates secret ballot elections and instead allows for union recognition when a majority of employees in the bargaining unit sign an authorization card. EFCA also calls for mandatory binding arbitration if a contract isn't finalized within 120 days of forming a union. The bill also raises fines against businesses and employers that are found guilty of union-busting tactics. EFCA is expected to breeze through the heavily Democratic House, but could get bogged down in negotiations with Senate Republicans.

Even without EFCA, organized labor is on the upswing. The Bureau of Labor Statistics reports that union membership grew by 428,000 workers in 2008, even as the overall economy shed about 2.9 million jobs. An additional 1.2 million jobs were lost in the first two months of 2009.

Most impressively, National Labor Relations Board data show that healthcare unions won 75% of certification elections in 2008. That victory rate is even higher for sophisticated and well-funded unions like Service Employees International Union and California Nurses Association/National Nurses Organizing Committee, which won more than 80% of the elections they entered in 2008. SEIU accounted for 44% of all certifying petitions filed in 2008.

Jim Trivisonno, president of Detroit-based IRI Consultants to Management, Inc., says organized labor's gains in 2008 mark the first time in 20 years that union membership gained ground as a percentage of the total workforce.

He says healthcare unions focus on three areas: management treatment, or what the union calls dignity and respect; employee engagement and involvement in the decisions that affect their jobs; and communication, or lack thereof. "People rarely organize over wages and benefits," Trivisonno says. "A nurse can go across the street or across town and get the same deal. It's that people don't understand their wages and benefits and there is more of a communication issue than there is a pay issue."

With membership growing and so much at stake, healthcare unions are for the most part resolving turf wars and collaborating. On March 19, SEIU and CAN/NNOC, announced joint efforts to organize hospital workers across the nation, with CNA/NNOC as the "leading voice" for RNs, and SEIU concentrating on all other hospital workers.

The organizing campaign will target the nation's largest hospital systems. The two unions also pledged to stop "raiding" from one another's existing membership. "This agreement provides a huge spark for the emergence of a more powerful, unified national movement that is needed to more effectively challenge healthcare industry layoffs and attacks on RN economic and professional standards and patient care conditions," CAN/NNOC President Rose Ann DeMoro says.

In February, the 85,000-member CAN/NNOC announced a merger with the United American Nurses and the Massachusetts Nurses Union that when finalized will form the nation's largest RNs union, with 150,000 members.

Trivisonno says the collaborations should be as "equally worrisome" to healthcare organizations as EFCA. "As good as SEIU is, CAN/NNOC is almost better. For them to collaborate with a common cause in a single industry is a great concern, Trivisonno says. "What they've realized is that there is a bigger prize out there in EFCA, and they have to put their differences aside. That is huge."

What's the best way to fight a union effort?

The key, Trivisonno says, is for hospital management to acknowledge that labor is making a concerted and aggressive push into healthcare. Understand the threat to your hospital and get ready to push back by providing employees with alternatives that address their concerns. Smart managers are speaking with staff, making the management's case against unions, listening to employee grievances and addressing those grievances before they're exploited by union organizers. "Oftentimes healthcare organizations are a little reluctant to react because they feel they are going to push forward the union's message.

Nothing could be farther from the truth, Trivisonno says. "Stating your position on labor unions before an organizing attempt occurs, and particularly once you see the first signs of organization is essential so that people understand what your position is."

John Commins is the human resources and community and rural hospitals editor with HealthLeaders Media. He can be reached at
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