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Unions' Merger Creates Daunting Adversary for Hospitals

John Commins, for HealthLeaders Media, September 8, 2009

Healthcare reform has elbowed out a lot of other major healthcare industry news of late, and that's understandable. The next few weeks in Washington could determine—or not—how healthcare is delivered in this nation for decades to come. Trillions of dollars and the welfare of hundreds of millions of people are at stake.

In case you missed it, however, healthcare news was made outside of the Beltway recently with the auspicious announcement that three of the nation's largest nurses unions—California Nurses Association/National Nurses organizing Committee, United American Nurses, and Massachusetts Nurses Association—would merge and form the nation's largest registered nurses union.

The newly named National Nurses United will have 150,000 members and a national organization, after each union holds a separate ratifying convention, and then a founding convention in Scottsdale, AZ, on Dec. 7-8.

The merger had long been in the works, but that did nothing to quell the bald-faced glee of labor advocates salivating over the organizing potential for the new, well-funded, well-organized union. "As staff nurses, our time has finally come," Sandra Falwell, RN, with the District of Columbia Nurses Association, and a UAN director, said when the merger was announced. "Just think about all the management heads that turned grey when they heard what we are doing."

James G. Trivisonno, president of Detroit-based IRI Consultants, says the merger means the unions will end years of acrimonious and self-defeating infighting. "It's a big deal because these organizations were literally stealing members from one another, and now they are working together. Clearly there is plenty to split up. There are millions of organizable workers in healthcare," he says.

Most healthcare systems and hospitals already have enough on their plate structuring employee compensation packages that compete with those of nearby rivals. Trivisonno says a large, well-organized union with a national reach could change that dynamic.

"If they get a favorable contract in one part of the country, staffing ratios or favorable benefits or pay practices, they can hold that up as a model contract," Trivisonno says. And unions are very, very good at recruiting. Trivisonno says the new, larger union will parachute in experienced, smart, professional "nurse flight teams" during local organizing drives to make "nurse-to-nurse connections" with potential new members. They will know the issues at a particular hospital, they will listen to the employees' concerns, and they will explain how a union can resolve those concerns.

"To have someone come in from another part of the country to say how great it is, that is hard to dispel and it allows them to bring in experienced folks that have dealt with whatever they are dealing with in that particular organizing drive," Trivisonno says.

So, what can you do?

Trivisonno says hospitals must understand the concerns of their staffs with respect to patient care, staffing, compensation, and other critical areas that unions are sure to exploit in an organizing campaign. If hospital leaders don't listen to their staff, be assured that union leaders will. "Unions are excellent listeners and they can make promises that they don't have to deliver," he says.

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