Healthcare Unions Post Strong Gains

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."