At Mission Hospital in Asheville, North Carolina, nurses won their first contract in July 2021, with language ensuring enough staffing in each unit based on patient volume, paying extra for the overtime and overtime nurses, as well as full personal protective equipment that meets federal, state and local guidelines. The contract also stipulates that nurses cannot be transferred to units where they have not been trained.
Claire Siegel, a registered nurse in the adult medical surgery unit at Mission Hospital and an organizer of National Nurses United, said the union has since worked to maintain conditions. clause of the contract.
“Our contract is as strong as the nurses willing to keep it,” says Siegel.
Mission, part of HCA Healthcare, takes a different view. Nancy Lindell, a spokeswoman for Mission Health, said: “We do not believe that having a labor union benefits the hospital and our colleagues, nor does it help us promote provide quality care to its patients.
Tens of thousands of healthcare workers went on strike in 2022, and a number of contracts were signed on the negotiating table that resulted in significant wins for unions. Emboldened by those wins, nurses are using a variety of methods to ensure promises on paper are put into practice on topics including staffing, safety issues and benefits. of workers.
After their previous three-year contract expired in March, nurses at Three Rivers Health Hospital approved a contract in June that included improvements to the paid time off policy. and an average salary increase of 12% in the first year and 3% in the following two years. Brandy Shoup, an emergency room nurse and president of the local union, part of the Michigan Nurses Association, said that although the hospital in Three Rivers, Michigan, has generally followed through with the agreement, it still there are some disagreements.
To resolve issues, nurses often talk to their department manager, and problems can often be resolved fairly quickly, she said. If not, Shoup said she helps staff fill out complaint forms to send to managers and then to hospital management for the necessary feedback.
She said union members had filed complaints to make sure nurses were being paid the right wages and were given at least four days’ notice before being called to work overtime.
Beacon Health System, which owns Three Rivers Medical Hospital, did not respond to requests for comment.
Sometimes enforcing contract terms requires more effort.
President Sal Rosselli said shortly after Northern California mental health clinicians approved an October contract with Kaiser Permanente calling for the health system to change its behavioral health program to recruit and better retain employees, they have encountered resistance from the health system. of the National Federation of Healthcare Workers.
In addition to being slow to implement an increase in the time it takes therapists to complete patient care tasks, Rosselli said, Kaiser Permanente disagrees with union members over contract language around the length of meetings, Rosselli said. appointment to receive children.
Coalition members have invited Sacramento Mayor Darrell Steinberg, who has acted as a mediator in contract negotiations, to clarify the agreed language, he said. The mayor had several follow-up discussions with Kaiser Permanente and union leadership.
Although the health system has made progress in allowing therapists more time for indirect patient care, the question is whether Kaiser Permanente should continue to offer admissions sessions. mental health longer while the committees determining best practices remain unresolved, Rosselli said.
At Fountain Valley Regional Hospital and Medical Center in California, a unit of more than 900 clinicians discovered that the health system was not following a contract clause that created a process to nurses take on more responsibilities and receive higher remuneration, he said.
“We have filed a complaint but more importantly we have met with management, including the leadership of this registered nursing unit, who have become radicalized during this negotiation and threatened to organize major actions” such as strikes if the hospital did not honor the contract, Rosselli said.
He said the hospital then started implementing the process agreed in the contract.
Tenet Healthcare, which owns Fountain Valley Regional Hospital and Medical Center, did not respond to requests for comment.
Regular communication is becoming more essential to ensure contract terms are followed.
Catherine Kennedy, a registered nurse in the neonatal intensive care unit at Roseville Medical Center in Roseville, said that with certain unions, Kaiser Permanente has a TB Management Partnership agreement. The initiative provides for monthly meetings where union members share information about nurses’ recommendations and needs with system leadership. , California, and vice president of National Nurses United.
Kennedy said nurses can also fill out an Objection Transfer form to notify management if there aren’t enough staff members to safely care for patients at the start of a shift. Kaiser Permanente has one week to respond to the form, after which union members ask unit leadership questions about how they plan to provide needed staffing and resources., she speaks.
“It’s really important for nurses to really understand the content of the contract and then when there’s any form of violation, they know what to do,” she said. “They need to speak up and advocate to make sure they have the right number of ancillary support staff for the nurses to do their jobs.”
Kaiser Permanente’s contract with its Northern California facilities, approved in December, guarantees a 22.5% increase in more than 21,000 workers over four years as well as increased tuition reimbursement, protective equipment stock personal household for three months and hire an additional 2,000 registered nurses and nurse trainees.
Steve Shields, senior vice president of national industrial relations and labor management partnerships at Kaiser Permanente, said the health system works to maintain contracts, collaborate with members of the public groups in areas of mutual interest such as patient and healthcare staff experience.
“We take those obligations very seriously, and with such a rich, long relationship with workers, it is our absolute obligation to stand behind those agreements and make sure we execute those terms as intended.”
Having a contract that focuses on creating a better workplace—in addition to wages, hours, and other terms and conditions of employment—is a great way to show potential employees that they will have a say in decision making and no labor relations. to be controversial, Shields said.
“We have to find new and innovative ways to get people into the industry, and some of these deals help make that happen,” he said.
However, not all health systems consider partnering with labor groups necessary to improve staff experience or patient care.
Lindell said that even without a union presence, Mission Health would still provide the benefits it provides to off-contract employees, such as student loan repayments, tuition reimbursement, money login bonuses and scholarships..
By 2022, she said, the system had provided more than $22 million in salary increases to all clinicians, exceeding the amount negotiated contractually with the union.
Often, experts recommend that clinicians and system leaders try to find common ground, regardless of involvement.
John August, director of healthcare industrial relations at Cornell’s School of Industrial and Labor Relations, says it’s best for labor and management to discuss the basics behind the condition together. burnout and vacancies, while addressing areas that speak for each other’s interests. He said: “Having in-depth discussions instead of filing complaints and going on strike can be a more effective way to bring about change in the long run.
Likewise, before moving on to legal processes such as filing a law violation, filing a complaint with the Department of Labor or reporting unfair labor practices to the National Labor Relations Board To force systems into compliance with contracts, union members should first try to work with management to resolve the issue. Rosselli said.
Legal tactics not only take more time and resources, he said, but also go against the union culture that organizes members to direct action.
Shoup said union members should be prepared to act collectively as the first line of defense to keep contracts, while also updating labor relationships at other health systems so they know. goals of his hospital.
“The more people you have in the coalition, the more people invested in it, the more people willing to fight for what they want, the better results you will get,” she said.
The pandemic has taught clinicians that employers’ lack of concern for patients and workers, Rosselli said, means an impetus for union members to campaign for their interests.
“Now that healthcare workers feel less threatened by COVID-19, they are fighting harder than ever to get employers to improve conditions for them and their patients,” he said. employees, and that includes implementing the improvements they have won in contract negotiations.”
