Archive for the ‘unions’ Category

Finger pointing is easy. Figuring out what to do about labour relations in healthcare is harder.

See this recent story: Patient Dies During Hospital Labor Dispute

California authorities are investigating the death of a patient at an Oakland hospital that police and hospital and union officials said resulted from a medication error made during a labor dispute between nurses and the health system that runs the hospital.

Police and officials at Alta Bates Summit Medical Center told the local media the woman died after she received an incorrect dose of medication administered by a replacement nurse. At the time, regular staff nurses employed by Sutter Health System were locked out following a one-day strike by 23,000 nurses across the state….

A couple of things differentiate labour disputes in healthcare from labour disputes in, say, the auto industry. One is that in healthcare, the “labourers” tend to be licensed professionals, subject to a code of ethics, etc.

The other difference is that, in healthcare, there’s always a shared focal point for ethical argumentation, namely the patient. Both sides in a healthcare labour dispute have to put some of their most central arguments in terms of patient wellbeing. In the auto industry, by comparison, there’s much less common ground. Sure, both GM and the UAW have an interest in making sure the company stays in business. But beyond that, it’s “us vs. them.” Every dollar gained by the workers is a dollar lost by someone else (managers, shareholders, etc.) In healthcare everyone has to bow to patient interests. You can be as cynical as you want about the other side, but you still know that, in public at least, the arguments they give must give priority to patient wellbeing.

One final note: an ethicist quoted in the story above blames inadequate compensation for troubles like this. I’m skeptical about that. I don’t doubt that wages are an issue. But higher wages wouldn’t necessarily mean fewer labour disputes. You would likely still see the regular cycle of negotiation, strike, contract, period of calm, and then renewed negotiations. And so on. And after all, wages aren’t the key issue in the eyes of nurses, are they? What do you think?

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Unionization by health professionals is a touchy subject. And when it’s not, it ought to be.

See this story by James Warren for the New York Times: Finally, Nurses Are Set to Vote on Unionizing

The American Federation of State, County and Municipal Employees is still at it and will finally get a representation election next Wednesday and Thursday among about 270 registered nurses at one of the group’s locations, Our Lady of the Resurrection Medical Center.

It’s a drawn-out, nearly decade-long tussle fit for the times. The union has met resistance and filed 50 complaints about unfair labor practices with the National Labor Relations Board. The company voluntarily settled 18 of the 50 complaints brought against its various properties before any federal hearing….

Interestingly, Warren’s article makes absolutely no mention of the fact that nurses are not just regular employees, that they are health professionals. Nurses are licensed professionals with a code of ethics and an avowed commitment to the public good. That makes them pretty different from municipal employees or auto workers. That’s not to say that they shouldn’t unionize. But it does raise concerns about nurses joining unions that are not exclusively unions of nurses. Unionization has a purpose, and unions have their goals. But the goals of a union can quite easily conflict with the goals to which a health professional swears upon joining the profession.

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