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Union are turning their attention to the health care industry, a move that could have significant implications for long-term care administrators. The authors discuss the evolution of the health care amendments to the National Labor Relations Act and analyze what this means for the long-term-care administrator.
Over the past 3 years, the massive unionizing campaigns forecasted have not materialized. Even so, the parameters of the AHA case are still being established. For example, the NLRB currently is attempting to determine if nurse practitioners still should be placed in a bargaining unit with registered nurses or physicians. Until this and other issues are resolved more clearly, nurse administrators must play a key role in balancing the professional concerns of patient care quality and staff satisfaction with the reality of current economics and healthcare reform. Clearly, unionization cannot be ignored in attempting to achieve that balance.
Public sector, higher education unit determination decisions are often made shortly after enabling legislation becomes law. Once created, units seldom undergo major revisions. Units have a lasting impact on the bargaining relationship, the nature and content of agreements, and the contract administration process. This article reviews the unit determination process being used by administrative agencies in the various states with public sector bargaining statutes. Administrative agencies usually follow precedents set by the NLRB unless specific statutory provisions otherwise control. Some agencies are charged with finding an appropriate unit. Others are required to find the appropriate unit, a more demanding task. Still others merely have to create units that have been defined by the legislature. Criteria used in the unit determination process is also reviewed.
The increasing control of third-party payors over independent physicians through the use and management of practice parameters and utilization management protocols along with significant fee reductions has led to frustration and disappointment for many physicians. In response, some physicians are seeking solutions to balance the inequities. One action that has been suggested is the formation or assimilation into trade unions or organized labor. This report will explore some of the significant legal issues.
Nursing teachers employed in the community college nursing programmes in Ontario were discontent with their workloads. Along with other teachers in the community college setting, they went on strike in the fall of 1984. Attention was focused on the workload formulae. In 1986, a new contract was ratified for all the teachers in the community colleges in Ontario. What issues emerged? Discussion will focus on contract changes with respect to instructional assignments, the effects upon the nursing instructors and students, and finally the implications for the programme.
The implications for hospital pharmacists of recent National Labor Relations Board (NLRB) rulings are discussed. The history of hospital coverage under federal labor laws is reviewed, including the removal of the exemption of nonprofit hospitals from the Taft-Hartley Act in 1974. Also discussed is the ruling of the NLRB in the case of Mercy Hospitals of Sacramento wherein appropriate bargaining units of hospital workers were defined. Finally, the question of exclusive bargaining units for hospital pharmacists, as addressed in NLRB rulings in the Kaiser Foundation Hospitals and San Jose Hospital and Medical Center cases, is reviewed. Apparently, the NLRB did not rule in favor of exclusive hospital pharmacist units primarily because of an insufficient history of such units. Although there are inconsistencies in the NLRB's rulings in Mercy Hospitals and San Jose, it is unlikely that the policy expressed in these cases will be changed in the near future.
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Increasing governmental regulation, the proliferation of alternative health-care options, and a glut of physicians in some areas have substantially affected the way physicians practice medicine today. Health-care consumers are not the only people affected. Where physicians were once their own bosses, many now find themselves as employers of health-care providers. In this new role, physicians are now considering union representation as a vehicle to assert their interests and concerns. This article examines why some doctors favor unionization, why some oppose it, and the legal implications of unionized physicians.
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Explore the source record for details and available documents.