SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
The long tradition of successful campaigning and industrial action by nurses counters the profession's complacent image. Throughout the century, nurses have fought for, and gained, improved working conditions and pay in line with inflation. The threat of local pay bargaining means that nurses continue to need the protection of their unions.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Most of us have heard of 'best practice' but what does the term really mean and how is it being applied in the health sector? Is there a relationship between best practice and enterprise bargaining? What are the key issues which this industry must address to ensure best practice approaches can be successfully applied?
During work redesign in nursing units, five common pitfalls can emerge: moving too fast, failing to involve major stakeholders, discounting bargaining unit contracts, separating training classes and not defining desired outcomes. Suggestions on how to avoid these problems are given.
In 1974, the National Labor Relations Act was amended to include not-for-profit healthcare institutions. This triggered an important expansion in union organizing activity in the industry. Based on an examination of National Labor Relations Board election data, this article examines the impact of that development on hospital bargaining units, the labor organizations involved, and the geographical locations of the organizing activity. It concludes with some general recommendations to management.
The intent to expand, shrink, reorganize, or redistribute will have vastly different effects on the workforce. This article discusses employment law issues in general as they apply to MCOs that have both unionized and nonunionized employees.
If allowed by the courts to stand, the National Labor Relations Board's bargaining-unit rules for hospitals will encourage unionization of employees. Employer responses can include legal challenges and involving more employees in, and rewarding them for, organizational success.
It appears that the NLRB's lack of familiarity with the health care industry and particularly with the day-to-day functioning of a hospital led it to search for touchstones such as the status of an RN or the certification of technicians that would enable it to make easy but illogical distinctions. As the cases are reviewed in the judicial system, the separate units for RNs, technical employes, and business office clerical employes will be closely scrutinized. Finally, the bargaining units as outlined and the placement of particular groups of employes based on their formal status will necessarily have an impact on the functional integration of hospital activities.
This article examines union decertification elections conducted by the National Labor Relations Board between January 1999 and February 2002 in hospitals and nursing and residential care facilities. Employees petitioned 92% of all decertification elections. Service Employees International Union was involved in nearly 43% of all decertification elections and won 57%. Forty-three percent of all decertification elections involved bargaining units with 50 employees or less. Unions lost 66% of decertification elections in departments, but won 75% in bargaining units consisting of both professional and clerical employees. The union win rate in non-right-to-work states was 52% compared with 37% in right-to-work states.
In 1987 the National Labor Relations Board set out to promulgate a rule to define the appropriate bargaining units for the health care industry, making the first use of its substantive rulemaking powers. This departure from the traditional process of adjudication of unit determination issues occurred because of thirteen years of NLRB frustration resulting from congressional admonition against proliferation of bargaining units and subsequent inconsistent judicial interpretation of that admonition. This article traces the factors that led to the decision to rulemake, discusses the development of the rule itself, and examines the rule's judicial experience to date. It presents empirical findings of hospital union election activity during the period from 1985 through 1987 that confirm the thesis that bargaining unit size is a significant variable in election outcomes. Finally, the authors assess the likely outcome of the impending Supreme Court decision on the rule, along with implications for labor and management.
Proliferation of bargaining units in currently unionized organizations will create new challenges and complexities for nurse executives. Although the literature abounds with strategies to prevent unionization, little had been presented on establishing and maintaining effective relations with bargaining units. The authors focus on currently unionized nursing practice environments and present a model for facilitating positive, cooperative relations between unions, the nursing profession, and the healthcare organization.
The National Labor Relations Board is poised to issue a decision in Saints Memorial Medical Center. The narrow legal issue to be decided is with which of the eight acute care bargaining units nurse practitioners should be placed. The practical consequences of the decision, however, will be profound. The NLRB will determine, among other matters, the ease or difficulty of organizing nurse practitioners into labor organizations. Numerous friend-of-the-court briefs have been filed by various health care labor organizations, employer groups, and professional groups, taking contrary positions. The authors favor placement of the nurse practitioners and other advanced practice nurses within the physicians bargaining unit, because as a practical matter, this will lead to the creation of more nurse practitioner positions. Such a ruling, however, will make it more difficult to organize nurse practitioners.
The U.S. Supreme Court, in ruling that nurses who direct lower-level employees are supervisors, has redefined the relationship of staff nurses with management. Nurses who make assignments for and supervise the work of lower-level employees may not be entitled to National Labor Relations Board protection because of this decision.
The general issues of equity and efficiency are central to the analysis of resource allocation problems in health care. We examine them using axiomatic bargaining theory. We study different solutions that have been proposed and relate them to previous literature on health care allocation. In particular, we focus on the solutions based on axiomatic bargaining with claims, and show that they are appealing as distributive criteria in health policy. Finally, we present the results of a survey that tries to elicit moral intuitions of people about resource allocation problems and their different solutions.