Managed care, MSOs and unions. What is really going on here?
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This study examined the use of nursing practice standards in British Columbia in labour arbitrations related to patient care for the years 1987-1994. Retrospective secondary content analysis was the method used to analyse the cases. Although practice standards were referred to in some of the cases, the nature and clarity of these standards were not always evident. In addition, corporate and industrial precedents, rather than health care precedents, formed the basis for much of the arbitration deliberations. The perspectives of nurses, patients, and families were not significantly represented. Many of the arbitration hearings did not get beyond procedural matters, and so did not address substantive patient care situations. Clearly, the visibility and importance of nursing standards need to be raised among nurses and non-nurses alike. Implications and recommendations for nursing practice, administration, education and research, as well as for nursing professional associations and unions are discussed. Research questions for the future are suggested.
Using direct observations and extensive field interviewing over a 4-year period, this paper examines practices and beliefs of shop stewards in their effects on drinking patterns and consequences. It also includes response frequencies from a random sample survey questionnaire (n = 984) that are consistent with the qualitative analysis of steward behavior. Several themes are extracted which position steward handling of alcohol-related cases as intervening between disciplinary measures of supervisors and consequences of work-related drinking of union employees.
In the early 20th century, U.S. monopoly corporations responded to the movement against work accidents by setting up a business-controlled "compensation-safety establishment," which kept down compensation costs but did little to improve working conditions. The "establishment" was able to keep the issue of occupational safety and health out of public debate until the late 1960's through its control of research, education, compensation, and government appointments in the area, and by creating the public impression that the problems of occupational disease were almost nonexistent. Despite the occurrence of sporadic rank-and-file uprisings, unions have been seriously involved in health and safety only since the late 1960's, when they mobilized in an effort to pass the Occupational Safety and Health Act of 1970. The passage of the OSHA law was made possible by the help of progressive professionals, worker dissatisfaction, the new environmental consciousness, and a general climate of social unrest. Although the corporate elite, through the "compensation-safety establishment," has been able to dominate the operation of the federal institutions created by the new law, the question of occupational health and safety is now on the permanent agenda of workers, unions, and the public.