Category Archives: Health Care Workers

Licensed Practical Nurses: Protected “Employees” or Statutory “Supervisors” Under the NLRA? The Impact of the 11th Circuit’s Lakeland Health Care Decision

Source: David P. Twomey, Labor Law Journal, Vol. 64 no. 2, Summer 2013
(subscription required)

With headlines like “Licensed Practical Nurses Ruled Ineligible for Union Representation”, and “Eleventh Circuit Rules Licensed Practical Nurses Are Supervisors, Providing Strong Ammunition to Long-Term Healthcare Facilities,” Human Resources publications and law firm blogs welcomed the Eleventh Circuit Court of Appeals decision vacating the National Labor Relations Board’s (NLRB) determination in its Lakeland Health Care Associates, LLC v. NLRB decision that the licensed practical nurses (LPNs) at Lakeland’s Wedgewood Health Care Center were employees protected under the National Labor Relations Act (NLRA).

Enumeration and Characterization of the Public Health Nurse Workforce: Findings of the 2012 Public Health Nurse Workforce Surveys

Source: Matthew L. Boulton, Angela J. Beck, University of Michigan Center of Excellence in Public Health Workforce Studies, June 2013

From the press release:
Public health nurses play an essential role in improving the population’s health and delivering essential health services to communities, but the public health nursing workforce is facing significant challenges. More than two in five state health departments report having “a great deal of difficulty” hiring nurses and nearly 40 percent of state and local health departments report having insufficient resources to fill vacant nurse positions.

Those are among the findings of a report released today by the Robert Wood Johnson Foundation (RWJF), which provides the first comprehensive assessment of the size, composition, educational background, experience, retirement intention, job function, and job satisfaction of nurses who work for state and local health departments.

Enumeration and Characterization of the Public Health Nurse Workforce: Findings of the 2012 Public Health Nurse Workforce Surveys, produced by the University of Michigan Center of Excellence in Public Health Workforce Studies and funded by RWJF, collected data from state and local public health departments and surveyed public health nurses themselves. It finds that public health nurses report concerns about job stability, compensation, and career growth in light of budget-tightening at many state and local health departments. Yet these nurses also report very high levels of job satisfaction and that they feel they are making a difference in their communities—factors that could bolster recruitment efforts.

The Inequality of Declining Wages During the Recovery

Source: National Employment Law Project, Fact Sheet, July 2013

A previous NELP analysis found that while job losses during the recession were heavily concentrated in mid-wage occupations, the early recovery was led by employment growth in lower-paying occupations. This fact sheet turns from analyzing employment to analyzing occupational wage trends during the recovery to date. For the period 2009 to 2012 we find the following:
– Averaged across all occupations, real median hourly wages declined by 2.8 percent.
– Lower-wage and mid-wage occupations saw significantly bigger declines in their real median wages than did higher wage occupations.
– Real median wages fell by 5.0 percent or more in five of the top ten lower-wage occupations: restaurant cooks, food preparation workers, home health aides, personal care aides, and maids and housekeepers

Don’t “Lean” on Me, Hospital Workers Say

Source: Alexandra Bradbury, Labor Notes, #412, July 2013
(subscription required)

Today’s hospitals are as committed to running lean as any factory. Highly paid consultants scrutinize hospital processes, measuring “metrics” such as staff-hours-per-patient-per-day. … In health care, 50 or 60 percent of operating expense is labor. So there is constant pressure to reduce staff. …
Related:
Employee Involvement: Watching Out for the Tricks and Traps
Source: Charley Richardson, United Steelworkers of America, Collective Bargaining Services Department, (n.d.)

…While the USWA was working on its plan for giving the members an enhanced voice in their own future, many in management were busy developing their alternative – “new management” programs and techniques which often contain the rhetoric of involvement and voice, without the substance of collective worker power. These management-designed programs, under names like Continuous Improvement, Employee Involvement, Kaizen, Corrective Action Teams, Six Sigma, etc., seek to make changes in the workplace and to engage the workforce in the discussion of change, but only while maintaining strict management control over the process. They are designed to bypass the mechanisms of union power. They specifically interfere with the union “acting like a union” as it discusses change with management. We have too often failed to treat these discussions as bargaining, and have arrived at the table unprepared.

This document is designed as a warning to us all – a guide to questioning the techniques and watching out for the “Tricks and Traps” of involvement. It takes a critical look at the techniques used in many of the involvement programs, particularly (but not exclusively) those where we have failed to aggressively maintain control of the program. As such, it is the first step, and only the first step, in developing a true union strategy for bargaining over change. …

Prospective study of violence against ED workers

Source: Terry Kowalenko, Donna Gates, Gordon Lee Gillespie, Paul Succop, Tammy K. Mentzel, American Journal of Emergency Medicine, Volume 31, Issue 1, January 2013

From the abstract:
Background: Health care support occupations have an assault-injury rate nearly 10 times the general sector. Emergency departments (EDs) are at greatest risk of such events.
Objective: The objective was to describe the incidence of violence in ED health care workers (HCWs) over 9 months. Specific aims were to (1) identify demographic, occupational, and perpetrator factors related to violent events (VEs) and (2) identify predictors of acute stress in victims and predictors of loss of productivity.
Methods: A longitudinal, repeated-methods design was used to collect monthly survey data from ED HCWs at 6 hospitals. Surveys assessed number and type of VEs, and feelings of safety and confidence. Victims also completed specific VE surveys. Descriptive statistics and a repeated-measure linear regression model were used.
Results: Two hundred thirteen ED HCWs completed 1795 monthly surveys and 827 VEs were reported. Average VE rate per person per 9 months was 4.15. Six hundred one events were physical threats (PTs) (3.01 per person). Two hundred twenty six events were assaults (1.13 per person). Five hundred one VE surveys were completed, describing 341 PTs and 160 assaults. Men perpetrated 63% of PTs and 52% of assaults. Significant differences in VEs were reported between registered nurses (RNs) and medical doctors (MDs) and patient care assistants. The RNs felt less safe than the MDs. The MDs felt more confident than the RNs in dealing with violent patients. The RNs were more likely to experience acute stress than the MDs (P < .001). Acute stress reduced productivity. Conclusion: Emergency department HCWs are frequent victims of violence perpetrated by visitors and patients. This results in injuries, acute stress, and lost productivity. Acute stress has negative consequences on workers' ability to perform their duties. Related: Detroit area hospitals fight to stem emergency room violence
Source: Karen Bouffard, Detroit News, July 1, 2013

The Surrender of Oakland: The 2012 National Agreement between the Coalition of Kaiser Permanente Unions and Kaiser Permanente

Source: John Borsos, WorkingUSA, Volume 16, Issue 2, June 2013
(subscription required)

From the abstract:
A new, controversial agreement negotiated by the Coalition of Kaiser Permanente Unions (CKPU), led by the Service Employees International Union (SEIU) with Kaiser Permanente, the nation’s largest health maintenance organization, may portend a dangerous shift in labor relations in the U.S. In this case, it is the unconditional surrender of a union to a corporation’s agenda. The Surrender of Oakland—embodied in the 2012 Kaiser–CKPU national agreement—represents the complete capitulation of labor to management: in production, in marketing and capitalization, and even by allowing the employer to control Kaiser workers’ lives outside the workplace through an invasive wellness program. Abdicating their role as patient advocates, the new agreement requires SEIU and other coalition unions to promote wellness programs that may not be in anyone’s best interest except for employers trying to shift healthcare costs onto employees.

Verbal Abuse From Nurse Colleagues and Work Environment of Early Career Registered Nurses

Source: Wendy Budin, Carol Brewer, Christine T. Kovner, Ying-Yu Chao, Journal of Nursing Scholarship, Early View, 2013

Verbal abuse against nurses in the workplace, including abuse by other nurses, is both common and well-documented. The negative effects of that abuse and the adverse impact on patient care are also well-documented. Now, a study of newly licensed registered nurses (NLRNs) finds that nurses who are verbally abused by nursing colleagues report lower job satisfaction, unfavorable perceptions of their work environment, and greater intent to leave their current job….Intimidating and disruptive aggressive behaviors in the nursing workplace such as bullying, harassment, and verbal abuse contribute to medical errors, poor patient outcomes, and nurse turnover….
See also:
press release