It didn't take long for the U.S. Supreme Court's recent decision involving nurse supervisors to lead to conflicts concerning unionized nurses.
But healthcare administrators who decide to broadly interpret the high court's ruling would be advised to tread carefully. Taking on established labor protections of nurse organizations can be an effort rife with mine fields.
The National Labor Relations Act defines a supervisor as someone who has the authority to do things in the interest of his or her employers, such as hiring, firing and disciplining others.
The recent Supreme Court decision said skilled nurses who supervise lesser-skilled employees aren't protected by the National Labor Relations Act and seemingly left unprotected workers who perform even the smallest supervisory function. Providence Hospital in Alaska already has used the decision to challenge the composition of a proposed nurse bargaining unit because it includes charge nurses, or nurses assigned to oversee nursing care on their units on a given day. The hospital lost round one but said it will appeal.
The second effort is more problematic, involving a lame-duck administrator at a small Montana hospital who is using the ruling to try to oust an established union representing 90 registered nurses. Gary Kenner is departing Bozeman (Mont.) Deaconess Hospital Sept. 1 to start his own consulting company, leaving the hospital with a major headache.
In defusing the situation at Bozeman, board members would do well to weigh the changing contributions of nurses in an evolving healthcare environment.
As key participants in increasingly popular team approaches to patient care, nurses often are cast into a quasi-supervisory realm. Administrators must be clear about their expectations. If they want nurses to take on expanded duties and surrender labor protection, administrators will face nurses' demands for increased pay and attendant privileges granted to supervisors.
Executives should join labor officials in pushing the National Labor Relations Board to quickly develop a definition of what constitutes a nurse supervisor. Meanwhile, administrators ought not perpetuate strategies that alienate staff members who were in such short supply just a few years ago.