As healthcare providers rethink their operating styles and re-engineer work processes, they're pushing workers into new situations and unfamiliar responsibilities. Many employees are being pushed out of jobs entirely.
Workers-emboldened by management's drive to squeeze out inefficiencies and cut staffing-are pushing back. And nurses are leading the charge.
Healthcare unions report heightened interest in organizing among nonunionized workers. Some of this interest is arising in parts of the country traditionally unreceptive to the labor movement.
In Wichita, Kan., for example, nurses at a psychiatric hospital have channeled their anger into a union election. In Georgia, the nation's third-least-unionized state, union sentiment has surfaced at Emory University Hospital in Atlanta. Nurses at a small psychiatric facility south of Atlanta recently lost a credentialing election by a few votes.
In suburban St. Louis a nurse is trying to organize one hospital in the gargantuan BJC Health System, which employs 22,000 people. Although St. Louis is a union town, bargaining units are notably absent from hospitals there.
And in locales where unions have been a fact of life for years, hospital workers are looking management coolly in the eye and upping the ante. The New York State Nurses Association is advising the public in television, radio and subway ads to "Ask for a Real Nurse. Ask for an RN."
The California Nurses Association filed a lawsuit against Alta Bates Medical Center in Berkeley, alleging consumer fraud. Like many institutions, Alta Bates is moving toward so-called patient-focused care. Nurse's aides and other lower-skilled workers are being substituted for registered nurses. The CNA, which acts as a bargaining unit, argues that patients are deceived into believing they're receiving a standard of care that's not really there. Stepping up the pressure, the CNA has launched a $67,000 ad campaign inviting nurses and patients to send in reports of inadequate care.
The activism isn't limited to nurses and hospitals. The managed-care