Nurses are mad as hell and they're not going to take it anymore. So what are they going to do about it?
Join unions, if recent activity is any indication-just not their American Nurses Association. Instead nurses are signing on with the carpenters, the mine workers, the laborers and the service workers.
Apparently the inherent tensions between the ANA's roles as professional association and labor organization are starting to pull, hard. The conflicts of its dual nature are playing out most obviously at the state association level.
For example, members of the Pennsylvania Nurses Association recently voted to split the organization into three: a union, a nonunion association and a nursing foundation. The union would contract with the association (which would remain as the constituent member of the ANA) for certain professional services and association benefits.
Association executives hope to have the split in place by next July, but their proposal can't go through without the blessing of the ANA, which is reviewing the matter.
The Oct. 18 vote of the PNA came shortly after the painful defection of 2,000 nurses employed by the state who joined the Service Employees International Union. An additional 1,000 nurses at Penn State University Hospital-Milton S. Hershey Medical Center jumped ship before that, also to the SEIU. And 120 nurses left to join a state teachers' union. In sum, the PNA's membership has nosedived to 5,000 from 8,000 in late 1995.
The problem is the divisions between the union and the professional sides of the association had become untenable, said Barry Ciccocioppo, a PNA spokesman. Hospitals were pressuring nurses not to join the professional organization because it also acts as a union (although many nurses in the PNA are not in bargaining units).
The PNA's image was cloudy, he said: "At times, the union members and nonunion members would take a different position on issues. We don't have that conflict by splitting up. If union members want to take a hard-and-fast stance on a particular issue, they can do that. That will give them additional strength at the bargaining table. They will control their own budget. They will hire as many labor reps as they feel they need."
Meanwhile, the ANA isn't sure it likes what it sees. "We are in the process of analyzing and reviewing that model as far as bylaw compliance and whether or not that model truly enhances services," said Geri Marullo, ANA executive director.
Of course, Pennsylvania's proposed model might be more pleasing to the ANA than the course the California ANA affiliate followed two years ago. Under a newly militant leadership, the California Nurses Association took its 20,000 members and its dues money and walked out of the ANA.
Since leaving the ANA, the CNA has organized 10 units totaling 2,800 RNs.
Marullo readily acknowledged "some static tension" within the ANA because of competition for resources and for strategies.
Despite the tension, she said, the ANA remains an attractive union to nurses. It is "getting swamped with calls and requests to organize," Marullo said. In fact, the ANA board's finance committee has asked her to boost the budget for collective bargaining next year.
Will more money do the trick? Not likely, said Joni Ketter, a former ANA communications specialist who departed for the SEIU a year ago. "I always felt the ANA had the potential to be the union for nurses," she said. "They had everything in place. I don't believe they were aggressively organizing nurses the way that they could and should have."
There is a palpable "weirdness" within the ANA because of competing interests, Ketter said, especially among nurses who eschew the union label. "It actually hampers quite a bit what they're trying to do," she said.
Added Chicago-based labor attorney Bruce Stickler: "The ANA has never determined what it wants to be when it grows up. It's bifurcated."
Stickler represents hospitals trying to keep unions out. His firm just defeated a drive by the District Council of Carpenters to organize nurses at St. John's Hospital in Springfield, Ill. The vote was 648 to 298 against unionizing.
Healthcare organizing in Illinois is "huge" right now, Stickler said. In nursing campaigns, more and more his adversary is the United Food and Commercial Workers Union or the Southern Illinois Laborers' District Council, not the Illinois Nurses Association.
Kay Jones, an organizer for the INA, said that's because her union won't pursue a campaign unless a majority of nurses sign up. "Therefore we don't file a petition with less than 70% of the nurses saying they want a union," she said. The carpenters in Springfield filed with 30%, she said, and they lost. "We simply would not do that. It doesn't help the nurses if they don't win that election."
The INA has 7,000 members, of whom 5,300 are in collective bargaining units. The vast majority of those work for public institutions.
While the state nurses associations fiddle, the SEIU is on the hustings. It is organizing nursing units in Connecticut, Florida, New York, Ohio, Pennsylvania and Washington, said SEIU national organizer David Snapp. "There's a lot of activity."
The ANA's Marullo said she doesn't believe non-nurses unions can possibly represent nurses' interests as effectively as the state associations. "They may be organizing them, but I don't believe they're representing them well at all," she said. "Nurses represented through (state nurses associations) have higher wages, better working conditions, better clinical language than these other unions have a clue about. It's the quality of the collective bargaining agreements."
As far as organized nurses, "we're still the largest," Marullo said. "Are we organizing more nurses? Yes, we are. State nurses associations have five campaigns on right now."
From other unions' perspective, that doesn't count as aggressive. "Only five in the U.S.?" said Brandon Phelps, who organizes 27 counties for the Southern Illinois Laborers' District Council.
He beat Stickler's firm at Hamilton Memorial Hospital in McLeansboro, Ill., on July 17 and at Hillsboro (Ill.) Area Hospital last year, successfully organizing RNs and other clinical workers.
"I've got probably five healthcare organizing drives going on right now by myself," Phelps said. "Nothing against the ANA, but it's all about beating the bushes and being aggressive."