Unions hoping to tap into growing discontent over working conditions and pay have launched the first major drive in decades to unionize nurses at L.A.-area hospitals.
In the past two years, 1,200 registered nurses have voted to join unions at three local private-sector facilities: 600 nurses at Good Samaritan Hospital in downtown L.A.; 350 nurses at St. Vincent Medical Center, also near downtown; and 250 at the Henry Mayo Center in Newhall.
In addition, several hundred other hospital workers who perform functions similar to those done by registered nurses have also voted to join unions in recent months. Among them are 575 nurse technicians and other staff at Good Samaritan in March, and a total of 300 workers at St. Francis Hospital in Lynwood and Robert F. Kennedy Hospital in Hawthorne.
While those numbers may be a drop in the bucket when compared to the estimated 35,000 non-unionized nurses in L.A. County, it represents a significant turning point. Before the current drive, only a few hundred nurses at City of Hope Medical Center in Duarte and an estimated 6,000 nurses in Kaiser Permanente hospitals in the county were unionized, with Kaiser nurses on membership rolls for several decades.
"We've made a major push in L.A.," said Beth Kean, organizing director of the California Nurses Association. "The frustration level is very high among nurses in L.A., because patient care conditions are so substandard and extreme cost-cutting is taking place at the bedside."
Hospital officials say the union's concern about patient care is a smokescreen for the real issue: more money.
"It's all about money," said Jim Lott, executive vice president of the Health Care Association of Southern California, which represents local hospitals. "They are not here out of some high-minded moral concern about the quality of care for the patients. They are here because most of the hospitals up north are already unionized and this is now where the money is."
Hospital administrators have resisted the union organizing tactics. In February, they successfully stopped a nurse unionization drive at one of the region's largest hospitals, Long Beach Memorial, which employs 1,200 registered nurses. The tally was 10 votes short of the threshold needed to unionize. Since then, the California Nurses Association has filed an appeal of the election with the National Labor Relations Board, claiming its drive was defeated due to interference from the hospital.
Despite the defeat, union leaders say they intend to press on. Kean noted that there are 78 non-union private-sector hospitals in L.A. County, far more than in any other part of the state.
Here, less than 10 percent of all private-sector nurses are unionized. (The figure is higher for public-sector nurses at places like County-USC Medical Center.) L.A's long-standing reputation as a non-union town and the region's sprawling geography are cited as the major factors for this low rate of unionization. By contrast, about 80 percent of nurses in the Bay Area are organized and have been for nearly 50 years.
"We have a big challenge facing us over the next several years," said Amado David, organizing director for Service Employees International Union Local 399, which represents local hospital workers, including some registered nurses.
Even though higher wages is the most common rallying cry sounded these days by organized labor, it's relatively low on the list of concerns voiced by nurses. Rather, their focus is on working conditions.
Kean and other union officials say the shortage of nurses in L.A. has resulted in excessive workloads at hospitals, and frequent reassigning of nurses outside their areas of expertise. Also, organizers contend that managed care has led to a reduction in resources allocated to patients and doctors.
Lack of control
Hospital officials counter that, while there is a nursing shortage, it's not the fault of hospitals.
"We agree with the unions that there are too few nurses for the number of patients in our hospitals," said Lott. "We pay huge bonuses to sign on new nurses, and we still can't get the supply we need. The supply isn't there because nursing graduates have far more options than working in hospitals."
Among them are the exploding number of health-related Internet sites and phone-in services that offer medical advice and information.
Despite such competition, hospitals may soon be left with no choice except to hire more nurses. Last year, Gov. Gray Davis signed into law AB 394, sponsored by Assemblywoman Sheila Kuehl, D-Los Angeles. The law includes a provision mandating a certain ratio of nurses for every 100 patients. However, the law did not specify what that ratio would be. That will be negotiated in coming months and may not be implemented until 2002.
But the problem often goes beyond numbers. Union officials say that many nurses who do choose to work at hospitals feel they are treated like second-class citizens.
"The real issue is that nurses don't feel they have control over the conditions under which they work in hospitals," said Dave Bullock, president of SEIU Local 399. "They are severely undermined by staffing shortages and feel they can't spend the time with each patient that they need to. It's literally driving nurses out of hospitals."
Lott countered that health care workers other than registered nurses have contact with patients and pick up many duties.
"Back when many of the nurses came into the business, they were the primary providers of care outside of doctors," Lott said. "But today, you have more specialists, like respiratory and physical therapists, who spend time with patients."
To union leaders' charge that hospitals frequently reassign nurses to jobs outside their areas of expertise, Lott conceded that such reassignments do occur, but they are not frequent. "Look, if we did that on a regular basis, we would be opening ourselves up to huge malpractice liability if errors in patient care were committed," he said.
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