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Sept. 22, 2006 Good morning. I’d like to start by thanking the Center for American Progress for hosting this important forum. My name is Cheryl Johnson. I’m the president of 104,000 registered nurses who are members of the United American Nurses, AFL-CIO. I’m also a practicing staff nurse working in a critical care unit every week at the University of Michigan Medical Center. Ladies and gentlemen, it’s no secret that workers’ rights to union representation have been under attack…from employers and unfortunately from our own government. The latest salvo comes from the very federal agency that ought to be protecting workers rights to that representation. The rights of 8 million workers are at stake in the ruling, according to analysis by the Economic Policy Institute. One tenth of us are registered nurses -- 843,000 of us could be reclassified as supervisors and denied union representation. About 1.4 million RNs work in hospitals as staff nurses. We’re the ones who care for patients day-in, day-out, 24-7. Do you think for one minute that 843,000 of those nurses are supervisors? That’s more than half of us – a supervisory ratio of more than one-to-one. Do you think for a minute that hospitals actually would have that many supervisors? I’d like to leave you today with two thoughts on this threat: First, nurses make decisions every day about patient care. That does not make us supervisors. Nurses know that, and hospitals know that. Second, redefining nurses as supervisors does nothing to fix the out-of-control problems we face in health care today, and it probably will make them worse. Let me start by giving you a very short overview of what my day is like in the ICU where I work. The first thing I do when I get to work is confer with the nurse going off-duty about the patients we’re caring for and any problems they might face … over the course of the day I’ll talk with the doctors on changes I’ve noticed in the patient I’m caring for and make suggestions when I have them … along the way I may ask other members of the health care team—LPNs, patient care technicians, dietitians and others—for help in tasks like taking someone’s blood pressure or helping to move a patient. I may find that I’ve been assigned charge nurse duties that day. This is not a position I apply for, nor one I have every day…it’s assigned by a nursing supervisor. I may not even know I’m the charge nurse for my shift until I get to work. At no point during my day as a staff nurse – even when I’m assigned as a charge nurse – do I have the authority to hire anyone, fire anyone, or reorganize the staff. (Though there are days when I’d like to.) I’m a registered nurse. I take care of patients. I’m very good at it. I make decisions every day, and I give a few orders from time to time whether I’m assigned as charge nurse or not. I am a key leader on the health care team. But I’m not a supervisor. Making a judgment call or even giving another staff member instruction is not the same as administration. Nurses know the difference … our nursing supervisors know the difference … and, hospitals certainly know the difference. Only the NLRB seems to be confused. * * * So why has this ill-advised notion to label everyone a supervisor gotten this far? I have a few theories. One has to do with the profit-driven big business that is the health care industry today. The other comes down to simple politics. Once upon a time, the National Labor Relations Board was created to defend the right of every American to exercise the labor rights afforded them under the National Labor Relations Act—including the freedom to choose a union, or not. That is why the Labor Board exists. Period. It’s a system that has stood the test of time since the Great Depression. Today, we have a Labor Board that makes its bread and butter out of determining who should get the privilege of exercising their democratic rights. When did this become a privilege granted only to a few? About four years ago, administrators running the Salt Lake Regional Medical Center in Utah challenged an election held by nurses seeking representation with UAN on the grounds that the vote included charge nurses—about a third of their RN staff. Overruling a regional NLRB decision, the NLRB in Washington, DC, agreed to hear the case and impounded the ballots. They are still uncounted pending this decision. Democracy denied. That is a gross failing by the NLRB of every working American. And that NLRB is being driven by an anti-union president and his administration. I also do not believe it is simple coincidence that health care workers will likely bear the brunt of a bad decision by the NLRB. About 20 percent of working registered nurses are represented by a union, compared to about 14 percent of all workers, and nurses are organizing more and more. When nurses and other health care workers do organize ourselves into a union, we fuel the engine of change in health care policy. The big business that is health care in this country doesn’t share power easily—whether they are hospital CEOs, doctors, lawyers, Republicans or someone else. We have had a health care system and a union representation system that has worked since nurses first started organizing back in the 1940s. What’s so different now that we need to change? Nurses and other health care workers are more vocal, more active… and more unionized. * * * Now here’s the interesting thing about this case. No hospital anywhere is obligated to reclassify their nurses if the NLRB issues the negative decision we expect. And nurses who are currently union members will continue to be covered until their contracts expire. So what’s the problem? We already have a lot of evidence that hospitals will jump at this new opportunity being offered to them by the Labor Board. I already mentioned to you the experience of the Salt Lake City nurses. More recently, the Virginia Mason Medical Center in Seattle tried to declare last spring that all 600 of its RNs are supervisors and therefore not covered by their union contract. After protests from the nurses and their union, the United American Nurses and its Washington State affiliate, the hospital withdrew the claim. But we have no doubt that they’ll keep trying. Unfortunately, hospitals have shown they may be all too willing to take this misguided “gift” from the NLRB. * * * Let’s talk for a minute about what reclassifying some or all registered nurses as supervisors does for our health care system. We have some very big problems in hospitals today. We face a critical shortage of nurses. As a result, nurses are being forced to work at dangerously unsafe staffing levels –and if you don’t believe that, see how long it takes for a nurse to get to you the next time you have to press a call button in a hospital. Fatigued nurses are mandated to work overtime after shifts that are already too long. We have statistics that show patients are suffering complications and even death from medical errors that could and should have been prevented. And I haven’t even touched on out-of-control health care costs or the 46 million Americans who lack health insurance. A decision by the NLRB to reclassify me and other nurses as supervisors does nothing to fix any of these problems and may make some of them worse. That is a decision that serves no one well—not nurses, not hospitals, and certainly not patients. I’ll tell you one solution that is making a dent in these problems: unions, and the nurses who belong to them. Through union contracts, we are negotiating with hospitals to put more nurses on the floor and requiring that nurses care for no more patients than they can safely cover. That’s good for patients. We are limiting forced overtime to true emergencies so that the nurse you see when you’re admitted to a hospital hasn’t been on duty for the past 14 hours or more. That’s good for patients too. The NLRB and hospitals need to take a hard look and reevaluate their course of action. We have a health care delivery system that relies on a functioning health care team and provides the best medical care in the world. And we have a tool in place—unions—that gives nurses and other workers a seat at the table to make the decisions with management that will improve the system. Why would you change that? * * * I do not believe that RNs will stand by in silence as their union rights being taken from them. Those of us who’ve seen how much we can accomplish for our patients and our profession through our union are not about to give up our voice and our rights. We saw that during the rallies in the streets this summer, I’ve seen it in hospitals like Virginia Mason in Seattle, and I think you will see it in other hospitals if the decision excludes any nurses from unions. Nurses are dedicated to providing the best care possible for our patients and we will continue to act in the best interest of our patients, as we always have. I expect that hospital CEOs who are committed to the same thing will continue to recognize the difference between a staff nurse and a supervisor. So there’s a lot a stake in how hospitals respond. For hospitals, for nurses, and for patients. Thank you. |