Nursing Leadership &
Management
Patricia Kelly-Heidenthal
0-7668-2508-6
Delmar Learning
Copyright © 2003 Delmar Learning, a Thomson Learning company
Chapter 25
Collective Bargaining
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Objectives

Upon completion of this chapter, the reader should be
able to:
• Review the history of collective bargaining and associated
legislation.
• Discuss collective action models and associated
terminology.
• Identify the American Nurses Association’s role and
function in collective bargaining.
• Discuss professionalism in the context of unionization.
• List pros and cons of collective bargaining.
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Collective Bargaining: Definitions
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Collective action, or simply acting as a group with a
single voice, is one method by which to deal with
problems.
Collective bargaining is the practice of bargaining
with reference to wages, work practice, and other
benefits by employees in a collective group with
management.
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Collective Action Models: Shared
Governance
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Shared governance is where nurses and managers
work together to define their roles and expected
outcomes. It holds everyone accountable for his or her
role and expected outcomes.
•
•
•
•
Partnership
Equity
Accountability
Ownership
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Workplace Advocacy
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Workplace advocacy refers to the activities nurses
undertake to address problems in their everyday
workplace setting.
Activities include forming committees to address
problems, devising alternatives to achieve optimal
care, and inventing new ways to implement change.
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Collective Bargaining
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Collective action is simply acting as a group with a
single voice.
When a group acts with a single voice and brings
ideas to management, it changes from collective
action to collective bargaining.
If the group cannot achieve its desires through
informal collective bargaining with management, the
group may decide to form a union.
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Whistleblowing

Whistleblowing is the act where an individual
discloses information regarding a violation of a law,
rule, or regulation or a substantial and specific danger
to public health or safety.
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Factors Influencing Nurses to Unionize
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Feelings of powerlessness
Desire to eliminate discrimination and favoritism
Desire to communicate concerns to management
without fear of losing jobs
Need to initiate change
Concerns over wages, staffing, safety, job security
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Process of Unionization

A collective bargaining agent is an agent who works
with employees to formalize collective bargaining
though unionization.
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Steps in Organizing a Collective
Bargaining Unit
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Assemble a group of nurses who support collective
bargaining.
Arrange a meeting with a representative of the state
nurses’ association.
Assess the feasibility of an organizing campaign.
Conduct necessary research to develop a plan of action.
Establish an organizing committee and subcommittees.
Begin the process of obtaining union authorization
cards.
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Steps in Organizing a Collective
Bargaining Unit
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Schedule an informal meeting for nurses eligible for
the collective bargaining unit.
Keep the lines of communication open with nurses.
Seek voluntary recognition from the employer.
Move toward formal organization of the unit.
Seek certification by the National Labor Relations
Board as the exclusive bargaining agent of the unit.
Initiate contract negotiations.
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Manager’s Role During Process

Unions may increase the cost for the hospital and limit
the authority of its managers.
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Manager’s Role During Initiation of
Unionization
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Know the law, and make sure rights of the nurses as
well as management are clearly understood.
Act clearly within the law, no matter what the
organization delegates to you as manager.
Find out the reasons the nurses want collective action.
Discuss and deal with the nurses and the problems
directly and effectively.
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Manager’s Role During Initiation of
Unionization
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Distribute lists of disadvantages of
unionization, such as paying dues.
Distribute examples of unions that did not help
with patient care issues.
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Employees’ Role During Process

Nurses desiring to choose a collective bargaining
agent must be sure they know the laws that have been
instituted and follow them carefully.
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Nurses’ Role During Initiation of
Unionization
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Know your legal rights and the rights of the manager.
Act clearly within the law at all times.
If a manager acts unlawfully, e.g., by firing an
employee for organizing, report the employer’s
actions to the National Labor Relations Board.
Keep all nurses informed through regular meetings
held close to the hospital.
Set meeting times conveniently around shift changes
and assist with child care during meetings.
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Striking
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A collective bargaining agent cannot make the
decision to strike.
The decision to strike can be made only by a majority
of union members.
Most nursing collective bargaining agents put a nostrike clause in the contract.
The 1974 Health Care Amendments to the National
Labor Relations Act contain provisions that guarantee
the continuation of adequate patient care in a strike
situation.
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Collective Bargaining Agents
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Service Employees International Union
State Nurses’ Associations of the American Nurses
Association
National Union of Hospital and Health Care
Employees of the Retail, Wholesale and Department
Store Union
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American Nurses Association (ANA)
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The ANA is a full-service professional organization
representing the nation’s entire registered nurse
population.
Functions of ANA
• Represents the interest of nurses in collective bargaining
• Advances the nursing profession by fostering high standards
for nursing practice
• Lobbies Congress and regulatory agencies on health care
issues affecting nurses and the general public
• Initiates many policies pertaining to health care reform
• Publishes its position on issues
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Professionalism and Unionization
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Characteristics of a profession include: requiring a
long period of specialized education, having a service
orientation, and having autonomy.
Many nurses believe that autonomy precludes
involvement in a union.
Others believe unionization is the only way to achieve
autonomy.
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Definition of Supervisor
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The National Labor Relations Act defines supervisor.
Many supervisory characteristics are exhibited by
nurses.
The question exists of whether a supervisor can
belong to a union.
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Physician Unionization
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In some health care settings, physicians are seen as
employees, not supervisors.
This means they have the ability to join unions.
Factors influencing physicians to unionize:
• Loss of autonomy
• Low wages
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Managing in a Union Environment
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Nursing management may not be part of the union,
but nurse managers must work with the union to
manage within the rules and context of contract
agreements.
A grievance is where a union member feels that
management has failed to meet the terms of the
contract or labor agreement and communicates this to
management.
All union contracts specify grievance proceedings for
their members.
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Collective Bargaining: Advantages and
Disadvantages
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Advantages:
• Contract to guide standards
• Participation in decision-making process
• All union members and management must conform to terms
of contract without exception
• Process exists to question manager’s authority if member
feels something was done unjustly
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Collective Bargaining: Advantages and
Disadvantages

Disadvantages
• Reduced individuality
• Other union members may outvote one’s decisions
• All union members and management must conform to terms
of contract without exception
• Disputes are not handled with individual and management
only; less room for personal judgment
• Must pay union dues even if one does not support
unionization
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