Nurses

Union Everything You Ever

Wanted to Know
About Forming a

Nurses Union 1
Nurses
“Organizing was the best, most professional decision
we ever made. Together, we work with management to
ensure adequate staffing for the highest quality patient
care, job security, fair compensation – and a real voice for

Union
RNs in our hospital.”
- Robert Armstrong, RN, Penn State Hershey Medical Center

2 On Cover: SEIU members: Jessica Bickers, RN; Judy Kuzupas, RN; Teresa Kozak, RN, Altoona Regional Medical Center
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 s
It’s about working together rather than going it alone.
If you’re like most health care professionals, chances are you want more input in decisions that affect the
quality of patient care and your profession. With the whirlwind of changes taking place in health care
today, more and more nurses and other hospital employees are forming unions as a way to achieve a
voice on the job and to stand up for quality care.

Forming a union can give you a way to work together with your co-workers rather than
going it alone. By joining together in a union, hundreds of thousands of
other nurses and health care professionals across the country are

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making their hospitals better places to work and to receive care.

Is forming a union right for you and your hospital? That’s

a question only you and your co-workers can answer. This book-
let was designed to give you facts and information you can use
to make your decision. It was prepared by the Nurse Alliance of
Pennsylvania and SEIU Healthcare Pennsylvania – the largest
and fastest growing health care union in PA.

SEIU members: Jessica Bickers, RN; Judy Kuzupas, RN, 2

Altoona Regional Medical Center 3
5 Reasons Nurses are Forming Unions
Q: Why are so many nurses forming unions?
A: To solve problems like short staffing, gain a voice on the job, improve pay and
benefits, and stand up for quality patient care.
As cost-cutting, managed care, and hospital mergers dramatically change the way health
care works, growing numbers of nurses and other employees are improving their jobs by
joining together in unions.
1. A voice for nurses in our hospitals. A union gives front-line caregivers a say in how the hospital
operates. Instead of simply reacting to arbitrary decisions coming from management, we can work together
to solve problems and influence policies that affect our job and our patients.

2. Better staffing and higher quality care. Through our unions, nurses and other hospital employees
negotiate better staffing guidelines and more reasonable workloads, preserve professional standards, and
stand up for quality patient care.

3. Higher pay and regular raises. Forming a union means negotiating guaranteed rewards for hard work,
a pay system that recognizes professional education, experience, and the increase in the cost of living.

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 “The health care industry is changing
- and not in a good way. It’s time that
nurses have the power to affect those
changes for the better.”

SEIU Members: Robin Brosh, Lucille Davis, Barb Lanunziata, RNs

at Geisinger Wyoming Valley Medical Center

4. Benefits we can count on. Together, registered nurses negotiate benefits

like affordable family health insurance, pensions, vacation, and sick leave – and
they are guaranteed in writing.

5. Job security. Forming a union allows nurses to bring fair procedures and job
security to a hospital. It allows nurses to speak out about concerns on the job
without fear of retaliation, and to have a say when staffing changes, cost-cut-
ting, and other decisions are considered.

Unions are a way of making sure nurses have a voice – on the

job and in the delivery of health care. Having a union helps to
balance the growing power of health care corporations while
protecting quality care.

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 “I considered leaving nursing because
of the stress of having too many patients
under my care. Instead I vowed to get
more involved with the implementation
of the staffing ratios we negotiated in our
union contract. Now I head up a unit-
based committee that meets monthly to
resolve unit issues. Our union is about
nurses and other health care workers
supporting each other to improve condi-
tions for nurses and our patients.”

- Cathy Doerfler, RN,
Allegheny General Hospital

SEIU member: Cathy Doerfler, RN, Allegheny General Hospital

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How does a health care union work?
Q: How does a union give us a voice in the hospital?
A: Tens of thousands of nurses and other health care professionals were right where you are now –
wondering if whether forming a union will really make a difference. Today, as union members, they
have more control over their work, their future, and the quality of care they provide.

99 Negotiating a contract. Rather than leaving all the decisions about staffing, working conditions, patient care
standards, and wages and benefits to hospital administrators, having a union allows you and your co-workers to negoti-
ate over these issues. A union contract doesn’t mean you’ll get everything you want, but like SEIU members in hundreds
of hospitals nationwide, you can gain a real voice in decision-making and dramatically improve pay, benefits, and work-
ing conditions. Any changes in your contract must be negotiated. Management can’t arbitrarily change the rules or cut
benefits on its own.

99 A say in hospital policies. Growing numbers of union nurses and other hospital employees are participat-
ing in union-mangement committees designed to give them a voice in staffing, scheduling, and patient care decisions.
Through their unions, hospital staff work to strengthen and enforce regulations that govern patient care and lobby for
legislation to protect patients and health care workers.

99 A way to resolve problems fairly. When problems arise, co-workers elected as delegates and representa-
tives will help work out solutions. Issues that are not resolved informally may go to grievance and arbitration procedures
in which a neutral arbitrator, not management, gets the final say.

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 How can forming a union improve staffing and patient care?

Q: Can a union really improve the staffing and workload situation?

A: Understaffing and workload problems didn’t crop up overnight, and solutions will take time,
too. As the health care industry continues to cut costs, it will take a combination of union bargain-
ing, consumer action, and legislative measures to put staffing trends back on the right track.
But even now, union nurses have ways to improve staffing levels in their hospitals through union-
management committees or through procedures negotiated in union contracts, including:
Staffing and patient care standards that set limits on how many patients nurses must care for in a particular area or
on a particular shift. In some cases, union-negotiated guidelines include the optimum number of staff to be scheduled for each
shift and establish a mechanism for monitoring and implementing the standards.

A ban on mandatory overtime to protect nurses and ensure the highest quality of patient care. Nurses negotiated elimina-
tion or limits on mandatory overtime in union contracts before working together to pass a law in Pennsylvania against mandatory
overtime in every health care facility. Now that the regular use of mandatory overtime is banned in Pennsylvania, union nurses have
more options in working with management to ensure our hospitals comply with the law and provide the best care.

Special committees that develop staffing and workload guidelines and oversee their implementation. In many cases, these
committees have created staffing ratios that better reflect patient acuity – not just numbers.

Protection against excessive workloads and practices that undermine standards for quality and safety.

Recruitment and retention programs that focus on improving benefits, salaries, and working conditions in order to
attract and maintain staff.
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“My sense of responsibility to my
patients and my community
required that I work to change
conditions at our hospital. For
me and my co-workers,
forming a union was the best
way to win a voice at the
table and create real change.
Since forming our union we
have seen real improve-
ments—for us as nurses
and for our patients.”
Did YOU know?
When California passed
minimum RN-to-Patient ratios
for hospitals, hospital vacancy
rates plummeted and the
number of actively licensed
RNs grew by over 10,000 each
year – compared to 3,200 per
year before the law passed.
Source: California Board of Nursing
SEIU member: Margaret McGinley, RN
Penn State Hershey Medical Center
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Benefits
What about professional pay, benefits, and standards?

Q: What kind of raises and benefits can we achieve with a union?

A: Every situation and every union contract is different. But if you’re wondering what
difference a union will make, consider these facts:

• In 2008, on average, union members were paid 28 percent more than non-union employees. 1

• Negotiated union contracts typically include guaranteed cost-of-living increases, pay steps that reward lon-
gevity in addition to various types of merit pay, on-call pay, shift and weekend differentials, and certification
and specialty bonuses.

• Whatever you negotiate, your pay and benefits will be guaranteed in writing. With a union, you’ll know
when your next raise is coming and that your benefits are there to stay.

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1 United States Department of Labor, Bureau of Labor Statistics, “Union Members in 2008,” January 28, 2009. http://www.bls.gov/news.release/pdf/union2.pdf
 “Before we had our union, the
hospital broke its own rules. Rules
were changed according to the
day, the people involved, or the
situation. Now, we help make the rules.
It’s a work in progress, but now we have
more stability.”
- Bonnie Franciosi, RN,
Altoona Regional Health System
Did YOU know?
A 2003 survey of Massachu-
setts nurses found that 42%
of nurses not working in hos-
pitals would strongly consider
returning to bedside care if
safe staffing legislation were
passed (from a pool of 42,000
nurses).
SEIU Healthcare members
at Chambersburg Hospi- 11
tal, Sue Russell, Lab Tech
and Crystal Brunner, RN.
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 Q: How will forming a union help us advance our profes-
sion and achieve more job security?
A: Through our unions, professional caregivers have been able to
negotiate clinical ladders, expand continuing education benefits,
and other provisions to ensure broad opportunities for profes-
sional advancement.
Unions also create an environment in which everyone is treated fairly and with
respect. Contracts spell out even-handed policies that keep the hospital free of favorit-
ism and discrimination, protect employees from arbitrary discipline, and guarantee that
no one will be penalized or fired without just cause. And through their unions, tens of
thousands of hospital employees have protected their jobs by negotiating restrictions
on layoffs, replacement of professionals by less-skilled staff, and unfair downsizing.

Did YOU know?

SEIU is North America’s health care union, representing
nearly one million health care workers – including nurses,
physicians, techs, aides, and every other professional service,
administrative, and technical employee in hospitals.
SEIU member: Leslie Kozak, RN
12 Allegheny General Hospital
Why join SEIU Healthcare Pennsylvania?
Q: Why should we form a union with SEIU?
A: SEIU is the largest and fastest-growing health care union in North America, and the largest
union of registered nurses and other health care workers in Pennsylvania. SEIU members have
earned a reputation as outspoken and effective advocates for safe, quality care. SEIU members
are leading the way to a health care system that works for patients and caregivers alike by:
99 Bargaining for better staffing guidelines and patient care standards as well as for the highest pay and benefits in
the health care industry.

99 Pioneering union-management committees that give front-line caregivers a voice in the way health care is delivered.

99 Educating and organizing consumers to stand up for quality care, and lobbying for a Patients’ Bill of Rights and safe
staffing legislation at the federal and state levels.

99 Winning a ban on mandatory overtime in Pennsylvania, strengthening and enforcing state regulations that protect
licensed health care professionals and ensuring safe staffing decisions.

99 Backing legislative initiatives to improve safety, winning a mandate to put safer needle devices in hospitals, allowing
“whistleblowers” to speak freely about improving patient care, holding corporate health care providers accountable for
the quality of patient care, and more.

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 Q: Who are members of SEIU Healthcare Pennsylvania?
A: SEIU Healthcare PA is Pennsylvania’s largest and fastest-growing health care union.
Over 20,000 health care employees are members of SEIU Healthcare PA, including nearly
9,000 nurses.

SEIU Healthcare PA
members work in over 25
hospitals,110 nursing
homes and home care
agencies, and 60 state
health care facilities. Among
the hospitals with registered
nurse members in SEIU
Healthcare PA are Mercy
Hospital in Scranton,
Geisinger Wyoming Valley
Medical Center, Altoona
Regional Health System,
Allegheny General Hospital,
Heritage Valley Medical
Center in Beaver, and Penn
State Hershey Medical
Center.
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Q: How do we form a union?
A: The first step is to establish a committee of nurses that will share information about
how to form a union to make your hospital a better place to work and provide quality
health care. The next step is to sign cards showing that you wish to form a union.
When a majority of your co-workers have indicated that you want to stand together to make changes at the
hospital, you will work with management to win formal recognition of your union. Nurses will then elect a team
of their co-workers to negotiate a contract.

Q: Do we have a right to form a union?

A: Yes. Federal law protects the right of private-sector hospital employees to join a union
and work to improve the quality of your jobs and patient care. You have the same right to
talk about the union while you’re working as you do any other topic. You also have the
right to read and distribute materials about the union on your non-work time in non-work
areas such as break rooms and cafeterias.

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 Q: What do union dues pay for?
A: Union dues are each member’s contribution to ensure that their organization has the
strength and resources to be effective. Dues are used to help employees negotiate contracts to
improve staffing, working conditions, patient care standards, and wages and benefits.
SEIU Healthcare PA dues are 1.8% of gross pay, not including overtime hours worked, plus $1 per month that goes into
a special fund for legislative advocacy for safe staffing and other professional issues.

New members don’t pay any dues until they have negotiated and approved a contract with
improved wages and benefits.

Union dues can only be changed by a majority vote of the statewide union membership.

Q: Who makes the decisions in the union?

A: The members do. A union is a democratic organization. Members elect union leaders and
vote on union contracts, dues structures, and every other important decision that affects them. A
union is a membership organization and it’s guided by the priorities members choose.

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Q: What is the advantage of having many types of health
care employees in one organization?
A: Problems in hospitals are best solved by working as a team. What happens in one segment
or department of the hospital affects everyone else.

Each group of health care employees negotiates its own contract to address its own issues, but they do so with the
added clout of 1 million SEIU health care employees. Standing together in an organization also gives all health care
employees a stronger voice on legislative and regulatory issues that affect them.

SEIU members: Linda Creighton

Lisa Harvey, Christie Osatchack, OR technicians,
Schuylkill Medical Center

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 Q: Will organizing a union ultimately lead
to a smooth relationship with management?
Did YOU know?
9 out of 10 union mem-

s
t
A: Most hospital nurses say forming a union improves their bers say they would vote
relationship with supervisors because everyone knows what for the union again if an
to expect and there are clear ways to resolve any problems that
arise day-to-day. With a union, nurses share in decision-
election were held today.
making, and the needs of nurses and patients are always taken Source: Nationwide survey by Peter Hart
Research Associates, 1997.
into account.

Without a union, hospital management has sole authority over schedul-

ing, staffing, pay, and benefits. By forming a union, you and your co-work-
ers are choosing to work together, rather than go it alone. You can be
sure that your opinions will be heard, and that what’s best for nurses and
patients is part of the decision-making process.

We Are Stronger Together

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strong
togeth
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1500 N. 2nd Street
Harrisburg, PA 17102

717-238-3030

strongER
800-252-3894 (in PA)
www.SEIUHealthcarePA.org

We are

together
Stronger
Together
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