Employee health debated at union bargaining table
December 1, 2000 3 minutes read
Employee health debated at union bargaining table
From fatigue to latex allergy, issues strike chord
Employee health issues have moved to the forefront as a bargaining issue as unions raise concerns about working conditions and demand action on latex allergy, needlestick safety, ergonomics, and other issues.
"Every year, we’re negotiating more health and safety language on a broad range of health and safety issues that health care workers face," says Bill Borwegan, MPH, occupational health and safety director of the Service Employees International Union (SEIU) in Washington, DC. "It’s such a pertinent issue, and the government really has not accepted its responsibilities [to protect workers] and neither has management."
As nurses walked the picket line at Washington (DC) Hospital Center in October, some held signs urging action on safety issues.
Efforts to limit mandatory overtime were a major focus of the strike, but negotiations also touched on latex allergy and the labor-management safety committees.
The American Nurses Association and its affiliate, the District of Columbia Nurses Association, both in Washington, DC, asserted that mandatory overtime caused stress and fatigue that could lead to medical errors as well as employee injury. Four other strikes this year have involved the issue of mandatory overtime.
Washington Hospital Center contended that the union exaggerated the problem of mandatory overtime. Areas most likely to face mandatory overtime include the operating room and trauma unit. "The reality is that 90% of our nursing units only have to work involuntary overtime a couple of times a year," says Lisa Wyatt, MSM, vice president of public affairs for Washington Hospital Center. "We have made extremely reasonable proposals on capping the mandatory overtime for the nursing units that are hardest hit."
"Realistically, if this only happened once or twice a year, it would not be an issue," counters Karen Skinner, RN, MSN, RNC, spokeswoman for the District of Columbia Nurses Association. "They would not be out of their jobs for three weeks if this was an occasional issue. It happens routinely, and it’s a major concern.
"It doesn’t happen on all the units, but it does happen on many of the units," she says. "It’s enough of a problem that they’re saying we have to address this before we can go back to work."
The relationship between stress, fatigue, and injury is gaining new attention from federal agencies and academic researchers. A conference sponsored by several agencies in October focused on the link between patient safety and working conditions.
"Finally, the health and safety of health care workers — of caring for people who care for others — is getting the attention it needs and deserves," says Susan Wilburn, RN, MPH, senior specialist for occupation safety and health with the American Nurses Association.
While needlestick and back injuries attract more publicity in the media, they also are touchstones for union organizers, says Borwegan. "It’s low-hanging fruit for a union that’s looking to help improve the conditions of unorganized workers," he says.
Unions also have successfully included health and safety language in contracts.
At San Francisco General Hospital, the SEIU negotiated a contract provision that requires purchasing decisions on safer needle devices to be made by a joint labor-management committee. Last year, ANA negotiations at Children’s National Medical Center in Washington, DC, included the replacement of latex products with nonlatex alternatives.
The SEIU negotiated language in a contract with Jackson Memorial Hospital in Miami that states, in part, "The Employer will continue to comply with applicable federal, state, and county laws and regulations pertaining to occupational safety and health. To this end, any unsafe conditions reported by nurses will receive priority corrective action by management."
Unions also have demanded the involvement of frontline health care workers in safety issues, such as the prevention of needlestick injuries.
"There’s a great deal more awareness in the problem [of health care worker injury] as well as the fact that there are many solutions," says Wilburn. "Those solutions will be more specific and effective if nurses are involved in them."
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