Union-Management Negotiations over Nurse Staffing Issues in Hospitals

Abstract

Over the past several decades, systematic understaffing in hospitals under the pressures of managed care and mergers has led to a diminution of job satisfaction and morale among nurses and, even more critically, has had an adverse impact on patient outcomes. In reaction, unions have attempted legislatively to enact bans or limits on mandatory overtime. Some unions as well have sought to enact statutes setting staffing levels based on patient mix and acuity. In this paper, the authors, utilizing as a database Michigan contracts, have assessed the relative success of unions in limiting the discretionary authority of management over staffing in such areas as layoffs, floating, limitations on nursing duties, staffing of units, and assignment of overtime. Although unions have had some success at the bargaining table, the results indicate the significance of continued union efforts to achieve improvements in working conditions through legislation