Labor Relations Review Questions
2. Using the hospital as a setting, give two examples of what would violate the NLRA.
One of the provisions of the NLRA is the right to self-organization. Section 157 of 21 US Code, also known as the National Labor Relations Act, provides, among others, that employees have the right to organize themselves, either by forming, joining or assisting unions and bargain with their employers as a group through the union. This provision would be violated under healthcare setting, when a hospital management, for example, would deal directly with its employees for the setting of terms of their contracts. This happened in Jersey City Medical Center when it violated the rights of the employees to organize by bypassing the employees union when it negotiated directly with employees for the terms of their contracts as well as committed several unfair labor practices against its employees. The National Relations Board, acting on the complaints of the hospital union, filed several complaints against the latter (Ugolik 2014).
While healthcare workers are given the right to self-organize and their unions the right to represent them during collective bargaining with the employer under the NLRA, the same law also upholdS the right of the employer, and employees, against unfair labor practices of unions. Section 158(2) of Title 29 of the US Code prohibits the union from forcing the employer to discriminate against an employee with respect to hire and tenure of employment for the purpose of encouraging or discouraging them from labor-related activities. For example, a nurses’ union cannot compel a hospital to terminate the employment of a nurse because the latter’s membership in the union was ended for reasons other than non-payment of dues. In St. John’s Mercy Health Systems v. National Labor Relations Board, 436 F.3d 843 (C.A. 8, Mo. 2006), the only reason the Court upheld the charge of unfair labor practice against the employer hospital was that it refused to terminate a worker when the latter has failed to pay his union dues (cited in Pozgar 2012).
3. How do patients’ rights come into play during a strike?
In the enforcement of rights of healthcare workers under the laws, such as the right to strike, patients are the most likely to suffer. The law ensures that the safety and health of patients do not hang in the balance during strikes and that the delivery of care to them is not impaired, or disrupted, by providing certain mechanisms towards this end. Under Health Care Amendments Act 1974, nurses unions are obligated to notify management in advanced, ten days before, of the strike. In addition, the use of mediation is compelled, and a 60-day cooling period, if it is determined by the mediator that the strike will potentially harm patients (Kjervik et al p. 123). Management has also the right to hire replacement workers. In Charlesgate Nursing Center v. State of Rhode Island 723 F. Supp. 859 (D.R.I. 1989), the Court held that a Rhode Island statute that prohibited management to hire substitute workers during a strike was unconstitutional because it deprived strike-affected employers from obtaining a remedy for their situation (cited in Pozgar 2012, p. 483). The rationale for the decision in that case has been suggested in studies that reviewed the impact of healthcare workers’ strikew on patients. Grueber and Kleiner (2002), for example, measured the impact of nurses’ strike on patient care in New York City from 1984 to 2004. It revealed several poor patient outcomes in hospitals where the strikes occurred. These outcomes include 18.3% increase in mortality of patients in the hospitals involved and 5.7% increase in readmission rates for those admitted during the strikes. Moreover, hospitals that hired substitutes during strikes did not fare better than those who did not make any hires. It was also determined that the cause of the poor outcomes was due to a decrease in major procedures during the strikes (Grueber and Kleiner 2002).
References:
Grueber, J. and Kleiner, S. (2012). "Do Strikes Kill? Evidence from New York State." American Economic Journal: Economic Policy, 4(1): 127–57.
Kjervik, D., and Brous, E. 2010. Law and Ethics in Advanced Practice Nursing. Springer Publishing Company.
Pozgar, G. (2012). Legal Aspects of Health Care Administration. Jones & Bartlett Learning.
Ugolik, K. (2014). NLRB Accuses NJ Hospital Of Union-Busting. Law 360. http://www.law360.com/articles/508068/nlrb-accuses-nj-hospital-of-union-busting
