Unions Score Health-Care Victory : U.S. Labor Board OKs More Hospital Bargaining Units

Associated Press

The National Labor Relations Board is widening the door for unions to recruit millions of health-care workers, telling hospitals that they no longer can lump nurses with physicians, or lab technicians with janitors as a tactic for thwarting organizing drives.

In a 153-page set of proposed regulations to be published today, the NLRB is establishing eight broad categories of hospital employees as appropriate separate bargaining units.

A copy of the regulations was obtained in advance by the Associated Press.

The regulations effectively reverse a 1984 board ruling allowing for only three or four bargaining units at a hospital unless unions could prove that the interests of different groups of workers were so distinct as to justify more.


Since that ruling, the proportion of hospital workers nationwide who belong to unions has dropped to 19% from 23%, according to the Service Employees International Union, which represents some 300,000 health-care workers.

John Sweeney, the union’s president, attributed part of the decrease to “delays caused by fighting over bargaining units” and hospitals’ efforts to make unions represent “workers with different professional or other interests instead of addressing each’s individual needs.”

“I’m hopeful that we’ll see some significant gains now,” Sweeney said, calling the NLRB’s proposal a great step in “advancing union representation to health-care workers.”

NLRB officials said they hope to issue the regulations in their final form before the end of the year--after a 45-day comment period.


The American Hospital Assn. and most hospitals had vigorously opposed the new rules in hearings around the country. They have contended in hundreds of individual cases before the board that only two unions are appropriate: one for all professionals and another for all non-professional employees.

“This is going to be expensive, disruptive and ultimately it is going to increase the costs of health care,” said Michael Anthony, the hospital association’s executive vice president. “This industry is in a state of change, using team approaches and flexibility to keep costs down.”

Battled Since 1974

Both Anthony and labor leaders acknowledged that the ruling effectively eliminates many of the procedural hoops that unions had to jump through to win representation elections.


“The practical effect was that if a union tried to organize less than wall to wall, the employer would object and tie it up in the NLRB,” said David Silberman, associate general counsel for the AFL-CIO. “The larger the group, the harder it is to organize, particularly when you have to cross different groups that have few common concerns.”

Unions and hospital owners and have been engaged in the high-stakes legal wrangling ever since 1974, when Congress extended the right to unionize to employees of nonprofit hospitals, the largest health-care employers in the nation.

NLRB Chairman James M. Stephens said: “We have attempted to streamline the process by eliminating delays and protracted hearings inherent in the case-by-case adjudicatory approach. We feel this rule will finally stabilize this area of the law.”

The eight categories that the board listed as specific bargaining units in hospitals are:


All registered nurses; all physicians; all professionals except for nurses and physicians; all technical employees such as lab technicians; all skilled maintenance employees such as plumbers, electricians and heating and air conditioning specialists; all business office clerical employees; all guards; and all other non-professional employees.