Union Competition May Help Nurses

Something seems to be wrong with the approach that the respected American Nurses Assn. has been using to attract registered nurses since it was founded in 1896.

Today, after trying for 94 years, the ANA has as members 190,000 of the nation’s 1.6 million RNs, and the venerable organization doesn’t even admit any of the more than 600,000 licensed vocational or practical nurses.

Maybe the ANA isn’t militant enough for the nurses, a group that is generally underpaid and overworked, which explains in large part why there has been an increasing nursing shortage--now more acute than ever before.

Stronger, more aggressive organizations of nurses probably could raise their salaries and improve their job conditions, and that, in turn, could attract more people into the profession and alleviate, if not end, the shortage.

Gains are being made these days by ANA in California and a few other states, but perhaps newly intensified competition starting to come from a plethora of unions affiliated with the AFL-CIO will spur the independent ANA’s recruiting efforts and at the same time help ease the plight of the profession.

Last week, the giant American Federation of State, County & Municipal Employees met in Washington for a founding conference of what it named the United Nurses of America. The union, formed by combining existing locals, has about 36,000 members.

Kathy Sackman, co-chairwoman of the new organization, predicts that it will become the leading voice for nurses, both politically and in collective bargaining to negotiate significant improvements in salaries and working conditions. The parent union, AFSCME, says it is prepared to spend millions of dollars to achieve those goals.

And that union is only one of several now pressing organizing campaigns among nurses. Also immersed in recruiting drives are the Service Employees International Union, with 40,000 nurses already signed up, the United Food & Commercial Workers, American Federation of Teachers, Communication Workers of America, Teamsters and the International Assn. of Machinists.

Together, the AFL-CIO unions represent about 100,000 nurses, all covered by union contracts. A majority, but not all, members of the American Nurses Assn. are under collective bargaining agreements.

If they don’t spend too much time and money fighting each other, the rivalries between the organizations may be useful. Too often, unions seek membership gains by raiding other unions instead of by recruiting first-time members.

All the unions and the association insist that they are aiming their campaigns at the vast majority of nurses who are not members of any organization, but they are competing with one another in several hot contests, including some in Washington state.

Lawrence MacLachian, labor counsel for the ANA, warns association leaders against complacency in the face of the challenge by the other unions: “The outcome of these campaigns will determine whether the association or labor unions will be the voice for nursing in this country in the future.”

But the real issue for the nation is not which organization represents nurses. We need at least 200,000 more nurses to fill present vacancies. Some hospitals have closed entire wards because of the shortage.

Even if all goes well during the next four years or so, the critical shortage will be eased only slightly by the current small increase in enrollment in nursing schools.

Obviously, better pay and job conditions are essential to retain nurses and attract new people.

Almost all nurses today are women, which helps explain why their salaries are still relatively low. Sex discrimination is declining, but it is still a fact of life. Jobs filled mostly by women, such as nursing, teaching and secretarial, are poorly paid compared to those held mostly by men.

Still, under that old supply and demand theory, earnings of nurses should be rising dramatically across America in view of the urgent need for more of them. The national average is only $28,300 a year, according to the latest study by Wyatt Co.

Salaries have gone up significantly in some large cities as a result of aggressive contract negotiations and a few strikes.

For instance, last year, 1,600 nurses in San Francisco’s service employees’ union won a minimum salary of $40,000 a year, going up to a top of $56,000. In Los Angeles, nurses who are now in the new United Nurses of America at Kaiser Permanente won an entry-level salary of $31,500 and other contract improvements.

Gains like those may give unions an advantage over the ANA in their competition for new members, although that association, too, has been winning salary increases.

The ANA may be handicapped, however, because its members include not just rank-and-file staff nurses but also supervisors and others nurses from management ranks.

MacLachian, the ANA attorney, concedes that the influence of supervisors is a risk to the association because, some believe, that means it is management-dominated and less willing to fight for rank-and-file nurses. Several key positions in the ANA are held by nurses who are executives.

But he strongly denies that argument, insisting that nurses who are part of management are insulated from contract negotiations and that their presence in the association makes it more diverse and strengthens its ability to represent nurses.

With the salary gains made in some communities and the competition among organizations to win members by fighting harder for nurses, maybe it won’t be long before nursing becomes the kind of well-paid profession that will attract more young people and end the shortage that means less care for millions of patients.