High Court Ruling Aids Hospital Unions : Labor: The justices uphold the specialized bargaining units favored by organizers. Opponents warn of possible strikes at medical facilities.

The Supreme Court gave a big boost Tuesday to union organizing in the nation’s hospitals, ruling that nurses, technicians, clerical workers and maintenance employees may set up separate bargaining units.

Lawyers on both sides of the issue said that the ruling could transform labor relations in the fast-growing field of health care. Unions promised to increase their organizing efforts. Hospital spokesmen said that the decision would lead to labor “disruptions” and possibly to strikes at medical facilities.

The ruling, which had been sought by organized labor since the mid-1970s, makes it easier for unions to win representation elections by allowing them to separately organize workers in eight individual crafts within a hospital. It also prevents the hospital industry from delaying elections for years by challenging the makeup of bargaining units before the National Labor Relations Board.

Previously, hospitals had insisted on just three bargaining units for all workers--professional, non-professional and security. Unions contended that this forced them to conduct elections among broad bargaining units in which members often had little in common. Nursing groups, for example, have wanted to organize nurses, but not maintenance workers.

Labor leaders have contended that hospitals successfully thwarted them by insisting on these broad units, keeping the proportion of union hospital workers lower than 20%.

During the 1980s, the number of hospital workers grew by one-third to 3.6 million. As a result, the industry is regarded as a crucial target for organized labor, whose share of the workplace has fallen steadily during the last several decades.

It was only in 1974 that Congress voted to allow employees of private, nonprofit hospitals to organize. The issue of the makeup of bargaining units soon slowed down that activity, however.

Two years ago, the NLRB proposed that organizing elections be separated into eight categories in the nation’s 4,000 acute-care hospitals: registered nurses, physicians, other professionals, technical employees, skilled maintenance workers, clerical employees, guards and other non-professional employees.

Arguing that the rule would create labor troubles and “endanger the delivery of quality patient care,” the hospital industry challenged the NLRB proposal in federal court.

In Tuesday’s ruling, the Supreme Court upheld the NLRB rule unanimously.

“There will be a dramatic increase now in union organizing at acute-care hospitals,” said Robert M. Stone, a Los Angeles attorney who represented the California Assn. of Hospitals and Health Systems. He estimated that unions have organized only about 10% of the hospitals in the Los Angeles area.

“Clearly the effort to organize hospital unions will be stepped up now,” said Fredric J. Entin, counsel for the American Hospital Assn. in Chicago. “We have been concerned about the potential for disruption and the expense.”

Labor leaders hailed the ruling and said that it could lead to better wages for hospital workers.

“For the first time ever, the playing field is level for union organizing in hospitals,” said John J. Sweeney, president of the Service Employees International Union, which represents 375,000 health care workers.

“Freed from legal bondage, workers can now choose to be represented by a union and fight back against the poor wages and benefits, short-staffing and lack of protection from infectious diseases like AIDS and hepatitis B,” he said.

In its lawsuit challenging the eight separate bargaining units, the American Hospital Assn. said that the NLRB exceeded its authority in setting the nationwide rule. A federal judge in Chicago agreed and blocked its enforcement. But a federal appeals court in Chicago upheld the rule last year.

In its decision in the case (American Hospital Assn. vs. NLRB, 90-97), the high court said that it was upholding the judgment of the federal labor board, not endorsing the wisdom of its rule.