Bargaining for Safe Staffing
Understaffing is a difficult and complex problem, particularly during a time of growing shortages of nurses and other staff. But by forming unions, nurses can work together to improve staffing and the quality of care. Here’s how.
1. Negotiate minimum staffing guidelines. To ensure that staffing levels accurately reflect patient acuity as well as the size of the clinical area, the skill of personnel, and patient census, nurses can negotiate staffing standards into a union contract. These guidelines often specify minimum patient-to-staff ratios by unit or department or the number of healthcare provider hours per patient per day for each unit.
2. Make joint decisions through a patient care committee. Most unionized nurses participate in staffing decisions through union-management committees. These committees, where staff and managers meet regularly as equals, typically are charged with resolving issues relating to staffing levels, staff mix ratios, scheduling practices, professional standards, and patient classification systems.
3. Set up avenues for solving specific problems. With a union, nurses have formal and informal avenues for addressing staffing problems. Unsafe staffing situations can be solved with the help of union delegates in the hospital and through grievance procedures in which, if necessary, a neutral arbitrator has the final say.
4. Recruit and retain staff with better pay and conditions. As the nursing shortage increases the number of unfilled vacancies in hospitals, nurses are negotiating improvements in pay, benefits, and working and patient care conditions to attract and retain more staff.
5. Pursue public policy solutions. In addition to negotiating for better staffing, nurses also are calling on legislatures and regulatory agencies to enact and enforce standards for safe staffing and quality patient care.