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A major crisis looms for labs.

A major crisis looms for labs Lab managers already face a multitude of problems. Yet another critical dilemma may very well be in the immediate future. That problem is spelled U-N-I-O-N.

Now don't tune out or turn the page, as so often happens when lab managers see articles discussing unions. This column may be your last warning to develop a plan of action if the regulations regarding bargaining units proposed by the National Labor Relations Board should be finalized.

* Ghost from the past. In the December 1988 issue of MLO, I introduced these proposed regulations in this column under the ttle, "Will unions solve the lab staffing problem?" [1] To my surprise, the MLO readership survey for that month showed that column had been read by a lower percentage of readers than any of my previous columns. I can only assume one of two things: Either lab managers know all there is to know about unions and union activity, or they don't think they need to know more than they do.

The American Hospital Association is most concerned with the recent appellate court ruling that upheld that legality of NLRB bargaining units. AHA is appealing the decision to the Supreme Court. The appellate court granted their motion to temporarily prevent the NLRB from using the new rules, thus delaying the May 2, 1990, implementation date. Laboratory managers, however, cannot sit back and relax, as there is no guarantee the AHA will win.

* Interpretation. What do these controversial new rules mean to laboratory managers? To answer this question, we need to review the NLRB ruling and to examine the recent history of union activity in the health care field.

A 1973 amendment to the National Labor Relations Act placed hospital bargaining units into one of three catetories: professional, nonprofessional, or guards. In 1989 the NLRB increased the number to eight to include registered nurses, physicians, other medical professionals, technical service employees, skilled maintenance employees, office workers, guards, and all other nonprofessional employees. Under these rules, three to four separate units could conceivably exist within the lab. This woudl mean having three or four different contracts to manage.

The AHA sees the new rules as an invitation for a greater number of unions to organize in the hospital. Unioins have delayed organizing or filing recognition petitions pending the final court decision. In 1988 there were 106 hospital union elections. Of the 88 that took place in 1989, union won 51 per cent.

John Sweeney, president of the Service Employees International Union, sees the change as "a rebirth" of hospital organizing. SEIU now represents 375,000 health care workers. Sweeney believes that the new rules will, for the first time, allow many hospital wrkers to be represented and permit speedy and fair elections. We can be sure that other unions representing health care workers feel the same and are primed to move aggressively if the Supreme Court does not overturn the ruling of the appellate court.

The growing dissatisfaction of health care workers has increased hospitals' vulnerability to union action. Areas of contention include salaries, reduced staffing levels, pressure for higher productivity, and overall stress--all of which are prevalent in the clinical lab.

* Know your facts. If union activity increases, laboratorians may not look the other way, as lab managers expect them do. It is therefore incumbent on both management and staff to learn everything they can about organizing, what management can and cannot legally do, and employee designation for bargaining units.

The employees at Twin City Hospital in Dennison, Ohio, learned the consequences of being uninformed. Had they understood bargaining units, perhaps the court would not have ruled that the hospital laboratory's MTs were ot "professionals." The decision was based on lack of evidence.

During negotiations, nurses and technologists had been put in a professional unit. The hospital challenged this classification. The nurses were declared professional, but the technologists were not. The rationale was that MTs do not meet the National Labor Relations Act definition for professional employees. That definition states that they "must engage in work that's predominantly intellectual, involves consistent exercise of discretion and judgment, can't be measured in terms of output over time, and requires specialized education."

This statement makes me see red! There is absolutely no reason why technologists could not be declared professional if they used the resources that have been available to them for many years.

The ASMT publication "Labor Relations for Medical Technologists: An Overview" [2] gives basic information on unions and cites cases in which MTs were declared professional. Until the bargaining unit question is settled, the publication will remain an up-to-date resource for management and staff.

* Start now. Lab managers must realize that they may soon face organizing even if the NLRB rules fail to go through. A recent editorial in Modern Healthcare [3] chastised hospital administrators for relying on the NLRB and the Federal courts to help them stop workers from unionizing. The editor stated that the best way to avoid organizing in the hospital is to eliminate reasons employees seek unions.

Institutions can begin now by paying fair wages, installing a reasonable grievance system, encouraging staff input, increasing communication, and treating all staff members with respect.

Although lab managers may not be able to influence wages much, they have other responsibilities. Unions do not seek recognition where they are not wanted. Poor personnel policies invite unionism.

When you act, act with full understanding of all aspects of unionism. The more knowledge you have, the better you will be able to help your employees make the right decision if a union comes knocking on your door.

(1) Barros, A. Will unions solve the lab staffing problem? MLO 20(12): 17, December 1988.

(2) Sharp, W.H. "Labor Relations for Medical Technologists: An Overview." Washington, D.C., American Society for Medical Technology, 1982.

(3) Bell, C.W. Hospital managers must look to selves to limit unionization. Mod. Healthcare 20(17): 17, April 30, 1990.

The author is a management consultant and educator; director of Health Management Analysts, Los Gatos, Calif.; and laboratory operations adviser, Ernst & Young, Great Lakes Region, Cleveland.
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Title Annotation:how new collective bargaining rules affect hospital laboratories
Author:Barros, Annamarie
Publication:Medical Laboratory Observer
Article Type:column
Date:Aug 1, 1990
Previous Article:Financial incentives and diagnostic testing.
Next Article:Lab groups assess CLIA '88 regs.

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