5 minute read
A Provocative Question
Recently, I attended a session on healthcare workforce development at the Arizona State of Reform conference in Phoenix. The State of Reform is a national organization that facilitates healthcare policy meetings across the country. This session focused on problems and opportunities related to healthcare workforce in Arizona.
During the Q&A session, I asked the panel if they believed that organized labor was a solution to the current strikes and shortages in healthcare. One panelist said “If unions are part of the conversation, then the healthcare employer has failed in their recruitment and retention. That’s my two cents on the topic.” I replied, “That was great, more like four cents!”
Across my career, I’ve hired a grand total of three workers. I’ve never fired anyone or managed complex salary and benefits packages. But I do follow the news and I see clear themes of strikes, shortages, and stressed workers.
Strikes, Shortages, and Stress
In November, Kaiser Permanente’s healthcare workers voted to ratify a new contract with the hospital chain, ending the largest recorded healthcare strike. 75,000 members (nurses, medical technicians and support staff) took part in a three-day strike, at hundreds of Kaiser hospitals and clinics from California to Virginia.
The new contract includes across-the-board wage increases totaling 21% over four years, an increased payout for employees under a performance-sharing plan and commitments to address a staffing crisis, including increased training, education and mass hiring events. Workers accused the company of failing to address a prolonged staffing crunch that left employees feeling overworked and underpaid while compromising patient care.
Post-COVID workforce shortages in healthcare continue across the country. The projections for shortages in healthcare are staggering: a shortage of up to 124,000 physicians in the next 12 years; and a shortage of 195,400 nurses by the year 2031.
In my home state of Arizona, the Board of Regents has responded by announcing their Healthy Tomorrow initiative to rapidly grow the state’s health care workforce. The state’s three public universities are working to implement the plan with the creation of two new medical schools and an increase in graduates from the existing medical school.
According to a recent CDC report on quality of worklife, poor mental health and burnout has increased among healthcare workers over the past five years. Solutions like resiliency-training and even high-quality employee-assistance programs are not the right solution. Burnout more often stems from current workplace policies and practices, not individual-level causes. So, it’s not surprising when I see survey results showing 1 in 3 healthcare workers want to leave their positions.
Should You Join a Union?
You may be interested to know that CFHA has collected survey responses on quality of worklife. We found that 44% strongly agreed with the statements “I am satisfied working as a BHP” and “I plan to stay at my current employment for at least the next two years”. That is encouraging news for HR managers and seems to be higher than satisfaction data reported in other medical sectors.
What role does organized labor play in the current healthcare workforce climate? In the Kaiser Permanente strike situation, unions were instrumental in securing higher compensation, better workload distributions, and faster hiring processes. These changes will likely make workers happier and improve retention. That is a very good development.
On the other hand, unions require dues and fees, engage in long negotiation battles, increase bureaucracy, and sometimes result in strikes and other job actions. Joining a union is not a trivial matter.
Unions seem somewhat newer to the healthcare industry than other industries. A quick search shows examples like the National Nurses United (NNU) and National Union of Healthcare Workers (NUHW). Other larger unions like the SEIU and UFCW also represent healthcare workers.
Should healthcare workers in integrated care settings join unions? I don’t know. I’ve always had the sense that collaborative, integrated care was a better experience for both the patient and the healthcare worker. I still believe that idea. I also believe that healthcare is a difficult place to work and that workers need the compensation and workplace policies that make it easy for them to answer the question “Do I see myself working here in the next two years?”
I agree with the panelist who answered my provocative question at the policy conference. When unions enter the playing field, that means that the current system has failed in a major way and that a powerful mediator is required to clean things up.
Unions can present challenges for employers, particularly in terms of increased labor costs and potential limitations on management flexibility. While there’s no guaranteed way to prevent unionization, there are proactive measures employers can take to create a positive and supportive workplace environment, reducing the appeal of unions among their employees.
Preventing unionization is not about suppressing employee rights or creating a culture of fear. It’s about building a positive and supportive workplace environment where employees feel valued, respected, and heard. By focusing on employee well-being, fostering open communication, and maintaining fair and consistent management practices, employers can create a workplace in healthcare where unionization holds little appeal.