BURLINGTON, VERMONT. A jolt of tension hits the room at the Burlington Sheraton Hotel as presenter Maureen Srocznski tells a group of high-level hospital administrators that the two crews that just filmed them were from local TV stations. Since their seminar on "Critical Strategies for Positive Labor Relations" is sponsored by the University of Vermont, a publicly funded institution, the news crews had to be admitted during the first hour. "The labor community feels we are union busting," she explains.
One of the attendees mutters, "Oh jeez."
"Do I look like a union buster?" asks Srocznski, a partner in Michigan-based O'Connor Consulting Group, a firm specializing in labor relations in the health care industry. She throws her arms wide and gives the group a broad smile. "We are simply giving a balanced view."
She announces that about 100 people "sent by unions" have gathered outside. But she assures the attendees "the hotel has taken steps to ensure that we are all safe . . . from those of the opposite persuasion."
"Is this a great country or what," says company President James O'Connor, a short, beefy guy with an easy, avuncular manner.
The university's continuing education program has invited Srocznski and O'Connor to Vermont, which, like many states, has experienced a boom in union organizing among health care employees. The seminar has drawn about two dozen hospital executives, administrators and nursing directors from around New England (and one from Maryland). Most have already faced or are dreading the union at their door.
Throughout the two-day presentation, Srocznski and O'Connor explore nuts-and-bolts tactics for keeping unions at bay alongside "touchy-feely" techniques to show employees that management cares. Using the language of public relations, pop psychology and new-age wisdom, the consultants teach attendees how to similarly couch their message. "We are not trying to talk union busting, we are trying to diffuse anger," Srocznski says. "Call it a positive employee relations program."
||"You take this back and you will be able to change the world. There will be no more unions."
Nonetheless, the objective is clear to all by the time Srocznski ends the final day with the charge: "You take this back and you will be able to change the world. There will be no more unions."
In fact, as the presenters readily acknowledge, unionization among heath care professionals is one of the fastest growing areas in a re-energized union movement. Last year, in the biggest victory in a single election since the '30s, the Service Employees organized 75,000 home care workers in California (and the union has scheduled more than half a dozen elections for next few months). The American Nurses Association, the American Federation of Teachers and other groups are hitting hard at the health care field, where unions are currently winning 54 percent of their elections.
Among the factors that have figured into this success is that hospitals and nursing homes -- unlike factories -- cannot run away to low-wage developing countries. Furthermore, changes wrought by HMOs and industry privatization and consolidation have created high levels of worker dissatisfaction. Nurses face grinding stress, not only from handling life-and-death situations on an hourly basis, but from a rash of cost-cutting measures such as mandatory overtime, understaffing, lack of specialized personnel and cut-rate equipment.
In a July 1999 survey released by the Kaiser Family Foundation, 78 percent of nurses responded that as HMOs and other managed care plans have increased, the quality of health care for people who are sick has decreased. Some 69 percent say inadequate staffing levels at their workplace are of "great concern." "When I look back to nursing in the '70s, I think we now expect nurses to do more for less," says Sue Lucas, a nurse at Copley Hospital in Morrisville, Vermont. "Patients are sicker now that the HMO and Medicare criteria are so tight. As you have fewer nurses to care for more and sicker patients, you have to make decisions not to do things. Clearly you do the life-and-death care, but you no longer have the time to teach patients to understand what symptoms to report or to care for themselves when they go home."
||"When you have the business model, health care becomes a product. "Management doesn't care about the reality, only the perception."
Nurses say that management's obsession with the bottom line is not just hurting patients, it is endangering staff. Health care workers are exposed to a stew of antibiotic-resistant organisms and are becoming increasingly sensitized to latex used in gloves. More seriously, according to the American Nurses Association, they sustain as many as 1 million needlestick and sharp instrument injuries every year -- resulting in thousands of new cases of HIV and hepatitis. "When you have the business model, health care becomes a product," says Ken Eardley, a nurse at Fletcher Allen Hospital in Burlington. "Management doesn't care about the reality, only the perception."
Managing perception is at the core of Srocznski and O'Connor's message to seminar attendees. When the union comes "you have to be very sensitive," O'Connor advises. "You don't overreact with your own children, not that I mean your employees are like children."
The consultants say administrators should present themselves as employees' allies against "outsider" unions. "You should acknowledge that hospitals are often understaffed and overburdened," Srocznski suggests. "Let the employees know that unions will only make things worse. They will take nurses off-task from focusing on caring for patients."
They say employee grievances should be treated as psychological and public relations problems. Administrators should launch a hearts-and-minds campaign to defuse stress and anger, reassuring employees that they are sympathetic, aware of problems, working on solutions and acting in the best interest of patients and staff. Managers should allow workers a modicum of input, the illusion of influence and the right to grumble. "There is a high level of anger," Srocznski notes. "We need to validate that anger and know how to work through it and continue to do what we do."
But what some nurses want is not validation but immediate reform, especially in those areas that affect patient care. "We had a situation where cardiac monitors were kicking out lethal arrhythmia and nobody saw it and a patient died," says a nurse at a large New England hospital. "Patients are hooked up to cardiac monitors that output to a central desk where qualified medical personnel are supposed to continuously watch for problems. There would have been time to react, but nobody was there to see it."
||Srocznski advises administrators to give the disgruntled the "magic minute." "When someone is upset and asks for a minute, don't say, 'I'm too busy, I have only a minute.' You make it seem like longer if you say, 'Yes, I have a minute,' and then sit and give them your full attention for a minute.
Compromised patient care, the consultants warn, often forms the irritating grain around which organizing drives form. "If management learns to align with employees," O'Connor says, "that weakens the employee-union bond. It's the touchy-feely stuff that often gets you the edge."
"How many times do we actually talk to the nurse on the 3 to 11 shift?" Srocznski asks. "We take the nurses for granted [and they] perceive a lack of professionalism, dignity and respect." This inattention "leads to frustration; frustration leads to rage and dread. . . . Rage and dread open the door to union organizing."
Srocznski advises administrators to give the disgruntled the "magic minute." "When someone is upset and asks for a minute, don't say, 'I'm too busy, I have only a minute.' You make it seem like longer if you say, 'Yes, I have a minute,' and then sit and give them your full attention for a minute. By sitting, you equalize the power. And then say, 'I look forward to having my secretary schedule some time for you.'"
If efforts to assuage employee concerns fail, management still can do a lot to undermine the threat of unions. Srocznski and O'Connor say administrators must know the limits of the law, get supervisors "on the same page," and implement pre-emptive and reactive strategies to undercut union access and organizing by all legal means. First, they should implement regulations to restrict where and how unions can access employees. Then, the consultants -- making unionism sound like cancer -- advise administrators to keep an eagle eye on employees and look for "early symptoms." The list of these signs of organizing activity, Srocznski notes, "was left out" of the printed packet given to the seminar attendees "because it could have been controversial . . . and embarrassed the university."
Watch out, Srocznski says, when employees gather in the parking lot, get together before and after work, hang around a unit or in smoking areas, take long bathroom breaks together, or are found in different units and then say they are "just visiting"; stop talking when management comes in the room; ask for their personnel records or for policy and procedure statements that they may be passing on to the union; engage in such "symbolic acts" as refusing mandatory overtime or increased absenteeism; "use their involvement with patients as a way not to cooperate"; "want the public to believe that patient care level is not safe" because of the management policies; or discuss safe work conditions and needlesticks or question staffing levels, policies and benefits such as HIV insurance. Another warning sign: "You give a Christmas party and no one comes."
Although surveillance of union activity is illegal, "you have to keep track of what's going on," O'Connor says. "You need your supervisors to structure rounds and change the pattern of visits" so pro-union workers can't predict when they will show up.
Planning should also go into personnel decisions. Srocznski cautions seminar participants that they "legally can't exclude people because they are union." But she recommends particular scrutiny of nurses from different counties or out of state. "Information about union associations may be embedded in resumes. It's like a red flag to me," she says. "You have to be careful and ask casually: 'Oh, you used to be in the Massachusetts Nurses Association?'"
||When continuing education program developer Ellen Ceppetelli announces that she has gotten the TV stations to agree not to show participants' faces on the news, there is an audible sigh of relief.
With a mischievous grin, O'Connor holds up a well-paged volume of Saul Alinsky's famous book, Rules for Radicals, and advises the audience to read it to be prepared. "It is important to be pre-emptive and try to prevent organizing before it begins," he warns.
On a gray winter day -- the first of the seminar -- about 100 protesters gather outside the hotel. The demonstration, organized by the Vermont Workers Center, includes not only union members, but church representatives, politicians and students. "We are here to support the biggest wave of organizing in Vermont's recent history and to show that Vermonters oppose any effort to interfere with workers' basic rights for fair treatment and decent working conditions," says organizer Jason Serota-Winston. "That our tax-supported state university feels it is appropriate to work with private union busters only reinforces the need for a public outcry."
The university, which has union problems of its own, counters that it is only supporting free speech and that the course is simply about good management, not union busting. Nonetheless, those sitting in the overheated conference room don't want to be identified. When continuing education program developer Ellen Ceppetelli announces that she has gotten the TV stations to agree not to show participants' faces on the news, there is an audible sigh of relief. The smiles are abruptly short-circuited by her next pronouncement: "Some of the protesters may sign up for the seminar, and we can't prevent that."
A nervous flurry of questions ensues as participants begin taking off name tags. Then someone points out that a list of registrants is included in the hand-out packet. "No one will know you were here," Ceppetelli promises and quickly leaves to remove the list of names from the remaining packets.
LOAD-DATE: February 4, 2000