Who should represent nurses -

at the I * *

bargaining Last September, 24 registered nurses in California found their iobs in jeopardy be- cause they refused to join the California Nurses Association (CNA). The hospitals where they worked participate in hospital- wide CNA contracts which require the hospital administrators to terminate employ- ment of nurses who refuse to join CNA.

The nurses sent in their $97.50 dues to CNA, but with letters of protest against having to join the state nursing association. Although they didn't like being forced to join CNA, they benefited directly from the CNA-negotiated contract providing a total of $113.20 a month wage and benefit package over a two-year period.

Start talking about unions to nurses and voices become louder, and opinions clash. But like it or not, nurses are going to be hearing and talking this year about collec- tive bargaining and unions.

A proposed amendment to the National Labor Relations Act (Taft-Hartley) will ex- tend that law to nonprofit hospitals. Unions, which are looking for new areas to de- velop, are eager to organize health care workers. According to an editorial in The American Nurse, "The health care field i s the third largest in numbers of employees

table? in the US and the largest unorganized in- dustry-a tempting target."' In New York State, unions are already trying to gain control of all nursing.

The American Nurses' Association (ANA) i s a labor union as well as a professional organization. Many nurses find it difficult to accept ANA's dichotomy, but this has been a long-standing policy of the or- ganization. One-third of ANA's members work under contracts negotiated by their state nursing organizations. Recently, ANA launched a campaign to enroll 800,000 active registered nurses for collective action.

"The association will commit substantial financial resources to support the 52 con- stituent nurses' associations to bring collec- tive bargaining to each health care facility," Rosamond Gabrielson, president of ANA, stated in a news release.

ANA's announcement brought protest from some nurses. "We do not believe in collective bargaining. It i s not of interest to us.''

"I can't afford to join a specialty group because I am forced to belong to ANA to work."

The announcement also raised some questions,

Can ANA compete with the big unions?

AORN Journal, April 1974, Vol 19, No 4 785

It will be a tough battle. Unions are ex- perienced, skilled and hard-nosed organ- izers. It may be a David against Goliath struggle. This i s why ANA wants to make nurses aware of the disadvantages of rep- resentation by unions instead of by ANA.

Will ANA have the resources to represent nurses on a large scale? And will all the income and energies of the state nurses’ associations (SNA) be consumed by collec- tive bargaining? Will other interests such as continuing education be neglected? ANA has promised substantial financial help to the state associations. The membership campaign should provide additional reve- nue. As of December, ANA‘s member- ship was 174,997. The goal of enrolling all nurses, or approximately 800,000, may re- flect more idealism than realism, but in- creasing membership should expand the organization’s capabilities.

Will nurses resent paying membership dues to join ANA in order to work? Yes, many probably will. However, Ms Gabriel- son pointed out that collective bargain- ing through ANA i s a bargain. Union membership dues would be much higher.

Can collective bargaining improve pa- tient care? Collective bargaining affects more than salaries and benefits; it extends to all issues related to wages and hours. It could include, for example, the ratio of nurses to patients, or the ratio of nurses to technicians in the OR. The nurse’s working conditions certainly have a direct relation- ship to patient care.

One nurse at Headquarters recalls that in a hospital where she worked, the nurses bolted the state nurses’ association and joined the local plumbers‘ union. The question really is: Who can best represent nurses?

We believe that ANA can better repre- sent nurses because i ts interests go beyond wages and benefits, It i s concerned with the nurses‘ total working environment and professional development. We agree with

ANA that nurses should speak for nursing, should control nursing practice and should participate in determining their employ- ment conditions.

ANA i s the logical organization to unite nurses for the purpose of collective bargain- ing.

FOOTNOTES I . R C Gabrielson, “ANA President‘s Message

for 1974, The American Nurse, 6 (January 19741,

P 4.

Often, in this column, we talk about what nurses can do to help others. This time, we are going to urge you to do something for yourself.

April i s national cancer control month. This issue on breast cancer emphasizes the importance of early detection and early diagnosis for the number 1 cancer killer for women.

Health professionals often know what they should do, but they frequently neglect to take care of themselves.

There is one thing you can do about breast cancer. You can check your breasts each month after your menstrual period. While in the shower, lying down, and sitting up, feel for a lump or thickening. Check with your physician if you find any change.

Simple, isn‘t it? But only 18% of all women practice monthly breast self-exam- ination, according to a recent Gallup poll.

If you are in a high risk category for breast cancer, you should have an annual examination that includes mammography and thermography. The American Cancer Society and the National Cancer Institute have set up 20 centers throughout the country for mass screening for women who have a high risk for breast cancer.

Do yourself a favor. Early detection and early diagnosis are vital in the baftle against breast cancer. Take care of your- self.

Do yourself a favor

Eiinor S Schrader edifor

786 AORN Journal, April 1974, Vol 19, N o 4