Can joining a union really change the future for my patients? Yes!

Ask some of the more than 22,000 nurses and health care professionals who make up the MNA (Massachusetts Nurses Association) what it means to be a member of a union, and you hear a common theme repeated in their answers.

"It's all about the patients," explains Edith Harrigan, an RN at St. Vincent Hospital in Worcester for 35 years. "Organizing a union within our hospital is letting us take our practice back and, as a result, we're getting closer to providing the level of professional nursing care that our patients need and deserve."

It is this spirit, this mentality, this desire, that has led hundreds of thousands of nurses and health care professionals throughout Massachusetts to organize a union within their place of employment.

"The process of organizing was pretty scary at times," says Harrigan, adding that the union at St. Vincent completed its long drive to organize in 1998, and that it didn't sign its first contract until after a 49-day strike. "But what was scarier was what would have happened if we didn't organize. We just couldn't do it anymore. We couldn't let management put us in the position of providing substandard care to patients—and we knew we couldn't change things without the strength of the MNA."

The union myth

Although it is commonly believed by some audiences that the sole purpose of a union is to improve the wages and benefits of its members, this it is only a small part of the picture.

Union members—and MNA members in particular—select to "organize" so that they can improve their workplaces across a spectrum of issues. For most MNA members, these issues have included inadequate staffing, mandatory overtime, the lack of proper orientation for new and "floating" nurses, and other professional concerns.
By organizing an MNA bargaining unit at their places of employment, members create, grow and use "a real voice"—or a voice grounded in solidarity that will influence change. Organizing a union also lets members join forces with millions of other professionals, and they in turn can use this power to influence important changes at both the state and national levels.

"We tell nurses that in today's health care environment it is more important than ever to have a union at their facility," explains Eileen Norton, director of organizing for the MNA. "With the current staffing shortages in health care, you need to have an effective voice. You need to be part of the decision-making process so that you have a say in everything that affects you and the work you do."
Norton adds that as non-unionized nurses become more vocal about their working conditions, management responds with strategies that make them believe they have a voice in what is happening.

"They use nurse councils, task forces, shared governance, quality circles, committees to redesign the workforce and, of course, the latest ploy, ‘magnet status,'" says Norton. "These approaches only work as long as management wants the same things that you want. Try to get something passed that management is opposed to and you'll see they don't work. Having a legally binding contract in place that allows RNs to sit with management is the only way for nurses and health care professionals to protect their patients and licenses."

Organizing: what it means to RNs

According to Marlena Pellegrino, also an RN at St. Vincent Hospital, the catalyst to organize came when the hospital announced that it would be introducing "a new type of nursing."

"Management brought in a new model called ‘patient care re-design,' which meant more support staff, but also meant a much higher RN-to-patient ratio," says Pellegrino. "Basically, they were selling us a bill of goods. The ratios increased to seven to nine patients per nurse and it failed miserably because patient safety was compromised."

For the nurses at St. Vincent, this was the proverbial straw that broke the camel's back. "A group of us took our concerns directly to the MNA," adds Pellegrino, "and we held our first organizing meeting in 1996. I went to that initial meeting thinking there would just be a few people, but I couldn't find a parking spot! There were more than 100 people there. That's when I knew that something big was going to happen."

Pellegrino and Harrigan both recall the highs and lows of establishing an MNA bargaining unit at St. Vincent and signing that first contract. Those highs and lows included two long years and a 49-day strike that was overwhelmingly voted in favor of due to management's refusal to include mandatory overtime language in the contract.

"The day after we finally got the contract," describes Pellegrino, "I walked into work and, while everything was the same, it was not the same. I walked in with my head held high because I felt empowered. We finally had a say in the care we provided for our patients."

The highs and lows

For the nurses at UMass Memorial Hospital in Worcester, the need to organize became undeniably apparent in 2001—right as the hospital's then CEO was dramatically cutting benefits and mandating overtime at an alarming rate.

"The administrators at our hospital wanted to manage patient care like they were counting beans," says Jackie Brosnihan, an RN at UMass for 10 years and chairperson of the hospital's MNA bargaining unit. "They were only looking at the bottom line and they were doing so at the risk of their patients and nurses."

"We weren't looking for anything from the hospital other than the ability to do our jobs the way we were trained to," adds Lynne Starbard, also an RN at UMass and co-chairperson of her bargaining unit. "So people started asking questions; listening to what was going on; paying attention to potential opportunities that might provide us with the right opportunity to organize. This was hard though because, at the time, most people were afraid of management."

But two such opportunities came up when the hospital's CEO "opened the flood gates" so to speak.

"Word began to spread that we were working with the MNA, and it didn't go over well with management," says Brosnihan. "In fact, the CEO showed up on my floor one day and, in essence, threatened me for being ‘one of the faces' of the organizing movement."

Although Brosnihan didn't realize it at the time, the MNA's organizing department was quick to recognize the CEO's actions as behavior in violation of labor law—and the CEO's mistake would greatly benefit the UMass nurses almost immediately, as it allowed them to continue through the organizing process under the protection of a neutrality agreement.

Starbard found herself faced with a similar opportunity during an "employee forum" that was held by the CEO during the early days of the organizing process. "He stood up at this ‘open forum' asking for input and feedback, so I brought up the issue of mandatory overtime and how it was devastating to the care of our patients and the well being of our nurses," says Starbard. "Do you know what his response was? He told me that it wasn't an issue. That ‘mandatory overtime' was just a union term."

It was at this point that both Brosnihan and Starbard realized they were becoming two of the more recognizable faces of the organizing movement at UMass. "That realization was scary because there was no hiding after that," says Starbard. "But I couldn't turn back. Management's behavior was just too infuriating, and it was hurting my patients."

UMass Memorial successfully completed its organization efforts in 2001 and is now in the midst of negotiating its second contract. Both Brosnihan and Starbard say every part of the process was worth the effort.

"We've felt that as long as we are speaking the truth; as long as we are honest; as long as we are fighting the right fight that we'll win," explains Brosnihan. "And we did. All of the RNs in the bargaining unit at UMass stuck together, and we won."