Changing Trends in Healthcare - Essay Example

Running head: CHANGING TRENDS Changing Trends in Healthcare: Nursing You're Changing trends in health carecould be in a large part due to the formation and lasting structure of Labor Unions which attempt to rectify poor working conditions, as well as pay and benefits through collective bargaining. In nursing, history has shown that the professional nurse, nurse's assistant and CNA have had very little power when negotiating with their employer, however with a nurses union; many nurses have finally found a way to gain the power to achieve results through bargaining and negotiating. This is one of the issues that this research discusses among others. Although unions aren't as notable in the nursing field as in other industrial areas, many nurses feel that they are a good idea to have in order to effectively change the working environment of nursing professionals. The conclusion of this research shows that due to how nurses in particular view their working environment there have been many nursing shortages in the past but due to the various new powerful changes that have taken place that grant nurses more control of that environment the trend in nursing is starting to shift to one of a normalcy. Changing Trends in Health Care: Nursing Within the field of nursing in the health care environment, for years there has been an abundance of staffing shortages in this area. This has been due to low pay, long hours, and inequality in the working environment. However, with the powerful idea of a form of a union among nurses this has changed the outlook for this field immensely. CNA's, Nurses assistances, LPN's and Registered nurses have all gone through a number of changes due to the various issues that have taken place through the years. For instance, the view of the Nurse's Unions that shows what the most common reasons are for organized labor to walk off the job and strike are wage related and the employment environment. The shortage of nurses has occurred due to the high demands that have been placed on them for years but for which now they are and have not wanted to put up with any longer. Therefore, this explains why there has been such a trend in the nursing area for years now. The very profound reasons for nurse's strikes are wages, benefits, and patient care demands. In California, the marathon contract dispute between Kaiser Permanente and the California Nurses Association (CNA) alleges bad-faith bargaining, poor quality of care, understaffing of licensed beds and improper closures of facilities. In 1997, the union issued daily press releases alleging poor quality of care and cited daily instances in which Kaiser sacrificed patient welfare to save money (Sherer, 1998). Due to this situation from in the late 90's, the nurses staged six one-day long strikes up until the contract expired in January 1997. The issues include not only wages, but the fight for "the clout they (the nurses) wanted in setting and enforcing standards" (Sherer, 1998). In today's era, nurses from LPN's, to C.N.A's want to be equal team members in reviewing and evaluating whether acuity systems and classification methods are effective. Typically, these systems are used to determine staffing levels and if inaccurate, working conditions could be not only poor, but also dangerous. C.N.A's are organizing politically in California as well and in the last half of the 90's it was shown that they did score a in the California Assembly with a bill that, if signed into law would mandate minimum nurse-to-patient ratios (Sherer, 1998). In August, 1999, the tight healthcare labor market along with nurses' frustration at hospitals where they worked had allowed the C.N.A. to make strong gains through areas of organizing and collective bargaining (Moore, 1999). This made definite changes in this field of nursing care and in fact has contributed to the current trends today. Furthermore, on August 23, the C.N.A. won a 20% pay increase over three years, plus the provisions on the joint staffing/patient acuity committees at four Columbia HCA hospitals in California. After the months of negotiation, the nurses' vote contributed to the authorization of C.N.A. to serve a notice to serve lead towards a settlement. Gary Chaison, a professor of industrial relations at Clark University in Worcester, Massachusetts, states "I don't think there's a major union in the United States that isn't in one way or another approaching the health care sector." Of course the reasons statements like this were made and still are made quite regularly was and is due to trying to prevent further upset in the nursing profession that deeply affects the health care system all over the United States (Greene, 1998). These past actions and movements in this profession have resulted in many recent changes in healthcare which have subjected nurses to the effects of cost cutting, shuffled duties and reorganization, as well as the problem with a chronic nursing shortage. It is almost ironic to see that only 17% of the nation's 2.2 million RNs belong to unions, and therefore labor groups are looking to nursing to boost their dwindling ranks. Two AFL-CIO affiliated unions actively pursuing nurses are the Service Employees International Union (SEIU) and the United Food and Commercial Workers Union (UFCW). There have been several instances of already formed collective bargaining units represented by the state nurses' association switching to AFL-CIO affiliated unions. These occurrences have the American Nurses Association reeling from the defections, including the defection of the 20,000 member C.N.A. from the ANA in 1995. The California affiliate complained that the national leadership wasn't doing enough to combat layoffs and staff shortages. (Jaklevic, 1999) Each state nurses association (except now California) is a member of the ANA. Each state nurses association is divided into two branches, a policy branch and a collective bargaining branch. The ANA is loudly protesting that "only nurses should represent nurses", however, unions such as the SEIU charge that the associations are much more geared toward policy making and academic issues than collective bargaining. Through the haze that is slightly lifting from the various mixes of union influence and political implications in nursing care, there is still a critical shortage of nurses in this country, however not anywhere as extreme as what it was in the 1990's. However, what is being pointed out is the fact that as long as trends such as these being discussed continue, nurses will continue to feel disenfranchised, unprotected and under siege by doctors and health care administrators, and therefore their interest in unions will grow stronger. The many reasons that the majority of nurses organize are not only to protect themselves, but also to protect the patients under their care, as evidenced by the recent activity regarding staffing levels and acuity systems. If the administrators would make a better initiative towards attempting to understand nurses it is felt there would not be so many problems in the profession. Also, if the administration would allow nurses to effectively care for their patients, then half of the battle in this employment area would have been won already. This of course could lead to better healthcare which would consequently mean better labor management relationships. Nevertheless, because so many in charge are continuing to turn a blind eye, there are still many collective bargaining units waiting for the opportunity to organize. As has been stated, the activities that have taken place within all aspects of nursing within the past ten years have affected the outlook of the job market and have shifted what the responsibilities of nurses are as well. Now basically all of those who work as patient care givers receive equal job responsibilities and almost always there are equal demands placed onto them. The nature of the nursing work is very similar in all the various areas of nursing now, for instance the C.N.A., L.P.N., and A.C.N.A., have work responsibilities that include performing routine tasks under the supervision of R.N. nursing staff. They answer call bells, deliver messages, serve meals, make beds, and help patients eat, dress, and bathe. Aides also provide skin care to patients, take pulse, temperature, respiration, and blood pressure and help patients get in and out of bed and walk. They also escort patients to operating rooms, exam rooms, keep patient rooms neat, set up equipment or store and move supplies. Aides observe patient's physical, mental, and emotional condition and report any change to the R.N. Likewise the L.P.N. provides basic bedside care. They take vital signs such as temperature, blood pressure, restorations, and pulse. They also treat bedsores, prepare and give injections and enemas, apply dressings, apply ice packs and insert catheters. L.P.N.'s observe patients and report adverse reactions to medications or treatments to the R.N. or the doctor. They help patients with bathing, dressing, and personal hygiene, and care for their emotional needs. These trends appear to show that the R. N. is not as engaged with the patient care any longer as much as the lower levels of nurses are. Instead they play more of a support role for the other nurses and answer straight to the doctor about the patients care. It is felt that this trend will continue in nursing for years to come as well. To conclude the research has shown how nursing has transformed within the past seven years. Responsibilities have shifted which have lead to different employment options in the field for all nursing care providers. Although there have been high shortages of nurses in the past it has started to mend and due to the changes that have occurred the shortage is beginning to disintegrate. These trends are current and it is perceived that more people will enter into the profession of nursing now with the incentives that are available and also due to the fact that a far better communication and understanding of nurses has developed as well. References Human Resource Management (9th ed.) (1998). Cincinnati, OH: South-Western College Publishing. Inc. Sherer, J. (1998, 20 March). "Kaiser's labor pains." Hospitals & Health Networks, 72(8), 30-32. Jaklevic, M. (1999, 5 July). "Employment and Changing Trends." Hospitals and Health Networks, 72 (8), 38-40. Maidment, F. (1997). "Doc, nurse organizations want to give their members a stronger voice, new services." Modern Health Care. Moore, J. (1999). "Nurse union gains in California: CAN uses favorable market conditions to win pay increases, organize new units." Modern Healthcare Journal, Crain Communications. Mathis, R., & Jackson, J. (2000). Annual Editions: Human Resources 1997, 98, Guilford, CT: Dushkin/McGraw-Hill. Read More