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The San Francisco Chronicle

Nurses Unions Join Together for More Clout

Victoria Colliver

The California Nurses Association, which organizes rallies like this one in Oakland, has allied with two other unions. (Photo: Liz Mangelsdorf / The Chronicle)

Nurses from three unions, including the
powerful California Nurses Association, have founded a new national
union to influence national health care policies and try to extend
California's patient ratio law into other states.

Organizers said the 150,000-member National Nurses United, the
largest professional union for registered nurses in the country, will
also flex its power to push for a stronger voice in the health care
overhaul process going on in Congress and the expansion of
representation for nonunion nurses.

The merger, approved Monday at a convention in Phoenix, combines the
California union, which has 83,000 members in several states, with the
Massachusetts Nurses Union, with 23,000 members, and the 45,000 members
from the United American Nurses, who work primarily in the Midwest. The
unions will continue to operate separately, but will be aligned under
the larger umbrella of National Nurses United.

Pushing health reform

The union's creation, which has been eight months in the works,
comes at a time when the country is involved in a debate over how to
overhaul the nation's health care system.

"We're just thrilled we are finally all moving forward together, and
we're expecting we will be able to play a much bigger role in the
health care debate in the future," said Karen Higgins, a Massachusetts
nurse who is one of three organizers elected president of National
Nurses United.

The nurses, while virtually uniformly in favor of a national or
single-payer health care system, a concept that is not on the table in
Washington, say they also want a larger voice in setting policies that
affect patient care and the quality of health services.

Critics questioned whether the new "super union" is merely an
attempt by the already powerful bargaining groups to add to their
membership and maintain job security. At a time when health care costs
are in the spotlight, some questioned whether the merger could actually
add to the price of health care.

"They could increase the cost of health care if they use their
leverage to negotiate higher salaries," said Steven Rousso, principal
with HFS Consultants, an Oakland financial consulting firm for clinics
and hospitals. He said 70 percent of a hospital's operating costs is
consumed by salaries, with two-thirds of that devoted to earnings by
registered nurses and other nursing staff members.

The California Nurses Association/National Nurses Organizing
Committee and an increased demand for nurses, partially brought on by
the union's push for a California law that establishes nurse-to-patient
ratios, have been largely credited with helping to dramatically raise
nurses' salaries.

The average income for a California nurse rose from $59,937 in 2004
to $81,428 last year, with about a fifth of registered nurses reporting
salaries of more than $100,000, according to the California Board of
Registered Nursing's 2008 survey of nurses. National studies have shown
that nurses who are represented by a union make an average of 5 to 10
percent more than nonunion members.

Rousso also dismissed California's nurse-to-patient staffing ratios
as "job security," and said there is little evidence that it improves
patient care. The ratio law was phased in starting in 2004 and is still
the only such law in the country.

Officials from the California Nurses Association rejected the notion
that ratios don't improve patient care, citing studies that support
their position as well as the introduction of legislation this year by
Sen. Barbara Boxer, D-Calif., that would extend those ratios

Tough tactics

The state association and other nurses unions have been
controversial because critics, including some nurses, don't believe
that first-line caregivers should ever go on strike. Others don't
always support unions' tough negotiation and organizing tactics.

"But love them or hate them, you have to respect them," Joanne
Spetz, an economist and faculty researcher at UCSF Center for the
Health Professions said of the California group. "A nurse or health
administrator might not like their tactics or them as an organization,
but they're effective. They have a strong vision and they carry it
forth very actively."

Spetz said she is uncertain whether the new, larger union would have an impact on national health policy.

"A hundred and fifty thousand nurses is big, but there are 3 million nurses in the U.S.," she said.

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