Nearly 18 months of pandemic hardships have increased tensions between the healthcare workforce and their employers.
Not only have longer hours, mounting stress, and a litany of safety concerns fueled labor shortages across the industry, they have also been the rallying cry for numerous protests, rallies, and organizing efforts that have sprung up in the whole country.
“When the pandemic hit, there was a huge shortage of [personal protective equipment (PPE)]. The unions felt that it was the perfect time to try to start many of these organizing drives in these non-union hospitals, ”Ivan D. Smith, a lawyer at Buchanan Ingersoll and Rooney, specializing in labor and employment law, told Fierce Healthcare. “You saw huge organizing campaigns[Service Employees International Union (SEIU)] in particular, going after different organizations to do that, and that has affected other industries as well because it is about worker protection issues. That has definitely been on the rise and continues to be. “
The 2 million members of SEIU and other health worker unions have frequently highlighted staff shortages and other safety concerns as the impetus behind recent demonstrations, one of the most notable being a strike of almost five months at Tenet Healthcare’s St. Vincent Hospital in Massachusetts which is endorsed by the Massachusetts Nurses Association.
National Nurses United (NNU), a 170,000-member national union, was also among the most vocal advocates of federal guidance on masking and spearheads your COVID-19 campaigns with calls for increased infection control and PPE policies in health facilities.
However, the conversation about health care workplace safety has become more nuanced as the focus shifts to the COVID-19 vaccine.
Nurse and health worker unions say largely that they support vaccination as a complement to other safety and infection control measures. However, while policies requiring COVID-19 vaccination as a condition of employment have been widely accepted by dozens of multidisciplinary professional and industry organizations, responses from labor groups have been far less consistent.
RELATED: Kaiser Permanente, Ascension Health, and 86 Other Health Systems Requiring Mandatory COVID-19 Vaccines for Their Workforce
NNU recently expressed support for the vaccine mandates of employers and public officials, telling Fierce Healthcare in an email statement that the organization “strongly believes[s] all eligible individuals must be vaccinated, respecting the need for medical and religious accommodations. “
A few weeks ago, the National Union of Healthcare Workers, a 15,000-member union based in California, applauded Governor Gavin Newsom’s decision to require all healthcare employers to verify the vaccination status of their employees and to ensure masking and testing among those who are not vaccinated.
On the contrary, health labor groups such as the Ohio Nurses Association and based in New Jersey Health professionals and allied employees He said they generally support vaccination, but cannot endorse mandatory policies that remove their right to negotiate.
SEIU did not respond to a request regarding its position on vaccine requirements. Weather educational resources available on the union’s website encourage members to get the vaccine and describe when an employer may require it, the group’s local affiliates have supported demos before Against policies requiring vaccination as a requirement for employment.
“We believe that our members are better equipped to make the right health care decisions for their bodies and their families,” Cara Noel, communications director for 1199SEIU, told an ABC affiliate in late July. “We have been promoting vaccination, but making vaccination a condition of employment is absolutely wrong.”
Increased union activity and ramifications beyond COVID-19
The disparate responses from health unions are not surprising, Smith said.
Support for vaccination is “unfortunately” geographic, he said, and state or local unions in regions with lower population coverage are generally more willing to voice concerns about protecting workers’ rights to physical safety.
Additionally, any facility that already has a union must negotiate changes to terms and conditions of employment, he said.
Unions with large numbers of members who do not want vaccines have an obligation to their members and will take the opportunity to discuss policies and procedures to protect workers in lieu of vaccines, Smith said. Others will come to the table thinking about future negotiations.
“They do not want to give ground [or] to say, ‘Okay, I’ll let you do this mandate for other types of vaccines or other types of things when they have only been considered for emergency use,’ ”Smith said. “So they look ahead to other things that people might have trouble with:[for instance] there are many hospitals that do not require their workers to get a flu shot. “
RELATED: Southern California Healthcare Workers Plan Payment, Safety Protest During Tenet Healthcare Investor Meeting
Advocacy around COVID-19 vaccines and, to a much greater degree, PPE and staff safety concerns is also a potential selling point for non-union workplaces, Smith noted.
Unions from all industries have been prominent in the nationwide conversations on COVID-19, and the safety demonstrations to date have gained a lot of public awareness, he said. The combination of these advances with labor shortages and a more labor-friendly White House gives organizations little reason to slow down as new cases and problems emerge.
“I hope to see more union activity and organizing drives, absolutely,” Smith said. “Unions realize that it will take a little time for them to get back to the norm, and what they will also realize is… that they will be better prepared to address those issues very quickly. Ultimately I think this [pandemic] It has been an opportunity for unions to campaign and organize effectively. “
Vaccine Controversies Can Be Resolved, But Engaged Employees Are A Long-Term Boon
Experts said they expect unions and their memberships to adapt to vaccination mandates in the coming months.
Ezekiel J. Emanuel, MD, vice chancellor for global initiatives at the University of Pennsylvania, former White House health policy adviser and the organizing force behind the joint statement in favor of the industry mandate, said that more and more organizations that Representing nurses and other healthcare professionals have been reaching out to add their signatures and support.
RELATED: Geisinger: Targeted Messages Encouraged More Employees To Sign Up For COVID-19 Vaccination
He was hesitant to characterize the unions as uniformly opposed, noting that several with whom he had spoken prioritized people’s safety and, as such, were inclined to support mandates. Over time, he said, increasing pressure from supportive patient groups, the public and employers will attract employees who are reluctant to participate.
“I think when it becomes widespread in the population and among employers, and you have seen a huge tsunami last week, it becomes the norm,” Emanuel said during a recent press question and answer session. “You need the vaccine to start working, and that will become standard practice and take a back seat.”
Instead, Smith’s conversations with unions have focused on full regulatory approval of vaccines as the tipping point many groups are waiting for.
“As long as they have that emergency use [authorization]They are not going to start that fight with their members, ”he said. “What I’ve seen is that they’ve been trying to educate more about vaccines and their reluctance … but emergency use has been the concern.”
Some health care employers, including Spectrum health Similarly, they have looked to regulators as a lifeline, announcing mandatory vaccination policies that will only go into effect once full clearance is obtained. Others like Ballad healthThey have been wary of a labor shortage, and are concerned that a mandatory requirement could drive many of their employees onto the street and affect their ability to provide care.
Emanuel dismissed the concerns of these organizations as “more theoretical than real.”
“If you look at the health systems that have really demanded this, they have retained more than 99% of their workforce,” he said. “Your workforce agrees when the employer requires it.”
RELATED: Coworker, Institutional Support Helped Nurses Maintain Mental Well-Being During COVID-19 Pandemic: Survey
Rather, Smith cautioned against mandatory policies that don’t start with a conversation.
Be it COVID-19 vaccinations or any other term and condition of employment, his advice to hospitals concerned about job setbacks was to engage employees about their needs long before a union sees the need to intervene.
“They are human beings, right? When it comes to these kinds of issues, their lives are at stake and their professions are at stake, ”he said. “There are things you can do to help them: make sure they have training in mental health or [employee assistance programs]. Little things like that, where you say, ‘We understand what you’re going through, we appreciate what’s going on, and we want your feedback to make it easier and better,’ can serve a thousand ways to improve your facility. “
Specifically for facilities where unions already exist, Smith said it would be better for employers to think of labor groups as partners addressing a shared challenge.
Despite strikes, adverse relations between management and workers can deprive organizations of a crucial bargaining chip when it comes to seeking outside support.
“If you have a union, come in and say, ‘We are partners here, we have to figure this out. How can you help us deal with what we are going through? How can you help to hire nurses or any staff we need? How can you help us get the equipment we need from the government or the states? ‘”Smith said. “Unions have resources and power. I think sometimes employers don’t ask unions to do what they need to do to help [employers] to be able to do his job and move effectively in his space. “