The Other Kind of Labor in Hospitals: 4 Tips to Manage Union Battles

Most of the time, when we are talking about hospitals and labor, the result is a cute newborn baby. Nope, on the heels of the Labor Day holiday, we’re taking on a far more contentious topic. Unions. Love them or hate them, if you are part of a hospital communication team, you better know how to handle them.

While union membership has seen a sharp decline in most industries (10.7% of wage and salaried workers in the U.S. in 2017, down from 20.1% in 1983, the first year for which comparable data are available, and the peak at more than 34% of the workforce in 1954), hospitals are challenging that trend. A 2014 report uncovered an increase in health care union membership by 47,000, even in a year when overall U.S. union membership declined by more than 200,000.

What has changed for hospitals? In some ways, it’s all the same. Often the largest employer in the communities they serve, hospitals have a big target on their back. Unlike manufacturing and other industries that have seen union membership decrease, hospitals can’t threaten to farm out jobs overseas, so they have less bargaining power. But, mainly, it’s that the environment is ripe for unionization, in part because of job dissatisfaction due to cost pressures and consolidation. A nationwide survey published in BMJ Quality and Safety shows that more than half of nurses worry that their jobs are affecting their health, and 35% would like to resign.

For hospitals that are not currently unionized, it’s worth noting that unions have a better batting average in health care too. In 2014, unions won 77% of representation elections in health care – 10 percentage points higher than the success rate of unions across all other sectors. A National Labor Relations Board rule that took effect in 2014 has no doubt impacted that success rate by expediting the election process from approximately 42 days to between 14 and 21 days.

What does all this mean to you?

1. Scouts motto: “Be Prepared.” If your hospital isn’t unionized and wants to stay that way, it’s important to have a game plan in place. With a shortened window of time to convince your employees to not join a union after a petition has been filed, you want to have a playbook and messages ready so that you can begin confidently executing.
2. The best defense is a good offense. Engaged employees are less likely to seek unionization. For hospitals seeking to avoid unionization, a strong internal communication strategy is essential. For unionized hospitals, this is just as important to help maintain a positive relationship with the union and your employees. Your strategy should be guided by an internal communication audit that provides a baseline measurement and helps identify gaps in communication. And, follow up with regular pulse checks to ensure that you are moving in the right direction. This is especially important in today’s heavy M&A environment in health care. My colleague Natalie Smith outlines some specific approaches to ensuring employee engagement during times of change.
3. R-E-S-P-E-C-T. Not just a great song from the late Aretha Franklin. According to a study cited in Healthcare Finance, people don’t vote for a union because of wages and benefits. It’s all about dignity and respect, or lack thereof. In the same article, David Rittof, president and CEO of Modern Management, Inc. shared, “I’ve had union campaigns start because employers wouldn’t fix the microwave. Unions do not drive wages, the market drives wages.” Believe that this translates to your communication strategy, as well. Engaged employees also are more likely to feel that they are being listened to and respected.
4. Own the conversation during negotiations. If your hospital is already unionized, but is about to start contract negotiations, it’s important to be armed with the necessary tools to manage the conversation. Anticipate challenges and develop a game plan that addresses them so that you can focus primarily on execution. Create a communication platform that will serve as a single version of the truth – this may be a landing page or microsite with key information, articles, and data in support of your position. Identify advocates and arm them to be ambassadors – both internal stakeholders and, ideally, third-party experts.

Take note, health care communicators – if recent trends continue, unionization threats and contract negotiations will increasingly occupy your time (and may even keep you up in the middle of the night like that newborn!). Get ahead of the game – assess your internal communication landscape, make a plan, and create tools in anticipation. With faster election timelines and aggressive union communication practices, it’s a game of speed – and your chance to get ahead of the proverbial eight ball is right now.

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