By Linda Shrieves
Orlando Sentinel
November 23, 2010

Actions in Sanford, Kissimmee reflect national trend

Registered nurses at two Central Florida hospitals have voted to unionize, reflecting a national trend in which nurses are banding together to fight what they call chronic understaffing.

At Central Florida Regional Medical Center in Sanford, nurses voted 132-62 Monday night in favor of representation by National Nurses United. Last week, nurses at Osceola Regional Medical Center in Kissimmee voted 354-30 to join the same union, which is the largest in the country for nurses.

The victories in Florida follow a wave of union organizing among nurses in Texas and Nevada — all states that traditionally have been unfriendly to unions. Nurses at three hospitals on Florida's west coast are scheduled to vote this week.

As hospitals cope with shrinking revenue from Medicare and Medicaid, the unionization of nurses could mean power struggles within hospital systems, with administrators trying to cut costs and unions demanding to hold the line on nurses' workloads.

"This union is an all-nurse union, comprised of working, bedside nurses," said Karyn Hayduk, a nurse at Central Florida Regional. "We feel we're in a better position to advocate for our patients if we join together in one voice."

For unions, which have been losing members as manufacturing declines, the health-care industry's growth offers potential. Union membership nationally has declined from 24.1 percent of all workers in 1979 to 12.3 percent today, but membership among health-care workers has grown slightly over the past decade, to 13.6 percent.

"Unions thrive in environments of economic uncertainty," said Gary Chaison, professor of industrial relations at Clark University in Massachusetts. "Workers — nurses, in particular — have this sense that they're losing control over the process, over the decisions that are being made."

In Florida, the union has targeted nurses who work at HCA facilities, including the Osceola and Sanford hospitals. HCA, also known as Healthcare Corp. of America, is the nation's largest for-profit hospital chain, operating 163 hospitals across the country and more than 30 in Florida.

Union officials said they targeted HCA because of its dominance.

Responding to the nurses' votes, HCA said in a prepared statement that "we will continue to provide the same high-quality care for which we are known. … While we do not believe having a union is in the best interests of our hospitals, we respect our employees' rights to make this decision."

Although several South Florida hospitals have nurses unions, the recent votes in Sanford and Osceola are the first wins by National Nurses United in Florida, which represents 160,000 nurses nationwide. It was formed in 2009 in a merger of several nurses unions.

Nurses at HCA hospitals in New Port Richey, Largo and Port Charlotte are scheduled to hold union votes this week.

Although unions have traditionally fought to increase wages, many nurses say they're aligning with the union to improve working conditions and patient care. Specifically, the nurses union is lobbying for a state law that would reduce the number of patients assigned to each nurse. A similar law was implemented n California in 2004.

"In a Florida hospital, you could be taking care of seven or eight patients on a floor, while in California, the maximum is five," said Liz Jacobs, a registered nurse and spokesman for the union. The result, she said, is better care.

"Nurses don't go into the profession to get rich," Jacobs said. "They want to do a good job for their patients." The average nursing salary in Florida is $62,270, according to the U.S. Department of Labor.

But hospital administrators argue that they want to do a good job too – and to act as financial watchdogs.

"I am sure the nurses have the interests of the patients at heart," said Bruce Rueben, president of the Florida Hospital Association. "But management would tell you the same thing. The patient has a multifaceted interest here. They want effective, safe care, but they also want affordable care."

In recent years, hospitals across the country have cut costs by reducing staff and increasing work hours. A 2010 survey by the American Hospital Association found that 53 percent of the nation's hospitals have cut staff to cope with the economic downturn and 89 percent have increased hours or have not replaced staff members who have left.

Linda Shrieves can be reached at lshrieves@orlandosentinel.com or 407-420-5433.