Chapter 19

Workforce Engagement and Collective Action

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Objectives Distinguish the differences between the role of

leaders and followers and the role followership has in collective action.

Evaluate how key characteristics of selected collective action strategies apply in the workplace through shared governance, workplace advocacy, and collective bargaining.

Distinguish between the rights of individuals included in the collective bargaining contracts and the rights of at-will employees.

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Objectives (Cont.)

Compare traditional bargaining practices with a more contemporary approach, Interest-Based Problem Solving (IBPS).

Evaluate decision-making strategies for their effectiveness within diverse workplace environments.

Evaluate how participation of staff nurses in decision making relates to job satisfaction and improved patient outcomes.

Analyze the influence of culture on the selection of a governance model or model of care delivery

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Terms to Know

At-will Employee Collective Action Collective Bargaining Culture Empowerment Engagement Followership Governance Interest-Based Problem

Solving

Institute for Healthcare Improvement (IHI)

Mentor Right to Work Role Model Shared Governance Subculture Whistleblower Workplace Advocacy

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Collective Action

Definition: Activities that are undertaken by a group of people who have common interests.

Examples:Parishioners contribute to a missionNurses collaborate to achieve Magnet™ designationDelivery of high-quality patient care (24/7)

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Collective Action (Cont.)

Historical perspective includes issues of power and gender that have transcended over time.

These strategies can coexist in any given setting. Differences about how to approach collective action exist geographically, philosophically, and certainly by type of facility.

Be informed and proactive about working together on issues of importance to nurses.

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Collective Participation

Main Purposes: To promote the practice of professional nursingTo establish and maintain the standards of careTo allocate resources efficiently and effectivelyTo create satisfaction and support in the practice environment

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Nursing Governance

The method or system by which a department of nursing controls and directs the formulation and administration of professional nursing practice and nursing policy

This works best when done collaboratively with the shared interest of both the workforce and the organization in question.

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The Focus Shared governance Shared decision making (decentralized) Workplace advocacy Nurse engagement Responsibility Accountability Authority Autonomy Collective bargaining

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Shared Governance

A democratic, egalitarian concept A dynamic process A process of shared decision making and

accountability

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Shared Governance: Context

Culture Subculture

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Shared Governance Can

lead to better decisions. be more effective in day-to-day practices. generate additional ideas for implementation.

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Responsibility

Nurses historically have accepted responsibility or the “charge to act.”

Past Nurses were thought to exist to follow the

physician’s orders and have very little independent thought or action.

Today High-performing organizations are characterized

by the control of nursing practice by nursing. Structure, credentialing, and certification.

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Autonomy

Definition: Freedom to make independent decisions within

the scope of practice (State Dependent).

Presence of autonomy . . . Increases both patient and nurse satisfaction Creates better patient outcomes Encourages innovation and productivity

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Accountability

Six critical considerations in shared governance and accountability . . . Defined by the person in the role Defined by role, not job or task Based on outcomes Set in advance Linked to results Has observable processes

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Traits of a Good Follower

Trustworthy Dependable Excellent communicator and listener Team player Courage of convictions Collaborator Questioner

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Workplace Advocacy

The objective is to equip nurses to practice in a rapidly changing environment. Advocacy occurs within a framework of mutuality, facilitation, protection, and coordination

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Workplace Advocacy (Cont.)

Manifestations of workplace advocacy: Ensuring relevant information Enabling the selection of information Disclosing a personal view Providing support for making and implementing

decisions Helping determine personal values

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Culture and Subculture

Culture Geographic and organizational norms that make

up how employees contribute to or experience the work environment

Subculture Rooted in the mission of the organization, division,

department, or unit Macro: For-profit, not-for profit, faith based Micro: Critical care, perioperative, hospice, day

shift, night shift

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Characteristics of Empowerment

Owner, not renter, mentality Safe to take appropriate risks Professional and personal diversity are

celebrated Less hierarchy Locus of control is closer to point of care

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Interest-Based Problem Solving

Foundational philosophy of trust and mutual respect: this takes time

Transition from a focus on an individual or group position to common interest or end: state goals

Commitment to finding common ground, avoiding conflict

Facilitated with a goal to move all parties forward

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Collective Bargaining

“…the performance of mutual obligation of the employer and the representatives of the employees to meet at reasonable times and confer in good faith with respect to wages, hours, and other terms and conditions of employment or the negotiation of any agreement or any question arising thereunder...”

Labor Management Reporting Act, 1947, Section 8

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Collective Bargaining (Cont.)

Nurses have a low rate of unionization.

Nurses are a prime target for membership growth.

Constant challenges exist to the way nurses are viewed for collective bargaining purposes.

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Terms to Know

Nurses as knowledge workers Union or at-will Whistleblower

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Nurses as Knowledge Workers

Past Workers in manufacturing were treated as

interchangeable cogs

Today Health care is more complex than ever . . . The

scientific discipline of nursing requires specialized education – NOT interchangeable

As the role of advanced practice continues to evolve, nurses bring the professional knowledge and expertise to all areas of the healthcare field.

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Union or At-Will

At-will States that employees work at the will of their

employer Designation is said to favor management or the

employer Union

Said to provide a greater sense of job security Requires equity and due process when managing

employee performance, benefits, and compensation

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Whistleblower Protection

Whistleblowing “refers to a warning issued by a current or former employee of an organization to the public about a serious wrongdoing or danger created or concealed within the organization” (Hunt, 1995, p. 155). The 1989 Whistle Blower Protection Act protects federal workers. The law does not cover the private sector.

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Suggested Criteria for Selecting a Bargaining Unit

A strong commitment to nursing practice, legislation, regulation, and education

A well-prepared practice, policy, and labor staff; a minimum of a bachelor’s degree in nursing

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Suggested Criteria for Selecting a Bargaining Unit (Cont.)

Representative of those the bargaining unit represents in both gender and ethnic makeup

National scope and local implementation Control by individual members over

bargaining unit activities

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Alternative Dispute Resolution

Interest-Based Problem Solving (IBPS) Negotiation Facilitation Mediation Arbitration

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Conclusion

There is greater diversity in nursing than ever before.

Collective action must exist in environments where high-quality, cost-effective care is provided by an engaged and professional workforce.

Whether a nursing workforce is unionized or not should not preclude nurses from practicing to the full extent of their education and licensure.

New relationships and continued evolution of public policy must take place for there to be continued progress.

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