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The effects of COVID-19 have been felt across nearly every part of our society and business sector, yet none has been as severely impacted as the healthcare industry. Organizations have had to react quickly to the new realities of the pandemic, preparing for massive shifts in treatment priorities and revenue projections. Employees, meanwhile, have proven themselves truly essential through their courageous efforts to ensure patients suffering from COVID-19 and other conditions receive the care and treatment they need.

Amid the uncertainty and unprecedented challenges, unions and labor organizations have identified an opportunity to expand their membership. These groups are attempting to use COVID-19 to drive a wedge between workers and their employers at hospitals, long-term care facilities, and other healthcare organizations. The pandemic and its challenges have become a rallying cry for unions seeking to organize nurses, nurse assistants, security, custodial staff, and other workers. These organization strategies do not typically differ by worker classification, although many unions will attempt to organize lower-paid staff such as nurses’ aides and custodial staff first.

Minimizing Union Interference in Healthcare Organizations

Contrary to popular belief, the push to unionize groups of workers doesn’t usually start with a focus on pay – though compensation is a key point in most union negotiations. Rather, unions typically attempt to organize workers around terms and conditions of employment. This includes issues like workplace safety, training, and scheduling, which have all been flashpoints throughout the COVID-19 pandemic. Personal protective equipment (PPE), on-site safety protocols, training, and effective scheduling have been the source of disputes over the last several months. Unions are eager to take advantage of these rifts by infiltrating workplaces and alerting regulators to perceived violations. In fact, OSHA whistleblower claims increased by 30% during the first four months of the pandemic, and healthcare organizations have not been immune to the increased regulatory scrutiny.

On top of everything else they’re facing, hospitals, nursing homes, and other sites have been forced to devote time and resources to addressing concerns about unionizing and the potential for misinformation and unrest among staff. Here are five key steps organizations can take to be proactive about addressing unionization efforts and making sure employees have the information and resources they need.

1. Maintain Open Lines of Communication

The most effective tactic for maintaining an engaged workforce and addressing the temptation for workers to organize is open and honest communication. Create meaningful channels to receive and act on employee feedback and share progress on key challenges to providing the best care. As healthcare facilities nationwide struggled with PPE shortages over the summer, countless inspiring stories emerged of employees and management finding new sources of equipment and coming together to protect each other and patients. When employees and the organization are working toward shared goals, it’s more difficult for unions to foster dissent among the workforce. Remember these employees are under tremendous mental stress, and any effort that show you are trying to be part of the solution can go along way.

2. Consider the Role of Patients and Families

When patients or their families perceive a drop in quality of care, they may look to unions as a way to maintain standards around staffing levels and employee resources. This is especially common in long-term care facilities. Family members who believe residents aren’t getting the services or attention they deserve can alert local unions. In other cases, comments or complaints from nurses or other employees to patients, residents, or family members may instigate union activity. Facilities should ensure their communications efforts consider patients and their families as well.

3.  Show Appreciation

COVID-19 has forced individuals and families to make significant sacrifices. Any increase in compensation or benefits can go a long way in helping employees see their contributions are valued. These compensation increases don’t need to be 10 percent raises – even small merit increases or bonuses have proven to be effective. If monetary increases or benefits enhancements aren’t an option, consider other ways to make employees feel valued and appreciated. From additional paid time off to free lunch vouchers and more, there are options organizations have to show their workers how valuable they are.  

4. Educate Managers on Labor Practice Rules

Employees have a broad set of rights when it comes to organizing, and there are strict rules that govern how union campaigns must be allowed to play out on the job. Any supervisors who may find themselves in situations dealing with union discussions or other organizing efforts should be properly trained. To remind supervisors of actions to avoid during a union campaign, the National Labor Relations Board recommends the TIPS acronym – Threats, Interrogation, Promises, and Surveillance.

5. Maintain Due Diligence in Hiring Practices

Unions often use a technique known as “salting” in which a pro-union individual is hired at a facility and begins promoting the idea of unionizing the workforce. Employers can prevent these “salts” from joining their workforces by continuing to utilize thorough hiring procedures – particularly reference checks. The staffing shortages created by COVID-19 have made recruitment and hiring more challenging than ever, but following the proper protocols is key to reducing the chance of pro-union workers joining the ranks.

More Organizing Efforts are Undoubtedly Coming

As the pandemic rages on, it’s unlikely that efforts to unionize healthcare facilities will slow anytime soon. With case rates and hospitalizations rising in much of the country, healthcare organizations will continue to face challenges around staffing and resources that give unions a chance to start conversations. At the same time, evolving treatment and prevention protocols, including a vaccine in the near future, also create uncertainties and potential risks that unions will be eager to exploit to gain an organizing advantage. Open, honest communication and the other key tactics outlined above can offer a meaningful first line of defense for healthcare facilities.

Handling the potential for union activity at your healthcare facility poses real legal and communications challenges. Working with established professionals can prevent mistakes so organizers don’t have the chance to get a foothold among your workforce. The healthcare team at Buchanan has extensive experience addressing these issues with the expertise and insights to navigate the new considerations and best practices brought about by COVID-19.

Read more insights from Ivan Smith in the Modern Healthcare article, "Union actions, outcry reveal tension during pandemic."