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Flashcards in Chapter 26 Deck (25):
1

You and other nurses in your organization have chosen to act as a group with a single voice when dealing with some workplace problems. This is known as:
a. unionization. c. collective bargaining.
b. collective action. d. workplace advocacy.

B: Collective action is when individuals act together as a group with a single voice, and it is one method for dealing with workplace problems. Collective bargaining is the practice of employees acting as a collective group and bargaining with management regarding wages, work practices, and other benefits. Workplace advocacy pertains to actions that nurses undertake to address problems in their everyday work setting, and it is another form of collective action.
INTRODUCTION

2

A nurse manager who held a commission in the Army was notified of mandatory military duty and had to go to Iraq to serve for 2 years. After discharge, the nurse returned to the hospital to resume the previous position but was informed that the position was no longer available. The hospital then offered the nurse employment as a staff nurse, which involved a major reduction in salary. The hospital was in violation of which of the following?
a. 1964 Civil Rights Act
b. 1974 Taft-Hartley Amendments to the Wagner Act
c. 1935 National Labor Relations Act (Wagner Act)
d. 1973 Vietnam Veterans Act

D: The hospital’s action was in violation of the 1973 Vietnam Veterans Act. This act was passed to provided reemployment rights for individuals who leave their place of employment to perform military duties. According to the act, these individuals are entitled to be restored to their former position or to “a position of like seniority, status, and pay.” The 1964 Civil Rights Act provided equal employment standards, and the 1974 Taft-Hartley Amendments to the Wagner Act allowed for employees of nonprofit organizations to join unions. The original Wagner Act (1935 National Labor Relations Act) gave employees of private companies the right to organize unions. TABLE 26-1 SUMMARY OF SELECTED LEGISLATION AFFECTING THE WORKPLACE

3

You are caring for a 97-year-old patient whose cancer has returned. The patient tells you that he has had a good life and would like to avoid any additional surgeries. The family insists that the patient should have the surgery. You share with the physician the patient’s preference not to have surgery. Your actions are an example of which of the following?
a. Patient preservation c. Patient advocacy
b. Family negotiation d. Patient bargaining

C: When nurses preserve and protect the wishes of patients, they are practicing a type of workplace advocacy called patient advocacy. Workplace advocacy is the process or the activity that nurses undertake to address problems in their everyday work setting. WORKPLACE ADVOCACY

4

During a presentation on workplace advocacy, the speaker asks the group to identify some of the methods nurses can become involved with in order to promote workplace advocacy. Which response by the participants would indicate to the presenter that further clarification is needed?
a. Collective bargaining c. Professional practice councils
b. Shared governance d. Refirmative action

D; Workplace advocacy can take a variety of forms. Some forms in which nurses may be involved are collective bargaining, shared governance, and professional practice councils. WORKPLACE ADVOCACY

5

As a nurse manager, you have heard your staff talking about poor wages, unsafe staffing, and mandatory overtime issues. An initial effective way of dealing with this type of conversation would be to:
a. report this to upper management.
b. discuss these concerns with your staff using a nonpejorative tone.
c. ask your supervisor what to do.
d. do nothing because it will go away on its own.

B: Whenever staff members gather to discuss workplace issues such as poor wages, unsafe staffing, mandatory overtime, and job security concerns, there is the potential of collective bargaining actions such as unionization or strikes. An effective nurse manager would initially discuss these matters with staff (especially with those who were overheard discussing these concerns) first to find out exactly what the concerns are and then try to determine how widespread they are among the unit. FACTORS INFLUENCING NURSES TO UNIONIZE

6

When you were hired, you joined a group that utilized a collective bargaining agent to formally present desires to management. The group you joined is known as which of the following?
a. Whistle-blowing c. ANA
b. Nurse advocacy d. Union

D: A union is a formal and legal group that works through a collective bargaining agent to present desires and needs to management formally through the legal context of the National Labor Relations Board (NLRB). COLLECTIVE BARGAINING

7

You have always dreamed of becoming a nurse and participating in collective bargaining. Some of your ideas and views are a direct result of growing up in a family of union workers. Both your mother and father were union stewards, and they promoted workplace advocacy. Your background has taught you that workplace advocacy is:
a. a collective action model. c. a workplace agency shop.
b. a qui tam situation. d. the initial step in whistle-blowing.

A: Workplace advocacy is a collective action model that is more informal and encompasses everyday creativity and problem solving tools that occur everyday in nursing. A qui tam lawsuit is filed in whistle-blowing cases, and an agency shop is a term that refers to employees who are not required to join a union. WORKPLACE ADVOCACY

8

At the conclusion of a class on factors that can lead to unionization among nurses, the instructor would recognize that further clarification is needed if a student included which of the following as one of the factors?
a. Job stress c. Unsafe work environment
b. Whistle-blowing d. Physical demands

B: The instructor would recognize that further clarification is needed if a student responded that whistle-blowing was a factor that leads to unionization among nurses. Some reasons that contribute to nurses wanting to unionize are job stress, unsafe work environment, feeling powerless, the physical demands of the job, and the need to communicate concerns and/or complaints to management without fear of losing their jobs. Whistle-blowing is the act in which an individual discloses information regarding a violation of a law, rule, regulation, or a substantial and specific danger to public health or safety. FACTORS INFLUENCING NURSES TO UNIONIZE

9

When a group of nurses employed at a particular hospital act together as a group to bargain with management concerning workplace issues, they are practicing:
a. workplace bargaining. c. workplace advocacy.
b. collective striking. d. collective bargaining.

D: The practice of employees acting together as a collective group to bargain with management regarding workplace issues such as wages, work conditions, and benefits is called collective bargaining. COLLECTIVE BARGAINING

10

You and other nurses in your organization have decided to use a collective bargaining method that is used in the workplace, commonly known as:
a. workplace advocacy. c. collective brainstorming.
b. unionization. d. collective striking.

B: Collective bargaining through unionization is also a collective action model that is legally based and formal. It utilizes a written contract to guide nursing and workplace issues. COLLECTIVE BARGAINING

11

A nurse working in a private physician’s office noted that several of the clinic patients had been given prescriptions for cholesterol medications even though the laboratory results did not indicate the need for these medications. Concerned with the patients’ health and safety, the nurse reported her suspicions to the proper authority. The nurse’s actions are based on which piece of legislation which encourages individuals to come forward to report a danger to public health or safety?
a. Edmunds-Tucker Act
b. Taft-Hartley Amendments to the Wagner Act
c. False Claims Act Modification
d. Anti-fraud Act

C: In 1986, the False Claims Act was modified to encourage whistle-blowers to come forward and report information regarding a violation of a law, rule, regulation, or a substantial and specific danger to public health or safety. The Edmunds-Tucker Act (1887) prohibited polygamy in the United States, and the Taft-Hartley Amendments to the Wagner Act allowed employees of nonprofit organizations to unionize. Various states such as Connecticut (2003) have state anti-fraud acts that prohibit fraudulent activities. WHISTLE-BLOWING

12

A colleague is asking you for information regarding qui tam lawsuits. Which of the following would not be a correct statement about such lawsuits?
a. Anyone can file them.
b. Only an attorney can file them.
c. They are used in whistle-blowing cases.
d. They can be filed on behalf of the government.

B: Whistle-blowing claims are brought forth in qui tam lawsuits. An interesting characteristic of these types of lawsuits is that anyone can file them on their own behalf or on behalf of the government. WHISTLE-BLOWING

13

There is a rumor that your union and the management in the organization that you work for will be going into arbitration. Which of the following statements concerning arbitration is false?
a. It is the last step in a dispute.
b. It utilizes a non-partial third party.
c. It must be voluntary.
d. An impartial person selected will make the final decision.

C: Arbitration is a method used in settling disputes. It is generally the last step in the dispute; it utilizes a non-partial third party who will make the final decision; and it can either be voluntary or imposed by the government. TABLE 26-2 COLLECTIVE BARGAINING TERMINOLOGY

14

As a new graduate, you have interviewed at several hospitals for your first nursing position. One of the hospital recruiters informs you that the nursing union has created turmoil for the hospital. The recruiter also tells you that if you choose this hospital, you will have to sign a contract stating that you will not join the nursing union. You recognize that requiring you to sign such a contract would be in direct violation of which of the following?
a. 1898 Erdman Act
b. 1935 National Labor Relations Act (Wagner Act)
c. 1938 Fair Labor Standards Act
d. 1947 Taft-Hartley Act

A: The 1898 Erdman Act was the first piece of legislation to outlaw discriminatory acts by employers against unions. By refusing to allow all new employees to join the nursing union, the hospital is interfering with the union’s membership and the union’s ability to represent all nurses employed by the facility. The 1935 National Labor Relations Act (Wagner Act) allowed employees of private companies to organize unions to demand better wages and safer working conditions, and the 1938 Fair Labor Standards Act set minimum wage and maximum hours that can be paid before overtime is paid. The 1947 Taft-Hartley Act returned some rights to management but still equalized the balance between unions and management. TABLE 26-1 SUMMARY OF SELECTED LEGISLATION AFFECTING THE WORKPLACE

15

While doing retrospective chart review, a nurse manager discovers that patients in the unit are having their Medicare double-billed for certain hospital services over a 5-year period. The nurse manager is very concerned and feels this may be a case of fraud, but she is afraid to tell anybody because the general opinion of most employees is “we have always done it this way.” What step would be least effective in addressing the nurse manager’s concerns?
a. Filing a qui tam lawsuit in secret with the court
b. Confiding in a close manager friend at work about what the nurse manager is planning
c. Providing a copy of the complaint to the Department of Justice with a written disclosure of all the information concerning the fraud
d. Telling no one at work about the nurse manager’s discovery or planned actions

B: In this situation, the nurse manager has just discovered fraudulent activities occurring in the hospital. Steps that the nurse manager should take to report this occurrence are file a qui tam lawsuit in secret with the court, provide a copy of the complaint to the Department of Justice with a written disclosure of all the information concerning the fraud, and DO NOT let anybody at the hospital know that a lawsuit is being filed (this includes another manager who is a close friend). WHISTLE-BLOWING

16

In your class on collective bargaining, you learn about unions. Which of the following is incorrect in terms of individuals who are able to unionize?
a. All nurses c. Employees of nonprofit organizations
b. Medical practitioners d. University professors

A: While there are unions for many nurses, the statement that all nurses are now able to unionize is incorrect. For example, managers and supervisors employed in hospitals are not in unions. Other groups able to join unions include medical practitioners (the Service Employees International Union is the largest collective bargaining agent for this group), employees of nonprofit organizations (the 1974 Taft-Hartley Amendments to the Wagner Act allowed this), and university professors. However, many chairpersons and deans of nursing programs cannot join unions because they are considered to be part of the administration. KEY CONCEPTS

17

The union representative for the nurses at your hospital calls a meeting to discuss the possibility of a strike. Several issues are discussed. Which statement made by one of the nurses would indicate that further clarification regarding a strike is needed?
a. “The decision to strike is made only if all union members agree.”
b. “The decision to strike occurs if the majority of union members agree.”
c. “If a no strike clause is in the union contract, we will not be able to strike.”
d. “An advance strike notice must be provided.”

A: A union strike is an act in which union members withhold the supply of labor for the purpose of forcing management to accept their terms. Some characteristics of these strikes are the decision to strike is made if a majority of union members agree (not all members), the union must provide a contract expiration notice and advance strike notice, mediation is mandatory for dispute settlement, and the hospital or agency has the option of establishing a board of inquiry before the work stoppage. STRIKING

18

You are considering forming a union for nurses at the organization for which you work, and you would like to have as many nurses in your organization join as possible. According to the current laws governing unions, which nurses have the legal right to unionize?
a. Staff nurses c. All nurses
b. Managers d. Nurse leaders

A; Nurses who are not managers or nurse leaders and are considered employees, such as staff nurses, have the legal right to unionize. Nurses who are considered managers, supervisors, or leaders are not allowed to unionize under the current labor laws. DEFINITION OF SUPERVISOR

19

A new graduate questions a colleague about organizations that have collective bargaining agents that work for nurses. Which organization would not be included on the colleagues list?
a. National Nurses United c. Unites States Nurses
b. Service Employees International Union d. Service Employees International Union

C: Some of the largest collective bargaining agencies/unions working for nurses include the National Union of Hospital and Health Care Employees and the Service Employees International Union. Other agents that support nurses are the United American Nurses AFL-CIO, the Teamsters Union, and the American Nurses Association. COLLECTIVE BARGAINING AGENTS

20

A nursing instructor asks the student nurses about the requirements for a vocation to be recognized as a profession? Which comment by one of the students would indicate to the instructor that further teaching is needed?
a. Long period of specialized education
b. Service orientation
c. Ability to be autonomous
d. Use of evidence-based guidelines and practice standards

D: Three requirements for a trade or vocation, such as nursing, to be considered a profession are a long period of specialized education, a service orientation, and the ability to be autonomous (able to be self-regulating and have control over their functions in a work situation). The use of evidence-based guidelines and standards promote effective and quality nursing care, and their incorporation into a nurse’s everyday practice is called evidenced-based nursing practice. PROFESSIONALISM AND UNIONIZATION

21

A non-nurse questions why nurses make such an effort to serve and protect the wishes of their patients. You, as a nurse, respond that by serving and protecting the wishes of their patients, nurses are participating in:
a. unionization. c. collective bargaining.
b. workplace advocacy. d. legal decision making.

B: Nurses who serve and protect the wishes of their patients are participating in workplace advocacy. Patient advocacy is a form of workplace advocacy. WORKPLACE ADVOCACY

22

With the help of the union representative, a nurse files a grievance against the hospital because of unfair practices when promoting the staff. Mediations between the union representative and management have been unsuccessful, and the situation now requires the input from a non-partial third party. This final step of the grievance procedure is known as which of the following?
a. Dispute c. Fact-finding
b. Arbitration d. Lockout

B: Arbitration is the last step in a dispute. At this step, a non-partial third party will be involved and may make the final decision. Arbitration may be voluntary or imposed by the government. TABLE 26-2 COLLECTIVE BARGAINING TERMINOLOGY

23

A recent graduate is deciding on which union and professional organizations for nurses would be appropriate to join. You inform the graduate that the largest union and professional organization for registered nurses is:
a. American Nurses Association.
b. National Nurses United.
c. National League for Nursing.
d. American Association of Colleges of Nursing.

B: The largest union and professional association of registered nurses is National Nurses United. In 2010, there were over 150,000 members.
STRIKING

24

You are employed in a large physician-owned private clinic. Negotiations of the new contract are at a stalemate. The administration refuses to address the issues of unfair wages for the nurses and the unsafe practices of the clinic physicians. During a union meeting, the union representative informs the nurses that the clinic’s management team has threatened to close the clinic if the nurses do not accept the new contract as written You understand that management’s threatened actions are considered which of the following?
a. Dispute c. Lockout
b. Negotiation d. Mediation

C; By threatening to close the clinic, management is threatening a lockout. A lockout relates to closing a place of business by management in the course of a labor dispute to attempt to force employees to accept management terms. TABLE 26-2 COLLECTIVE BARGAINING TERMINOLOGY

25

In 2007, your favorite nursing instructor, a 65-year-old African American, retired from the school of nursing. The instructor had decided to travel around the world and enjoy life; however, after the instructor’s spouse became unemployed and the family lost their life savings in the stock market, the nurse educator decided to return to teaching. During the job search, the instructor was told by the deans of the different nursing programs that they were interested in hiring individuals whose formal education was much more current. However, each dean acknowledged that the instructor’s record demonstrated a wealth of experience that included a number of awards, publications, and grants. The deans of the schools are most likely in violation of which of the following?
a. The Age Discrimination Act c. The Taft-Hartley Act
b. The Civil Rights Act d. The Erdman Act

A: The dean’s are most likely in violation of the Age Discrimination Act. The Age Discrimination Act promotes employment of older persons based on their ability rather than on their age. The instructor’s accomplishments as noted by numerous awards, grants, and publications are proof of the abilities to meet the requirements of the position. TABLE 26-1 SUMMARY OF SELECTED LEGISLATION AFFECTING THE WORKPLACE