Changes Afoot
California watches as the ANA revamps

By Mary Ann Hellinghausen
Illustration by William Jacoby
August 9, 1999

Change is on the horizon at the American Nurses Association, largely due to a new arm of the organization that offers support for collective bargaining. But California members are expecting little change locally.

“The changes will be more at the national level, in terms of who can come to the table and have a discussion on collective bargaining issues,” said Judy Martin-Holland, MS, FNP, RN, president of ANA\ California, the state ANA affiliate. “The ANA will now have a force that’s easily identifiable. I think it’s a positive move for nursing. It makes the labor arm of the organization stronger and more cohesive.”

A new structure

That force is the United American Nurses (UAN), which the ANA formed to strengthen efforts of affiliates in collective bargaining states to recruit and retain members. In response to the concerns of affiliates in non-collective bargaining states, which feared the ANA might focus too much of its energies and finances on union issues, the ANA also created a task force to focus on workplace advocacy issues. The Task Force on Professional Practice Advocacy is slated for further development on the ANA’ s year 2000 agenda.

ANA President Beverly L. Malone, PhD, RN, FAAN, said the ANA was striving to maintain balance with its bylaw changes. “We walk a tightrope. It’s obvious we’re balancing our movement as much as possible. Our goal has been to create a space big enough for those many different views, to build a house that allows both,” she said. “I think we won, both for the states that do collective bargaining and for the states that don’t. We [nurses] are so liable to split. Our job was to make sure that didn’t happen. We came out whole.”

Twenty-four states or U.S. territories, including Guam, the U.S. Virgin Islands, and the District of Columbia, have collective bargaining for nurses; 29 do not, according to the ANA.

An old issue

The issue of collective bargaining has been a contentious one in California. It contributed to a split in California in 1995, when the California Nurses Association broke away from the ANA, saying that the ANA did not offer enough support in the collective bargaining arena. CNA officials declined to comment for this article, but the group’s Web site describes the split as “motivated primarily by the ANA’s failure to adequately respond to the crisis for nursing caused by the corporatization of health care in California and the country.” The CNA has organized more RNs at facilities in the last two years than any other union in the country, according to the group.

Soon after the CNA split from the ANA, a new ANA state affiliate, the ANA\C, was formed to advocate for nurses and nursing practice issues through individual rights issues and workplace advocacy, such as the passage of state laws covering needle safety, said Marian Lowe, ANA\C executive director. Collective bargaining “takes a lot of time and resources, both human and financial, which a new entity doesn’t have,” she said. “The CNA engages in collective bargaining and is very good at it. That niche of collective bargaining is occupied. Our focus is on quality and practice issues.”

The creation of the UAN could make it more feasible for the ANA\C to consider collective bargaining, but that would be up to the membership. “We move in the direction our membership asks us to move them,” Martin-Holland said, adding she does not foresee a change in that direction “unless [the UAN] acts as a motivator for members to approach us requesting those kinds of services.”

Just a thought

The possibility of affiliating with the AFL-CIO, which the ANA is exploring in a preliminary phase, is too premature to discuss, Martin-Holland said. The AFL-CIO is a federation of trade and professional unions; an affiliation would protect ANA affiliates in states that have collective bargaining from raids by other federation unions, according to the ANA. The ANA is a long way from an AFL-CIO affiliation, and the concerns of affiliates in non-collective bargaining states would be addressed before such a move took place, Malone said.

The ANA’s goal for the year 2010 is to double its membership, which currently is about 180,000 nurses, Malone said. To achieve that goal, states that use collective bargaining want a national labor entity to support them and help fend off raids from other unions, the ANA says.

Martin-Holland thinks it is interesting that physicians, through the American Medical Association, also have decided to create a national labor organization to more effectively deal with health plans. “It’s been quite amazing to watch,” she said. “All of a sudden—boom—the same thing is happening with the AMA. It speaks to the environment that healthcare professionals are functioning in. We’re finding we want more control over our individual participation. We certainly support them in this effort.”