Wednesday October 01, 2014

QUESTION OF THE WEEK

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Improving patient care: Beyond the negotiating table

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It is well known that collective bargaining allows healthcare workers to achieve progress in areas such as compensation and working conditions, but the important role registered nursing unions play in improving patient safety and outcomes is often overlooked.

In Canada, over 80% of registered nurses are unionized. This is the majority of the single largest group of healthcare professionals in the country, who comprise close to one-third of the Canadian healthcare workforce. Whether in hospitals, long- term care, mental health, home care or community settings, registered nurses touch the lives of every Canadian. No other healthcare provider is more integrally involved in direct patient care than a registered nurse.

But what does a unionized registered nurse really mean for patients?

Maintaining competitive wages is central to decreasing staff turnover and limiting the need to constantly retrain new, inexperienced staff, but in reality collective bargaining is about so much more. The positive impacts registered nursing unions have on the quality of patient care go well beyond the negotiation table. Research has demonstrated a direct relationship between improved patient outcomes and registered nurse unionization.

By advocating for safer staffing, registered nursing unions work to ensure registered nurses are able to dedicate more time and expertise to direct patient care. Better staffing levels mean registered nurses have greater workplace support, resulting in less stress and burnout. This translates into more time at the bedside, fewer mistakes and less chance of subtle, and often critical, changes in a patient's condition being missed.

Registered nursing unions do more than advocate for safer staff numbers; they also promote the importance of the right staffing mix. This means matching patients with the appropriately qualified care providers, who possess the necessary education and foundational knowledge to ensure the safest level of care at all times.

Decades of national and international research consistently demonstrate a link between inadequate registered nurse staffing and poor patient outcomes, including increases in death rates, hospital-acquired infections, pneumonia, sepsis, pressure ulcers, gastrointestinal bleeding, shock, cardiac arrest, medication errors and falls, as well as, longer than expected lengths of hospital stays.

Unions representing registered nurses have made it a priority to raise awareness about this research and constantly strive to make evidence-based safe staffing a guiding principle in healthcare.

One of the greatest benefits for patients is that registered nursing unions provide a consistent collective voice for registered nurses in the workplace. They empower registered nurses to actively participate in shaping healthcare reform and care delivery, and afford them the protected right to stand up and speak out for their patients, their practice and their profession. There is no greater patient advocate than a unionized registered nurse.

It is not always clear whether changes in healthcare are associated with improved patient outcomes or driven by other factors such as budgets or competing political ideologies. What is clear is that all healthcare stakeholders - from direct care workers to health regions, unions and government - constantly engage in spirited discussions about what's best for patients. For those who depend on the healthcare system, this public debate can often seem chaotic and confusing. It is important to know that positive changes do come out of these exchanges because of the dedication and input from stakeholders such as registered nursing unions.

Nowadays people are older and sicker than they ever have been before and patients are being rushed through the healthcare system because of limited space and resources, and budget driven decisions. With these increased pressures, the role of registered nursing unions becomes increasingly critical as they continue to be a voice for registered nurses and their patients, and passionate advocates for high quality, safe patient-centred care.

Tracy Zambory, RN, President, Saskatchewan Union of Nurses


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