UNIONIZATION POPULAR TOPIC OF NURSES IN MISSOURI

As an effort to educate registered nurses at St. Francis Medical Center in Cape Girardeau about what a union can offer continues with a meeting today, nurses statewide are showing a growing interest in unionizing.

While Missouri doesn't have a history of unionization, more registered nurses in the state are showing an interest in unions as managed care and budget cutbacks impact the quality of nursing care, said registered nurse Belinda Heimericks, executive director of the Missouri Nurses Association, a professional organization for registered nurses and a constituent member of the American Nurses Association.

Nick Trupiano, an organizer with United Food and Commercial Workers International Local 655 in St. Louis, said the union organization began sending literature to St. Francis nurses after receiving requests for information. At this point the union is trying to gauge the interest here, he said.

"Right now we're at the point of seeing if there is a need for a union," Trupiano said.

That is being done with literature meant to educate registered nurses at St. Francis about what a union can offer and the process it takes to form a union here. There are also meetings like the one set for today being held every two to three weeks for those who have expressed an interest in bringing a union to St. Francis, he said

"It's an education process. We tell them about the union, and they tell us about the situation here," Trupiano said. "We give out information and get information."

He said registered nurses from around the state have requested information following the vote to unionize St. John's Mercy Medical Center in St. Louis last July. Trupiano said there have been a few requests from nurses at Southeast Missouri Hospital in Cape Girardeau, but not as much interest has been shown there.

Heimericks said the driving force behind the unionization movement among registered nurses nationwide is changes occurring in the health-delivery system.

"States like Michigan that are known for supporting labor have long had collective bargaining for nurses," Heimericks said. "But in the South where there has been little support for unions few hospitals have had unionized nurses. But that has changed in the last few years, and the variable affecting it is managed-care penetration."

The issues registered nurses are usually most concerned about aren't pay or fringe benefits normally associated with collective bargaining, said Heimericks. Instead nurses are concerned about increasing nurse-to-patient ratios, mandatory overtime for registered nurses and delivery of patient care by non-nursing staff, all of which affect the quality of patient care, she said.

In fact, such issues were at the forefront of the election to unionize St. John's Mercy Medical Center in St. Louis.

With 362 nurses and 8,056 admissions, St. Francis has an admission-to-nurse ratio of 22 to 1. Southeast Missouri Hospital has 440 nurses and 11,025 admissions, resulting in an admission-to-nurse ratio of 25 to 1. Both compare favorably to other area medical facilities including Western Baptist in Paducah, Ky., with an admission-to-nurse ratio of 29 to 1; Lourdes in Paducah with an admission-to-nurse ratio of 40 to 1; and Carbondale Memorial Hospital in Carbondale, Ill., with an admission-to-nurse ratio of 41 to 1.

Heimericks' organization, the Missouri Nurses Association, has an arm that unionizes nurses. It currently represents nurses at University Hospital and Clinics in Columbia, Mo., Prime Health and Humana in Kansas City and at state mental health hospitals.

Representing registered nurses and other health-care workers at five Veterans Administration hospitals in the state is the American Federation of Government Employees.

Desma Reno, a Cape Girardeau registered nurse who is president of the Missouri Nurses Association, said St. Louis and Kansas City are the areas where nurses have shown the most interest in unions. There are more nurses there, more upheaval in hospital ownership and more managed-care penetration.

Union organizing efforts are more rare in rural areas such as Cape Girardeau, she said.