Is Patient Safety Really the Agenda?

There are two different unions representing nurses in Nova Scotia. Their leaderships seem to live in different worlds. A little history might provide some explanation.

Joan Jessome is president of the Nova Scotia Government Employees Union (NSGEU). Local 97 includes the registered nurses at the Queen Elizabeth II Health Sciences Centre and the Nova Scotia Hospital. The Nova Scotia Nurses Union (NSNU), led by Janet Hazelton, represents the remaining nurses in Capital Health and across the rest of the province.

Both express concerns that staff and patient safety can be compromised if staffing is inadequate. The resemblance ends there.

The recent NSNU collective bargaining agreement (CBA) includes provisions for working with management to ensure safe staffing levels, explicitly recognizing that simple ratios of nurses to patients do not tell the whole story. Other factors such as patient acuity are important. In this they were following success models in Ontario, Manitoba, Saskatchewan and British Columbia.

The NSNU completed its collective bargaining this year, as in past years, without any threats to patient care. The NSNU has not had a strike since 1977. Their last four agreements have been negotiated without the need of a conciliator, let alone an arbitrator.

Joan Jessome prefers confrontation. Three of the last four NSGEU agreements were imposed by arbitration because negotiations failed. In 2012 the NSGEU caused the cancellation of hundreds of operations and other procedures by threatening to strike.

Jessome works hard at fostering dissatisfaction among nurses. According to her nurses are overwhelmed with duties, yet in March she sent off-duty activist nurses to the hospitals to discuss union business.

She distorts facts. Thus she is reported as saying the health authority has recorded 40,000 safety blunders in two years. This is incorrect. Following what is widely agreed to be best practice in safety management, Capital Health strongly encourages employees to report near misses and other evidence of potential risks. The vast majority of those events caused no harm whatsoever.

She complains that Capital Health is not willing to even discuss staffing ratios. In fact they and all the other health authorities did discuss them with NSNU and came up with a workable arrangement which follows other successful Canadian precedents.

She refused to agree on staffing levels needed for even minimal patient safety during a legal strike, and instigated an illegal strike when legislation was tabled. It is amazing that she can keep a straight face when then accusing Capital Health of being heavy handed.

Or saying that her primary concern is patient safety. Half of the surgeries scheduled for Tuesday were cancelled because of the illegal strike and many more during Thursday’s legal walkout. How did that help patient safety?

The focus of NSGEU’s aggressiveness is not restricted to health care management. In 2003 they attempted a hostile takeover of NSNU employees working in Capital Health. They were only deterred then by a Canadian Labour Congress ruling that the application violated its constitution.

In yet another statement that strains credulity, Jessome (then already a veteran in union affairs) was reported as saying the ruling came as a shock and the union didn’t know it was in violation when the application began.

The NSGEU is a competitor of the NSNU, and that competition may be brought to a head when the nine regional health authorities (other than the IWK) are merged into one. That appears to be the real agenda being pursued by Ms. Jessome, not patient safety.

The NSNU has shown that finding ways to work cooperatively with management and other health care providers can benefit patients without disadvantaging nurses. It is actually much more pleasant for nurses to work in that kind of environment. The pay and benefits are very similar for members of the two unions.

Ms. Hazelton and other members of the NSNU leadership are all experienced nurses. It shows. The NSNU CBA includes the following words:

“The Union and the Employers acknowledge the challenges and financial pressures within our health care system. The Union and the Employers also acknowledge their respective commitments to quality health care and agree that Nurses play an important role in health care delivery. The Union and the Employers acknowledge the benefits of a collaborative approach…”

These are words that Joan Jessome will never say.

It is hard to see how government, in the face of hardball tactics, could avoid this week’s legislation to limit health care disruptions. The already difficult task of controlling health care costs will become impossible if confrontational unions are allowed to dictate spending.

There are no easy answers. If staffing must be provided during strikes for all essential services, as broadly defined in the new legislation, the unions lose most of their bargaining power. But even a minimal disruption clearly hurts the interests of patients and their families. In responding to NSGEU’s tactics government has also weakened the bargaining power of more collaborative unions such as the NSNU.

A different way forward is needed, one that does not have strikes as an endgame, but does provide unions with substantial influence on behalf of nurses and other health care workers. Words such as those quoted above from the NSNU agreement would establish the right starting point.


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