New national union aims to unite nurses

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Delegates from three major unions of registered nurses, meeting in Phoenix on December 7, merged their forces into a new national organization, the National Nurses United. The three founding affiliates --- the California Nurses Association, the Massachusetts Nurses Association, and the United American Nurses --- report a combined membership of 150,000. To thunderous applause from some 150 delegates, one of the three elected co-presidents proclaimed that this creation of the "largest union of direct care nurses is about a century overdue."

An inspiring campaign of ambitious organizing and political action by the new union was projected by one of its incoming leaders: unite all working registered nurses in a single union to deploy maximum power in health care; advance the interests of nurses in solidarity with nurses around the world; battle for quality health care for all; provide effective collective bargaining representation; campaign for patient rights and for safe patient to nurses ratios in hospitals. Its new executive director declared that immediately after the convention, National Nurses United would become an "organizing machine" that will set out to unionize all unorganized nurses in the country.

The supporters of the merger hail its formation as a long overdue step toward establishing a powerful united force to represent the interests of the nation's 2,500,000 nurses, in politics and on the job. Marilyn Albert, a registered nurse, sees the formation of the new NNU as a part of the movement to "reverse the decline of labor" that will "amplify the voice of nurses to a national level." Her opinion is backed by 30 years as a shop steward and organizer for 1199/SEIU followed by years as an organizer for the California Nurses. Their enthusiasm promises big progress. Still, there are problems because the evolution of nurses unionism in the United States has been, and remains, complicated and confusing.

United American Nurses: The UAN enters the new union with 45,000 members among its state affiliates, but it is not clear how many will stay for the long haul. Three top UAN leaders opposed the merger, including President Ann Converso, VP Jan Croft, and Director Kathleen Gettys. With the support of UAN delegates from a majority of the smaller locals, they boycotted the UAN conference called to consider the merger and blocked it from assembling a constitutional quorum. But delegates from affiliates, representing 80% of the membership, remained in the hall and voted for the merger. The two sides battled it out in court: In one suit, a federal court rejected the application of Converso supporters for an injunction to block the merger. In an opposing federal suit, merger advocates sought a federal court order barring interference with their plans.

Massachusetts Nurses Association: The MNA joins National Nurses United with 23,000 members. The union has a robust democratic tradition, reflected in its website. Nevertheless, it is not yet clear how enthusiastically the membership welcomes the new setup. Just over 500 of the union's 23,000 members voted in the referendum that approved the merger by 390 to 124. Fewer than 1,500 voted in the MNA referendum on a dues increase re-quired by the merger; it was approved 820 to 642.

On December 9, just one day after the NNU founding convention, dissenting MNA members, skeptical of the merger, formed a caucus independent of the leadership. Its supporters had begun by opposing the merger; now they are convinced that they must organize for the future to resist what they fear could be a disquieting drift away from their union's democratic spirit and an erosion of its autonomous rights in the larger national body.

California Nurses Association: Spearheading the new union is the California Nurses Association whose leadership and membership, unlike its two partners, seem wholeheartedly committed to the new venture. Rose Ann DeMoro, CNA executive director, becomes the new executive director; the CNA gets a majority on its national executive board.

The CNA left the American Nurses Association in 1993 after an insurgent group took over the California state affiliate, broke with ANA professionalism, and transformed the CNA into an explicitly labor organization. It affiliated with the AFL-CIO in 2006. By establishing its own National Nurses Organizing Committee, it reached out beyond California to become a national nurses union which now claims 86,000 members. It earned a reputation as an active, militant, progressive, proselytizing organization. In setting out to organize around the country, it engaged in jurisdictional battles with other unions, including the Service Employees International Union.

The formation of the new National Nurses United is not the first attempt to bring nurses into one national union with the California Nurses at its core. In 2002, five unions agreed to form the American Association of Registered Nurses which began by combining the CNA, the Massachusetts Nurses, the Maine State Nurses Association, the Pennsylvania Association of Staff Nurses, and the United Health Care Workers of Missouri into one national union with some 70,000 members. But, according to one participant, the deal fell through, mainly because some partners insisted upon a loose structure that would guarantee strict autonomy to the affiliates and concentrate upon mutual aid and lobbying for common aims; but the CNA, according to the report, wanted a more centralized traditional union international structure and went its own way. The desire for autonomous rights un-dermined the desire for unity.

At one point, the United American Nurses, whose state affiliates totaled 108,000 members, seemed to be a likely candidate to lead the charge. It was by far the largest of the nurses unions. But it comes into the new union only a shadow of its earlier self, with only 45,000 members. In 2007, UAN affiliates with over 60,000 members, including state nurses associations in New York, Ohio, Washington and Oregon, seceded from the UAN, leaving it reduced to its current level of 45,000. The UAN failure to fulfill the role of unifier points to a continuing dilemma. What brought those 108,000 nurses under the UAN banner was the call for autonomous rights inside the American Nurses Association. The disaffected affiliates were impelled to depart, it now seems clear, because they feared that their rights would be threatened in a strong, vigorous national union. A misgiving that was reinforced when the UAN began cooperating with the Service Employees International Union. The same impulse for autonomy that at first created the UAN, in the end undermined it.

Another new union - the National Federation of Nurses: Meanwhile in January 2009, after seceding from the UAN, those four nurses associations together with other former UAN affiliates, joined in a new national nurses group, the National Federation of Nurses, which claims 70,000 members. The prime mover in this second new national union is the 30,000-member New York State Nurses Association. The NFN is a loose confederation of labor organizations, each of which wants the advantages of combination with none of the commitments. The defining element of its constitution is the guarantee of complete auton-omy for all affiliates.

Earlier, the most promising contender for the role of unifier was the Service Employees International Union. After the affiliation of most of health and hospital Local 1199, it developed into an 1,800,000-member union by organizing and assorted mergers with smaller unions. It earned a reputation as a militant, progressive union, organizing exploited racial minorities, substantially raising their standard of living. It became the dominant union, by far, in health care, especially among the non-professional ancillary personnel. When it reached out to registered nurses, however, its appeal had limited effect. It claims to have enrolled 85,000 nurses, not in their own separate SEIU-linked union, but distributed among the various SEIU health care locals around the country.

At this point, in line with a grandiose reorganization plan, the SEIU program aims to recruit an additional million members, to revive the dwindling power of the labor movement, rebuild the American economy, change Washington, neutralize big capital, and create ties with worker organizations the world over. To accomplish these ambitious goals, the union centralizes excessive power in the hands of the international president who proposes to turn the whole cadre of appointed staff and elected officers, local and international, into a kind of quasi-military operation speaking with one voice, not only to the outside world, but to the SEIU membership as well. Whatever its virtues, the plan has at least this one flaw: it comes into head-on collision with nurses' insistence on autonomous rights. And so the SEIU, domineering over its membership in the lofty goal of leading the nation, has squandered its opportunity for leading registered nurses.

In any event, there are still miles to go before registered nurses can be united into a single predominant union. A majority of those registered nurses who are already organized remain dispersed among other unions, independent of the new organization. Of these, the National Federation of Nurses claims 70,000; American Federation of Teachers, 40,000; the SEIU 85,000. Thousands of other nurses are organized in unions like the Operating Engineers, the American Federation of Government Employees, AFSCME, Teamsters, and independents like the NY Professional Nurses Association.

What sets the stage for all these events is the long convoluted story of nurses unionism.

From "professionalism" to unionism: The historical trend among registered nurses has been a shift away from narrow "professionalism" toward unionism, that is, a realization by at-the-bed staff nurses that, like all other employees, their working conditions must be protected and their rights nailed down by unions in collective bargaining. For decades, the principal voice for nurses had been the American Nurses Association. Founded in 1911 as a professional society for developing ethical standards, lobbying, PR, and education, it rejected collective bargaining and was hostile to unionism. But in the mid-forties, when staff nurses sought representation on the job, the ANA established a separate bargaining division. It was necessarily a complicated setup because the ANA continued to be management controlled while federal law required that labor organizations be free of management domination.

The structure provided a limited degree of self government for employed staff nurses. Each ANA state affiliate set up its own separate quasi-autonomous collective bargaining unit, but financing and final administrative control remained in the hands of non-union boards of directors. In time, staff nurses demanded a greater degree of autonomy.

These quasi union state groups joined together in the United American Nurses, still controlled by the ANA and dependent on it for financing. In 2001, representing those 108,000 nurses, the UAN joined the AFL-CIO. Registered nurses were now identified as part of the organized labor movement. In 2003, the UAN became a fully autonomous organization financed by per capita payments from its own affiliates. For a time it remained loosely affiliated with the ANA but is now effectively independent.

In all these permutations and combinations, registered nurses have drifted toward unionism. Union enthusiasts, however, want a more deliberate, activist, organizing unionism. Dispersed now among all the organizations that compete for nurses, they look for a unifying force that can organize the drive to bring together most of the nation's 2,500,000 registered nurses. Now, the new National Nurses United, under the leadership of the California Nurses Association, stakes its claim to leadership as the "largest union of direct care nurses ... about a century overdue." But can it succeed where the American Association of Registered Nurses, the United American Nurses, and the SEIU have failed? The experience of at least 70 years indicates that the main barrier to the formation of a single strong union is the conflict between centralization and autonomy. The challenge is to find a way to com-bine the nurses' quest for union power with their persisting aspiration for autonomous rights.

The problem is that the main trend within the labor movement today is toward the obliteration of autonomous rights, away from rights down below toward the imposition of authoritarian control from above. To organize the unorganized, to reverse labor's decline, to meet the centralized power of management --- it is argued --- unions must centralize power in the top leadership, reduce the role of elected stewards, limit dissent by requiring elected officers and appointed staff to speak with one voice inside the union to the membership and outside to the public. This trend is graphically evident in the SEIU and in the building trades, especially in the formation of various regional and district councils whose structure turns locals into administrative shells and enables the officials to deny many of the rights that federal law, the LMRDA of 1959, was intended to protect. (Ironically, those union leaders who insist upon unbridled, super-centralized power as a necessary means of confronting hostile management are precisely those who, in real life, propose to increase union membership in agreement with cooperating employers.)

And so, at this point in the evolution of the American labor movement, the demand of nurses for union autonomy is a welcome and necessary counterweight to an encroaching authoritarianism and to the pressure for conformity. But autonomy has its own limitations. It doesn't assemble the resources and create the structure needed to fight labor's tough battles. For that you do need a measure of centralizing authority. In that respect its critics do have a point. Autonomy can limit arbitrary authority, but it is no substitute for a strong centralizing force.

With self-governing rights, the officers of a local union or an affiliate of a larger international can stimulate local initiative, negotiate contracts to suit their special needs, elect shop stewards to enforce contracts, pay attention to members' grievances, set local dues levels, retain their own attorneys, elect leaders and pay officers free from international political dictate, even organize and intervene in politics in their own jurisdictional area. It can do everything essential to stimulate initiative and convince members that the union is theirs. But it cannot meet the needs of the larger labor movement to organize nationally, to coordinate dealing with corporations nationally and globally,. to act as a force in national politics, to organize the millions of unorganized. For that, a union needs the authority to tax subsidiaries, a certain measure of discipline in national affairs, a national strike fund for mutual support.

If power centralized in the hands of officers at the international has the potential for abuse, so does autonomy at the local level, because autonomy is not necessarily synonymous with honest or democratic unionism. In some of our major unions, as in the Teamsters and construction trades, local officers have utilized their autonomous right to create regimes that are self-serving, repressive, and sometimes corrupt. None of the nurses unions, not the nationals, not the locals, have ever been the subjects of such corruption scandals; and in this respect these unions are many notches above most others. And so it is not a matter of idealizing or demonizing either autonomy or centralized union power as opposing principles. The practical question is: how to deal with the persisting clash between the manifest need for union power and the insistent aspiration for autonomy. The question continues to bedevil those who want to build a strong union for nurses.

One 'solution' is to suppress autonomy as a heresy, eliminate its partisans, and construct a centralized system in which the leading cadre moves in lockstep. That approach may restore union power, or it may be self-defeating. Whatever its future, so far the authoritarian spirit has failed to unify the scattered forces of nurses unionism. There is another way: It calls for reconciling the requirements of union power with the deep-seated aspiration for autonomous rights so that each may strengthen the other. That need, the need to temper centralized power with individual rights, was confronted in the formative days of the American republic.

After the Articles of Confederation turned the United States into a loose combination of sovereign states with an ineffectual central government, the new U.S. Constitution proposed to create a national government armed with enough power to sustain a strong nation capable of acting on the world scene. To allay the fears of those who argued that centralized power posed the danger of tyranny, a Bill of Rights, in ten amendments, was added. The disturbing trend of established labor leadership today is toward concentrated power and watered down rights. All power but no bill of rights, or only lip service to it.

The spirit that motivates the desire for autonomous rights can be a force that enhances union power when it is linked to respect for individual rights. It is precisely that spirit, that resentment against domination from above, that leads workers, who resent arbitrary rule by employers, to unionism. It is the quality that a healthy labor movement should cultivate in its own interests. It is that quality that domineering officialdom represses.

When unions respect workers' rights on the job and in the union hall and assure them that the movement truly belongs to them, union members can serve as an army of proselytizers, defending the labor movement and advancing its program in the broad population. With that kind of respect for members' rights, the labor movement recruits millions of representatives to speak on its behalf in churches, clubs, societies, and lunchtime diners.

The challenge for progressives is to find a way to combine the quest for union power with the insistence on autonomous rights. True in the labor movement generally, this precept is especially true among nurses, where a strong nurses union can satisfy the quest for autonomy by offering union democracy --- not the simulacrum of democracy, not deferential holiday bows to democracy, not democracy confined to printed constitutions --- but actual democracy in the life of the union.

The model of unabashed authoritarian unionism has not succeeded in uniting nurses, or even coming close. And yet the need and the desire for a unifying force remains. In merging three separate unions into one National Nurses United, the new union bases itself on that desire for a united effective, progressive union. However, nurse unionists are still divided between those who emphasize the effectiveness of coordinated power and those who demand the rights of autonomy. If anything can bring them together, it is the magnetic force of union democracy.