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Unions and continuing education
Our lives will not be sweated from birth until life closes Hearts starve as well as bodies; Give us bread, but give us roses. James Oppenheim
nions have long been identified with labor-hard hats and blue collar workers-and breadand-butter issues such as wages and working conditions. But not anymore. In the past decade, professionals have joined unions, and unions are assuming responsibility for continuing education of their members. Historically, union-sponsored continuing education has focused on skills necessary to negotiate or handle grievances. Today that focus has changed. New union members, such as registered nurses, are concerned with quality of life and professional issues. Many in the profession have been alarmed at unions moving into continuing education for nurses. Unions, however, are not going to debate whether it is appropriate for them to provide continuing education for nurses. If their nurse members ask for it, they are going to provide it. For unions, it is an organizing tool that helps them to attract and keep members. Continuing education for nurses has been primarily the province of the professional associations-the American Nurses’ Association (ANA) and the specialty organizations such as AORN. What are the implications of union continuing education activities for these professional associations? What will be
U
Unions and continuing education Sharon Lunn, RN
Sharon Lunn, RN, MS, is program specialist/ continuing education at AORN Headquarters in Denver. A diploma graduate of Sisters of Charity School of Nursing, Kansas City, Kan, she received a BS in nursing education from St Mary College, Leavenworth, Kan, and an MS in adult education from Kansas State University, Manhattan.
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AORN Journal, June 1980, V o l 3 1 , No 7
the impact on the quality of continuing education for nurses? These are some of the questions being asked within the profession. The new focus of union-sponsored continuing education is reflected in Bread and Roses, a cultural project of District 1199, National Union of Hospital and Health Care Employees, which represents nurses, technicians, ancillary personnel, and drug store workers. a grant proposal by a state nurses association to design an educational model specific to the needs of its members who are in collective bargaining. continuing education offered through the Federation of Nurses and Health Professionals of the American Federation of Teachers (FNHP/AFT). Bread and Roses is designed to bring the arts and humanities to rank-andfile union members, not only through conferences and seminars but also in poetry, drama, art exhibits, videotape, and films. Events are held in places of employment (hospitals and nursing homes), within the union community (at 1199’s mid-Manhattan headquarters), and in their homes (at Plaza 1199, the union-sponsored housing development in New York City). The union has planned the project to fit the needs of its 70,000 members, of whom 70% a r e black and Hispanic, and 85% a r e women. The theme of Bread and Roses is based on a poem by James Oppenheim written in 1912 to commemorate the struggle of striking textile workers in Lawrence, Mass, who were primarily women. The poet was inspired by one mill woman who carried a hand-painted placard: “We want bread and roses, too.” District 1199’s Bread and Roses project includes professional continuing education, and nurses are targeted in this union-sponsored project. A recent press release read:
A unique all-day conference of hospital workers, patients and health care administrators will investigate methods to deliver the best possible patient care on Saturday, December 1, at New York headquarters of District 1199 . . . . In an open give-andtake at workshops, participants will seek to determine whether patients in hospitals and nursing homes are now receiving the best care possible and what union members, as well as hospital administrators and state health officials, might do to improve that care.. . . . Those attending the conference will view videotapes of interviews with patients and hospital workers. The interviews focus on such potential problems a s staffhg, special needs ofsick people, worker attitudes, orientation of new employees and ethical issues involved in worker relationships with patients. . . a $2.50 registration fee includes lunch. Child care will be available. Another press release said: How nurses, hospital workers and administrators and physicians can improve the quality of patient care in hospitals and nursing homes will be discussed at a conference on Tuesday, March 11 (2 to 5 pm) at Manhattan’s Beth Israel Hospital. The conference is a major feature of the Bread and Roses cultural project of District 1199 . . . . Sondra Clark, RN, District 1199 executive vice-president i n charge of League of Registered Nurses, will keynote the meeting. Consider the sociological scope of the Bread and Roses cultural project and its programming. It is evident that the union has studied carefully the sociology of hospital workers, including nurses as a group. Nursing is primarily a women’s profession. A significant percent are in child-bearing years and have children less than ten years of age. These women still live in a society with
AORN Journal, June 1980, V o l 3 1 , No 7
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C
onsider what would make programming more cost-effective.
conservative values and certain expectations of wives and mothers. These values and expectations make it difficult for some women to participate in continuing education activities during other than the usual work day. Travel can be another problem. Bread and Roses offers continuing education a t three sites-hospitals, union headquarters, and union housing. They add another carrot-child care. Related to the sociological scope are flexibility in scheduling and low fees. In the two press releases, notice how the same subject matter, “quality patient care,” is presented on at least these occasions: as an all-day program at union headquarters and as a three-hour program in a hospital setting. Think of not only the choice but the convenience for the union member. Nursing as a profession is not known for high salaries. The fact that District 1199’s membership is primarily minority-black, Hispanic, and women-helps it in obtaining grants to finance Bread and Roses. The project is funded through at least four different grants. This in turn means low registration fees for continuing education activities, for example $2.50. A state nurses association grant proposal recently submitted to a federal agency seeks “to establish a model that weaves education into the fabric of the full-time working nurse, union member’s life without adding stress to
1214
its fibers.” The model is to be developed by initiating a unique relationship among a union, an educational institution, a professional association, employers, and registered professional nurses. The proposal also elaborates on the fact that nursing is primarily a women’s profession and that working women in our society are exposed to unique pressures and conflicting demands from profession, employers, family, and others. The model would be used to develop and then employ nontraditional, cost-effective continuing education to help nurses manage these pressures. In relation to this grant proposal, consider the sociology of nursing-that it is primarily a profession of women; that its members as women experience cert a i n problems i n t h e professional, health care, and social systems; and t h a t these problems often create barriers in the effort of these women to develop as professionals. Women are considered a minority group for the purposes of federal funding. Proposals seeking to assist minority groups have a priority for funding. A union in conjunction with others, including a professional association, is using this framework to obtain funding to meet the “educational needs of the union member who i s a registered nurse.” Further, the intent to employ cost-effective, nontraditional methods convenient to the learner reflects sen-
AORN Journal, June 1980,V o l 3 1 , No 7
sitivity to principles of adult education. Continuing Education Through the Federation ofNurses and Health Professionals, a book recently published by the FNHP/AFT, is essentially a directory of modules and texts for selfdirected or small-group study, The introduction, “The continuing education library,” contains these statements: 1. The CE Library is a collection of approved continuing education programs designed to meet t h e special needs of the members in t h e Federation of Nurses a n d Health Professionals. 2. The Library exists to provide FNHP members with cost effective approaches to programs that are accessible to licensed professionals in a cost effective manner. 3. The programs a n d textbooks housed in the CE Library are reviewed and rated by the FNHP Continuing Education Review Board (CERB). This external approval process guarantees t h a t FNHP programs not only present accurate information but also provide quality material to health care professionals who depend on utilizing that updated information in their daily practice. 4. The programs in the CE Library are available on a loan basis or may be purchased at a discount price for member local and state federations. Textbooks in the CE
Library are available to members for purchase a t a discount price only.2 Again, consider some of the characteristics of this union-sponsored activity for nurses. First, it provides convenient educational activities through non-traditional methods, such as independent study modules. This means the nurse can schedule learning activities a t her own convenience and select the location-for example, home, work, or during travel. Second, these activities are economical. The learner does not incur the expense of travel, lodging, or meals away from home. Materials are available to union members a t a special fee. Third, these activities are advertised as approved continuing education for nurses. However, it does not say what criteria or standards are used to review the design or content of these activities to determine their validity, accuracy, or quality; and it does not identify if organizations or groups within the profession recognize this approval, such as state boards of nursing in states where continuing education is mandatory for relicensure. Although saying t h e activity is “approved” is an attractive advertising gimmick, it could work against the nurse using these materials if no one within the profession recognizes the approval. Nursing providers might again consider factors t h a t probably make
AORN Journal. June 1980, V o l 3 1 , N o 7
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union-sponsored continuing education appeal ing-economy , convenience, and variety. Then they might ask themselves: What cooperative efforts can continuing education providers such as nursing organizations initiate that would make programming more cost effective and, therefore, less expensive to participants? Can providers avoid duplication in programming? How? Is everything being done to accommodate the learner in regard to program schedulesAays, hours, locations, and reofferings? Are activities scheduled for the convenience of the learner or the provider? Are adult education principles being used? Should nursing providers of continuing education consider t h e sociology of the profession in planning programs? For example, a significant percent of its members have children. Is the provision of child care appropriate? 0 If unions continue to offer programs, does your organization’s philosophy allow cosponsorship or cooperation to ensure that they are designed around professional standards? If not, go back to the preceding questions and ask how, then, other providers of continuing education can effectively compete with union programming. What are the responsibilities of individual regarding who provides continuing education within the profession? First, registered nurses should consciously establish and periodically assess their own philosophy of nursing and continuing education in nursing. This philosophy should guide them in determining who is a n appropriate provider of their professional continuing education.
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Second, if nurses believe that providing continuing education should remain within t h e profession, they should actively make their learning needs known and participate i n program planning. Third, if nurses believe it is acceptable for a union to provide continuing education, and they are members, they should insist that programming be done according to professional standards. Fourth, if unions advertise their continuing education activities a s “approved,” nurses should ask, by whom? They should question whether the advertised approval means a n y t h i n g where it counts, such as with a state board of nursing in a state that requires continuing education for relicensure. AFT has advertised its study modules as having the approval of its CE review board b u t does not mention what criteria or standards are used or who recognizes this approval. Fifth and foremost, professionals have a n obligation to keep informed of issues that affect not only them, but the profession. Look at what unions are doing for their members. Consider why nurses might turn to them to provide continuing education as well as to negotiate for them. Then ask not only, w a t is the profession of nursing doing for its members? but also, What am I, as a member of the profession, doing for it and its members? What do I believe in and why? Then act. Notes 1. Bread and Roses: A Special Report (New York: District 1199 Cultural Center, Inc 1979). 2 . Continuing Education Through the Federation of Nurses and Health Professionals (Washinaton. DC: American Federation of Teachers, 1979).
AORN Journal, June 1980, V o l 3 1 , N o 7
nions have long been identified with labor-hard hats and blue collar workers-and breadand-butter issues such as wages and working conditions. But not anymore. In the past decade, professionals have joined unions, and unions are assuming responsibility for continuing education of their members. Historically, union-sponsored continuing education has focused on skills necessary to negotiate or handle grievances. Today that focus has changed. New union members, such as registered nurses, are concerned with quality of life and professional issues. Many in the profession have been alarmed at unions moving into continuing education for nurses. Unions, however, are not going to debate whether it is appropriate for them to provide continuing education for nurses. If their nurse members ask for it, they are going to provide it. For unions, it is an organizing tool that helps them to attract and keep members. Continuing education for nurses has been primarily the province of the professional associations-the American Nurses’ Association (ANA) and the specialty organizations such as AORN. What are the implications of union continuing education activities for these professional associations? What will be
U
Unions and continuing education Sharon Lunn, RN
Sharon Lunn, RN, MS, is program specialist/ continuing education at AORN Headquarters in Denver. A diploma graduate of Sisters of Charity School of Nursing, Kansas City, Kan, she received a BS in nursing education from St Mary College, Leavenworth, Kan, and an MS in adult education from Kansas State University, Manhattan.
1212
AORN Journal, June 1980, V o l 3 1 , No 7
the impact on the quality of continuing education for nurses? These are some of the questions being asked within the profession. The new focus of union-sponsored continuing education is reflected in Bread and Roses, a cultural project of District 1199, National Union of Hospital and Health Care Employees, which represents nurses, technicians, ancillary personnel, and drug store workers. a grant proposal by a state nurses association to design an educational model specific to the needs of its members who are in collective bargaining. continuing education offered through the Federation of Nurses and Health Professionals of the American Federation of Teachers (FNHP/AFT). Bread and Roses is designed to bring the arts and humanities to rank-andfile union members, not only through conferences and seminars but also in poetry, drama, art exhibits, videotape, and films. Events are held in places of employment (hospitals and nursing homes), within the union community (at 1199’s mid-Manhattan headquarters), and in their homes (at Plaza 1199, the union-sponsored housing development in New York City). The union has planned the project to fit the needs of its 70,000 members, of whom 70% a r e black and Hispanic, and 85% a r e women. The theme of Bread and Roses is based on a poem by James Oppenheim written in 1912 to commemorate the struggle of striking textile workers in Lawrence, Mass, who were primarily women. The poet was inspired by one mill woman who carried a hand-painted placard: “We want bread and roses, too.” District 1199’s Bread and Roses project includes professional continuing education, and nurses are targeted in this union-sponsored project. A recent press release read:
A unique all-day conference of hospital workers, patients and health care administrators will investigate methods to deliver the best possible patient care on Saturday, December 1, at New York headquarters of District 1199 . . . . In an open give-andtake at workshops, participants will seek to determine whether patients in hospitals and nursing homes are now receiving the best care possible and what union members, as well as hospital administrators and state health officials, might do to improve that care.. . . . Those attending the conference will view videotapes of interviews with patients and hospital workers. The interviews focus on such potential problems a s staffhg, special needs ofsick people, worker attitudes, orientation of new employees and ethical issues involved in worker relationships with patients. . . a $2.50 registration fee includes lunch. Child care will be available. Another press release said: How nurses, hospital workers and administrators and physicians can improve the quality of patient care in hospitals and nursing homes will be discussed at a conference on Tuesday, March 11 (2 to 5 pm) at Manhattan’s Beth Israel Hospital. The conference is a major feature of the Bread and Roses cultural project of District 1199 . . . . Sondra Clark, RN, District 1199 executive vice-president i n charge of League of Registered Nurses, will keynote the meeting. Consider the sociological scope of the Bread and Roses cultural project and its programming. It is evident that the union has studied carefully the sociology of hospital workers, including nurses as a group. Nursing is primarily a women’s profession. A significant percent are in child-bearing years and have children less than ten years of age. These women still live in a society with
AORN Journal, June 1980, V o l 3 1 , No 7
1213
C
onsider what would make programming more cost-effective.
conservative values and certain expectations of wives and mothers. These values and expectations make it difficult for some women to participate in continuing education activities during other than the usual work day. Travel can be another problem. Bread and Roses offers continuing education a t three sites-hospitals, union headquarters, and union housing. They add another carrot-child care. Related to the sociological scope are flexibility in scheduling and low fees. In the two press releases, notice how the same subject matter, “quality patient care,” is presented on at least these occasions: as an all-day program at union headquarters and as a three-hour program in a hospital setting. Think of not only the choice but the convenience for the union member. Nursing as a profession is not known for high salaries. The fact that District 1199’s membership is primarily minority-black, Hispanic, and women-helps it in obtaining grants to finance Bread and Roses. The project is funded through at least four different grants. This in turn means low registration fees for continuing education activities, for example $2.50. A state nurses association grant proposal recently submitted to a federal agency seeks “to establish a model that weaves education into the fabric of the full-time working nurse, union member’s life without adding stress to
1214
its fibers.” The model is to be developed by initiating a unique relationship among a union, an educational institution, a professional association, employers, and registered professional nurses. The proposal also elaborates on the fact that nursing is primarily a women’s profession and that working women in our society are exposed to unique pressures and conflicting demands from profession, employers, family, and others. The model would be used to develop and then employ nontraditional, cost-effective continuing education to help nurses manage these pressures. In relation to this grant proposal, consider the sociology of nursing-that it is primarily a profession of women; that its members as women experience cert a i n problems i n t h e professional, health care, and social systems; and t h a t these problems often create barriers in the effort of these women to develop as professionals. Women are considered a minority group for the purposes of federal funding. Proposals seeking to assist minority groups have a priority for funding. A union in conjunction with others, including a professional association, is using this framework to obtain funding to meet the “educational needs of the union member who i s a registered nurse.” Further, the intent to employ cost-effective, nontraditional methods convenient to the learner reflects sen-
AORN Journal, June 1980,V o l 3 1 , No 7
sitivity to principles of adult education. Continuing Education Through the Federation ofNurses and Health Professionals, a book recently published by the FNHP/AFT, is essentially a directory of modules and texts for selfdirected or small-group study, The introduction, “The continuing education library,” contains these statements: 1. The CE Library is a collection of approved continuing education programs designed to meet t h e special needs of the members in t h e Federation of Nurses a n d Health Professionals. 2. The Library exists to provide FNHP members with cost effective approaches to programs that are accessible to licensed professionals in a cost effective manner. 3. The programs a n d textbooks housed in the CE Library are reviewed and rated by the FNHP Continuing Education Review Board (CERB). This external approval process guarantees t h a t FNHP programs not only present accurate information but also provide quality material to health care professionals who depend on utilizing that updated information in their daily practice. 4. The programs in the CE Library are available on a loan basis or may be purchased at a discount price for member local and state federations. Textbooks in the CE
Library are available to members for purchase a t a discount price only.2 Again, consider some of the characteristics of this union-sponsored activity for nurses. First, it provides convenient educational activities through non-traditional methods, such as independent study modules. This means the nurse can schedule learning activities a t her own convenience and select the location-for example, home, work, or during travel. Second, these activities are economical. The learner does not incur the expense of travel, lodging, or meals away from home. Materials are available to union members a t a special fee. Third, these activities are advertised as approved continuing education for nurses. However, it does not say what criteria or standards are used to review the design or content of these activities to determine their validity, accuracy, or quality; and it does not identify if organizations or groups within the profession recognize this approval, such as state boards of nursing in states where continuing education is mandatory for relicensure. Although saying t h e activity is “approved” is an attractive advertising gimmick, it could work against the nurse using these materials if no one within the profession recognizes the approval. Nursing providers might again consider factors t h a t probably make
AORN Journal. June 1980, V o l 3 1 , N o 7
1215
union-sponsored continuing education appeal ing-economy , convenience, and variety. Then they might ask themselves: What cooperative efforts can continuing education providers such as nursing organizations initiate that would make programming more cost effective and, therefore, less expensive to participants? Can providers avoid duplication in programming? How? Is everything being done to accommodate the learner in regard to program schedulesAays, hours, locations, and reofferings? Are activities scheduled for the convenience of the learner or the provider? Are adult education principles being used? Should nursing providers of continuing education consider t h e sociology of the profession in planning programs? For example, a significant percent of its members have children. Is the provision of child care appropriate? 0 If unions continue to offer programs, does your organization’s philosophy allow cosponsorship or cooperation to ensure that they are designed around professional standards? If not, go back to the preceding questions and ask how, then, other providers of continuing education can effectively compete with union programming. What are the responsibilities of individual regarding who provides continuing education within the profession? First, registered nurses should consciously establish and periodically assess their own philosophy of nursing and continuing education in nursing. This philosophy should guide them in determining who is a n appropriate provider of their professional continuing education.
1216
Second, if nurses believe that providing continuing education should remain within t h e profession, they should actively make their learning needs known and participate i n program planning. Third, if nurses believe it is acceptable for a union to provide continuing education, and they are members, they should insist that programming be done according to professional standards. Fourth, if unions advertise their continuing education activities a s “approved,” nurses should ask, by whom? They should question whether the advertised approval means a n y t h i n g where it counts, such as with a state board of nursing in a state that requires continuing education for relicensure. AFT has advertised its study modules as having the approval of its CE review board b u t does not mention what criteria or standards are used or who recognizes this approval. Fifth and foremost, professionals have a n obligation to keep informed of issues that affect not only them, but the profession. Look at what unions are doing for their members. Consider why nurses might turn to them to provide continuing education as well as to negotiate for them. Then ask not only, w a t is the profession of nursing doing for its members? but also, What am I, as a member of the profession, doing for it and its members? What do I believe in and why? Then act. Notes 1. Bread and Roses: A Special Report (New York: District 1199 Cultural Center, Inc 1979). 2 . Continuing Education Through the Federation of Nurses and Health Professionals (Washinaton. DC: American Federation of Teachers, 1979).
AORN Journal, June 1980, V o l 3 1 , N o 7