| Summary: | 碩士 === 國立政治大學 === 勞工研究所 === 103 === Nurses in Taiwan have long endured strict work rules and heavy pressure of providing care. However, they are powerless to change the unfair work rules and improve their labor conditions. This is mainly due to two reasons: 1. The law not being enforced. 2. Nurses associations, which nurses are obligated to become members of according to the law, have failed at one of their main missions – to protect members’ rights and interests. Moreover, there currently are not any powerful nurses associations that can speak out for nurses.
In light of the dilemma of nurses who are not able to exercise their rights because of long-term oppression from employers, this study proposes to learn from the successful experience of employees of Kaiser Permanente who unite together to negotiate with management and build partnership with them. The outcome is nurses did successfully improve labor conditions and help management stabilize business operations.
Kaiser Permanente had once improperly cut down the number of nurses and worse still lowered labor conditions due to a crisis in the past. The awareness of this crisis led unions of Kaiser Permanente’s employees to consider to form an alliance, so that they could collectively bargain with management. After building a consensus to form an equal partnership with management, they are able to sign a collective agreement to protect their work rights and labor conditions of employees, and at the same time assisted the medical center with performance improvement and medical quality plans with great success in over a decade. Besides transforming the crisis into an opportunity for forming a partnership, the reason they were successful was because: (1) Laborers were strongly united so that they have the strength to form an equal partnership with management; (2) Laborers understand that their labor-management partnership is in a dynamic balance and they know how to suitably maintain the balance; (3) Maintaining a balanced partnership helps them focus on negotiations and reach a consensus.
Most nurses in the medical industry and hospitals in Taiwan blame the National Health Insurance for the dilemma. However research shows that labor and management can still exchange opinions and work together to improve the labor conditions and medical quality in the medical industry. Unions of Kaiser Permanente’s employees formed a powerful alliance, while there is no such alliance for nurses in Taiwan. Moreover, under current laws and regulations, nursing professional association have the most current nurses, but they provide little protection for the rights of their members.
Recommendations of this study are as follows: (1) Nurses: Laborers should carefully examine their rights to join union and take action to actively participate. (2) Nursing professional associations: they should listen to the opinions of front-line nurses and understand their circumstances, and broaden their mission to include the protection of labor conditions and decent work as their main goal. Also, to maintain the unity of nurses, these associations should organize labor awareness workshops to strengthen the unity of nurses, and thereby increase their bargaining power with employers. (3) Medical institutions: Hospitals should stick to the core value as non-profit organizations that are not profit-driven but share with employees and comply with the requirements set forth in the Labor Standards Act by firstly improving labor conditions of existing medical personnel and then hire more staffs to deal with the nurse shortage challenge. In light of the successful experience of the case presented, an equal partnership between labor and management is the key to sustainable operation and performance improvement of hospitals. Hospitals should negotiate with nurses associations based on good faith to let nurses feel secure about their working environment, and be willing to stay in the medical industry and dedicate their efforts to improving medical quality. This will gain trust from patients and make patients willing to return in the future, creating a win-win situation for doctors and patients, as well as labor and management.
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