CH 18

15. A nurse is educating a new nurse on grievances. The teaching has been effective when the new nurse states: a. "I can file a grievance" b. "My employer cannot file a grievance" c. "The nursing union cannot file a grievance" d. "My coworkers cannot file a grievance"

ANS: A Any nurse, the employer, or the nursing union can file a grievance. PTS: 1 DIF: Cognitive Level: Evaluation REF: p. 408 OBJ: Identify the positive and negative aspects of traditional and nontraditional collective bargaining. TOP: Resolution of grievances MSC: NCLEX®: Not applicable

13. A nurse is discussing personal seniority with the department manager. The nurse has an adequate understanding of seniority when stating which of the following? a. "Seniority provides certain rights to those with the highest number of years of service" b. "Seniority provides the same amount of vacation time as new hires" c. "Seniority no longer provides protection in today's economy" d. "Seniority means that those with the highest number of years of service can be forced to retire"

ANS: A Seniority provides specific rights, which are spelled out in the bargaining agreement, to those who have the highest number of years of service. These rights will differ with each organization. PTS: 1 DIF: Cognitive Level: Application REF: p. 408 OBJ:Identify the positive and negative aspects of traditional and nontraditional collective bargaining.TOP:The debate over collective bargaining MSC: NCLEX®: Not applicable

10. A charge nurse is providing education to coworkers on state nursing associations. The charge nurse judges that the teaching has been effective when a coworker states: a. "These professional associations address nursing practice." b. "These professional associations do nothing to support nursing." c. "These professional associations protect the rights of physicians." d. "These professional associations are managed by hospital administrators."

ANS: A State nursing associations have represented nurses since 1946. They are multipurpose and are involved in many activities such as addressing nursing practice. These organizations do not protect the rights of physicians and are not managed by hospital administrators. PTS: 1 DIF: Cognitive Level: Evaluation REF: p. 400 OBJ: Compare traditional and nontraditional collective bargaining models. TOP: Who represents nurses for collective bargaining? MSC: NCLEX®: Not applicable

18. A nurse has an adequate understanding of traditional collective bargaining when making which of the following statements? a. "The goal of traditional collective bargaining is to win something that is controlled by another." b. "The goal of traditional collective bargaining is to win something that another person has worked for." c. "The goal of traditional collective bargaining is to give all power to the nurse." d. "The goal of traditional collective bargaining is to give all power to the organization."

ANS: A The goal of traditional collective bargaining is to win something that is controlled by another. The other statements are not accurate. PTS: 1 DIF: Cognitive Level: Application REF: p. 400 OBJ: Identify the positive and negative aspects of traditional and nontraditional collective bargaining. TOP: Traditional collective bargaining MSC: NCLEX®: Not applicable

7. A nurse is preparing a presentation. How can the nurse explain one of the primary concerns of the proponents for a nontraditional collective bargaining unit versus the traditional, union-based nursing model? a. "The traditional-based union model frequently puts nurses and employers in adversarial positions." b. "The union dictates to members what they can and cannot do within the health care institution." c. "The union-based model can initiate strikes that can be detrimental to the provision of health care in an institution." d. "The union-based model is too expensive and nurses are not fairly compensated by the organization."

ANS: A The traditional-based union model is adversarial and frequently puts nursing and administration in antagonistic positions. Strikes are most often the last resort and are planned well in advance so that the institution can be prepared. Nontraditional process is referred to as interest-based bargaining (IBB) or shared governance. This is a nontraditional style of bargaining that attempts to problem solve differences between labor and management. Although this style of bargaining and mediation will not always eliminate the need for the more traditional and adversarial collective bargaining, many believe this nonadversarial approach of negotiation may be closer to the basic fabric of the discipline of nursing and its ethical code. In both models, nurses pay dues. PTS: 1 DIF: Cognitive Level: Synthesis REF: p. 400 OBJ: Identify the positive and negative aspects of traditional and nontraditional collective bargaining. TOP: Nontraditional versus traditional collective bargaining units MSC: NCLEX®: Not applicable

16. A nurse is teaching nursing students about issues that keep nursing from becoming a profession of choice. The nurse knows that the teaching has been effective when one of the nursing students states: a. "Nurses downplay their role in health care" b. "Nurse's take credit for their role in health care" c. "Nurses are often seen on the news discussing their role in health care" d. "Nurses are willing to take to media"

ANS: A There are many factors that prevent nursing from becoming a profession of choice. These include nurses downplaying their role in health care, not taking credit for their role, and nurses not being seen in the media. PTS: 1 DIF: Cognitive Level: Evaluation REF: p. 415 OBJ:Discuss the impact of the silence of nurses in public communications and the perception of nurses by the public.TOP:Future trends MSC: NCLEX®: Not applicable

7. What action can the registered nurse take to control personal practice? (Select all that apply.) a. Improve the professional practice of nurses and nursing assistants. b. Refrain from shared governance. c. Implement peer review. d. Identify and recommend elimination of hazards in the workplace. e. Identify and recommend processes that work to ensure the safety of patients.

ANS: A, C, D, E To control personal practice, the registered nurse can improve the professional practice of nurses and nursing assistants, implement shared governance, implement peer review, identify and recommend elimination of hazards in the workplace, and identify and recommend processes that work to ensure the safety of patients.

5. The nurse believes that an adequate understanding of arbitration through the traditional collective bargaining unit has been obtained. Which of the following statements supports this belief? a. "Arbitration is a management technique to discharge an employee." b. "Arbitration is useful to resolve conflicts having a basis in the labor-management" contract. c. "Arbitration is always used before the formal grievance process." d. "Arbitration is a process used to establish nursing standards."

ANS: B Arbitration has also been used to resolve issues involving the "integrity of the bargaining unit." Arbitrators have been asked to decide whether nurses remain eligible for bargaining unit coverage when jobs are changed and new practice models are implemented. Mediation, arbitration, and fact finding have all been used to resolve conflicts in union contracts. Nurses usually fare well when contract enforcement issues are submitted to an arbitrator and facts, not power or public relations, determine the outcome. Arbitration is used after a formal grievance process has not reached a resolution to the issue. Arbitration does not establish nursing standards because that is the purpose of national organizations to write and develop nursing standards of practice. PTS: 1 DIF: Cognitive Level: Application REF: p. 408 OBJ: Identify the positive and negative aspects of traditional and nontraditional collective bargaining. TOP: Arbitration MSC: NCLEX®: Not applicable

12. Which statement by the nurse indicates understanding of collective bargaining in the workplace? a. "Collective bargaining is not useful in the workplace." b. "Collective bargaining is used by nurses to control their practice." c. "Collective bargaining is used by managers to control nurses." d. "Collective bargaining is always an adversarial process in the workplace."

ANS: B Collective bargaining is used by nurses to control their practice by redistributing power within the health care organization. It is not used by managers to control nurses. It is used in the workplace. Traditional collective bargaining has been considered an adversarial process. Nontraditional collective bargaining or interest-based bargaining (IBB) attempts to problem-solve issues between staff and management in a shared governance approach. PTS: 1 DIF: Cognitive Level: Application REF: p. 403 OBJ:Identify the positive and negative aspects of traditional and nontraditional collective bargaining.TOP:The debate over collective bargaining MSC: NCLEX®: Not applicable

9. A nurse is educating coworkers on the establishment of collective bargaining. The nurse knows the teaching has been successful when a coworker states: a. "Collective bargaining is still not recognized by hospitals." b. "Nurse activists believed in a unified voice for nurses." c. "Nurse activists wanted to option of working more hours." d. "Collective bargaining is not effective."

ANS: B Nurse activists created the United America Nurse because they believed in the creation of a powerful, national, independent, and unified voice for union nurses. Collective bargaining is recognized in hospitals in states where it is effective. The other statements are not accurate of collective bargaining. PTS: 1 DIF: Cognitive Level: Evaluation REF: p. 399 OBJ:Identify the milestones in the history of collective bargaining. TOP: The evolution of collective bargaining in nursing MSC: NCLEX®: Not applicable

6. A staff nurse is scheduled to work 3 to 11 pm in the cardiac step-down unit. The staff nurse realizes they are the only RN that will be on duty. The staff nurse calls the supervisor to say that help will be needed. The supervisor replies that there are no available nurses to assign to this unit. What should the nurse do? a. Leave and go home rather than assume this responsibility. b. Protect themself by filing a written objection to the assignment. c. Call a temporary agency and arrange for coverage by a registered nurse. d. Call the state health department to investigate the staffing issue.

ANS: B Nurses who disagree with an assignment should submit their objection in writing when the assignment could violate the patient protection language of the state nurse practice act. An assignment-despite-objection report is submitted to the nursing administrator and the bargaining agent simultaneously, thus officially registering the complaint. This procedure is used both in the traditional and in the nontraditional collective bargaining units. Professional responsibility would be staying with the assignment and not abandoning the work (i.e., patients). The staff nurse does not have the authority or power to contact a temporary agency for obtaining staffing. The state department of health does not review or investigate staffing issues. PTS: 1 DIF: Cognitive Level: Application REF: p. 401 OBJ: Identify the conditions that may cause nurses to seek collective bargaining representation. TOP:Patient care assignments MSC: NCLEX®: Safe and effective care environment—management of care

1. Which statement best describes when collective bargaining by nurses can occur? a. Only when the nurses in the group are members of a union b. Whenever nurses see a need to organize to take collective action c. Only when the state nurses association is willing to represent nurses at a specific agency d. Whenever the state nurses association agrees that both wages and working conditions are inappropriate

ANS: B Professional nurses organize themselves. This may occur because administrators and nursing supervisors fail to recognize and address nurses' individual and collective needs. Collective bargaining can be addressed through a formal union representative or through interest-based bargaining (IBB). The state nurses association may or may not be involved with collective bargaining. PTS: 1 DIF: Cognitive Level: Application REF: p. 406 OBJ: Identify the conditions that may cause nurses to seek collective bargaining representation. TOP: Collective bargaining MSC: NCLEX®: Not applicable

4. What would the nurse identify as a primary difference between traditional and nontraditional collective bargaining? a. Traditional collective bargaining is not organized through the state nursing association. b. Traditional collective bargaining units are organized and members belong to the National Nurses United. c. Nontraditional collective bargaining units are not recognized by health care organizations as a collective bargaining agency. d. Nontraditional collective bargaining has a long history and is based on the support of organizations throughout the country.

ANS: B The nontraditional collective bargaining activities in nursing are organized and supported by the Center for American Nurses, which is affiliated with the American Nurses Association. The traditional unit in the past was the United American Nurses (UAN). This union has joined other traditional bargaining units and has become the National Nurses United, which is a relatively new union (started in 2009). PTS: 1 DIF: Cognitive Level: Application REF: p. 400 OBJ: Compare traditional and nontraditional collective bargaining models. TOP: Traditional and nontraditional collective bargaining MSC: NCLEX®: Not applicable

17. A nurse is striving to control personal nursing practice. Which action should the nurse avoid? a. Recommend a new system for bedside report. b. Refrain from participating in peer review. c. Create a unit presentation on how to increase patient safety. d. Identify ways to reduce hazards.

ANS: B The nurse can control personal nursing practice by recommending a new system for bedside report, participating in peer review, creating a unit presentation on how to increase patient safety, and identifying ways to reduce hazards. PTS: 1 DIF: Cognitive Level: Analysis REF: p. 411 OBJ:Identify barriers to control of professional practice. TOP: How can nurses control their practice? MSC: NCLEX®: Not applicable

6. A nurse believes that the patient assignment received is unsafe. Which action should be taken to correct this? (Select all that apply.) a. Leave the hospital. b. Submit a report about the assignment following protocol. c. Report the assignment to a supervisor immediately. d. Accept the assignment. e. Accept the assignment and only perform the skills that the nurse is comfortable with.

ANS: B, C The nurse should immediately report the assignment to the nurse supervisor and submit a report about the assignment following protocol. The nurse should not leave the hospital or accept the assignment if they cannot provide competent care. PTS: 1 DIF: Cognitive Level: Application REF: p. 402 OBJ:Identify conditions that may lead nurses to seek traditional or nontraditional collective bargaining.TOP:Common issues MSC: NCLEX®: Safe and effective care environment

4. The nurse manager has an adequate understanding of the common issues in nursing when stating which of the following? (Select all that apply.) a. "There are no common issues in nursing." b. "Mandated staffing is a common issue." c. "Unsafe patient assignments are a common issue." d. "Lack of overtime is a common issue." e. "Negotiations are a common issue."

ANS: B, C, E Mandated staffing, unsafe patient assignments, and negotiations are common issues faced by nurses today. Lack of overtime is not considered to be a common issue in nursing. PTS: 1 DIF: Cognitive Level: Application REF: pp. 401-403 OBJ:Identify conditions that may lead nurses to seek traditional or nontraditional collective bargaining.TOP:Common issues MSC: NCLEX®: Safe and effective care environment

2. Which action can the nurse take during a job interview to ensure job satisfaction in the future? (Select all that apply.) a. Ask about benefits associated with the job. b. Assess the potential employer's mission. c. Determine wages and pay increases. d. Ask questions to determine the culture of the organization. e. Question the hours that are required for a full-time status.

ANS: B, D In the job interview, it is important that the nurse focuses on questions that will help determine which job is right and will ensure job satisfaction in the future. The nurse should be prepared to assess the potential employer's mission and culture in order to determine if the job will support the nurse's professional practice and growth. Although information about compensation, benefits, and hours are needed, these are not best predictors of job satisfaction. PTS: 1 DIF: Cognitive Level: Application REF: p. 411 OBJ:Identify the milestones in the history of collective bargaining. TOP: Job satisfaction MSC: NCLEX®: Not applicable

5. A nurse believes that an assignment is unfair and refuses to care for the assigned patients. What could be the outcome if the nurse abandoned the patient assignment? (Select all that apply.) a. The nurse would be assigned to another group of patients. b. Untoward patient outcomes c. Other nurses would take on the nurse's assignment. d. Disciplinary action by the Board of Nursing e. Disciplinary action by the nurse's employer

ANS: B, D, E Abandoning a patient assignment risks untoward patient outcomes and can result in disciplinary action by the nurse's employer and the Board of Nursing. PTS: 1 DIF: Cognitive Level: Synthesis REF: p. 402 OBJ:Identify conditions that may lead nurses to seek traditional or nontraditional collective bargaining.TOP:Common issues MSC: NCLEX®: Safe and effective care environment

2. In which situation would the traditional type of collective bargaining (union) help nurses attain their goals? a. Management has agreed to no nursing layoffs for one year after reorganization. b. Nursing has received a 4% salary increase this year and next year. c. Nurses have identified workplace safety issues and health hazards. d. Management has arranged for nurse practitioners to have admitting privileges.

ANS: C A conflict regarding safety between administration and nursing is a situation that could benefit from a nurses' union. Many nurses support collective bargaining in the workplace as a way to control their practice by redistributing power within the health care organization. Salary increases, no nursing layoffs, and nurse practitioners having admitting privileges typically do not represent conflict. PTS: 1 DIF: Cognitive Level: Application REF: p. 400 OBJ: Identify the conditions that may cause nurses to seek collective bargaining representation. TOP: Collective bargaining MSC: NCLEX®: Not applicable

3. Which action by hospitals in the 1940s began the journey to collective bargaining for nurses? (Select all that apply.) a. Allowed nurses to work 40-hour work weeks b. Compensated nurses for overtime c. Scheduled nurses to work 50- to 60-hour work weeks d. Subjected nurse to arbitrary schedules e. Did not offer sick or personal time

ANS: C, D, E During the 1940s, nurses working in hospitals were subjected to arbitrary schedules, did not have sick or personal time, and were scheduled to work 50- to 60-hour work weeks. PTS: 1 DIF: Cognitive Level: Application REF: p. 399 OBJ:Identify the milestones in the history of collective bargaining. TOP: The evolution of collective bargaining in nursing MSC: NCLEX®: Not applicable

1. A nurse manager is speaking to a group of nurses about how to choose their representative if they wish to participate in traditional or nontraditional collective bargaining. The nurse manager knows the teaching has been effective if the nurses select which of the following as ways to choose their representative? (Select all that apply.) a. Service Employees International Union b. The National League for Nursing c. Their state nurses association d. The American Federation of Teachers e. National Nurses United (NNU) f. Center for American Nursing (CAN)

ANS: C, E, F The professional association has the means and responsibility to represent nurses. The national professional organization for nursing is the American Nurses Association (ANA) with its constituent units, the state and territorial nursing associations. Nurses can enjoy the benefit of representation by nurses either through a traditional organized union, such as the National Nurses United (NNU), or through nontraditional interest-based bargaining, such as the Center for American Nurses (CAN). PTS: 1 DIF: Cognitive Level: Evaluation REF: p. 400 OBJ: Identify steps nurses would take to initiate collective bargaining representation. TOP: Representation MSC: NCLEX®: Not applicable

14. A nurse is educating a new nurse on grievance mechanisms. The nurse judges that the teaching has been effective when the new nurse states: a. "Nurses should attend any meeting where they believe discipline may be given without representation" b. "The nurse must ask a supervisor to file a grievance" c. "As a new nurse, I cannot file a grievance" d. "Any nurse can file a grievance"

ANS: D Any nurse can file a grievance. The nurse does not have to ask permission from a supervisor. The nurse should be represented in any meeting where discipline may be given. PTS: 1 DIF: Cognitive Level: Evaluation REF: p. 408 OBJ: Identify the positive and negative aspects of traditional and nontraditional collective bargaining. TOP: Resolution of grievances MSC: NCLEX®: Not applicable

11. A union nurse is educating a new nurse on common issues faced by nurses today. The union nurse knows that the teaching has been effective when the new nurse states: a. "There are no common issues; nurses faces different issues based on their job." b. "Today, there are no issues because of the advancement of technology." c. "Hospitals are fully staffed at all times." d. "Hospitals frequently mandated nurses due to staffing shortages."

ANS: D Common issues today include staffing shortages that lead to mandating nurses to work overtime. Nursing shortages create issues that cannot be fixed by advances in technology and leave hospitals inadequately staffed. Although each nurse faces different issues based on the job, collectively nurses experienced many of the same issues in their day-to-day nursing activities. PTS: 1 DIF: Cognitive Level: Evaluation REF: pp. 401-403 OBJ: Identify conditions that may lead nurses to seek traditional or nontraditional collective bargaining. TOP: Common issues MSC: NCLEX®: Not applicable

8. A nurse is giving a lecture on the primary problem that decreases the power of both types of collective bargaining models. The nurse knows that the teaching has been effective when a colleague states: a. "The small number of states that recognize either type of collective bargaining" b. "The political influences of the American Hospital Association on nursing organizations" c. "The adversarial goals of each of the respective organizations or models" d. "The lack of membership of the majority of practicing nurses"

ANS: D Lack of membership of the majority of practicing nurses decreases the power of both types of collective bargaining models. Most people join an organization in response to a particular need. Almost 80% of nurses do not belong to any professional nursing organization. The traditional union based model is more adversarial than the nontraditional model. The American Hospital Association's political influence does not decrease or increase power in either model. The other options do not accurately show the primary problem that decreases the power of the collective bargaining models. PTS: 1 DIF: Cognitive Level: Evaluation REF: p. 409 OBJ: Compare traditional and nontraditional collective bargaining models. TOP:Nontraditional versus traditional collective bargaining units MSC: NCLEX®: Not applicable

3. Which provision—if labor management included it in a contract—would not be to nursing's advantage? a. A workforce retraining provision b. Seniority rights c. A grievance procedure d. Wage adjustments based on bed occupancy

ANS: D Unions may stimulate better hospital management by fostering formal, central, and consistent personnel policies with better lines of communication. Consistent personnel policies include a consistent wage base, regardless of bed occupancy. Workforce retraining, seniority rights, and a grievance procedure would be important provisions in a labor contract that would be advantageous to nursing. PTS: 1 DIF: Cognitive Level: Analysis REF: p. 407 OBJ: Identify the conditions that may cause nurses to seek collective bargaining representation. TOP: Contracts MSC: NCLEX®: Not applicable