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PubMed2001

Strike action by nurses in South Africa: a value clarification.

The Labour Relations Act (South Africa, 1991) made provision for protected strike action by employees, subject to certain conditions, procedures and negotiated agreements. This led to the removal of the strike clause in the Nursing Act (South Africa, 1992). The labour rights of all citizens are entrenched in the Constitution of the country (South Africa, 1996). Participation in strike action by the nurse/midwife, regardless of the legal requirements and specifications, does, however, pose an ethical question. It is therefore necessary to conduct a value clarification on strike action by nurses in South Africa. The purpose of this research is to explore and describe the perceived values of participants from an accessible population on this phenomenon. A qualitative, exploratory and descriptive research design was deployed. The perceived values of nurses on strike action were collected by means of an open-ended questionnaire/sketch. Over a period of three years a purposive and convenient sampling method was used, involving all the enrolled post basic nursing/midwifery students/learners at a particular Nursing Education Institution. The justification of the sample was further enhanced by also collecting data on the participants' age and provincial distribution location. Although a 63% sample realisation (of the accessible population) was achieved, this represents only 1.5% of the registered nursing/midwifery population in the country. A descriptive analysis of the participants' age and provincial distribution was undertaken, as well as a content analysis of their perceived values on strike action. The mean age of the participants was 48 years, which could be attributed to the fact that most of them were enrolled for a post-basic Diploma in Community Nursing Science. Most of the responses (52.7%) were against strike action and 32.5% supported strike action by nurses as a constitutional and legal right. A fairly substantial number of participants (14.8%) expressed mixed views as to whether strike action by nurses is right or wrong. Some respondents (15.7%) also reflected confusion regarding the enactment of strike action and the removal of the strike clause from the nursing legislation. Although this study does not claim external validity due to inappropriate representation of the nursing profession, the nurse of today opposes strike action. It is recommended that the study be replicated at national level and that the values be entrenched and published in position papers of and by the regulatory and organised nursing profession.

Adult↗
PubMed1982

Wrongful dismissal--an expensive mistake.

A contract of employment is based on implied terms (a nurse can be expected to work shifts while the same does not apply to a secretary in the purchasing department), on conduct (unacceptable tardiness or laxity can become an accepted term of the contract if it is not corrected by the employer), and on agreements either express (a signed contract) or implied (the acceptance of personnel manual terms during a probationary period). An employee's service can not be terminated without reasonable notice except for cause. To determine if summary dismissal (cause) is warranted, apply the test described in Stilwell v. Audio Pictures Ltd.

Absenteeism↗
PubMedDate not supplied

The experience of an occupational health centre during a prolonged work stoppage.

We describe the experience of the occupational health centre at the Sarnia Division of Dow Chemical Canada prior to, during and after a work stoppage of seven months duration. A descriptive analysis was performed of the occupational health case load during the work stoppage compared to the same period one year earlier. Total visits as well as those for dermatologic, upper respiratory, musculoskeletal and those associated with a non-occupationally related situation (e.g., sunburn) exceeded normal frequencies during the first ten weeks of the work stoppage. In particular, there was a peak number of visits during the first two weeks when a 'lock-in' prevented employees from visiting their own physicians except for emergency situations. In the Discussion section, recommendations are outlined to lessen the chance of adverse health effects in workers responsible for operating a chemical plant during a work stoppage.

Health Services Research↗
PubMed1986

Labour relations in health services management.

'Labour relations' or 'industrial relations' refers to employer-employee relations which are both economic as in matters of pay and conditions, and managerial, i.e. the political relationships between management and employees, collectivized through trade unions and professional associations. This paper traces the development of managerial relationships as illustrated by experiences in the British National Health Service particularly over the past 20 years focusing on groups of actors--management (within which may be distinguished government and local managers), health professional workers and other workers--whose interactions need to be studied if managerial relations within health services are to be satisfactorily analysed. We conclude that, although until recently, developments in management have had little impact upon worker behaviour outside unskilled groups, changing economic and other circumstances could create the conditions in which stronger managerial control over professional workers might emerge.

Forecasting↗
PubMed1998

Striking against managed care: the last gasp of la médicine libérale?

The French health care system combines a strong tradition of autonomous private practice with nearly universal health care coverage through the social security system. The French state's responses to rising health care expenditures have included limitation of the number of medical students, control over physician fees, rules to prohibit certain clinical practices, experiments with generalist physicians coordinating care and access to specialists, and collective physician responsibility for expenditures beyond the health care budget. The failure of physicians' protests, including a strike of French residents and fellows in 1997, may signify the end of traditional private practice in the face of France's statist version of managed care.

Delivery of Health Care↗
PubMed1985

Policy perspectives on newspaper reports of nurse strikes.

Content analysis was used to study 1980 U.S. newspaper articles about nurse strikes. Multivariate analysis revealed that the 893 nurse strike articles presented a more negative image of the nurse than newspaper articles on other nursing subjects. There were more negative headlines, criticism of nurses, and negative relationships. Desire for higher salaries was the major strike issue reported by newspapers, conveying that nurses are interested in personal economic gain as opposed to quality patient care. Nurse strike articles were more likely to appear in larger circulation newspapers and be about strikes in hospitals rather than other health care settings. The most extensive and favorable press coverage occurred in states were organized labor is concentrated. Policy implications of these findings include the difficulty of using the nurse strike as a labor tactic in states with a strong antiunion press.

Humans↗
PubMed1987

Effects of the Israel doctors' strike on hypertension control in Ashdod.

We examined hypertension control during the Israel doctors' strike in a defined insured population of known hypertensives enrolled in a nurse-based hypertension control program. The strike was associated with a measurable increase in the prevalence of uncontrolled hypertension which was limited to males of relatively higher social class. No strike-related changes in hypertension control were seen for women or lower social class males. We infer from this finding that the presence of a physician is a necessary component of good hypertension control in the sub-group of males of higher socioeconomic status. The incidence of hypertension-related complications in this relatively non-compliant subpopulation needs further investigation.

Adult↗
PubMed1990

The effect of a nurses' industrial action on psychiatric hospital admissions.

The socio-demographic and clinical characteristics of patients admitted to a large psychiatric hospital during a six month period of industrial action by nurses are described and compared with those from a similar period in the previous year. During the industrial action, the nursing staff agreed only to accept "emergency cases" for admission. The way that medical and social work practices were affected by the restricted conditions are discussed. The admission threshold was raised across all diagnostic categories, although the level of violence and social isolation was markedly less than expected. Chronic patients with a duration of illness of ten years or more were least likely to be admitted during the action. It is probable that some patients were admitted under a compulsory order to facilitate access to in-patient treatment.

Attitude of Health Personnel↗
PubMed1989

Effects of a psychiatrists' strike on emergency psychiatric referral and admissions.

This is a report on the effects of a psychiatrists' strike in Israel on emergency psychiatric referrals and admissions from two catchment areas. One had comprehensive psychiatric services, the other did not. Three periods were compared - before, during and after the strike. During the strike period, overall referrals to the emergency room decreased by 3.9%. A significant 15.8% decrease in referrals was registered in the comprehensive psychiatric service area, and an 11.4% increase in referrals in the other catchment area. Although no increase was seen in total emergency admissions during the strike, involuntary admissions increased by 21.6%, within the catchment area which did not have a comprehensive service, whereas within the area with the comprehensive service there was a significant decrease of 33% in involuntary admissions. The impact of these services on emergency referrals and admissions, especially during the strike, is discussed.

Emergency Services, Psychiatric↗