The Nursing Process

JEHANZEB KHAN YOUSAFZAI

R.N, M. Sc in Nursing
Post RN, B Sc N, Dip Card.
Graduate in Psychology/sociology,
(jzk_yz@hotmail.com)
Nursing Instructor
College of Nursing, PIMS, Islamabad
 Objectives

At the end of today’s session the students should

be able to:
– Define collective bargaining and
– Discuss collective action models and
associated terminology.
– Identify the American Nurses Association’s
role and function in collective bargaining.
– Discuss professionalism in the context of
unionization.
– List pros and cons of collective bargaining.
Collective Bargaining: Definitions

• Collective action, or simply acting as a group

with a single voice, is one method by which to
deal with problems.
• Collective bargaining is the practice of
bargaining with reference to wages, work
practice, and other benefits by employees in
a collective group with management.
Workplace Advocacy

• Workplace advocacy refers to the activities

nurses undertake to address problems in
their everyday workplace setting.
• Activities include forming committees to
address problems, formulating alternatives to
achieve optimal care, and inventing new
ways to implement change.
• If the group cannot achieve its desires
through informal collective bargaining with
management, the group may decide to form
a union.
Whistleblowing

• Whistleblowing is the act where an individual

discloses information regarding a violation of a
law, rule, or regulation or a substantial and
specific danger to public health or safety.
 Factors Influencing Nurses
to Unionize

• Feelings of powerlessness

• Desire to eliminate discrimination and favoritism

• Desire to communicate concerns to

management without fear of losing jobs

• Need to initiate change

• Concerns over wages, staffing, safety, job

security
Employees’ Role During Process

• Nurses desiring to choose a collective

bargaining agent must be sure they know the

laws that have been instituted and follow

them carefully.
 Nurses’ Role During Initiation of
Unionization

• Know your legal rights and the rights of the

manager.

• Act clearly within the law at all times.

• If a manager acts unlawfully, e.g., by

dismissing an employee, report the employer’s
actions to the National Labor Relations Board.
• Keep all nurses informed through regular
meetings held close to the hospital.

• Set meeting times conveniently around shift

changes, during meetings.
Striking

• A collective bargaining agent cannot make

the decision to strike.

• The decision to strike can be made only by a

majority of union members.
• Most nursing collective bargaining agents put
a no-strike clause in the contract.

• In USA, the 1974 Health Care Amendments

to the National Labor Relations Act contain
provisions that guarantee the continuation of
adequate patient care in a strike situation.
Collective Bargaining Agents

• PNF/PNA
• YNA
Managing in a Union Environment

• Nursing management may not be part of the

union, but nurse managers must work with
the union to manage within the rules and
context of contract agreements.
• A grievance is where a union member feels
that management has failed to meet the
terms of the contract or labor agreement and
communicates this to management.
• All union contracts specify grievance
proceedings for their members.
Collective Bargaining: Advantages

– Contract to guide standards

– Participation in decision-making process
– All union members and management must
conform to terms of contract without
exception
– Process exists to question manager’s
authority if member feels something was
done unjustly
Collective Bargaining: Disadvantages

– Reduced individuality
– Other union members may outvote one’s
decisions
– All union members and management must
conform to terms of contract without exception
– Disputes are not handled with individual and
management only; less room for personal
judgment
– Must pay union dues even if one does not
support unionization
Activities of PNF/PNA, Karachi Branch

• Fill up all the nursing vacant

seats
• Increase the salary package of
Nursing Professional, to retain
the brain drain.
• The stipend of student nurses,
increase according to
PNC:73rules and regulations
• Register all the nonregistered
nursing institutions
• Announce the scholarships for
Nursing programs
Activities of PNF/PNA, Karachi
Branch

• The nursing power must be handled over to

the nursing professionals,
• All the qualified Nursing professionals should
be promoted
• [there should be the policy as ongoing
promotion on the basis of higher education like
in medical].
• The president of PNC should be a "NURSE"
• The nursing vacancies should be on open
merit or there should not be any discrimination
with any gender, [female or male]
We have sent our suggestions (agenda) to the
PNC 11th session to include it in the Nursing
Policy.
• We have been highlighting, and presenting
many events/ activities of violations against
nurses and have been notifying to the
authorities, like
• Staff Saleem and Dr Sabeen case (NICH),
• Staff Rubina Nadeem Gynae Drs
negligence case (JPMC),
• Staff Rukhsana accommodation problem
case(sindh services hospital),
Advocacy for Nursing

• Student Nurse and Dr violation case (JPMC), and

• PNA Kar Branch protested against the violation by the
Director PIMS, Islamabad against nursing students.
• PNF/PNA, supported that the JPMC should be a Federal
Health University,
• We demanded scholarships for Nurses from National
Maternal, Neonatal and Child Health(MNNCH) [usaid
Project]
• We demanded for the general election of PNA Sindh and
PNF Pakistan.
• PNF/PNA, Karachi Davison has proudly announced a
unique and mega housing project even 1st time in Pakistan
specially for Nurses "New Health Cooperative Housing
Society"
 Achievements of PNF/PNA, Karachi
Branch
• The vacancies for the principal CON,JPMC and CNS
JPMC has been announced.
• The PNC, registered the Baquai Nursing graduates
and also promise that the students of Pride SON, will
be registered.
• The PNC inspection team, visited many Nursing
institutions in Karachi to proceed the process of their
registration.
• The Sindh govt changed its nursing allocation seats
60% for Females and 40% for Males
• At federal level the stipend of Nursing students is
increased according to the PNC rules
• NNMCH has announced some scholarships for the
students of BScN,CON, JPMC.
• To stop the violation against the Nurses the govt
provided the Ranger mobile security at NICH.
• Dr. Sabeen (the responsible character of staff
saleem NICH case) was suspended and her inquiry
was conducted.
• Staff Nurse Rubina JPMC case, after the inquiry
committee report two responsible Drs were
terminated while four were suspended.
• Staff Nurse Rukhsana, (sind services hospital) was
accommodated in Civi hospital’s hostel.
• Student Nurse JPMC case the Dr was suspended.
• The Director of PIMS was removed from her seat
and the case inquiry is being conducted.

• PNF/PNA has promised to start the election process

very soon.

• New Health Cooperative Housing Society is

established this is a unique achievement of the PNF
Karachi even first time in Pakistan for Nurses.