According to long standing NLRB doctrine, in healthcare facilities, restrictions on wearing non-official buttons and insignia in immediate patient care areas are valid. But if there is selective enforcement of the restrictions singles out union related buttons and insignia then there is a problem unless the hospital can show that the restriction was “necessary to avoid disruption of healthcare operations or disturbance to patients”. In this case, a hospital issued ribbons to its Registered Nurses that said “Saint John’s mission is patient safe care“. It had also permitted employees to wear ribbons that said “Respect and Dignity” and “Saint John’s Nurses – the Heart of Heathcare“. For a number of years the California Nurses Association/National Nurse Organizing Committee was conducting an organizing campaign at the hospital. During the campaign union organizers issued ribbons to RNs that stated “Saint John’s RNs for Safe Patient Care“. When those ribbons were worn by union supporters in direct patient care areas management issued a warning that wearing those ribbons in direct patient care areas would be insubordination and lead to discipline. Nurses were told to stop wearing the union’s ribbons.
The NLRB then got involved and ruled that the banning of the union ribbons was unlawful. It found that the hospital failed to provide any evidence that patients were or would likely be disturbed by the union ribbons; that patients were even aware of the union campaign; and that there was no real difference between the messages that were approved by the hospital and the message on the union’s ribbons.
Bottom line, a hospital’s restrictions on buttons and insignia must be limited to direct patient care areas and must be clearly established to avoid patient disturbance. Most of all, hospitals need to make sure that whatever restrictions are in place that they are uniformly enforced.
Saint John’s Health Center, (NLRB, December 30, 2011)
If you have questions regarding this topic, please contact Steve Lyman at 317.977.1422 or slyman@hallrender.com, Bruce Bagdady at bbagdady@hallrender.com or your regular Hall Render attorney.
