Mount Airy Psychiatric Center

National Labor Relations Board - Board Decisions

Jan 6, 1981

253 N.L.R.B. 1003 (N.L.R.B. 1981)

MOUNT AIRY PSYCHIATRIC CENTER
Mount Airy Foundation d/b/a Mount Airy Psychi-
atric Center and Professional & Health Care
Employees Division, Retail Clerks Union, Iocal
No. 7, chartered by United Food and Commer-
cial Workers International Union, AFL-CIO,'
Petitioner. Case 27-RC-5598
January 6, 1981
DECISION AND DIRECTION OF
ELECTION
BY CHAIRMAN FANNING AND MEMBERS
PINII.I.O AND TRUESi)AI
Upon a petition duly filed under Section 9(c) of
the National Labor Relations Act, as amended, a
hearing was held before Hearing Officer Robert L.
McCabe from October 31, 1977, through Novem-
ber 2, 1977. Following the close of the hearing, the
Acting Regional Director for Region 27 trans-
ferred this case to the Board for decision. Subse-
quently, briefs were filed by the Employer, 2 the
Petitioner, and the Colorado Nurses Association,
affiliate of the American Nurses Association, herein
called the Intervenor.
Thereafter, on March 30, 1979, the Board issued
its decision in Sierra Vista Hlospital. Inc., 241 NLRB
631, in which it made substantive rulings which af-
fected issues raised by the Employer in this case
concerning the Intervenor's qualification to repre-
sent the Employer's employees. On July 3, 1979,
therefore, the Board issued an order remanding this
proceeding and reopening the record for the limit-
ed purpose of receiving evidence bearing on the
question of the Intervenor's status as a labor orga-
nization, with instructions that, upon the conclu-
sion of such further hearing, the case be transferred
to the Board for decision on all issues. On July 12,
1979, however, the Intervenor filed a request to
withdraw its petition to intervene. On July 23,
1979, the Board issued an order granting the Inter-
venor's request to withdraw, making it unnecessary
for the Regional Director to conduct the additional
proceedings contemplated by the Board's remand
order of July 3. Accordingly, on July 26, 1979, this
case was again transferred to the Board for deci-
sion.
Pursuant to the provisions of Section 3(b) of the
National Labor Relations Act, as amended, the Na-
tional Labor Relations Board has delegated its au-
thority in this proceeding to a three-member panel.
' The name of1 the PeI'lionel has been amended to reflect the change
resultlilg from the June 7. 179, merger of RHtail Clerks Ilternatllonal
Ilniontl aid Amlnlgamatled Mealcutlers and illtcher WorkLtei 11l North
America
The Fmplyver has requested oral argtILnelit ' his reqestis Is hlcreh
dt'nied as he recrd and hrieR[ ;Ldeqlual ls preseit Ithe isvtls ilid i p i
1itl (of the parties
253 NLRB No. 139
The Board has reviewed the Hearing Officer's
rulings made at the hearing and finds that they are
free from prejudicial error. They are hereby af-
firmed.
Upon the entire record in this proceeding, the
Board finds:
I. The Employer is engaged in commerce within
the meaning of the Act, and it will effectuate the
purposes of the Act to assert jurisdiction herein.
2. The Petitioner is a labor organization within
the meaning of Section 2(5) of the Act claiming to
represent certain employees of the Employer.
3. A question affecting commerce exists concern-
ing the representation of employees of the Employ-
er within the meaning of Section 9(c)(1) and Sec-
tion 2(6) and (7) of the Act.
4. The Employer operates an 80-bed licensed
psychiatric hospital in Denver. Colorado, employ-
ing approximately 100 employees. The Petitioner
seeks to represent a separate unit of registered
nurses, excluding, inter alia, all other professional
employees and supervisors as defined in the Act.:'
'The petitioned-for unit consists of approximately 52
employees, including those registered nurses occu-
pying the position of charge nurse whom the Peti-
tioner argues are not supervisors within the mean-
ing of the Act. The Employer contends that such a
unit is inappropriate because it excludes other pro-
fessional employees who are not registered nurses
but who perform the same duties as the registered
nurses, and that the only appropriate unit is one
that includes all of the Employer's professional em-
ployees. Contrary to the Petitioner, the Employer
also contends that registered nurses occupying the
position of charge nurse are statutory supervisors
and should be excluded from the unit. The parties
stipulated that the director of nursing services, the
three nursing supervisors, the six relief nursing su-
pervisors, the five head nurses, the associate head
nurse, and the nurse consultant are supervisors
under the Act and are not properly included in any
unit.
The Employer's psychiatric hospital is function-
ally and administratively divided into four pro-
grams or sections: The general psychiatric unit
(GPU); the therapeutic community (TC); the alco-
hol treatment program (ATP): and the adolescent
section. Nursing services are provided in each of
these sections on a 24-hour basis with the regis-
tered nurses working one of three shifts: 7 a.m. to 3
p.m. (day); 3 p.m. to 11 p.m. (evening); and 11 p.m.
I he rejucstcd l. ita s set forth i tlhe petlltion. is a 1ill0 , 5r
All tull l l .±it1i regular palltn-iie Reglistlcrd 'Prl'fssilal Nurc.,
eclutdin g Al sIth pe'lsorf. tl er pttfessitials. confidelCnt l ipl occrs
biiilless olicc llcal elllplo ccs. gtl.rds ad all it ( ert ciliplt'c il
det'tilt' Iii lt ' Niltlllil [ iablh r R I.allo n, \,I
1(X)3
DECISIONS OF NATIONAL LABOR RELATIONS BOARD
to 7 a.m. (night). The director of nursing services,
Elizabeth Triebelhorn, works the day shift and is
responsible for overall patient care in the four sec-
tions. When she is not present one of the three
nursing supervisors assumes this responsibility.
Triebelhorn or one of the nursing supervisors is
always on duty.
Aside from this overall responsibility of the di-
rector of nursing services and the nursing supervi-
sors, nursing services are handled separately within
each of the four sections of the hospital. The GPU
and the TC each are under the immediate supervi-
sion of a head nurse who reports to Triebelhorn or
one of the nursing supervisors. The head nurse in
turn oversees the work of charge nurses, staff
nurses, and nurse assistants. However, the head
nurse is on duty during the day only, and on the
evening and night shifts a charge nurse is responsi-
ble for overall patient care in her particular sec-
tion. All the nurses in these two sections, as well as
those in the other sections in the hospital, are regis-
tered nurses licensed by the State of Colorado. The
nurse assistants are not.
The nursing hierarchy is somewhat different in
the ATP and in the adolescent section. The ATP is
headed by a program coordinator who is not a reg-
istered nurse.4 The program coordinator works the
day shift only and occupies an administrative posi-
tion similar to that of head nurse. However, be-
cause she is not a registered nurse, she works espe-
cially close with Triebelhorn and the nursing su-
pervisors on matters relating to patient care. In ad-
dition, during each shift, direct patient care in the
ATP is provided by a charge nurse, staff nurses,
and nurse assistants. In the program director's ab-
sence during the evening and night shifts, charge
nurses are responsible for assuring that proper pa-
tient care is provided. On these occasions, they are,
as are the charge nurses in the other sections, an-
swerable to the nursing supervisor on duty.
The adolescent section is headed by a program
director and an associate program director, neither
of whom is a registered nurse.5 A head nurse who
works the day shift is responsible for the overall
patient care in the section. Most medical assess-
ments as well as the preparation and dispensing of
medication is handled primarily by certain regis-
tered nurses referred to as "associate charge
nurses." Aside from these individuals, direct patient
care on each shift is provided by employees re-
ferred to as "charge persons" rather than charge
nurses and employees called "team leaders" rather
4 The record establishes, and we find, that the program coolrdinator is
a supervisor within the meaning of the Act.
5 The record establishes, and we find, that the program director alnd
the associate program director are supervisors within the meaning of the
Act.
than staff nurses. Two of the 5 charge persons and
6 of the 15 team leaders are not registered nurses.
Those that are not have a master's degree in psy-
chology or a related field and clearly are profes-
sional employees within the meaning of the Act.
The record shows that all the team leaders,
whether or not they are registered nurses, perform
virtually the same duties. On each shift, each team
leader is assigned to a small group of adolescents
and is responsible for the overall care of these chil-
dren during the shift. The team leader's responsibil-
ities typically consist of getting the child up in the
morning, taking vital signs, checking the child's
personal hygiene, feeding, assisting the child at var-
ious therapy sessions and with various teaching ac-
tivities, assisting with the study hour, and engaging
in one-to-one counseling. Triebelhorn testified that
if a team leader who is a registered nurse calls in
sick, that individual can be and has been replaced
by a team leader who is not a registered nurse.
Triebelhorn also testifed, however, that if an emer-
gency arose in the adolescent section requiring
someone to make a medical adjustment or to ad-
minister medication when the associate charge
nurse was unavailable, a registered nurse team
leader could assume the responsibility but a nonre-
gistered nurse team leader could not. Except for
such emergencies, which the record reveals are in-
frequent, registered nurse team leaders do not make
medical adjustments or administer medication be-
cause those functions have been given to the asso-
ciate charge nurse on duty. Thus, the daily respon-
sibilities of all team leaders generally are the same.
All team leaders are answerable to the head nurse
of the section and, in the head nurse's absence,
they work with the charge person on duty in assur-
ing that the adolescents receive proper care and
that their various therapy programs are being fol-
lowed. At the hearing, when asked why the Em-
ployer uses some individuals who are not regis-
tered nurses as team leaders, Triebelhorn explained
that most of the patients' needs in the adolescent
section are psychological, not physical, and that
trained persons with psychology degrees are very
effective in dealing with children and are able to
handle most problems that arise.6
Comparing the position of team leader to that of
the staff nurses in the three other sections, the
I Triebelhorn s explanation also related to the Employer's use of indi-
viduals with master's degrees as charge persons As with the team lead-
ers, all charge persons, whether or not they are registered nurses, per-
form virtually the same duties, with the exception that registered nurse
charge personls may respond to the medical emergencies that infrequently
arise he charge persons functiotn in the same way as do the charge
nurses in the olher sections. Whether the charge nurses and charge per
sons should he excluded from the unit as supervisors will he discussed
inrua.
1004
MOUNT AIRY PSYCHIATRIC CENT'ER
record shows that the positions are nearly parallel
with the exceptions that staff nurses may have
greater involvement with preparing and administer-
ing medication, and that staff nurses deal with
adults rather than children. Team leaders and staff
nurses stand at the same level in the personnel hier-
archy as they all are answerable to the head nurse
and/or the program director of their respective
sections. Team leaders and staff nurses also receive
the same pay and fringe benefits, including pension
benefits and vacations. With respect to interchange,
however, there is no evidence of any regular rota-
tion or transfer of team leaders to serve as staff
nurses in the other sections of the hospital. Nor is
there evidence of staff nurses transferring to the
adolescent section to become team leaders.
With respect to supervision, the record further
shows that Triebelhorn and the nursing supervi-
sors, in conjunction with the head nurses and/or
the directors of each section, are ultimately respon-
sible for hiring, firing, disciplining, evaluating, and
promoting all registered nurses and nurse assistants.
The record contains no express statement that these
supervisors exercise this authority over team lead-
ers who are not registered nurses. However, there
is no indication that these latter employees are sep-
arately supervised and, as noted above, the evi-
dence shows that all team leaders are answerable
to the head nurse of the adolescent section who, in
turn, reports to Triebelhorn and the program direc-
tor of the section.
In addition to the registered nurses in the peti-
tioned-for unit, and the six team leaders who are
not registered nurses, there are nine other employ-
ees working at the hospital who are alleged to be
professional employees as defined in the Act: two
pharmacists, two occupational therapists, four
social workers, and one educator. The pharmacists
are required to have graduated from an accredited
pharmacy school, interned for 2,000 hours, and
passed the licensing examination given by the State
Board of Pharmacists. The occupational therapists
are required to have a bachelor's degree from an
accredited school of occupational therapy, served a
9-month internship, and passed a registry examina-
tion. One of the occupational therapists also has re-
ceived her master's degree in the field. Of the four
social workers, two work exclusively in the adoles-
cent section and have a master's degree in the field
of social work. The two other social workers work
in the other sections of the hospital. Their training
consists of an undergraduate program in social
work or an allied field, and prior field experience
at another psychiatric hospital. The educator al-
leged to be a professional employee is employed as
a special education teacher. She was required to
obtain her bachelor's degree in the field of educa-
tion, to be certified by the State of Colorado, and
to complete a 2-year master's program in special
education. As part of her duties, this special educa-
tion teacher works with adolescents at the hospital
implementing an educational program requested by
a doctor.
These nine employees all have received training
and/or advanced education in their respective
fields. The record shows that they apply this edu-
cation in their respective fields. The record shows
that they apply this training as part of their daily
jobs and that their work is intellectual and requires
the exercise of independent discretion and judg-
ment. Under established Board law, we find they
are professional employees within the meaning of
Section 2(12) of the Act.7
The record contains scant testimony about the
extent of interaction between the requested nurses
and these nine professional employees. It shows
that the nine professional employees work the day
and evening shifts only and thus do not attend to
the patients on a 24-hour basis as do the registered
nurses. The record also reveals that the pharma-
cists report to the director of pharmacy and have
very little contact with any other professional em-
ployees. The occupational therapists report to the
director of the occupational therapy department,
except when they work in the adolescent section,
at which time they also must report to the asso-
ciate director of that section. The occupational
therapists are not directly accountable to the nurs-
ing hierarchy described above. However, the staff
nurses and the team leaders are present during oc-
cupational therapy. The social workers also work
outside the nursing hierarchy; the social workers
with master's degrees report to the associate direc-
tor of the adolescent section, and the two other
social workers report to the medical director of the
hospital. As with the occupational therapists, the
social workers, in the performance of their job,
may work with the nursing personnel at certain
times. The special education teacher also reports to
the associate director of the adolescent section.
The record contains no evidence about the extent
of her interaction with the other professional em-
ployees.
Based on the foregoing facts, we must determine
whether the petitioned-for unit of registered nurses
Set-. e g ( 'ron Drug (Compun, 108 N.R 1126 1954) lphlrma-
clsts) , iunit Air I-oundation, d , a Mount .I/ v PIyvchatr ( entr. 217
Nl.RB 8()2 (1975) (cc u pation;al therapit,). ,Gnaden Ituertn Metnmorial
liopiutal, . 219 NIRB 235 (1975) (,iclai workers and mental healh
cmprlipce); he Bu//hu, (nern lipriral, 21 NRB It()0 (19751 (cotun-
%sleir itllril l1 twi lh nalltr' dcgrce il pychology): 'sce alsio San Josw
lIrtpoul. 228 NI R 21 (1977) ph.amlll.tls, ph?,ical heraplts, occupa-
tl(~ilol therapllt .,..d sL.wrkers rrcll-lnal hrplt)
1005
I)[1FISI()NS OF NA IO()NAL LABOR REl.ATIONS BOARDI
is appropriate or whether, as the Employer con-
tends, the only appropriate unit is one that includes
the six team leaders who are not registered nurses
as well as the nine remaining professional employ-
ees.
Recently, in Newton- Wellesley Hospital, 250
NLRB 409 (1980), we reexamined at some length
the considerations to be applied in determining the
appropriateness of a separate unit of registered
nurses. In so doing, we specifically concluded that
"an irebuttable presumption of the appropriateness
of registered nurse units in all cases, without regard
to particular circumstances, should be disavowed"
and that "[s]uch a per se approach to unit determi-
nations is inconsistent with the Board's Section 9(b)
responsibility to decide 'in each case' whether the
requested unit is appropriate."" We held in that
case, after a thorough examination of the particular
facts, that the record demonstrated that the regis-
tered nurses possessed such a community of inter-
ests as to make their separate representation appro-
priate.
With our decision in Newton-Wellesley in mind,
we have carefully considered the record here and
are persuaded that the separate unit of registered
nurses sought by the Petitioner, which includes the
nine registered nurses who are team leaders, does
not by itself constitute an appropriate unit for col-
lective bargaining. We note that, unlike the team
leaders who are not registered nurses, the nurse
team leaders are separately licensed and have
unique training. Nevertheless, it cannot be said that
the registered nurse team leaders in the adolescent
section have a community of interest separate and
distinct from the six team leaders in that section
who have master's degrees but are not registered
nurses. Thus, all the team leaders, whether regis-
tered nurses or individuals with master's degrees,
perform virtually the same daily tasks, substitute
for each other, receive the same benefits, and are
subject to the same supervision. We are aware that
the registered nurse team leaders, unlike those with
master's degrees, are specially licensed to make
medical assessments and administer medication, and
we can perceive that this difference in professional
training may in other circumstances be a crucial
factor in finding appropriate a separate unit of reg-
istered nurses.9 This factor, however, is not crucial
here because, in the adolescent section, registered
nurse team leaders are not generally required to
N .Vewton- Wellestv Ilospital. upru at 414
9 See, eg. Newton- Wi'elily. supra, here certain registered nurses and
mental health counselors served as "key persons" in a psychiatric unit
and performed very similar duties. Ihe Board excluded the mental health
counselors from the nurses unit, in part. because onily the registered nrljrSe
key persons administered nmedications, changed dressings. oi serced in a
"charge" capacity
prepare or administer medication. With this nursing
responsibility essentially removed from these regis-
tered nurses and vested in an associate charge
nurse, all the team leaders stand in an identical po-
sition. In these particular circumstances, we con-
clude that the exclusion of the team leaders who
are not registered nurses from the unit sought is
improper. We note that such a conclusion is con-
sistent with Kaiser Foundation Health Plan of Colo-
rado and Permanente Services of Colorado, Inc., 230
NLRB 438 (1977). There, the Board, in a similar
situation, found inappropriate a unit of all profes-
sional employees, excluding registered nurses, be-
cause certain nonnurse professionals, called physi-
cian assistants, and certain registered nurses, called
physician extenders, performed identical jobs. In
light of that case and our decision in Newton-
Wellesley, supra, we find that an appropriate unit
here must include the nonnurse team leaders who
hold master's degrees' ° and, accordingly, that the
unit sought by the Petitioner is inappropriate.
Having found that a unit limited to registered
nurses is inappropriate because it would exclude a
number of similarly situated professional employ-
ees, the question remains whether the nine remain-
ing nonnurse professionals must also be included in
the unit. Clearly, based on the facts set forth
above, these nine professionals do not have as
strong a community of interest with the registered
nurses as do the team leaders with master's de-
grees. In this connection, the registered nurses and
these nine professionals perform different tasks,
have only occasional interaction with each other,
and do not share the same supervision. On the
other hand, these professionals do not exhibit an
overall community of interest among themselves.
Faced with the choice of creating a residual unit of
only nine nonnurse professionals or of including
them in a unit with the registered nurses and the
team leaders with master's degrees, we find that
the latter is more consistent with the purposes of
the Act. This is not to suggest that we will not in
other circumstances find appropriate a unit com-
posed of registered nurses and some, but not all, of
the nonnurse professionals. Suffice it to say that on
the facts of this case, where a substantial portion of
nonnurse professionals (the team leaders with mas-
ter's degrees) must be included with the registered
nurses, and where such a combined unit comprises
the vast majority of the Employer's professionals, it
"' I'his ana1l is applies equally I to the charge persons in Ihe adolescent
sectiornl r hi airc nirt registered nurses hut hold master's degrees, huld
e findl. ilru. that charge persills ad charge nurses arc not superissors
ilhiil t eC nlaning of the Act.
As tled pire iously, lCC rliie itotitulsC profesiinals cotnsist of
tso phllillclstt. 1tV occupatiot ial therapists, four social surkers, and
ione edluctator
I (X6
M()OUNT AIRY PSYCHIIATRIC CN'I R
is appropriate that the small remainder of disparate
residual professionals be included in the unit as
well. Accordingly, we find that the only appropri-
ate unit for the registered nurses is one that in-
cludes both the registered nurses and all of the Em-
ployer's other professional employees. Since the
Petitioner has not indicated an unwillingness to
represent these other professionals, we shall direct
an election in such a unit. 12
In addition to contesting the appropriateness of
the petitioned-for unit, the Employer contends that
the charge nurses and the charge persons are su-
pervisors under the Act and should be excluded.
Of the Employer's 52 registered nurses, 15 serve as
permanent charge nurses and 16 serve as relief
charge nurses.13 It is unclear from the record
whether the Employer seeks to exclude the relief
charge nurses.
As detailed above, at the top of the nursing hier-
archy at the hospital is Director of Nursing Serv-
ices Triebelhorn, and the three nursing supervisors.
One of these individuals is always on duty. Below
the nursing supervisors in the hierarchy are the
head nurses of each section. Each head nurse
works a day shift 5 days a week, but is responsible
for her section 24 hours a day, 7 days a week. All
of these individuals-the head nurses, the nursing
supervisors, and Triebelhorn-are stipulated to be
supervisors. They all are paid a salary and are not
paid extra for working overtime. All registered
nurses, including the charge nurses, are hourly paid
and receive extra pay for overtime. The charge
nurses are paid 25 cents per hour more than are the
regular staff nurses.
Each charge nurse works an 8-hour shift in her
respective section, during which time she is respon-
sible for assuring that all patient care in the section
is being properly provided. During the day shift
the charge nurses report to their respective head
nurse. During the evening and night shifts, the
charge nurses report to the nursing supervisor on
duty. Triebelhorn testified that the responsibilities
of the charge nurses typically consist of taking the
oncoming report from the head nurse or charge
nurse from the previous shift; making an initial
round of the patients; assigning rest and dinner
breaks for the staff nurses and nurse assistants;
J2 We note, however, that the unit found appropriate here is substan-
tially different from the unit sought by the Petitioner. It may be, here-
fore, that the Petitioner does not wish to proceed to an election in this
unit. or, desiring to do so. that its showing of interest is no longer ade-
quate. In these special circumstances, we direct the Petitioner to notify
the Regional Director within 10 days of this Decision whether it wishes
to proceed to an election and. if so. to submit at that time such additllonal
showing of interest as may be required to support its petition
sa The discussion to follow will refer to all charge nurses and relief
charge nurses and to their counterparts in the adolescent section. the
charge persons. collectively as "charge nurses"
making patient assignments to themselves, the staff
nurses, and the nurse assistants; charting patient
care and progress; charting and administering
medication; preparing the outgoing report for the
next shift; and counting narcotics. In the head
nurse's absence, the charge nurse also may have to
coordinate activities with other departments in the
hospital, such as the dietary department or the oc-
cupational therapy department, as they relate to pa-
tient care.
In addition to these administrative duties, the
record shows that charge nurses also spend a sig-
nificant amount of time in direct patient care along
with the staff nurses and nurse assistants.14 While
attending to the patients, the charge nurses are ex-
pected to instruct staff nurses and nurse assistants
on aspects of patient care and will correct them if
they are doing something improper or detrimental
to the patient.
The charge nurses do not have authority to au-
thorize overtime, schedule employees, call in off-
duty employees, or grant time off. Staff nurses and
nurse assistants who cannot be at work are in-
structed to call the nurse supervisor not the charge
nurse. While situations may arise in which charge
nurses need additional staff to help care for the pa-
tients, they cannot unilaterally arrange for the
transfer of a staff nurse or nurse assistant from an-
other section of the hospital without first consult-
ing with the nursing supervisor on duty. However,
in the event of an emergency, charge nurses might
summon for assistance without first consulting with
the nursing supervisor.
The record shows that charge nurses have been
asked to evaluate the performance of nursing per-
sonnel for purposes of wage increases. However,
the record also shows that the head nurses and the
nursing supervisors independently make such eval-
uations, and that they make the final decisions on
whether to grant the wage increase. Beverly
Renick, a charge nurse, testified that she recalled
no occasion on which her recommendation about
an employee under evaluation prevailed over a
contrary recommendation of a head nurse or nurs-
ing supervisor.
The record further shows that a charge nurse's
authority to effectively recommend the firing or
disciplining of staff nurses and nurse assistants is
similarly circumscribed. A charge nurse's major
4 The record shows that, depending on the particular section of the
hospital and the particular shift, charge nurses devote from 30 percenlt to
90 percent of their time to direct patient care Charge nurses spend
nearly all of their time in direct patient care n the night shifts where
they may hase the assistance of only one nurse assistant and perhaps a
staff nurse Charge nurses on the da.l and evening shifts tend to spend a
greater amount of tinie with sorme of the dministratise matters noted
above
I (X)7
DECISIONS OF NATIONAL LABOR RELATIONS BO()ARD
input into such decisions is through what is re-
ferred to as an anecdotal record, which a charge
nurse may fill out to report to higher management
on some aspect of an employee's work. However,
as part of their professional responsibility, all
nurses, not only charge nurses, may fill out these
anecdotal records, and, all such records may be
relied on by higher management in disciplining or
discharging an employee. Furthermore, while Trie-
belhorn testified to two instances in which employ-
ees were terminated on the basis of reports from
charge nurses, the record shows these reports
simply reported the incidents at issue and that Trie-
belhorn herself made the decision to discharge the
employees. Ray Himbaugh, a charge nurse, when
testifying about an incident in which a nurse cre-
ated an "intense problem" on the floor during his
shift, stated that his role in the situation solely con-
sisted of reporting the incident to the nursing su-
pervisor who in turn instructed Himbaugh to docu-
ment anything he saw. Himbaugh did not make the
decision to discharge this employee. In fact, the
record reveals no occasion in which a charge nurse
has made the decision to discipline or discharge an
employee and the four charge nurses who testified
all stated they have no such authority.
The record evidence concerning the hiring of
the nursing personnel shows that the process in
each section is coordinated by the head nurse. Fre-
quently, the head nurse will ask a charge nurse or
some staff nurses to evaluate an applicant. Then, as
Triebelhorn testified, the head nurse collects these
evaluations, talks with the employees about them,
interviews the applicant, and "does the hiring."
The record reveals that on one occasion Ray Him-
baugh applied for a head nurse position and was
evaluated by all the employees in the section. They
all recommended that he be hired over the other
candidate, but the other candidate was selected.
This incident appears consistent with Triebelhorn's
testimony in which she agreed that it is the hospi-
tal's policy to get as much input from as many em-
ployees as possible before she, the nursing supervi-
sors, or the head nurses make final decisions about
hiring or firing.
The record also discloses that newly hired nurses
are given a -week orientation and serve a 6-month
probationary period. During this period, the charge
nurse is expected to teach the new employee about
the daily routine and, along with the other staff
nurses, counsel the new employee on any problem
about patient care matters. Should the new em-
ployee perform poorly, and fail to improve, the
charge nurse is expected to report this to the head
nurse. This ultimately could lead to a conference
between the new employee and Triebelhorn, a
nursing supervisor, and a head nurse, at which the
employee could be terminated. The charge nurse
would not be present at the conference.
Upon considering the foregoing facts, we find
that the charge nurses and their counterparts in the
adolescent section, the charge persons, are not su-
pervisors within the meaning of the Act. The
Board has long recognized a distinction in the
health care industry between individuals who su-
pervise others as a representative of management
and those who give direction to other employees
and perform their tasks in the exercise of their pro-
fessional judgment, incidental to their treatment of
patients. Those in the former category are super-
visors; those in the latter are not. The charge
nurses here clearly fall into the latter category.
Thus, the primary function of the charge nurses is
to make certain that all patient care is handled
properly on a particular 8-hour shift. They devote
much of their time to direct patient care, and their
direction of the staff nurses and nurse assistants is
incidental to their treatment of patients. When they
assign themselves, the nurses, and the nurse assis-
tants to work with various patients, such assign-
ments again are made in the exercise of their pro-
fessional judgment with respect to the employees'
abilities and the patients' needs. Similarly, the ad-
ministrative tasks performed by the charge nurses
are all related to patient care and carry no indicia
of supervisory authority.
While we note that the charge nurses have some
input into decisions affecting hiring, firing, promo-
tion, and discipline, their role in such decisions is
too circumscribed to constitute true supervisory
authority. Much of the input sought from the
charge nurses on hiring and firing decisions is also
sought from all the staff nurses. All nurses, not
only charge nurses, can submit anecdotal records
about other employees. Significantly, Triebelhorn,
the nursing supervisors, and the head nurses, all
make independent evaluations of the employees
and are the ones who make all final decisions.
Therefore, the charge nurses' role in making anec-
dotal records or submitting evaluations seems little
more than a reporting function consistent with
their professional responsibility to assure the proper
and efficient treatment of patients in their sections.
For all the foregoing reasons, we find that the
charge nurses, relief charge nurses, and charge per-
sons are not supervisors within the meaning of the
Act and should be included in the unit with the
other professional employees.
Ihe Trusiees of Noble lospital, 218 NLR 1441 (1975); he Preshvre-
rian edical Center, 218 NRB 1266 11975), Valley Ilospital, Ltd., 220
NL.RB 1339(1975)
1008
MOUNT AIRY PSYCHIATRIC CFNTFR
Upon the entire record, we find that the follow-
ing employees of the Employer constitute a unit
appropriate for collective bargaining within the
meaning of Section 9(b) of the Act:
All professional employees, including full-time
and regular part-time registered nurses, charge
nurses, relief charge nurses, charge persons,
team leaders, pharmacists, occupational thera-
pists, social workers, and educator employed
by the Employer at its psychiatric hospital at
4455 East 12th Avenue, Denver, Colorado; ex-
cluding confidential employees, business office
clerical employees, guards, all other employ-
ees, and supervisors as defined in the Act.
[Direction of Election and Excelsior footnote
omitted from publication.]
1009