225 N.L.R.B. 1165 (N.L.R.B. 1976)

The Baptist Memorial Hospital

National Labor Relations Board - Board DecisionsSep 3, 1976

225 N.L.R.B. 1165 (N.L.R.B. 1976)

BAPTIST MEMORIAL HOSPITAL 1165 The Baptist Memorial Hospital and American Federa- tion of State , County and Municipal Employees, AFL-CIO, Petitioner . Case 26-RC-5113 September 3, 1976 DECISION AND DIRECTION OF ELECTION By MEMBERS JENKINS, PENELLO, AND WALTHER Upon a petition duly filed under Section 9(c) of the National Labor Relations Act, as amended, a hearing was held before Hearing Officer William K. Harvey. Following the close of the hearing, the Hear- ing Officer transferred this case to the Board for de- cision. Thereafter, briefs were filed by the Employer and the Petitioner. The Intervenor I did not file a brief. 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 Board has reviewed the Hearing Officer's rul- ings made at the hearing and finds that they are free from prejudicial error. They are hereby affirmed. Upon the entire record in this proceeding, the Board finds: 1. The parties stipulated that the Employer is a general welfare nonprofit hospital in Memphis, Ten- nessee, annually receives gross revenues in excess of $50 million, and annually purchases and receives goods and materials valued in excess of $50,000 from points outside the State of Tennessee. We find that the Employer is engaged in commerce within the meaning of the Act, and that it will effectuate the purpose of the Act to assert jurisdiction herein. 2. The labor organizations involved claim to rep- resent certain employees of the Employer. 3. A question affecting commerce exists concern- ing the representation of employees of the Employer within the meaning of Section 9(c)(1) and Section 2(6) and (7) of the Act. 4. The Petitioner seeks to represent employees in the following unit: All regular full-time and part-time service and maintenance employees including but not limit- ed to nursing assistants, attendants, floor secre- taries, transcribing secretaries, aides, and all nonsupervisory employees in dietary, engineer- ing, supply, transfer, laundry departments, and housekeeping department employed at the Employer's Memphis locations, excluding all business office clerical employees, technical and professional employees, including LPN's, guards, and supervisors as defined in the Act. The Employer contends that the only appropriate unit is an all-inclusive unit including all service, maintenance, technical, and clerical employees, in- cluding LPN's and technicians at all of its facilities, excluding only professional employees, guards, and supervisors as defined in the Act. The Employer does not include the business office clericals among the clericals which it seeks to include within the unit. The Intervenor reasserts the contentions made in two prior proceedings 2 that a separate maintenance unit and a separate unit of service and maintenance employees at the Lamar unit are appropriate. In ad- dition, the Intervenor indicates that it considers a unit including the nursing service, dietary, and housekeeping employees as well as the RN's and LRN's to be appropriate. The Employer's hospital facilities in Memphis, Tennessee, consist of several buildings, most of which are located in a central complex between Madison and Union Avenues. In addition to the hos- pital facilities at this location, the Employer also has office buildings housing some hospital departments, doctors' offices, a hotel for the use of relatives and visitors of hospital patients, four public food facili- ties, a parking garage and public parking lots, a bar- bershop, a gift shop, and other enterprises tradi- tionally associated with a hospital. The unit which Petitioner seeks, and to which the Employer is in basic agreement, is a traditional hos- pital service and maintenance unit. As we stated in Newington Children's Hospltal,3 a service and mainte- nance unit in a service industry such as the hospital industry is the analogue to a plantwide production and maintenance unit in the industrial sector. As such, it is the classic appropriate unit. Service and maintenance employees in the unit sought by Peti- tioner primarily perform manual and routine job functions. Accordingly, the Employer requires only minimal qualifications for employment in these posi- tions and whatever training is required is generally acquired in 2 or 3 weeks of on-the-job training. Ser- vice and maintenance employees are generally paid less than the employees sought to be excluded by Petitioner, and interchange with those employees is extremely limited due to educational and licensing 2 In The Baptist Memorial Hospital, 224 NLRB 201 (1976), Local 150 petitioned for a unit of approximately 119 service employees regularly as- signed to the Employer's Lamar unit located approximately a mile from the Employer's central complex of buildings situated between Madison and Union Avenues In The Baptist Memorial Hospital, 224 NLRB 199 (1976), Local 150 petitioned for a separate unit of the Employer's maintenance employees In both cases for reasons set forth therein we found the re-, , Service Employees ' International Union , Local 150-T, AFL-CIO, here- quested units to be inappropriate in referred to as Intervenor or Local 150 '217 NLRB 793 (1975) 225 NLRB No. 165 1166 DECISIONS OF NATIONAL LABOR RELATIONS BOARD requirements of the excluded positions. Among the service and maintenance employees sought herein, on the other hand, there is frequent interaction and job interchange. Thus, in accordance with our find- ings in numerous other hospital cases, we find that an overall service and maintenance unit is appropri- ate.4 We further find, for the reasons fully set forth in Barnert Memorial Hospital Center,5 that Petitioner's requested exclusion of professional and technical employees is, likewise, appropriate. Accordingly, we shall exclude the RN's and LPN's from the unit. The Employer's operations utilize employees in a wide range of job titles. During the course of this proceeding the parties reached agreement concerning the unit placement of many job classifications. The proper unit placement of other classifications, how- ever, was left to the Board. 1. At the hearing, the parties agreed that the fol- lowing job classifications should be included in any unit found appropriate: Dietary cooks, dietary butchers, dietary bak- ers, dietary helpers, dietary porters, dietary wait- ers, dietary aids, dietary clerks, laundry workers, watchhouse employees, laundry marker check- ers, laundry checker supervisor, laundry worker inspector, laundry worker leadman, laundry worker porter, laundry worker swingman, laun- dry worker washman, laundry linen transport- ers, laundry linen workers, laundry linen utility employees, laundry linen seamstresses, brace shop clerk typists, brace shop bracemakers, brace shop orthopedic shoe technicians, brace shop arch support technicians, brace shop tech- nicians, brace shop corsetiere technician, brace shop attendants, hotel maids and porters, admis- sion porters, GI technicians, GI runners, nursing floor secretaries, nursing transcribers, nursing monitor technicians, nursing EKG monitor technicians, OB nursing assistant, newborn nursing assistant, newborn floor secretaries, emergency room clerks, outpatient assistants, outpatient secretaries, outpatient attendants, nursing scheduling secretaries, nursing scrub as- sistants, anesthesia aids, anesthesia assistants, anesthesia secretaries, housekeeping storeroom clerk, housekeeping aids and porters, house- keeping seamstresses, pharmacy maids and por- ters, pharmacy central supply technicians, phar- macy central supply maids, pharmacy central supply porters, tube room operators, storeroom porters, printers helpers, radiology clerical aid, 4 See Mercy Hospitals of Sacramento, Inc, 217 NLRB 765 (1975), Yale- New Haven Hospital, 219 NLRB 198 (1975), Newington Children's Hospital, supra, Nathan and Miriam Barnert Memorial Hospital Association d/b/a Bar- nert Memorial Hospital Center, 217 NLRB 775 (1975) 5 Supra radiology attendants, radiology maids, and transport aids, pathology aids, outpatient house- keeping aid, collection station runners, laborato- ry housekeeping aid, animal caretakers, blood- bank housekeeping employees.' 2. The parties agreed that the following fob classi- fications should be excluded from any unit found appropriate: Administrative president, vice presidents, ad- ministrative assistants, administrative secre- taries, personnel director, personnel record su- pervisor, PBX supervisor, physical therapy director, therapist, physical therapy assistant di- rector, dietary chief dietician, head therapeutic dietician, dietary administrative dietician, thera- peutic dieticians, assistant to dieticians, secre- tary to chief dietician, dietary supervisors, di- etary chef and kitchen managers, laundry manager, assistant laundry manager, barbershop manager, all security personnel, hotel supervi- sor, hotel maid supervisor, social service direc- tor, garage manager, assistant garage manager, admissions director, assistant admissions direc- tor, admissions porter supervisor, admissions hostess supervisor, admissions insurance clerk supervisor, admissions coordinator, medical rec- ords director, registered nurses, nursing secre- tary (records), nursing administrative supervi- sors, cardiovascular RN, gastrointestinal lab director, chaplain, director of hostesses, house- keeping director, housekeeping supervisors, health records analyst, pharmacy director, direc- tor of public food service, EKG consultants, EKG training coordinator, EKG director, cardi- ac lab supervisor, EKG lab supervisor, cardiac lab director, pulmonary physiology director, pulmonary physiology technical director, pul- monary physiology engineer programmer, pul- monary physiology research engineer, pulmo- nary physiology assistant director, pulmonary physiology fellow, respiratory therapy chief technician, respiratory therapists, pharmacists, pharmacy central supply supervisor, pharmacy central supply assistant supervisors, public food managers, public food assistant managers, pub- lic food night supervisor (Fountain Room), pub- lic food assistant supervisor (Fountain Room), public service supervisor (Fountain Room), Pla- za North cafeteria chef, cafeteria assistant man- Upon a review of the record, we find that none of the employees in these job classifications are required to be certified or registered, and they do not exercise independent judgment in the performance of their jobs As such, they are not technical employees within the meaning of the Act or estab- lished Board policy and thus are appropriately included within the unit See Litton Industries of Maryland, Incorporated, 125 NLRB 722, 724-725 (1959). Barnert Memorial Hospital Center, supra BAPTIST MEMORIAL HOSPITAL 1167 agers, cafeteria supervisors, cafeteria managers, gift shop manager, purchasing director, purchas- ing storeroom supervisor, radiology personnel supervisor, pathology business manager, pathol- ogy secretary to director, pathology clerical su- pervisor, pathology evening clerical supervisor, pathology personnel payroll supervisor, patholo- gy supply and services supervisor, chemistry technologists, chemistry coordinator, chemistry supervisors, cytology technologists, microbiolo- gy technologists, microbiology assistant to su- pervisor, microbiology certified laboratory tech- nicians, hematology technologists, audiologists, EEG technical director, EEG technical supervi- sor, histology technologists, serology technolo- gists, serology supervisors, evening staff supervi- sors (pathology), evening staff assistant supervisors, night staff technologists, night staff certified laboratory technicians, lab supervisor, IV team supervisor, IV team assistant supervi- sor, pathology assistant in morgue. 3. At the hearing, some of the parties sought to include and the other parties took no position con- cerning the unit placement of, the following classifi- cations: Public food service employees, dietary clerks, gift shop clerks, elevator operators, collection station clerk technicians, lab IV technicians, nursing assistants, nursing attendants, OB tech- nician, perfusion technician, OR technicians, housekeeping team leader, medical education technicians, evening staff technicians, night staff technicians, night staff clerk technicians, eve- ning staff clerk technician, EKG special proce- dures technician, cardiac lab echo technician, cardiac lab echo electronics technician, cardiac lab peripheral vascular technician, cardiac lab technician, cardiac catheterization electronic technician, cardiac lab radiological technician, catheterization aid, cardiac lab secretary, pa- thology technician, autopsy and morgue diener, blood gas clerk receptionist, blood bank techni- cian, blood bank clerk technician, chemistry technician, chemistry clerk technician, cytology technician, microbiology technician, microbiolo- gy clerk technician, hematology technician, ENG technician, EMG technician, echo techni- cian, EEG technician, histology clerk techni- cian, urinalysis clerk technician, nursing educa- tion administration librarians. In their briefs to the Board, neither the Petitioner nor the Employer sought to exclude these classifica- tions from the unit. We conclude therefore that none of the parties have any current objection to the inclu- sion of these classifications in the unit. Upon a re- view of the record, we find that the employees em- ployed in the above-listed classifications share a community of interest with the service and mainte- nance employees and are therefore appropriately in- cluded within that unit. 4. At the hearing, the Employer sought to include the employees in the following categories: Dietary storeroom manager, flower shop at- tendants, flower shop clerks, station attendants, mechanics, public parking lot attendants, public parking lead attendant, close circuit television technician, close circuit television operator, pharmacy cashier, pharmacy head porter, phar- macy storeroom manager, pharmacy techni- cians, central supply secretary, pharmacy IV team technicians, methods analyst, storeroom clerk, physical therapy aids and assistants, phys- ical therapy clerks, nursing education adminis- trative librarian, and PR unit technician. Although at the hearing either the Petitioner or In- tervenor sought to exclude these classifications, in their briefs to the Board neither party indicated a continued desire for exclusion. Upon a review of the entire record, we find that the employees employed in these classifications share a community of interest with the service and maintenance employees. Ac- cordingly, we shall include them within the service and maintenance unit. 5. There are a number of unresolved employee job classifications which the Petitioner has continued to assert should be excluded from the unit. A. Petitioner seeks to exclude the following classi- fications on the basis that the employees are office clericals having a greater community of interest with the business office clericals than with the service and maintenance employees: nursing office secretaries; staffing secretaries; liaison office secretary; school of nursing in-service education secretary; the secretary in the chaplain's office; secretary to the director of housekeeping; medical education secretary; secre- taries and clericals in the cardiac laboratory; the pul- monary and respiratory department secretaries; pur- chasing secretary-buyer and clerk typist; the radiology department office clerks, file clerks, medi- cal typists, and medical secretaries; and the patholo- gy department clerks, clerk receptionists, file clerks, clerk typist, medical secretaries, medical transcribers, and classified data input clerk. The record discloses that while employees in these job classifications per- form duties basically clerical in nature, they work in locations throughout the hospital in close proximity with service and maintenance employees. These cler- icals spend a substantial amount of their time per- 1168 DECISIONS OF NATIONAL LABOR RELATIONS BOARD forming functions directly related to the care and treatment of patients (i.e., the purchasing secretary- buyer receives requisitions from various departments and along with the clerk typist prepares invoices and order forms; nursing office staffing secretaries han- dle private duty nurse calls and make appointments for people coming to the nursing office; the liaison office secretary is responsible for the patient and his family making arrangements for post hospital care and has contacts with aides and attendants regarding various equipment, such as crutches for patients). Thus, we find that the interests of these clerical em- ployees are more closely related to the functions served by employees in the service and maintenance unit than with the business office clericals. We shall, therefore, include these clerical employees in the ser- vice and maintenance unit.' B. The Employer and Intervenor would include and the Petitioner would exclude as business office clericals all the employees in the admissions office except for the admissions porter.' The admissions of- fice is located on the ground floor of the Madison and Union East buildings facing Dudley Street, an area removed from the Employer's business office but one readily accessible to the patients and public. Admissions employees fill out and process various forms after obtaining the necessary information from the patients. Some of these employees work directly with the patients while others deal primarily with in- surance companies and doctors. They are responsible for acquiring information (e.g., financial status, in- surance coverage, etc.) required for billing purposes. We find that the employees in the admissions office do not share a community of interest with the service and maintenance employees, but rather, because of the nature of their job functions, are more closely aligned with the Employer's business office clericals. As such, we shall exclude the admissions office em- ployees from the unit.9 C. The Petitioner also seeks to exclude the medi- cal records department employees 10 on the basis that they are business office clericals. The Employer would include these employees, while the Intervenor 7 See St Catherine's Hospital of Dominican Sisters of Kenosha, Wisconsin, Inc, 217 N LRB 787 (1975), Mercy Hospitals of Sacramento, supra, Trumbull Memorial Hospital, 218 NLRB 796 (1975), Gnaden Huetten Memorial Hospi- tal, Inc , 219 NLRB 235 (1975) B The following job classifications comprise the admissions office admis- sions clerks, admissions insurance clerk, admissions coordinator, admissions hostesses, admissions reservation clerks, admissions reservation mail clerk, admissions mail clerk 9 See Gnaden Huetten Memorial Hospital, supra, Mendenco Hospitals of Louisiana, Inc, d/b/a St Claude General Hospital, 219 NLRB 991 (1975), Kanawha Valley Memorial Hospital, Inc, 218 NLRB 846 (1975), Sisters of St Joseph of Peace, 217 NLRB 797 (1975) 0 The followingjob classifications are in the medical records department transcriber, clerk, clerk typist, electriever, receptionist, processor, profes- sional audit study abstractor and clerk, and coding clerk has taken no position. The medical records depart- ment is responsible for the processing, control, and filing of patients' records while they remain as pa- tients in the hospital and after their discharge. The department is located on the second floor of the Madison West building across the hall from the doc- tors' lounge and medical library-an area where it is convenient for the doctors to complete the patients' records so that the department can process them. Some employees are involved in abstracting specified data from the records relating to particular diseases, injuries, and medical treatment to be used for hospi- tal statistical and analytical purposes. Also within the medical records department there are three employees whose job titles would appear to signify a supervisory function-discharge analyst su- pervisor, supervisor of information release, and pro- cessing and filing supervisor. A close examination of the record, however, reveals that these individuals do not hire, fire, discipline, assign work, or evaluate em- ployees-all of which are duties performed by the medical records director. Instead, they spend the ma- jor portion of their time performing routine depart- mental work. By virtue of their greater knowledge and skill resulting from their lengthy tenure within the department, other medical records employees consult these individuals concerning such matters as coding, filing, processing, or other work-related problems. These individuals operate essentially as team leaders. Thus, we find that they are not supervi- sors and shall treat them for unit placement purposes in the same manner as other department employees. The record reveals that while the medical records department employees perform duties which are es- sentially clerical in nature, they are normally hired on the basis of their knowledge of medical terminolo- gy rather than on the basis of their clerical qualifica- tions. In addition, they spend a substantial amount of time performing functions, although clerical in na- ture, directly related to care and treatment of pa- tients. Thus, in accordance with our policy of includ- ing nonbusiness office clericals with service and maintenance employees, we shall include the medical records department employees in the unit." D. The Petitioner would exclude the telephone op- erators as lacking a community of interest with unit employees and would exclude the assistant supervi- sor in the telephone section as a supervisor. The Em- ployer would include both classifications. The Em- ployer characterizes the telephone operators' function as being essentially an adjunct to the admis- sions and information functions. These employees receive incoming calls and give information regard- 11 Mendenco Hospitals of Louisiana, supra , Gnaden Huetten Memorial Hos- pital, supra BAPTIST MEMORIAL HOSPITAL ing patient room numbers, phone numbers, and hos- pital department phone numbers. In addition, they page hospital personnel, handle wakeup calls for ho- tel guests, maintain schedules of various personnel so they can be easily located in emergency situations, and activate and deactivate patients' telephones. On the basis of the entire record, we find that the tele- phone operators and telephone room assistant super- visor perform functions closely related to those per- formed by business office clericals and therefore have a community of interest more closely aligned to those excluded employees. As such, we shall, like- wise, exclude such classifications from the service and maintenance unit.12 E. The Employer would include the hotel desk clerk. The Petitioner and Intervenor would exclude him as a business office clerical. The Employer oper- ates a hotel which is open to the public, but is pri- marily for the use and convenience of relations and visitors of the patients. The hotel desk clerk performs work traditionally associated with that fob, viz man- ning the desk and registering the hotel guests. When the desk clerk is not on duty, hotel guests register at the hospital admissions office. While the hotel falls administratively and organizationally under the ad- missions office, the hotel clerk is directly supervised by the hotel manager. The clerk has daily contact with, and thereby shares a community of interest with, the hotel maids and porter who work exclusive- ly at the hotel and were stipulated by the parties to be included within the unit. Thus, we find that the hotel clerk shares a community of interest with the service and maintenance employees and therefore shall include him within the unit. F. The Employer would include the social service clerks. The Petitioner and Intervenor would exclude them as business office clericals. The Employer oper- ates a charity service for persons living outside of Shelby County, Tennessee. The social service clerks are responsible for completing forms and verifying information which is received from patients and used to determine the patients' eligibility for charity work. Patients either report to the social service depart- ment, or the social service clerks interview them at the outpatient clinic or in their rooms. These employ- ees merely gather information and make no determi- nations as to eligibility for charity services. The Em- ployer requires no specific qualifications for these positions and from a review of the record it appears 12 See St Catherine's Hospital of Dommictan Sisters of Kenosha, Wisconsin, supra, Gnaden Huenen Memorial Hospital, supra. Mendenco Hospitals of Louisiana, supra In view of our exclusion of the telephone operators from the unit herein, we deem it unnecessary to reach the issue of the supervisory status of the assistant supervisor in the telephone section 1169 that they function essentially as an adjunct to the Employer's admissions operations. While their work may involve greater patient contact than does the admissions office, the responsibilities of the social service clerks are related to the hospital' s business office operations and are similar to those of admis- sions office employees whom we have excluded from the service and maintenance unit. Thus, we shall ex- clude the social service clerks from the unit. G. The Petitioner and Intervenor seek to exclude the barbers, manicurists, and porter working in the barber shop on the basis that they do not share a community of interest with unit employees. The Em- ployer seeks their inclusion. The Employer's barber shop is located in the Medical Center Plaza Building along with the pharmacies, the hotel, a cafeteria, and doctors' offices. Both the barbers and manicurist per- form their services in the patients' rooms as well as in the barber shop. The porter shines shoes, cleans the shop, and picks up supplies from the linen and sup- ply rooms. While their work is not limited to hospital patients, the Employer has provided the barber shop for their convenience. Since a hospital service and maintenance unit is the analogue to the industrial production and maintenance unit, it necessarily in- cludes employees performing a diversity of functions and having a variety of skills. There is little doubt that the barber shop employees perform a valuable "service" for the patients in the hospital. Since these individuals share a greater community of interest with the service and maintenance employees than with any other group of employees which we have found to constitute an apporpriate unit in the health care industry, we shall include them in the unit.13 H. The Employer and Intervenor would include the psychiatric activities director and the assistant psychiatric activities director. The Petitioner would exclude them as lacking a community of interest with unit employees. These two employees plan and direct recreational and therapeutic activities such as games, handicrafts, candymaking, and showing movies for confined psychiatric patients. They make no inde- pendent judgments of patients' progress, but at times report incidents of a patient's activities and behavior to RN's or a doctor. No special educational back- ground or training is required, and one of the indi- viduals currently holding one of these positions was previously a transcriber and secretary There is no distinction between the duties of the director and as- sistant. They generally work together with a small group of patients. In spite of their fob titles, neither individuals exercises managerial supervisory authori- ty. On the basis of the record as a whole, we find 13 See Saint Anthony Center. 220 NLRB 1009 (1975) 1170 DECISIONS OF NATIONAL LABOR RELATIONS BOARD these two classifications are appropriately included within the service and maintenance unit.14 1. The Employer operates a nursing school located in a separate building at the hospital's central com- plex. Apart from its separate location, the nursing school is otherwise financially and operationally inte- grated with the rest of the hospital; i.e., payroll, maintenance, heating, telephone, housekeeping serv- ices, etc. The Petitioner seeks to exclude the nursing ma- trons and nursing education administration regis- trars. The Intervenor would exclude only the nursing matrons. The Employer would include both. The reg- istrars serve as secretaries to the associate director of nursing, maintain the academic records of students, forward students' transcripts to other institutions, and register students in various courses. Nursing ma- trons serve as housemothers in the student nurses' dormitories, handle sign-in and sign-out logs, make periodic rounds, and act as hostesses for visitors. No specialized education is required for either position. Employees in both job classifications receive the same fringe benefits as other hospital employees. Upon a review of the record, we find that the nursing matrons and registrars in the nursing school share a community of interest with unit employees, and we shall therefore include them within the service and maintenance unit. J. The Employer would include the director of in- service education in the housekeeping department. The Petitioner would exclude the classification as lacking a community of interest with unit employees. This individual conducts an in-service training pro- gram for all housekeeping personnel. The major por- tion of his time is spent teaching a 9-hour basic train- ing program and administering a test following it, both of which are subject to the approval of the di- rector of housekeeping. In addition, a small portion of his time is spent inspecting floors, making nota- tions on a checksheet which he provides the supervi- sor following his inspection. The record, however, does not indicate that the checklist signifies whether specific employees' work or particular tasks are un- satisfactory, or that the inspection is anything more than a quality control, or that the checklist is used in employee evaluations. In assuming his present posi- tion, the director of in-service education left his job as housekeeping supervisor in the Lamar unit and made what the Employer characterized as a transfer from a line to a staff position. Based on the record herein, we are unable to determine whether the direc- tor of in-service education in housekeeping is a su- pervisor within the meaning of the Act. Accordingly, we shall vote this classification subject to challenge. 14 See Newington Children's Hospital, supra K. The Employer would include, and the Peti- tioner and Intervenor would exclude, the assistant purchasing agent. This individual is essentially a buy- er assisting the director of purchasing in establishing specifications for the purchase of various items and in preparing purchase orders for typing. He also han- dles questions concerning the status of purchase or- ders and the receipts of supplies. While he does not receive the requisitions directly from the various hos- pital departments, he reviews them and ensures their conformity to proper specifications. On the basis of both the assistant purchasing agent's indirect in- volvement with unit employees and the direct rela- tionship which his job function bears to patient care and treatment, we will include this classification in the service and maintenance unit.15 L. The Employer's utilization review department consists of three RN's and one non-RN coordinator. The Employer would include the coordinator classifi- cation and the Petitioner and Intervenor would ex- clude it. The department's responsibility is to ensure that only those persons who are actually sick are in the hospital so that the hospital will expeditiously re- ceive payments and reimbursements from Medicare and Medicaid. No party has sought the inclusion of the RN's, who are properly excluded from the unit as professionals. The utilization review coordinator dai- ly receives a list of new patients from the admissions office and organizes them by floor to distribute to the RN coordinators. Due to the medical and technical information involved, RN's actually complete the forms after discussions with the patients. The coordi- nator then abstracts information from the forms and enters it on a previously provided chart. The coordi- nator does not exercise independent judgment con- cerning information contained in the forms, but merely ensures that they are complete and that the review and patient discussions by the RN's were properly conducted on the patient floors. On the ba- sis of the record, we find that the utilization review coordinator functions essentially as a hospital cleri- cal, and as such we shall include this classification within the service and maintenance unit.16 M. The Employer would include and the Peti- tioner would exclude the photographer and assistant photographer. The photographer takes photographs of patients, tissues, cells on a slide, and other medical and hospital items. No special training, registration, or certification is required, but the photographer must know basic photography, viz developing, print- ing, angles and shadows, and, in addition, must be 15 See St Catherine 's Hospital of Dominican Sisters of Kenosha, Wisconsin, supra 16 St Luke's General Hospital, 220 NLRB 488 (1975) BAPTIST MEMORIAL HOSPITAL able to learn easily and on the job the medical as- pects of the position. The assistant photographer's primary duties are to answer the telephone and schedule appointments with the photographer. In ad- dition, the assistant mounts slides, prepares develop- ing solutions, and develops film. The assistant re- ceives approximately 1 month of on-the-job training. On the basis of the record, we find that the photographer's and assistant photographer's func- tions are related to the work of, and involve contact with, other members of the service and maintenance unit. Thus, we shall include these two classifications in the unit sought." N. The Petitioner and Intervenor would exclude, and the Employer would include, the department of religion hostesses. These hostesses serve in essentially a public relations capacity by daily visiting approxi- mately 150 patients in an effort to humanize the hos- pital stay by taking care of nonmedical needs. They write letters, run errands, file insurance forms, secure valuables, arrange patient appointments with the chaplain, and generally assist the patient in any non- medical manner to make their hospital stay easier. While operating out of the chaplain's office on the first floor, the hostesses spend their time on the pa- tient floors or with the patients, and thus have fre- quent contact with unit personnel. The hostesses di- rectly contribute to patient care and nonmedical treatment. In service and maintenance units such as the one herein with employees of widely varied skills, the requirement of a nonspecialized college degree in no way alters the community of interest shared by the hostesses and other unit members. Accordingly, we shall include the department of religion hostesses in the requested unit.18 The Petitioner also seeks to exclude the director of hostesses as a supervisor. The record discloses that this individual hires, fires, and supervises the host- esses. As such, we agree with the Petitioner and shall exclude the director of hostesses as a supervisor. 0. The Employer would include the printer. The Petitioner and Intervenor would exclude him as a supervisor. The printer is responsible for the overall workflow in the print shop. Further, if a department has a special type of form to be printed, they contact the printer who arranges the specifications and makes certain that the forms are printed as request- ed. The printer makes recommendations to the direc- tor of purchasing concerning the hiring and firing of his helpers, but it is the director of purchasing who, after an independent investigation, hires or counsels the employees. On the basis of the record as a whole, we find that the printer does not possess Section 17 See Newington Children's Hospital, supra 18 See Trumbull Memorial Hospital, supra 1171 2(11) supervisory authority and thus shall include him in the service and maintenance unit. P. The Employer would include the nursing chief attendant. The Petitioner seeks to exclude the classi- fication on the basis that it is supervisory. The em- ployee in this classification assists RN's in the train- ing of new attendants. During the course of the training he reports observations about the perfor- mances of particular trainees to the RN who in turn consults with other hospital personnel who have con- tact with the trainees. While the nursing chief atten- dant may recommend that certain action be taken concerning a trainee, an independent investigation and evaluation is made by superiors. In addition, the nursing chief attendant is in charge of the ambulato- ry wheelchairs and stretchers. Although this employ- ee is paid $25-$30 more a month than other atten- dants, on the basis of the record, we find that the nursing chief attendant does not possess any statuto- ry supervisory authority and we shall accordingly in- clude this classification in the unit. Q. The Employer would include the assistant su- pervisor and team leader in the storeroom. The Peti- tioner and Intervenor would exclude them as super- visors. Neither the assistant supervisor nor the team leader has the authority to hire, fire, or effectively recommend the same, but, instead, both report any employee difficulties to the storeroom supervisor. The assistant supervisor spends approximately 98 percent of his time "floating" in the storeroom, en- suring that the work is running smoothly and assist- ing in making deliveries if work is falling behind. The team leader spends approximately 95 percent of his time performing regular porter work, with the re- maining 5 percent spent in distributing work among the other porters and himself. This individual has at- tained the position of team leader by virtue of his greater tenure of service and not from any special training or skills. On the basis of the record, we find that neither the assistant storeroom manager nor the team leader possesses supervisory authority within the meaning of the Act, and thus we shall include these classifications in the service and maintenance unit. R. The Employer seeks to include the radiology department file clerk supervisor. The Petitioner and Intervenor seek to exclude her as a supervisor. This employee has attained her position by virtue of being the most senior file clerk in radiology. She continues to perform the regular work of a file clerk. She has no authority to hire, fire, recommend employees for a pay raise, participate in annual evaluations, or grant time off, but merely ensures that the file room is ade- quately run. On the basis of the record before us, we find that the radiology department file clerk supervi- 1172 DECISIONS OF NATIONAL LABOR RELATIONS BOARD sor is not a supervisor, but functions essentially as a team leader, and thus we shall include this classifica- tion in the unit. S. The Petitioner and Intervenor would exclude the blood bank clerical supervisor as a supervisor. The Employer would include her. This individual lacks authority to hire, fire, or effectively recommend the same, but functions essentially as a team leader. She is primarily responsible for ensuring that the rec- ords and filing required by the department are com- pleted. She receives approximately $20 more a month than the other clericals as compensation for unspeci- fied additional fob duties. If a clerical should request to leave work early, the clerical supervisor would probably grant the request if it was for only a few minutes, but would consult with the technical direc- tor of the blood bank if the request involved a length- ier absence. Although the clerical supervisor trains new employees, presents oral evaluations to the tech- nical director, and has authority to return work to the employees to be redone, the authority exercised by this employees is routine in nature and does not require the exercise of independent judgment. In- stead, such authority appears to emanate from her lengthier tenure with the Employer rather than some vested supervisory authority. Since this individual takes no employee action without the independent review and approval of the technical director, she cannot be said to possess the requisite supervisory authority. On the basis of the record as a whole, therefore, we shall include the blood bank clerical supervisor in the requested service and maintenance unit. T. The Petitioner and Intervenor seek to exclude the P & S Garage cashier on the basis that she is entrusted with the handling of money. Since we have found it appropriate to include within the unit other employees responsible for handling money, such as the hotel clerk, we do not find this is a sufficient basis upon which to exclude this classification from the unit. Having reviewed the entire record, we con- clude that the P & S Garage cashier shares a commu- nity of interest with other service and maintenance employees and thus should be included in the unit. U. The Petitioner and Intervenor seek to exclude the orthopedic assistant as a professional or technical employee. The Employer has taken no position with regard to this classification. The record discloses that while the orthopedic assistant is required to have an associate of arts degree in a curriculum specifically related to the application of casts and traction, the employee need not be registered, certified, or li- censed. Primary responsibilities include assisting physicians and nurses in putting the patient in trac- tion, and afterwards routinely checking the patient to ascertain whether the traction is functioning proper- ly The orthopedic assistant exercises independent judgment in view of his authority to change a cast or alter the traction apparatus without prior physician approval if he feels either has been improperly ap- plied. On the basis of the record as a whole, we find that the orthopedic assistant is a technical employee because he exercises independent judgment and uti- lizes special skills and training acquired through his required course of study. Moreover, while he is not required to be certified, licensed, or registered, the orthopedic assistant, due to the nature of his duties, lacks a community of interest with the service and maintenance employees. Accordingly, we shall ex- clude the orthopedic assistant classification from the unit requested herein.19 V The Employer seeks to include the recovery room technicians. The Petitioner and Intervenor would exclude them on the basis that they require the exercise of a high degree of judgment in their work. Recovery room technicians remain in the recovery room, watching the patients, taking each patient's temperature, pulse, respiration, and blood pressure, and reporting results to the nurses. These employees receive on-the-job training and are only informed as to the normal ranges for temperature and blood pres- sure so that they can report any deviation therefrom to the professional employees. No special education is required and these employees are not certified, reg- istered, or licensed. On the basis of the record as a whole, we find that the recovery room technicians perform duties similar to other unit members, and, therefore, we shall include that classification in the service and maintenance unit. W. The Employer would include the employees in the respiratory and pulmonary departments. The Pe- titioner and Intervenor would exclude them on the basis that they are technical employees. The respira- tory therapy technicians, therapists, supply clerks, electrotechnicians, pulmonary-physiology techni- cians, blood gas technicians, pulmonary rehabilita- tion technicians, and pulmonary rehabilitation labo- ratory assistant administer various tests, treatment and therapy to patients. None are required to be li- censed, certified, or registered. No formal education is required, although courses of study are available in several of these fields. Job duties are learned in on- the-job training of 3-8 weeks, depending on the par- ticular job. None of these employees exercise inde- pendent judgment, but instead they perform their jobs in a routine manner. On the basis of the record as a whole, we find that these employees perform 19 See Banner! Memorial Hospital Center, supra , St Catherine 's Hospital of Dominican Sisters of Kenosha , Wisconsin, supra BAPTIST MEMORIAL HOSPITAL 1173 routine functions directly related to patient care and treatment, share a community of interest with other unit employees, and are not technical employees. Thus, we shall include the employees in the respirato- ry and pulmonary departments in the service and maintenance unit. X. The Employer would include the pulmonary assistant technician supervisor. The Petitioner and Intervenor would exclude him as a supervisor. The record discloses that this individual substitutes for the supervisor in the supervisor's absence due to ill- ness or vacation but does not have the authority to hire or fire. Approximately 95 percent of the assistant technician supervisor's time is spent performing unit work. On the basis of the record as a whole, we find that the assistant technician supervisor herein does not possess statutory supervisory authority and is thus properly included within the unit.20 Y. The Employer also seeks to include the special area supervisors while Petitioner and Intervenor would exclude them as supervisors. The record estab- lishes that these individuals do not exercise statutory supervisory control over other employees but rather, by virtue of their greater experience, are charged with performing specialized tasks related to the respi- ratory and pulmonary departments in various locales throughout the hospital. On the basis of the record, we find that these employees are not supervisors, and, accordingly, we shall include this classification within the unit. Z. The Petitioner would exclude the medical edu- cation externs while the Employer and Intervenor take no position concerning these employees. The ex- terns, medical students in their last year of medical school, are employed part time to give evening and night call coverage to patient floors. The work of the externs is completely independent of their education; however, medical students are utilized for these posi- tions because the degree of judgment involved is greater than that exercised by RN's, LPN's, or atten- dants. On the basis of the record as a whole, we find that due to the high degree of medical judgment re- quired of the externs, these individuals do not share a community of interest with unit members, and we shall, therefore, exclude them from the service and maintenance unit. AA. The Employer seeks to include, the Petitioner to exclude, and the Intervenor takes no position con- cerning the medical education librarian. The librari- 20 The record will not support a finding that the assistant technician su- pervisor possesses the requisite statutory supervisory authority even when substituting for the supervisor Moreover, sporadic possession of such au- thority is not sufficient to make an employee a supervisor within the mean- ing of the Act See Green Brothers Lumber Corp, 158 NLRB 1642 (1966), Frederick Steel Company, 149 NLRB 5 (1964) an is responsible for the medical library, indexes the catalogues, and checks books in and out. In addition, the librarian serves as secretary to the obstetrics training program and the pediatric training program, handling applications for these programs. No degree is required for this position. On the basis of the rec- ord as a whole, we find that the medical education librarian functions similarly to other unit members and thereby shares a community of interest with them. Thus, we shall include this classification within the service and maintenance unit. Based on the foregoing, we find that the following employees constitute a unit appropriate for the pur- poses of collective bargaining within the meaning of Section 9(c) of the Act: All regular full-time and part-time service and maintenance employees, including but not limit- ed to, nursing assistants, attendants, floor secre- taries, transcribing secretaries, aides and all non- supervisory employees in dietary, engineering, supply, transport, laundry departments and housekeeping department, nursing office secre- taries; staffing secretaries; liaison office secre- tary; school of nursing in-service education sec- retary; secretary in the chaplain's office; secretary to the director of housekeeping; medi- cal education secretary; secretaries and clericals in the cardiac laboratory; pulmonary and respi- ratory department secretaries; purchasing secre- taries and clerk typists; radiology department office clerks, file clerks, medical typists, and medical secretaries; pathology department clerks, clerk typists, file clerks, clerk reception- ists, medical secretaries, medical transcribers, classified data input clerk; admissions porters; medical records transcribers, clerks, clerk typ- ists, electriever, receptionist, processors, profes- sional audit study abstractors, professional audit study clerks, coding clerk, discharge analyst su- pervisor, supervisor of information release, and processing and filing supervisor; hotel desk clerk; barbers; manicurists, barber shop por- ters; psychiatric activities director; assistant psy- chiatric activities director; nursing matrons; nursing education administration registrars; di- rector of in-service education in the housekeep- ing department; assistant purchasing agent; uti- lization review coordinator; photographer; assistant photographer; department of religion hostesses; printer; nursing chief attendant; storeroom assistant supervisor; storeroom team leader; radiology department file clerk supervi- sor; blood bank clerical supervisor; P & S Ga- rage cashier; recovery room technician; respira- tory therapy technicians; therapists supply 1174 DECISIONS OF NATIONAL LABOR RELATIONS BOARD clerks, and electrotechnicians; pulmonary-phy- siology technicians; blood gas technicians; pul- monary rehabilitation technicians; pulmonary rehabilitation laboratory assistant; pulmonary assistant technician supervisor; special area su- pervisors; medical education librarian employed at the Employer's Memphis locations, excluding all business office clerical employees, technical and professional employees, including LPN's, guards, and supervisors as defined in the Act. [Direction of Election 21 omitted from publica- tion.] 22 21 Inasmuch as the unit found appropriate is broader than that originally petitioned for by the Petitioner, the Regional Director shall determine whether the Petitioner 's showing of interest is sufficient before proceeding with the election 22 [Excelsior in omitted from publication ] MEMBER PENELLO, dissenting: For the reasons set forth in the dissenting opin- ions in Barnert Memorial Hospital Center,23 and Newington Children's Hospital,24 I disagree with the decision of my colleagues to exclude the technical employees including the LPN's from the service and maintenance unit herein. Mindful of the congressional mandate, as evi- dence by the legislative history preceding the pas- sage of the 1974 health care amendments to the National Labor Relations Act,25 to avoid prolifera- tion of bargaining units in the health care industry, I would require, unlike my colleagues, that all technical employees including the LPN's be in- cluded in the unit. 2' 217 NLRB 775 (1975) 24217 NLRB 793 (1975) 21 S Rept 93-766, 93d Cong, 2d sess 5 (1974), H Rept 93-1951, 93d Cong, 2d sess 7 (1974)