Valley Hospital, Ltd.

National Labor Relations Board - Board Decisions

Oct 16, 1975

220 N.L.R.B. 1339 (N.L.R.B. 1975)

VALLEY HOSPITAL, LTD.
Valley Hospital , Ltd. and Health, Professional &
Technical Employees Association , Local 707, Ser-
vice Employees International Union , AFL-CIO,
Petitioner.' Case 31-RC-3060
October 16, 1975
DECISION AND DIRECTION OF ELECTIONS
BY MEMBERS FANNING, JENKINS, AND PENELLO
Upon a petition z duly filed under Section 9(c) of
the National Labor Relations Act, as amended, a
hearing was held before Hearing Officer Jean A. Sav-
age of the National Labor Relations Board. Follow-
ing the close of hearing, the Regional Director for
Region 31 transferred this case to the Board for deci-
sion. Thereafter, briefs were filed by the Employer,
Petitioner, and the Intervenors.
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, includ-
ing the briefs filed herein, the Board finds:
1. The parties stipulated that the Employer is an
independent, investor-owned proprietary hospital of-
fering hospital services as a health care institution in
Las Vegas, Nevada. During the calendar year pre-
ceding the hearing, the Employer's dollar volume
from performance of services was in excess of
$500,000 and it purchased in excess of $50,000 worth
of goods from outside the State of Nevada. Accord-
ingly, in view of Employer's substantial effect on
commerce, we find that it is engaged in commerce
within the meaning of the Act and that it will effectu-
ate the policies of the Act to assert jurisdiction in this
proceeding.
2. The labor organizations involved claim to rep-
resent certain employees of the Employer.'
1 The name of Petitioner appears as amended at the hearing.
Local Joint Executive Board of Las Vegas , Culinary Workers Local 226 &
Bartenders Local 165, Hotel, Restaurant Employees and Bartenders Inter-
national Union , AFL-CIO (hereinafter referred to as Joint Board); and
Nevada Nurses Association , a constituent of the American Nurses' Associa-
tion (hereinafter referred to as NNA) were granted intervention at the hear-
ing on the basis of adequate showings of interest.
The Regional Director rejected Employer's motion to dismiss the peti-
tion alleging that Petitioner 's showing is invalid because of solicitation by
supervisors and doctors. Thereafter , Employer filed a motion for special
permission to appeal the Regional Director's administrative determination.
On August 5 , 1975, this motion was denied by direction of the Board.
3 At the hearing, Employer refused to stipulate that Petitioner is a labor
organization within the meaning of the Act. The record reflects, however,
that Petitioner exists for the purpose of representing employees in negotia-
tions with employers concerning wages , hours , and working conditions and
that employees participate in its affairs . Accordingly, we find that Petitioner
is a labor organization within the meaning of the Act.
Alleging that NNA discriminates with regard to membership , Petitioner
refused to stipulate at the hearing that NNA is a labor organization. NNA's
1339
3. A question affecting commerce exists concern-
ing the representation of certain employees of the
Employer within the meaning of Sections 9(c)(1) and
2(6) and (7) of the Act.
4. Petitioner seeks to represent a unit of all profes-
sional employees, excluding all other employees, em-
ployees represented by other organizations,4 office
clerical employees, guards, and supervisors as de-
fined in the Act, and a separate unit of all nonprofes-
sional employees, excluding all professional employ-
ees, employees covered by collective-bargaining
agreements with other organizations, office clerical
employees, guards, and supervisors as defined in the
Act.' Contrary to Petitioner, Employer contends that
the unit of nonprofessional employees should include
both employees covered by collective-bargaining
agreements with other organizations and office cleri-
cal employees. Intervenor Joint Board agrees with
Petitioner that a unit of nonprofessional employees
should exclude employees covered by other collec-
tive-bargaining agreements. In disagreement with Pe-
titioner, the Joint Board would include office cleri-
cals in the nonprofessional employee unit.
The Appropriate Units
1. Professional employees
a. Registered nurses
Intervenor NNA seeks to represent a single unit of
all registered nurses. The Employer agrees with Peti-
tioner and Intervenor Joint Board that a single pro-
fessional unit, including registered nurses, constitutes
an appropriate bargaining unit. Thus, in agreement
with Petitioner and Intervenor Joint Board, Employ-
er contends that a professional unit of registered
nurses, separate from a unit of other professional em-
ployees, is inappropriate. The Employer and Interve-
nor Joint Board, however, contrary to Petitioner,
contend that registered nurses classified as head
nurses should be excluded from the unit as supervi-
sors within the meaning of Section 2(11) of the Act.
Intervenor NNA takes no position with respect to
the issue of head nurses' supervisory status.
The Board recently has found appropriate separate
representative testified that the Association could represent employees who
are not eligible for membership on a fee-for-service basis . The record also
reflects that NNA exists for the purpose of representing employees in collec-
tive bargaining with the employer and that employees participate in its af-
fairs. Accordingly, we find that NNA is also a labor organization within the
meaning of the Act.
4 The parties stipulated , and we find, that the psychologist , social worker,
social worker assistant , and the adjunctive therapist , all of whom are em-
ployees of Psychiatric Associates at Nevada and work only part time in the
psychiatric center at Valley Hospital, are not employees of the Employer.
At the hearing, Petitioner amended the petition to reflect the units as
described hereinabove.
220 NLRB No. 216
1340 DECISIONS OF NATIONAL LABOR RELATIONS BOARD
bargaining units for registered nurses when they are
separately sought Mercy Hospitals of Sacramento,
Inc, 217 NLRB No 131 (1975) 6 In so determining,
the Board has recognized the distinctive role and re-
sponsibilities of registered nurses in the health care
industry as well as their impressive history of exclu-
sive representation and collective bargaining Ac-
cordingly, in light of the foregoing and since Interve-
nor NNA seeks to represent registered nurses in a
separate bargaining unit, we find a separate bargain-
ing unit of registered nurses appropriate in this case 7
At the time of the hearing, the hospital's nursing
services department employed approximately 169
employees, including 61 registered nurses, 30 li-
censed practical nurses, 34 nursing aides, 7 orderlies,
16 unit clerks, 1 social worker, 12 psychiatric aides, 1
certified operating room technician, and the director
of nursing's secretary 8 Director of Nursing Mildred
Filing 9 has ultimate responsibility for the depart-
ment and she reports directly to the hospital's execu-
tive director and administrator, Charles Showalter
Immediately under the director's supervision are sev-
en administrative supervisors, including an operating
room supervisor and a psychiatric center supervi-
sor10
Head nurses Directly under the administrative su-
pervisors in the nursing department's organizational
structure are nine head nurses The Employer and
Intervenor Joint Board contend that head nurses are
supervisors within the meaning of the Act and should
be excluded from the unit In determining whether
head nurses are supervisors within the meaning of
the Act, we are mindful, as was the Senate Commit-
tee on Labor and Public Welfare in its report on the
Coverage of Nonprofit Hospitals Under the National
Labor Relations Act, that existing Board decisions
have "carefully avoided applying the definition of
`supervisor' to a health care professional who gives
direction to other employees in the exercise of pro-
fessional judgment, which direction is incidental to
the professional's treatment of patients and thus is
not the exercise of supervisory authority in the inter-
est of the employer " 11
6 Since Mercy several other Board decisions have found appropriate bar
gaining units for registered nurses See e g The Trustees of Noble Hospital
218 NLRB No 221 (1975) Wing Memorial Hospital Association 217 NLRB
No 172 (1975) Doctors Hospital 217 NLRB No 87 (1975)
r The unit of registered nurses found appropriate here is substantially
narrower than the all professional unit sought by Petitioner It may be
therefore that NNA s showing of interest is no longer adequate According
ly we direct NNA to submit to the Regional Director within 10 days from
the date of this Decision such additional showing of interest as may be
required
The parties stipulated and we find that the director of nursing s secre
tar9y is a confidential employee
The parties stipulated to Filing s supervisory status
10 The parties stipulated that all administrative supervisors are supervisors
within the meaning of the Act We therefore shall exclude them from the
unit found appropriate herein
Each head nurse herein is in charge of a particular
nursing unit 12 The hospital is staffed three shifts per
day, 7 days a week " The director of nursing testified
that head nurses have ultimate responsibility for pa-
tient care on their shifts The record reveals, howev-
er, that whereas at least one administrative supervi-
sor is on duty at all times during the course of a
24-hour period, head nurses essentially work the day
shift Head nurses are responsible to the director of
nursing and they report immediately to the adminis-
trative supervisor who is in charge of the whole facili-
ty in terms of coordinating nursing care
When administrative supervisors take time off,
they are replaced only by other administrative super-
visors and not by head nurses When head nurses are
absent, most of their functions are handled by staff
nurses serving as charge nurses Thus, the director of
nursing testified that, when the head nurse is not pre-
sent, the registered nurse "who is in charge" is ex-
pected to run the unit In so doing, these charge nurs-
es routinely assign work, order supplies, and
discipline, if necessary 14 The record indicates, how-
ever, that "charge" nurses do not discipline employ-
ees beyond the stage of a verbal reprimand In addi-
tion, the director of nursing testified that RN's
serving as charge nurses are exercising their highly
professional training and skills Their duties and au-
thority, therefore, do not reflect indicia of superviso-
ry authority in the interest of Employer Accordingly,
we find that RN's who serve as "charge " nurses are
not supervisors within the meaning of Section 2(11)
of the Act and we shall include them in the unit
As the persons in charge of the nursing units to
which they are assigned, head nurses routinely assign
work and post schedules every 2 weeks The record
reveals, however, that schedules are not official until
approved by the nursing office, that head nurses do
not have the authority to resolve scheduling conflicts,
and that the director of nursing determines staffing
patterns in a nursing unit on a given day Although
i i S Rep 93-766 93d Cong 2d sess 6 (April 2 1974) See e g Wood
land Park Hospital Inc 36-RC-3079 (May 16 1973) review denied (June
22 1973) Board affirmed Regional Directors holding that Woodlands op
erating room head nurses were not 2(11) supervisors but merely highly
skilled professionals using independent judgment and discretion commensu
rate [with their ] training See also Diversified Health Services Inc d/b/a
Convalescent Center of Honolulu 180 NLRB 461 (1969) New Fern Restorium
Co 175 NLRB 871 (1969)
12 The units include intensive care medical unit north medical unit
south surgical unit 2 south orthopedic unit 2 north emergency room re
covery central supply and in service
i3 The shifts are as follows day shift 6 45 a in to 3 15 p in afternoon
shift 2 45 p in to 11 15 p in and night shift 10 45 p in to 7 15 a in
14 Apparently these staff nurses who fill in for head nurses are compara
ble to the charge nurses in The Presbyterian Medical Center 218 NLRB No
192 (1975) There the Board found that charge nurses were not supervisors
within the meaning of the Act See also The Trustees of Noble Hospital 218
NLRB No 221 ( 1971) wherein the parties stipulated that the charge nurses
were not supervisors
VALLEY HOSPITAL, LTD.
head nurses can change schedules for holiday time or
regular time off to which employees are entitled, spe-
cial requests for time off, such as leaves of absence
without pay and requests for vacation time, must be
approved by the nursing office. Further, when spe-
cial problems arise, such as an employee desiring to
go home because of illness, an administrative super-
visor will make arrangements for that employee to
leave and cover the vacant slot. The head nurse,
moreover, must notify the administrative supervisor
when a unit is short-staffed. When additional person-
nel is needed in a nursing unit, the supervisor, not a
head nurse, has the authority to go into another unit
in order to fill the vacancy elsewhere.
Head nurses are paid at an hourly rate ranging
from $5.48 to $6.65 per hour whereas the pay range
for staff nurses is $4.85 to $5.90 per hour. Experi-
enced staff nurses, however, may be paid more than
certain head nurses.
Head nurses attend monthly meetings with the di-
rector of nursing and administrative supervisors. The
director of nursing indicated that any suggestions
made by head nurses at these meetings concern tech-
nical nursing care problems. As a routine matter,
head nurses are not authorized to grant overtime.
However, Employer asserts, and it appears, that head
nurses can approve emergency overtime such as
when other personnel is not available to care for pa-
tients.
Head nurses also fill out periodic work perfor-
mance reviews of employees working in their units.
Based on forms which the hospital provides setting
forth well-defined criteria and standards to be used,
performance reviews are discussed by head nurses
with the employees being rated. Because of the vari-
ous shifts, personnel other than head nurses, includ-
ing staff nurses who are not supervisors, often fill out
performance reviews. These reviews are used by the
director of nursing to evaluate employees after their
90-day probationary period and for the purpose of
granting salary increases." Since the hospital began
operation, it has been Employer's policy to grant reg-
ular salary increases under its merit raise system. The
director of nursing makes the final decision on
whether to grant an employee a salary increase.
Employer also contends that head nurses have au-
thority to take immediate disciplinary action against
employees in their units including issuing written
warning notices and effectively recommending em-
ployee discharges. The record, however, does not
substantiate these contentions. Rather, the record in-
15 In The Trustees of Noble Hospital, 218 NLRB No. 221 ( 1975), head
nurses filled out similar evaluations . Notwithstanding this responsibility, the
Board concluded therein that head nurses were not supervisors within the
meaning of the Act . (Chairman Murphy and Member Kennedy dissenting.)
1341
dicates that possession of disciplinary authority, be-
yond the stage of a verbal reprimand, reposes in ad-
ministrative supervisors or the director of nursing.
For example, notwithstanding the director of
nursing's assertion that head nurses' recommenda-
tions have "great bearing," the record discloses that
the director made a "management decision" in not
acting upon former Emergency Room Head Nurse
Norma Cleveland's recommendation that RN Bar-
bara Von Urquidy be transferred to another nursing
unit because of her inability to function well in emer-
gency situations." With respect to the written warn-
ing issued to former emergency room orderly Robert
Ciardi, the record indicates that it was initiated and
prepared by Administrative Supervisor Ruth Ford
and merely signed by former Head Nurse Norma
Cleveland." The Employer asserts that on one occa-
sion central Supply Head Nurse Amos Chiarappa ac-
tually discharged nursing aide Marysteen Coleman.
Again, however, the record does not substantiate this
allegation. Thus, in support of its assertion, Employ-
er submitted a "termination report" which was pre-
pared by Chiarappa after Ms. Coleman's discharge.
As Employer indicates, the report is merely a docu-
ment to close an employee's personnel file. More-
over, nowhere in the report is there any indication
that the head nurse recommended termination of
Ms. Coleman. Instead, the last line of Mr.
Chiarappa's comments indicates that "[Ms. Cole-
man] might function more efficiently in another
area." 18
Based on the foregoing evidence, we conclude that
head nurses, unlike administrative supervisors, per-
form their duties and functions predominantly in the
exercise of professional judgment incidental to their
treatment of patients." Their duties and authority
are all directed toward quality treatment of patients
within their nursing units and do not, without more,
constitute supervisory authority in the Employer's in-
terest. Further, we find that head nurses possess nei-
ther the authority to hire or discharge, or discipline
beyond the stage of a verbal reprimand, nor the au-
16
After several weeks, Ms. Von Urquidy eventually was terminated. Ms.
Von Urquidy's husband was employed for an ambulance company. The
director of nursing indicated that the delay in Ms. Von Urquidy 's termina-
tion was prompted by threats of repercussions concerning the ambulance
bringing patients to the hospital . Ms. Filing's explanation also suggests,
however, that head nurses' recommendations are always subject to an inde-
pendent evaluation or investigation by the nursing office.
17 The notice included a notation that Ciardi had received verbal warn-
inpls from Ms. Cleveland.
8 Chiarappa was not called to testify in this proceeding.
19 This determination is also supported by the hospital's job description
for head nurses . Since about December 1971, the job description has been
contained in the hospital 's nursing service policy manual . Apparently, the
Employer submitted this document in support of its contention that head
nurses possess supervisory authority. The document, however , stresses that
head nurses' responsibilities are directed towards "PATIENT cAae" problems
and the quality of "PATIENT CARE."
1342 DECISIONS OF NATIONAL LABOR RELATIONS BOARD
thority to make effective recommendations affecting
employment status of employees Accordingly, we
find that head nurses are not supervisors as defined
in the Act and we shall include them in the unit
b Other professional employees
The parties stipulated, and we find, that employees
in the following classifications, including those in-
terning, are professionals within the meaning of the
Act histologist, physical therapist, registered nurses,
pharmacists, medical technologists II, medical tech-
nologists I, nuclear medical technologists, radiologic
technologists, social worker, health record analyst,
and the patient care evaluation assistant Although
Petitioner and Intervenor Joint Board sought to rep-
resent an all-professional unit, including registered
nurses,20 both have also expressed willingness to par-
ticipate in an election in any unit found appropriate
Having found that a separate unit of registered nurs-
es is appropriate herein, we must now consider
whether an all-professional unit, excluding registered
nurses, is appropriate
In making this determination, we are mindful of
our prior decisions in Mercy Hospitals of Sacramento,
Inc, 217 NLRB No 131 (1975), and Dominican San-
ta Cruz Hospital, 218 NLRB No 182 (1975),21 in
which we concluded that a unit consisting of all pro-
fessional employees, excluding registered nurses, can
be an appropriate unit In reaching this conclusion,
we particularly noted that, unlike registered nurses,
other professional groups had not demonstrated
unique characteristics warranting their separate rep-
resentation 22 Accordingly, for the reasons set forth
in more detail in Mercy and Dominican Santa Cruz
and based on the record herein, we conclude that a
unit consisting of all professional employees, exclud-
ing registered nurses, is appropriate and we shall di-
rect an election therein
2 Nonprofessional employees
As indicated above, Petitioner seeks to represent a
separate unit of nonprofessional employees of the
Employer The parties are in apparent agreement
that employees in the following classifications should
be included in such nonprofessional unit orderlies,
LPN's, unit clerks, psychiatric aides, nurses aides,
operating room technicians, respiratory therapists,
20 Employer agreed as to the appropriateness of such unit
2i In Dominican Santa Cruz we concluded that a unit consisting of all
professional employees excluding registered nurses can be an appropriate
unit even where no labor organization is seeking to separately represent the
latter
22 In Dominican Santa Cruz we left open the question of whether a unit
limited to physicians residents and interns would be appropriate
pharmaceutical technician, pulmonary function
technician, darkroom technician, EKG technician,
EKG trainees, EEG technician, EEG trainee, physi-
cal therapy aides, secretary I's, secretary II's, labora-
tory assistants, laboratory clerk, and laboratory
technician 1111 The parties disagree , however, as to
the placement of certain other employees in the non-
professional unit Thus, whereas Petitioner would ex-
clude both office clerical employees and medical rec-
ords personnel, Employer and Intervenor Joint
Board would include all clerical employees including
medical records employees In addition, Petitioner
and Intervenor Joint Board would exclude employ-
ees covered by existing collective-bargaining agree-
ments whereas Employer contends that such employ-
ees should be included in the nonprofessional unit
a Prior bargaining history 24
Since the hospital began operation in December
1971, Employer has executed two collective-bargain-
ing agreements with unions covering certain hospital
employees Thus, the Employer has a collective-bar-
gaining agreement with Intervenor Joint Board cov-
ering the dietetic clerk, food service worker supervi-
sor, cook, pantry worker, cafeteria leadman, food
service tray worker, dish machine operator, house-
keeping supervisor, linen attendant, lead maid, maid,
janitor, and utility janitor, which runs from January
1, 1974, to January 1, 1977,25 and one with Interna-
tional Union of Operating Engineers , Local Union
No 501, AFL-CIO, covering employees in the classi-
fications of senior engineer, maintenance engineer,
and apprentice engineer, effective for calendar year
1975 26
In maintaining that employees covered by existing
collective-bargaining agreements should be included
in an overall nonprofessional unit, Employer con-
tends that the currently recognized units are no lon-
ger appropriate because they are repugnant to the
Congressional mandate to avoid proliferation of bar-
23 Absent a request by any party to represent a separate unit of technical
employees we shall give effect to the parties agreement to include techni
cals with service and maintenance employees in the above nonprofessional
unit Cf Nathan and Miriam Barnert Memorial Hospital Association d/b/a
Barnert Memorial Hospital Center 217 NRLB No 132 (1975 ) The inclusion
of technicals and service and maintenance employees in a nonprofessional
bargaining unit contravenes neither the provisions or purposes of the Act
nor established Board policy See e g Mount Airy Foundation d/b/a Mount
Airy Psychiatric Center 217 NLRB No 137 ( 1975) For reasons set forth in
his dissenting opinion in Barnert Member Penello in any event would find
the appropriate unit to include service and maintenance and technical em
plojees
2 The parties stipulated as to the collective bargaining history at Valley
Hospital
25 This is the first contract between Employer and Intervenor Joint Board
26 This contract was agreed to in early January 1975 The first contract
between Employer and the Operating Engineers was in effect from Novem
her 1 1973 through December 31 1974
VALLEY HOSPITAL, LTD.
gaining units in the health care industry.27 Petitioner
and Intervenor Joint Board, on the other hand, agree
that the existing collective-bargaining agreements
constitute a bar to any representation proceedings
involving employees within existing units. For rea-
sons set forth below, we shall exclude all employees
covered by existing collective-bargaining agreements
from the nonprofessional unit found appropriate
herein.
We are not unmindful that the legislative history
of the health care amendments admonishes the
Board to avoid undue proliferation of bargaining
units in the health care industry.28 However, even in
the health care industry, the Board permits the par-
ties "the broadest, possible, [sic] latitude to mutually
define the context in which collective bargaining
should take place." 29 As noted previously, certain
employees of the Employer are currently represented
for collective-bargaining purposes under contracts
with International Union of Operating Engineers
and Intervenor Joint Board. These contracts will not
expire until the end of 1975 and 1976, respectively.
Accordingly, we do not believe that disturbing the
stability inherent in bargaining relationships involv-
ing currently recognized units which have been es-
tablished by the mutual agreement of Employer and
the respective Unions would effectuate the purposes
of the Act. In making this determination, we do not
necessarily mean to suggest that in the future, if the
issue as to the appropriateness of the currently recog-
nized units is properly and timely raised, we will
place our imprimatur on such preexisting units.30 Our
decision herein merely reflects our reluctance to dis-
turb mutually agreed-upon bargaining units so long
as such units do not contravene the Act or estab-
lished Board policy.31
b. Office clerical employees
The record indicates that employees in the follow-
27 At the hearing, Employer agreed to the exclusion of "all personnel
covered by other collective bargaining agreements " from the unit of non-
professional employees. Employer's position , however, was amended in its
brief.
28 See , e.g., S. Rept . 93-766, 93d Cong., 2d Sess. 5 (1974); H. Rept. 93-
1051, 93d Cong., 2d Sess. 7 (1974).
29 St. Joseph Hospital & Medical Center, et al. , 219 N LRB No. 161 (1975),
quoting Otis Hospital, Inc., 219 NLRB No. 55 (1975).
30 For example , we note that the collective -bargaining agreement between
Employer and International Union of Operating Engineers , Local Union
No. 501, AFL-CIO , covers a unit similar to that found inappropriate by a
Board majority in Shriners Hospital for Crippled Children, 217 NLRB No.
138 (1975) (Chairman Murphy and Member Fanning dissenting ). We fur-
ther note that in Mount Airy Foundation, d/b/a Mount Airy Psychiatric Cen-
ter, 217 NLRB No. 137 (1975), the Board rejected petitioner 's attempt there-
in to exclude dietary and housekeeping employees , an employee
complement similar to that currently represented by Intervenor Joint Board,
from a broader nonprofessional unit.
31 Otis Hospital, Inc., 219 NLRB No. 55 (1975).
1343
ing classifications are business office clericals : admit-
ting clerks ; insurance clerks; credit clerks ; cashier;
PBX operators ; the secretary and storekeeper in pur-
chasing ; keypunch operators ; accounting clerk;
bookkeeper ; and secretary in accounting . Employer
contends that notwithstanding our placement of
other business office clerical employees that the sec-
retary and storekeeper in purchasing should be
placed in the unit of nonprofessional employees
based on community of interest and integration and
interaction of work functions . We find no merit in
Employer's contention . Rather , the record indicates
that the purchasing personnel share common super-
vision with the business office employees 32 and they
are primarily engaged in office clerical duties. For
the reasons stated in Mercy Hospitals of Sacramento,
Inc., supra, and Sisters of St. Joseph of Peace, 217
NLRB No. 135 ( 1975),33 we shall not include busi-
ness office clerical employees in the unit of nonpro-
fessional employees.
c. Medical records employees
Medical records personnel consists of seven non-
supervisory employees in the classifications of medi-
cal transcribers and medical records clerks. Unlike
the business office clericals, these employees work on
the hospital's second floor, an area devoted entirely
to medical services. Although medical records per-
sonnel engage in clerical functions, they spend a sub-
stantial amount of their time in the patient care area
performing functions directly related to the care and
treatment of patients. Thus, medical records employ-
ees construct medical records to assist physicians, file
medical records stored in the medical records office,
and file documents from laboratories and various
nursing stations throughout the hospital into pa-
tients' medical records. Accordingly, it is apparent
that medical records personnel have considerable
contact with those employees involved in the medical
aspects of the hospital. In light of the foregoing, and
for reasons stated in Sisters of St. Joseph of Peace,
supra, and St. Catherine's Hospital of Dominican Sis-
ters of Kenosha, Wisconsin, Inc., 217 NLRB No. 133
(1975), we conclude that medical records employees
do not share a community of interest with business
office clerical employees, but rather with a broader
unit of nonprofessional employees. Contrary to
Petitioner's request, therefore, we shall include medi-
cal records employees in the unit of nonprofessional
employees found appropriate herein.
32 All business office clerical employees are under the supervision of Jack
Owens, department head of the hospital's business operations.
33 See also Meharry Medical College, 219 NLRB No. 57 (1975).
1344 DECISIONS OF NATIONAL LABOR RELATIONS BOARD
d X-ray supervisor (3 p m to 11 30 p m)
At the time of the hearing, the X-ray supervisor
working from 3 p in to 11 30 p in had held that po-
sition for only 1 week The record reveals that this
shift supervisor spends about 90 percent of her time
taking care of patients and 10 percent doing paper-
work The present record, however, does not suffi-
ciently detail the duties and responsibilities of this
employee to enable us to make a definitive determi-
nation as to her possible supervisory status We shall
therefore permit her to vote subject to challenge
Accordingly, for the aforementioned reasons, we
find that a unit of nonprofessional employees includ-
ing orderlies, LPN's, unit clerks, psychiatric aides,
nurses aides, operating room technicians, respiratory
therapists, pharmaceutical intern, pulmonary func-
tion technician, darkroom technician, EKG techni-
cian, EKG trainees, EEG technician, EEG trainee,
physical therapy aides, secretary I's, secretary II's,
laboratory assistants, laboratory clerk, laboratory
technician II, medical transcribers, and medical rec-
ords clerks constitutes a unit appropriate for collec-
tive bargaining within the meaning of the Act and we
shall direct an election therein
Conclusion
Based upon the foregoing and the entire record, we
find that the following groups of employees consti-
tute units appropriate for the purposes of collective
bargaining within the meaning of Section 9(b) of the
Act
UNIT A All full- time and regular part-time
registered nurses employed by the Employer at
its hospital in Las Vegas , Nevada , including
head nurses and staff nurses who relieve head
nurses , but excluding the director of nursing
services , administrative supervisors , operating
room supervisor, psychiatric center supervisor,
all other employees , guards , and supervisors as
defined in the Act
UNIT B All full-time and regular part-time
professional employees , including the histolo-
gist , physical therapist , pharmacists , medical
technologists II, medical technologists I, nuclear
medical technologists , radiologic technologists,
social worker , health records analyst , and the
patient care evaluation assistant , excluding reg-
istered nurses , employees of Psychiatric Associ-
ates at Nevada , and all other employees , guards,
and supervisors as defined in the Act
UNIT C All full-time and regular part-time
nonprofessional employees, including orderlies,
LPN's, unit clerks, psychiatric aides , nurses
aides, operating room technician , respiratory
therapist , pharmaceutical technician , pulmonary
function technician , darkroom technician, EKG
technician , EKG trainees , EEG technician,
EEG trainee, physical therapy aides , secretary
I's, secretary II's, laboratory assistants , laborato-
ry clerk, laboratory technician II, medical tran-
scribers , and medical records clerks , excluding
all professional employees , employees covered
by collective-bargaining agreements , business
office clerical employees , all other employees,
guards, and supervisors as defined in the Act
[Direction of Elections and Excelsior fn omitted
from publication 1 14
34 It is unclear from the record whether Intervenor Joint Board is willing
to proceed to an election in Unit A Subject to the submission of an ade
quate showing of interest and contingent upon its willingness to proceed to
such an election we have placed it on the ballot