Valley Hospital, Ltd.Download PDFNational Labor Relations Board - Board DecisionsOct 16, 1975220 N.L.R.B. 1339 (N.L.R.B. 1975) Copy Citation 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 Copy with citationCopy as parenthetical citation