The arbitration of cases involving improper professional conduct in the health care industry.

Provision for grievance arbitration has been found in the majority of union contracts in the health care industry. While experience with arbitration is limited in health care compared to the private sector, interest in the process has been growing (perhaps along with the parallel growth of unionization). Arbitration is the terminal step in the grievance procedure, as arbitration awards are enforceable in federal district courts. For the most part, arbitrators called in to hear grievances in the health care industry have gained their experience in the private sector and particularly, in manufacturing. Many of the concepts they utilize in connection with rendering their awards are applicable to health care. However, there are many unique features of the health care industry, such as, the high proportion of women employees (about 81%), the great disparity of skills between employees at the same institution, and the special patient-hospital-professional relationships. The most frequently arbitrated issues in health care (as well as in the private sector) involve the issues of discipline and discharge. Most contracts in health care call for discipline or discharge only for "just cause" or "proper cause." What constitutes just or proper cause leaves wide latitude for decision making on the arbitrator's part. Thus, such cases normally afford arbitrators the best opportunity for taking into account any unique aspects or consider. ations inherent to the health care field. Moreover, the facts and circumstances involved in discipline and discharge cases vary so widely, they usually do not set precedents. This article examines reported arbitration cases involving discipline and discharge for improper professional conduct. 1 Case 1 In the case of Auburn Faith Community Hospital and the California Nurses Association, 2 a registered nurse who worked in Intensive Care/Coronary