Barnert Memorial Hospital Center

BARNERT MEMORIAL HOSPITAL CENTER 775 Nathan and Miriam Barnert Memorial Hospital As- sociation d/b/a Barnert Memorial Hospital Center' and District 1199, National Union of Hos- pital & Health Care Employees, R.W.D.S.U., AFL-CIO,' Petitioner. Cases 22-RC-6184 and 22-RC-6190 May 5, 1975 DECISION AND DIRECTION OF ELECTIONS Upon petitions duly filed under Section 9(c) of the National Labor Relations Act, as amended, in Cases 22-RC-6184, 22-RC-6187, and 22-RC-6190, a hear- ing was held before Hearing Officer Bruce W. Taylor. Following the hearing and pursuant to Section 102.67 of the National Labor Relations Board Rules and Regulations and Statements of Procedure, Series 8, as amended, Cases 22-RC-6184 and 22-RC-6190 were transferred by direction of the Regional Director for Region 22 to the National Labor Relations Board for decision.' Thereafter, Petitioner and the Employer filed briefs which have been duly considered. 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 case, the Board finds: 1. The Employer is engaged in commerce within the meaning of the Act, and it will effectuate the purposes of the Act to assert jurisdiction herein. 2. Petitioner is a labor organization within the mean- ing of the Act. 3. A question affecting commerce exists concerning the representation of employees of the Employer within the meaning of Section 9(c)(1) and Section 2(6) and (7) of the Act. The Board is presented with the following issues in the instant proceeding: In Case 22-RC-6184, Petitioner seeks a unit of serv- ice and maintenance employees4 at Nathan and Mir- 1 Name as amended at the hearing 2 Name as amended at the hearing. 3 At the time of his transfer order to the Board, the Regional Director, by separate order, also severed Case 22-RC-6187 as Petitioner and the Employer were in agreement that the clerical unit sought there was appro- priate and the parties agreed to the scope of that unit. The issues outstanding in that case related only to the unit placement of certain alleged managerial and confidential employees, and to the status of part-time clerical em- ployees, and the issues presented in that case are not now before us for decision. 4 Petitioner's requested-unit is for all regular full-time and part-time employees in the service and maintenance areas including nurses aides and order lies, dietary employees; housekeeping employees, coffeeshop em- ployees, cafeteria employees, central room service employees, storeroom employees, engineering and maintenance employees, boiler room em- ployees; unit clerk; aides including morgue assistant, pharmacy aide, and x-ray aide employed by the Employer at its hospital facility location at 680 Broadway, Paterson, New Jersey, but excluding all administrators, profes- sions Is, confidential, office and clerical, and technical employees, registered iam Barnert Memorial Hospital Association d/b/a Barnert Memorial Hospital Center, herein called the Employer or the Hospital. In Case 22-RC-6190, Peti- tioner seeks a unit of employees it contends are techni- cal employees at the Hospital. The Employer contends, however, that the only appropriate unit here,- among the employees sought by Petitioner, is one including all the service and maintenance employees sought by Peti- tioner and all the Employer's technical employees.' At the hearing, the parties agreed to exclude all li- censed practical nurses (LPN's), registered nurses (RN's), and a category called patient care technicians from any unit or units the Board might find appropri- ate here.' In seeking a separate unit of technical employees, Petitioner contends that some 11 categories of em- ployees at the Hospital are technical employees' and that a 12th category' has such a community of inter- est with technical employees that he should be included in any technical unit found appropriate. The Employer agrees with Petitioner that two of the categories sought are technical employees,' but the Employer argues that they are the only technical employees in its employ and that (1) they share a community of interest with the service and maintenance employees and (2) to grant a separate unit of technical employees when there are so few of them would create an unwarranted fragmenta- tion of the bargaining units at the Hospital. With re- spect to the balance of the classifications that Petitioner claims are technical employees, the Employer claims that certain of them share a community of interest with the service and maintenance employees;10 certain of them are professionals;" certain of them are supervisors;" and certain of them share a community of interest with the LPN's and RN's whom the parties agreed to exclude.' 3 The parties are also in dispute on the eligibility of certin part-time employees. Petitioner contends that all nurses, licensed practical nurses, pharmacists, social workers, therapists, dieticians, medical record librarians, patient care technicians, guards, super- visors as defined in the Act, and all other employees not included 5 The Employer has agreed that the employees sought by Petitioner in its requested service and maintenance unit properly belong in such unit but would expand the unit to include the additional employees discussed below. 6 But see the discussion below of the status of the LPN's with respect to the requested unit of technical employees. 7 These are the x-ray technicians, respiratory care technicians, EKG technicians, EEG technician, psychiatric technician, infant care techni- cians, operating room technicians, orthopedic technician, laboratory section heads, medical technologists, and laboratory technicians, both registered and nonregistered 8 The darkroom technician. 9 These are the x-ray technicians and the respiratory care technicians - 10 These are the EKG technicians, EEG technician, psychiatric techni- cian, and darkroom technician- 11 These are the medical technologists and laboratory technicians, both registered and nonregistered, the chemists in the laboratory; and the section heads in the laboratory 12 These are the section heads in the laboratory. 13 These are the infant care technicians, operating room technicians, and orthopedic technician But see our discussion of the LPN's status below 217 NLRB No. 132 776 DECISIONS OF NATIONAL LABOR RELATIONS BOARD regular part-time employees working less than 2 days, or 16 hours, per week should be excluded from any unit or units found appropriate here, while the Employer would apply what it contends is the Board's usual crit- eria respecting the eligibility of part-time employees. The Hospital is a New Jersey corporation engaged in providing health care services. Its facilities are located in several buildings at and around 680 Broadway, Pat- erson, New Jersey. The 680 Broadway location is the main hospital building which comprises six floors plus a penthouse and a basement. The main building houses 260 adult and pediatric beds and approximately 30 nursery beds. A total of about 750 individuals are em- ployed by the Hospital. The Hospital is managed by its executive vice-presi- dent, who also has the title of director. Comprising the executive vice president's immediate managerial and administrative staff are an associate director, a director of finance, two assistant directors , and an assistant to the director. Each of these individuals has administra- tive responsibility and control of several departments of the Hospital. The Hospital's remaining managerial and supervisory 'staff for nonclerical departments is com- prised of department heads, assistant department heads, and various managers and supervisors. There are some 15 departments in the Hospital and Petitioner seeks, in a separate unit, employees it con- tends are technical from 6 of them; namely, the EEG department; the radiology department; the nursing ser- vices department; the cardiopulmonary services de- partment; the community mental health center; and the laboratory. Section 9(b) of the National Labor Relations Act gives the National Labor Relations Board the authority to define bargaining units and indicates that the Board's purpose in making unit determinations should be "to assure to employees the fullest freedom in exer- cising the rights guaranteed by [the National Labor Relations Act]." In attempting to fulfill this direction of the Act, the Board is constantly faced with the prob- lem of determining what is an appropriate unit. The Board, in construing the term "appropriate ," has held that, to be appropriate, the unit sought does not have to be the only, or the ultimate, or the most appropriate unit, but rather that it be an appropriate unit, appropri- ate in order to insure employees the fullest freedom in exercising their rights guaranteed by the Act." It is elementary that there may be more than one appropri- ate unit among the employees of a particular enterprise and the Board's unit determination in a particular case thus of necessity involves, as the Supreme Court long 14 Morand Brothers Beverage Co., 91 NLRB 409, 418 (1950), see also N.LR.B v Metropolitan Life Insurance Co., 380 U S 438 (1965), and S. D. Warren Co. v. NL.R.B, 353 F 2d 494 (C A 1, 1965). ago noted, "a large measure of informed discretion.s15 In exercising this "informed discretion," the Board has come to utilize certain general criteria in making its determinations concerning units. Such factors as em- ployees' duties, skills, working conditions, experience, wages, hours, interchangeability with other employees, history of bargaining, and even the extent of a union's organization are all factors the Board can and has util- ized in making its unit findings generally. Applying these and other criteria, the Board has long held that a unit of all technical employees in the indus- trial sphere is an appropriate unit.'6 From early on, the Board recognized the differing interests of technical employees because of their distinctive training and ex- perience and functions. At one time , the Board ex- cluded technical employees from any other unit when one party objected to their inclusion ." And while the Board, in The Sheffield Corporation," abandoned that policy of automatically excluding technical employees from units of other employees simply because a party objected to their inclusion and instead held that the placement of technicals would be determined upon an analysis of their community of interest with other em- ployees, the Board has consistently found the exclusion of technicals appropriate based on factors inextricably allied with their technical status.19 As the Board has stated, it "does not normally include . . . technical employees" in a unit of service and maintenance employees.20 In the health care field, as illustrated by those em- ployees we find are technical employees below, we find continuing reason to approve separate units of techni- cal employees. Thus, the kinds of employees we would include in the technical unit are those whose special- ized training, skills, education and job requirements establish a community of interest not shared by other service and maintenance employees. This separate community of interest is frequently evidenced by the fact that such employees are certified, registered, or licensed. However, we also fmd employees may meet such standards without having been certified, regis- tered, or licensed, and, if they do, we shall include them in the technical unit. We find nothing in the recent amendments to the National Labor Relations Act which has any under- mining effect on the well-established principles con- cerning the determination of units which we have set 15 Packard Motor Car Company v, N..L.R.B., 330 U S. 485, 491 (1947) 16 See, e g., Bulldog Electric Products Company, 96 NLRB 642 (1951) 17 See Litton Industries of Maryland, Incorporated, 125 NLRB 722 (1959). l8 134 NLRB 1101 (1961). 19 See, a g., Brown & Root-Northrup, 174 NLRB 1005 (1969) 20 The President and Directors of Georgetown College for Georgetown University, 200 NLRB 215, 216 (1972). BARNERT MEMORIAL HOSPITAL CENTER 777 out above, or on Petitioner's position that a service and maintenance unit and a technical unit are separately appropriate units here. We note that , while the Report of the Senate Committee on Labor and Public Welfare on the new health care amendments stated that the Board should give "due consideration" in the health care industry to preventing the proliferation of bargain- ing units,' Senator Williams of New Jersey" also commented that the Committee, by its admonition, did not intend to preclude the Board , acting in the public interest, "from exercising its specialized experience and expert knowledge in determining appropriate bargain- ing units."" Senator Williams also stated that "some- times circumstances require that there be ,a number of bargaining units among nonsupervisory employees, particularly where there is such a history in the area or a notable disparity of interests between employees in different job classifications ."" We therefore do not believe that the Committee's admonition against the proliferation of bargaining units was meant to apply to our determination here that the two units Petitioner seeks are appropriate units.25 Accordingly, we find that Petitioner's requested separate unit of technical employees is an appropriate unit.26 We shall, accordingly, grant a separate unit of technical employees here and at other health care facili- ties when such a unit is sought and the facts indicate that the employees sought in that unit are, in fact, technical employees. Having decided that a unit of service and mainte- nance employees and a separate unit of technical em- ployees in a hospital may constitute appropriate units, we shall now consider whether the various categories 21 S Rept. No 766, 93d Cong, 2d Sess 5 (1974) 22 Senator Williams is the chairman of the Senate Committee on Labor and Public Welfare and chairman of its Subcommittee on Labor He intro- duced on the Senate floor, the original bill which forms the bulk of the amending legislation 23 120 Cong Rec S 6940 (daily ed. July 10, 1974). 24 Fn 23, supra. 25 Even the most narrow of the bills offered to extend coverage of the Act to nonprofit hospitals, i e., S 2292 , introduced by Senator Taft, provided for four basic units in the health care field, i.e., units of professional employees, technical employees, clerical employees, and service and maintenance em- ployees. This bill did not become law and Senator Taft, in later commenting on the "due consideration" language of the Committee Report on the pre- sent legislation, stated that such language was a "sound approach and a constructive compromise as the Board should be permitted some flexibility in unit determination cases." 120 Cong Rec S6940 (daily ed May 2, 1974) Thus it is clear our determination here does not run afoul of the legislative history of the new amendments to the Act 26 In concluding that a separate unit of technical employees is appropriate here , we are not unmindful that the service and maintenance employees and those employees we find to be technical employees below share various benefits of uniform application and various employee facilities , have con- tacts with each other , and have similar work schedules However, we find these, and the other considerations raised by the Employer which stress the commonality of interest between the employees, are not so pervasive as to destroy the separate and distinct community of interests of technical em- ployees flowing from other , more substantial, factors of training, skills, and certification, registration, or licensing, which the technical employees pos- sess, and the service and maintenance personnel lack of employees, who Petitioner claims are technical em- ployees, or claims share a community of interest with technicals, are, in fact, technical employees, or whether, as contended by the Employer, they either belong in the service and maintenance unit, are profes- sional employees, or share a community of interest with categories the parties agreed to exclude from both units and should therefore also be excluded. In determining whether the following categories of employees are tech- nical employees we apply the Board's standard criteria that technical employees are those "who do not meet the strict requirements of the term `professional em- ployee' as defined in the Act but whose work is of a technical nature involving the use of independent judg- ment and requiring the exercise of specialized training usually acquired in colleges or technical schools or through special courses.s27 The EKG Technicians: The wage scale for this posi- tion is level II28 and the category is in the cardiopul- monary services department. The Hospital prefers that applicants for this position be high school graduates, but there is no requirement of any further education or formal training. There is no licensing requirement for EKG technicians by the State or Federal Government, nor is there any private organization which certifies or registers EKG technicians . Although the Hospital pre- fers that applicants have prior experience, it does not require prior experience for hire. After being hired by the Hospital , employees em- ployed as EKG technicians do not receive any formal- ized education or training; rather they receive informal on-the-job training which includes an explanation of the operation of the EKG machine and an observation of an EKG test. The training lasts a week or two. Although the EKG technicians administer the EKG test, the procedure for doing so is set out for them and they make no determination of test results . They exer- cise some judgment only in a situation where , in admin- istering a test, they note something is so severely abnor- mal that the immediate attention of a doctor or coronary care nurse is warranted. This situation occurs rarely. We conclude the EKG technicians are not technical employees. Their work requires no independent judg- ment; they receive no specialized training in order to perform their duties; and they are neither certified, licensed, nor registered by any school , governmental body, or private organization. 27 Litton Industries, of Maryland, Incorporated, 125 NLRB 722, 724-725 (1959). 28 The wages of the Employer's employees are established by a schedule of several levels (from level II to level XX with level II being the lowest) and steps within the levels The schedule is applicable to all the employees sought by Petitioner in each unit except the laboratory employees who are paid pursuant to a separate wage schedule. 778 DECISIONS OF NATIONAL LABOR RELATIONS BOARD The EEG.Technician:The wage level for this occupa- tion is level. XII and the category is in the electroen- cephalogram department. The EEG technician administers electroencephalo- grams and echoencephalograms. The Hospital requires that applicants for the position be high school gradu- ates but there is no requirement of any further educa- tion or formal training. There is no licensing require- ment for EEG technicians by the State or Federal Government and there is no private organization which has certified or registered these technicians. The incumbent in this position at the time of the hearing had experience in operating an EEG machine when hired and the Hospital prefers to hire experienced personnel for this job. But if the Hospital hired an inexperienced employee for the position, the Hospital would train the employee and, depending on the in- dividual, the training would take 2 to 4 weeks. The EEG technician requires no direction in per- forming the tests which she administers , but the proce- dure for testing is set out for her, and, as with the EKG technicians, she makes no determination or interpreta- tion of the tests' results. We find that the EEG technician is not a technical employee. As with the EKG technicians, the work in- volved here requires no independent judgment ; there is no specialized training needed in order to perform the job; and there is no requirement that the EEG techni- cian be certified, licensed, or registered. Darkroom Technician: This category is paid at wage level II and is in the department of radiology . There is one employee in this position who is a high school graduate with no education or formalized training in his field. He was taught his job while working as a volunteer at the Hospital. The training took about 3 months and entailed instructions concerning the loca- tion of various equipment, the different film sizes, the handling of x-ray film, and how to keep specific areas of the darkroom dust free. The result of the functions performed by the dark- room technician is a radiograph , an image on the x-ray film. He does not develop the x-ray. That is done by an automatic process. His role is limited to placing the film in an apparatus where it is developed automati- cally. The finished product then comes out of the ma- chine and is removed by other employees. While Petitioner concedes that the darkroom techni- cian is not a technical employee, it contends, citing Brown & Root-Northrop,29 that the relationship of this job to that of the x-ray technician is such that the darkroom technician should be included in the techni- cal employee unit . However, in Brown & Root, where the Board included certain employees in a technical unit without specifically passing on their technical 29 174 NLRB 1005 (1969) status, the Board found in any event that their work entailed the exercise of independent judgment with re- spect to matters of a technical rather than clerical na- ture and skills they exercised were more closely identi- fied with technical duties than manual or clerical skills. Such is not the case with respect to the darkroom tech- nician whose skills are essentially manual and devoid of any technical expertise . Thus, we shall include him in the service and maintenance unit. Psychiatric Technician: This position is paid at wage level VI, and is located in the community mental health center. This position is in a department which receives, Federal funding and the Government requires that em- ployees performing this specialty have an associate de- gree. The employee in this position has a high school diploma and at the time of the hearing was attending - school to secure the required associate degree. There is no licensing requirement for psychiatric technicians by the State nor is there any private organization which certifies or registers psychiatric technicians. The- psychiatric technician assists the professional staff of the community mental health center . She does patient intake and works with patients and/or families at home or in various hospital settings . This latter func- tion is called "resocialization" and is similar to the work of a social worker. She assists in the determina- tion of need and reports her findings to the professional staff and makes recommendations regarding treatment. She also works with outside agencies as a patient advo- cate, speaking on the patient's behalf, and attends weekly sessions with the psychiatrists, psychologists, and nurse clinicians. We find the psychiatric technician is a technical em- ployee based on her work duties, which indicate the necessity for the exercise of independent judgment, and on the formal educational requirements for her job. X-Ray Technicians?' This category is paid at wage level XIII and is in the department of radiology. This position requires a high school diploma , a 2-year full- time course of training, and 300 clinical hours of expe- rience in order to be eligible for licensing by the State of New Jersey. The licensing is a requirement of the job. The parties stipulated that the x-ray technicians' job requires knowledge of all the various types of x-rays; positioning for such x -rays; and the ability to handle isotopes, give injections, and do blood testing. In light of the educational requirements for this posi- tion, the licensing by the State, and the independent judgment the x-ray technicians must exercise in their jobs, we find they are technical employees. 30 The parties agree that these employees and those we discuss immedi- ately below are technical employees we agree with the parties' stipulation in each case However, in order to better illustrate our conclusions as to who should be considered a technical employee in the health care field, we wish to note our reasons for agreeing with the parties' stipulation here and with regard to the respiratory care technicians BARNERT MEMORIAL HOSPITAL CENTER 779 Respiratory Care Technicians: This category is paid at wage level VIII and is in the respiratory therapy department. These employees are concerned with the administration of treatments.and the operation of vari- ous types of equipment. There is a private organization, the National Board of Respiratory Therapy, which has a registration program for these technicians. It requires a registrant to be a graduate of a 2-year degree program in respiratory therapy or have 64 hours of college cred- its, plus clinical work in the area. Based on these employees' duties and the registration requirement noted, we agree that the respiratory care technicians are technical employees. Infant Care Technicians: This category is paid at wage level V and is in the nursing services department. At the time of the hearing, there were seven employees in this category, two of whom were assigned to the newborn nursery and the other five to the pediatric unit. These employees are required to be high school graduates and they must have completed an infant care technician program. The program extends for 1 year and is given in a facility serving infants, most often a hospital. The seven infant care technicians in this case received their year,of training in the New York Foun- dling Hospital, an institution specializing in training for the care of newborns and infants. The program involves classroom work and clinical training. The graduates receive a recognized diploma and, after their hire at the Employer, they receive on-the-job training in specific techniques employed at the Hospital and receive specific training in pediatric diseases. There is no licensing requirement for this category established by the State or Federal Government and no private organization certifies or registers infant care techni- cians. The infant care technicians in the nursery administer basic nursing care to newborns from the time of admis- sion to time of discharge. Inter alia they check and identify new admissions and give routine admissions care, which entails checking the condition of the new- borns' skin, organs, and limbs; they take the newborns' temperatures and bathe them; they instruct the moth- ers in how to feed and burp the baby; they prepare babies for doctors' exams; and they prepare special formulas if a newborn has an allergy and a doctor writes a prescription for a special formula. They are, in effect, responsible for the daily care of the newborns. In pediatrics, the infant care technicians also admin- isterr basic nursing care to the children. They assist with admissions and discharges which entails, in admissions, taking the child's temperature, weighing the child, and asking questions of the parent concerning matters such as allergies, foods, sleeping habits, and bowel move- ments; they take care of the basic physical needs of the children in bathing, feeding, and elimination, which entails a knowledge of how to handle children having various illnesses; they record intake and output and take temperatures, pulse, and respiration, and record such information; and they also assist in - the use of enemas (for cleansing or reducing high temperatures), alcohol sponges (to reduce temperatures), and dress- ings and binders (after an operation or for burns). The infant care technicians receive the same in-hos- pital training as the LPN's and attend weekly and monthly in-service programs with RN's and LPN's. These meetings are not attended by any nurses aides or orderlies. Based on their training, skills, and specialized nurs- ing duties, we find the infant care technicians are tech- nical employees. Their work requires independent judgment in technical matters and the ability to per- form their job adequately is obtained only through a period of schooling. In fact, because of their training, they are better qualified to provide care to patients in the nursery and in pediatrics than LPN's, who we find are technical employees below, because their training has been totally geared to the care of newborns and children while the LPN's training has been more diver- sified. Orthopedic Technician: This employee is located within the nursing services unit.31 The job of orthope- dic technician requires a high school diploma. In addi- tion, the orthopedic technician takes a formal course of study given at a hospital by orthopedic surgeons and the program results in a certificate of completion. The course, which is a 3- to 6-month program, includes the study of bone structure, the various types of traction, body alignment, and the use of specialized equipment, such as a Stryker frame, which is a type of bed, and circular beds. There is no licensing requirement for the orthopedic technician by the State or Federal govern- ment and no private organization which certifies or registers orthopedic technicians. The orthopedic technician spends 75 percent of his time in the various nursing units setting up and apply- ing traction to patients. In most hospitals, this function is performed by a registered nurse or a physician. In addition to the traction equipment, the orthopedic technician operates equipment such as the hypothermic unit and suction equipment. He also does repairs of all equipment he uses; works on charts; orders supplies; prepares deceased bodies for the morgue; and assists in teaching the nursing staff various orthopedic tractions. Although every function performed by the orthope- dic technician is a result of a physician's order, the orthopedic technician actually sets up traction and ap- plies it to the patients without the aid of a physician. He is, in fact, performing treatment and is basically 31 The wage level of this category is not revealed in the record. 780 DECISIONS OF NATIONAL LABOR RELATIONS BOARD unsupervised in doing so in many cases. When he has problems in his work, he deals directly with a physi- cian. In his speciality, he has more training than most of the registered nurses, with whom, along with the LPN's, he attends various in-service training sessions concerned with specialized training in orthopedics. At the time of the hearing, two orderlies were being trained to perform certain aspects of the orthopedic technician's work. One was being trained by the or- thopedic surgeons to become a full-fledged orthopedic technician, while the other was being trained to per- form some of the orthopedic technician's duties. How- ever, the latter employee does not give and is not being trained to give any treatments or apply any equipment to patients. We find the orthopedic technician is a technical em- ployee. His job entails the use of independent judgment of a technical nature and, although he is not licensed, certified, or registered, he has learned his work through a formal program of study administered by orthopedic surgeons in a hospital setting. We shall also include in the technical unit the orderly who, at the time of the hearing, was being trained by the orthopedic surgeons to become a full-fledged or- thopedic technician, since this orderly will, at the end of the training program, be proficient in and will be capable of performing all duties of an orthopedic tech- nician and will then be a technical employee. Operating Room Technicians: This category is paid at wage level V and is under the supervision of the nursing services unit. There are two classes of operating room technicians, certified and noncertified, and all are assigned to the operating room.32 In order to be certified, a technician must pass an exam given by the State of New Jersey and, in order to be eligible for the exam, a formal accreditation course is required. The course is given at a hospital and lasts 6 months. The noncertified techni- cians receive less formal on-the-job training that takes from 3 to 6 months to complete. The certified operating room technician gives guidance and direction to other operating room technicians; assists in on-the-job train- ing of other operating room technicians; performs du- ties related to very major surgery, such as pacemaker implantations; and works alone in the minor surgery room. The Hospital trains nurses aides to be operating room technicians, but when an aide becomes an operat- ing room technician, he or she no longer functions as an aide. All the operating room technicians, whether certified or not, assist with surgical operations and perform related services. They perform surgical scrub according to established procedure; assist the surgeon by handing 32 At the time of the hearing there was one certified operating room technician and eight noncertified operating room technicians him instruments ; arrange instruments and sutures on a sterile table; manage contaminated instruments and supplies to prevent the spread of infection; place opera- tive specimens in properly labeled containers; keep the sponge count with the circulating nurse ; clean or car- bolize the operating room; place used equipment and supplies in their proper place after an operation; and place the packs needed for the next operation in the operating room. A percentage of these duties is also performed by nurses aides, who are included in the service and maintenance unit. Operating room technicians attend in-service train- ing sessions in the same place and at the same time as RN's and LPN's. These sessions deal with post- and preoperative problems of patients, surgical techniques, aseptic techniques, and infection control. We conclude that the certified operating room tech- nician is a technical employee but that the noncertified operating room technicians are not. In finding that the certified operating room technician is a technical em- ployee, we note that her extra duties entail the use of independent judgment in technical matters and we note too the certification and additional training she pos- sesses. The noncertified operating room technicians, however, receive no formal training; perform nontech- nical functions, some of which nurses aides, who are in the service and maintenance unit, also perform; and are not certified. Licensed Practical Nurses (LPN's): The parties agreed to exclude LPN's from any unit or units the Board might find appropriate here. However, on the basis of the record evidence before us, we find the LPN's meet the Board's criteria for technical em- ployees and share' a community of interest with other employees whom we have found to be technical em- ployees. While the Board will generally honor a stipula- tion of the parties if that stipulation is not contrary to Board policy, it is Board policy to join in a single unit all technical employees similarly employed" and to find a unit of technical employees inappropriate where it does not include all of the employees in that category. We therefore include the LPN's in the technical unit we have found appropriate, notwithstanding the parties' stipulation, since we find that stipulation contrary to Board policy.34 In finding the LPN's to be technical employees, we 33 Aerojet General Corporation, 131 NLRB 1094 (1961). 34 In addition to the parties' stipulation to exclude RN's and LPN's from any unit the Board might find appropriate here, the parties also agreed to exclude the category of patient care technician from any unit or units found appropriate. The evidence revealed that patient care technicians are RN's in foreign countries who are under contract to the Hospital They are in the process of taking the exam to become RN's and will either pass the exam and become RN's in this country or, if they fail to pass the exam after two attempts, will not be retained as employees In these circumstances, and because of their job duties which are RN functions except as proscribed by law, we find the patient care technicians share a community of interest with the RN's and shall exclude them from the units found appropriate here. BARNERT MEMORIAL HOSPITAL CENTER 781 note that they are licensed by the State of New Jersey and must attend a 1-year course of instruction in their field after high school . This course of instruction re- sults in a diploma. The course is broad in scope and deals with the nursing care of adults, children, and babies. It encompasses both classroom work and clini- cal training. At the Hospital,- the LPN's work in various capacit- ies. There are LPN's in the nursery and in the pediatric section who perform the same duties as outlined above for the infant care technicians . There are other LPN's who are assigned to the operating room and who func- tion as operating room technicians . Additionally, there are LPN's who work in the in-patient section of the community mental health center and on medical -surgi- cal units. In addition to their work duties, the LPN's attend in-service training sessions concerning operating room techniques, orthopedic techniques , and infant care mat- ters. The LPN's license is official recognition of their technical competence and proficiency in providing im- portant and necessary nursing care, It also attests to their ability and allows them to administer certain types of treatments specifically authorized by a profes- sional nurse, a licensed physician, or a licensed dentist. Based on the LPN's training , licensing, and job du- ties which require the use of independent judgment, we conclude they are technical employees.35 Section Heads in the Laboratory: The Hospital's laboratory has two basic divisions : Anatomic Pa- thollogy and Clinical Pathology. There are then five sections in the laboratory. Histology is the only section in the anatomic area. The sections in the clinical area are: biochemistry and clinical chemistry, microbiology and serology, hematology and clinical microscopy, and blood bank. Each of the five sections in the laboratory is overseen by a section head .36 In addition, there is a subsection head in the chemistry section. Petitioner claims that the section heads, and the subsection head in chemistry, are technical employees, while the Em- ployer contends they are (a) supervisory and (b) profes- sional employees who should be excluded from any unit or units here found appropriate. 35 The Employer claimed that the infant care technicians , the operating room technicians, and the orthopedic technician should be excluded from any unit or units found appropriate here, as their community of interest was with classifications, such as the RN's and LPN 's, whom the parties had agreed to exclude. As set out above, however, we here include the LPN's in the technical unit. And since we find certain similarities in job functions between the three categories the Employer would exclude and the LPN's, and certain other contacts of significance , particularly the various in-service training sessions which various of the three categories and the LPN's attend, we find no reason to exclude the three categories from the technical unit here Rather, this points up the validity of our conclusion that all these technical employees should be included in one technical unit. 36 At the time of the hearing, the section head position in the blood bank section was vacant Although the parties presented a great deal of evi- dence on the issue of the section heads' supervisory status, much of that evidence was in conflict and, on this record, we cannot make an informed decision as to the section head's supervisory status . However, we note that two of the section heads, in microbiology and hematology, are register"ed medical technologists. We note too that the section head and subsection head in chemistry are chemists . Since we find below that the registered medical technologists who work in the Hos- pital's laboratory are professional employees , and that the section head and subsection head in chemistry, as chemists, are also professional employees, we shall ex- clude the section heads in microbiology, hematology, and chemistry, and the subsection head in chemistry, as professional employees , without deciding whether they, in fact, are also supervisors under the Act.37 Medical Technologists: This category is paid the equivalent of a figure between wage levels XVII and XVIII and is in the department of laboratories . In addi- tion to the two technologists who are also section heads, there are 21 technologists working in the labora- tory. The 10 technologists on the day shift are divided as follows: 4 in hematology, 3 in biochemistry, 1 in microbiology, and 2 in blood bank. The other 11 tech- nologists work evenings, weekends, and holidays and are not assigned to a specific section but work through- out the laboratory , except in histology. The technologists' main function, according to the Hospital's job description, is to "perform technical as- signments of a complex nature" in the laboratory. This includes analyzing blood , feces, urine, stool, transu- dates, exudates, sputum, organs, byproducts , and or- gan contents. These analyses are performed at the re- quests of treating physicians . In performing the various kinds of analyses, the technologists operate such equip- ment as binocular light microscopes, centrifuges, pho- tometers, spectrophotometers, incubators , water baths, and chemical analyzers. All the technologists have the knowledge and ability to use all the laboratory equip- ment enumerated and the knowledge to determine if each piece is functioning properly , and each technolo- gist has the ability to make various kinds of repairs on the enumerated equipment. After using one or more of the above-mentioned pieces of equipment in testing and after reaching a conclusion, the technologist prepares and signs a re- port, which contains a recitation of the test and its results, and the opinions, and sometimes the recom- 37 The section head in histology is a registered histology technician We find that category to be technical below and ordinarily we would include this employee in the technical unit we have found appropriate , absent a claim that the employee is also a supervisor Since we cannot determine his super- visory status presently, we shall allow the registered histology technician, who is also the section head, absent an agreement by the parties as to his status, to cast a challenged ballot in the technical unit. 782 DECISIONS OF NATIONAL LABOR RELATIONS BOARD mendations of the technologist, based on the test's re- sults. The physician then uses the report to make a diagnosis or to institute or change treatment and the physician may consult further with the technologist on the test's results. Technologists also perform various tasks connected with blood transfusions, including the screening of a prospective blood donor with regard to his medical history to determine whether the donor has any disease which would eliminate him as a donor (the decision whether a prospective donor should be allowed to give blood is one the technologist makes); the collecting of blood from donors; the typing of the donor's blood through independent testing; the determining of whether a patient can receive a compatible unit of blood of a different type where the patient's specific blood type is not available or in short supply; and the determining of the clotting time of a patient's blood so that a physician can decide whether or not to give the patient anticoagulants and, if so, the dosage level to give. In addition to these duties, technologists partici- pate in reviewing and developing new techniques and methods in the laboratory, and do some instruction, in an on-the-job capacity, of the students in the Hospital's School of Medical Technology. Technologists are also expected to keep abreast of articles in scientific and medical journals concerning new procedures in their field and/or the specialization of old procedures. The Hospital's educational requirements for the po- sition of medical technologist are (1) 4 years of college with a bachelor of science in medical technology de- gree, or a degree in a related science; (2) the completion of a year of clinical training, which can be part of the 4-year college program or can be taken after college; and (3) registration by the American Society of Clinical Pathologists (A.S.C.P.) after meeting their require- ments which include the above two employer require- ments and the passage of an exam.38 All but seven of the technologists employed at the Hospital at the time of the hearing had passed the exam given by the A.S.C.P. and were registered by the A.S.C.P., while the remaining seven technologists had completed all re- quirements for registration, except the exam, and were eligible to take the exam the next time it was offered. Those technologists who have not yet passed the exam are formally called "medical laboratory technicians" and the record reveals that, at the Hospital, in terms of work performed, there is no distinction between those technologists who are fully registered after passing the A.S.C.P. exam and those technologists who have not yet passed the exam. While Petitioner, in contending that the technolo- gists are technical employees rather than professional 31 There are no state or Federal Government registry requirements for the position of medical technologist. employees, asserts that there are procedure manuals which describe the method in which almost all of the tests in the laboratory are to be performed by the tech- nologists; that there are numerous tests whose results are self-explanatory; and that technologists spend a percentage of their time in clearly nonprofessional du- ties, we conclude on balance that the technologists at the Hospital are professional employees. As detailed above, the technologists' work fulfills the requirements of Section 2(12)(a) of the Act, which defines a profes- sional employee, in that the technologists' work is predominantly intellectual and varied; involves the ex- ercise of discretion and judgment; cannot be standard- ized; and requires knowledge of an advanced type ac- quired by a prolonged course of specialized intellectual instruction. In reaching the conclusion that the medical technologists are professional employees, we note that the technologists spend a major portion of their time investigating and analyzing the contents of materials, relying heavily on their own reason and judgment in determining results and coming to conclusions ; reason out as to the meaning of the facts; are alone responsible for the outcome of their work; give instruction to stu- dents in their specialization; use and repair complicated laboratory equipment; review and develop new labora- tory techniques; and possess college degrees and have had additional formal training of a specialized nature. Technicians: This category is paid the equivalent of wage level XII and is located in the department of laboratories. There are four technicians employed in the laboratory. Two are registered histology techni- cians and one of those two is also the section head in the histology section of the laboratory. The other two technicians are nonregistered. The registered histology technicians have met all A.S.C.P. registration requirements, which include graduation from high school or the equivalent and ei-_ ther a year of formal training in histology, or a mini- mum of 3 years of appropriate experience in a histo- pathological laboratory, and the passage of an exam. They have training and skill in anatomic pathology and perform tasks such as screening Pap smears, which is a test for uterine cancer, and which requires the use of independent judgment. They prepare and sign written reports which are utilized by physicians. Of the nonregistered technicians, one attended a training program of 6 months' duration in a commer- cial school and is skilled and trained in urinalysis. He is a longtime employee of the hospital. The other tech- nician, who has had no formal training but who has worked in the laboratory for over 20 years, performs certain tasks similar to the technologists, such as typing `blood, screening blood donors, and drawing blood from donors. He also does some testing of an uncomplicated nature. The hospital no longer hires nonregistered tech- BARNERT MEMORIAL HOSPITAL CENTER 783 nicians and any further technicians who are hired will be registered technicians. Technicians in the Employer's laboratory perform certain procedures that are repetitive but they do use discrimination in comparing similar objects . There is a difference in the degree of complexity and difficulty of the work performed by the technologists and the tech- nicians, with the technologists performing mostly com- plex multistepped procedures that include first-line dis- crimination, and the technicians performing procedures that are more simplified , with guidelines as comparatives for normal or abnormal results. On the basis of the above, we conclude that the tech- nicians, both registered and nonregistered , do not meet the statutory criteria for professional employees, but that both the registered and nonregistered technicians are properly included in the technical employee unit. It is clear that the work which the technicians perform does not involve the "consistent exercise of discretion and judment in its performance" so as to qualify them as professional employees, but it is equally clear that their work is of a technical nature, which involves at times the use of sufficient independent judgment so as to render them technical employees . In reaching this conclusion, we note too the schooling and registry re- quirement that the registered histology technicians pos- sess. And while the two remaining technicians have neither formal training in their area nor registration by the A.S.C.P., they have much experience in their field secured by many years of work at the Employer. Addi- tionally, when they leave the Hospital 's employ, their positions will only be filled by technicians who are, in fact, registered. We thus find the nonregistered techni- cians, in these circumstances, to be technical employees also. Chemists- There are two chemists in the laboratory. As noted above, one is a section head and the other a subsection head, but here we consider them in their duties as chemists. They are paid in excess of wage level X K, the highest level in the Employer's wage schedule. The chemist who is the section head has a bachelor's degree in chemistry and, except for a written thesis, has satisfied all educational requirements for a master's degree in chemistry. He has satisfied the registry re- quirements of the American Society of Clinical Chem- ist s, which requirements include a bachelor's degree and the passage of an exam. This employee performs complex chemical tests and analyses in the laboratory and thereafter prepares a report which is forwarded to the treating physician who then treats the patient ac- cordingly or institutes certain procedures . The em- ployee also conducts original research to find new pro- cedures which would be used in the laboratory, after approval by the head of the laboratory, whose decision, however, is based almost totally on this employee's recommendation. If put into effect, any new procedure is used by the technologists- and technicians in their duties. Additionally, this employee attends meetings with physicians to discuss either a particular patient or a new laboratory test in relation to new therapy that is being instituted. The other chemist, who is the subsection head, at- tended 3 years of college where his major was biochem- istry. He has had 25 years of laboratory experience as a chemist. His functions include, with the exception of one or two procedures, all the tasks and functions per- formed by the technologists and most of the test proce- dures done by the other chemist. We conclude that both of the chemists are profes- sional employees. Their work is predominantly intellec- tual in character; it involves discretion and judgment; it cannot be standardized over a given period of time; and it requires knowledge of an advanced type. In the case of the subsection head chemist, his lack of a degree in chemistry does not negate our finding that he is a professional employee where, as here, he performs sub- stantially the same tasks as other professionals and has 25 years' experience as a chemist. Part-Time Employees: Petitioner seeks to exclude from both units we have found appropriate any em- ployee who would otherwise be included in either unit, but who works less than 2 days, or 16 hours, per week. Petitioner claims that these employees do not have the same community of interest as employees who work 2 days, or more, per week. The record reveals, however, that all part-time employees in the two, units found appropriate here, whether they average more or less than 16 hours per week, are regularly scheduled by the hospital and perform the same work as all other full- time employees in their classification, doing the work in the same place and under the same supervision. Ac- cordingly, we reject Petitioner's contention that em- ployees working less than 2 days, or 16 hours, per week should be excluded from the units we have found ap- propriate and conclude instead that all regularly sched- uled part-time employees are eligible to vote in the elections we are directing. In sum, we find appropriate Petitioner's request for separate units of service and maintenance employees and technical employees. We include in the technical employee unit the x-ray technicians, the respiratory care technicians, the licensed practical nurses, the in- fant care technicians, the psychiatric technician, the certified operating room technician, the orthopedic technician and trainee, and the registered39 and non- registered technicians in the Hospital laboratory." 39 The registered histology technician who is a section head may vote subject to challenge in the technical unit. 40 The technical unit found appropriate here is substantially different than the unit sought by Petitioner, including a category of employees (LPN's) not initially sought by it, and not heretofore included in a technical unit. More- Continued 784 DECISIONS OF NATIONAL LABOR RELATIONS BOARD We therefore find the following units appropriate for the purposes of collective bargaining within the mean- ing of Section 9(b) of the Act: In Case 22-RC- 6184.• All regular full-time and part- time employees in the service and maintenance areas including nurses aides and orderlies; dietary employees; housekeeping employees; coffeeshop employees; cafete- ria employees; central room service employees; store- room employees; engineering and maintenance em- ployees; boilerroom employees; unit clerk; aides including morgue assistant, physical therapy aide, pharmacy aide, lab aide and x-ray aide; and in addition, all EEG technicians; EKG technicians; darkroom tech- nician; noncertified operating room technicians em- ployed by the Employer at its hospital facility location at 680 Broadway, Paterson, New Jersey, but excluding all administrators, professionals, confidential, office and clerical employees, and technical employees, regis- tered nurses, patient care technicians, pharmacists, so- cial workers, therapists, dieticians, medical record li- brarians, medical laboratory technologists, chemists, guards, supervisors, as defined in the Act and all other employees not included. In Case 22-RC- 6190: All regular full-time and part- time x-ray technicians; respiratory care technicians; in- fant care technicians; licensed practical nurses; regis- tered and nonregistered technicians in the laboratory; psychiatric technicians; certified operating room tech- nicians; orthopedic technicians; orderly-orthopedic technician trainee employed by the Employer at its hospital facility located at 680 Broadway, Paterson, New Jersey, but excluding all administrators, profes- sionals, confidential, office and clerical employees, reg- istered nurses, patient care technicians, pharmacists, social workers, therapists, dieticians, medical record librarians, medical laboratory technologists, chemists, guards, service and maintenance employees, supervi- sors as defined in the Act and all other employees not included. [Direction of Elections omitted from publication.]" MEMBERS KENNEDY AND PENELLO, dissenting: We agree with our colleagues that the medical tech- nologists and chemists are professional employees within the meaning of the Act and must be excluded from any unit sought by the Petitioner herein. How- ever, we dissent from their finding appropriate a sepa- over, the LPN's comprise in number more than 50 percent of the unit. It may therefore be that the Petitioner does not wish to go to an election in this unit, or,- desiring to do so, that its showing of interest is no longer adequate. In these special circumstances, we direct Petitioner to notify the Regional Director within 10 days of this Decision whether it wishes to proceed to an election, and, if so, to submit at that time such additional showing of interest as may be required to support its petition . Cf CT.L. Testing Laboratories, Inc., 150 NLRB 982, 986 (1965) 41 [Excelsior fn. omitted from publication.] rate unit of technical employees . In our view, a separate unit of technical employees can only contribute to the undue proliferation of bargaining units in the health care industry. Mindful of the congressional mandate in the legislative history of the 1974 health care amend- ments to the Act to establish broad units in this indus- try, we would include the technical employees in the service and maintenance employees unit. Our colleagues admit that the service and mainte- nance employees and those employees placed in a sepa- rate unit "share various benefits of uniform application and various employee facilities , have contacts with each other, and have similar work schedules." They summarily concluded that "commonality of interest" between these two groups does not "destroy the sepa- rate and distinct community of interests of technical employees flowing from other , more substantial, fac- tors of training, skills, and certification, registration, or licensing, which the technical employees possess, and the service and maintenance personnel lack." However, the factors recited by the majority to justify a separate unit of technicals are the very same factors on which the majority relies in finding such employees to be technical employees. Therefore, in effect, the majority is saying that a finding that employees are technical requires the establishment of a separate unit for them. This is directly contrary to the policy followed by the Board since The Sheffield Corporation.42 The Board announced in Sheffield that it was abandoning the policy of automatically excluding all technical em- ployees from other units whenever their placement is in issue. Surely, there are no more reasons to automatically establish a separate unit for technicals in this vital in- dustry than in other industries . Such a policy contra- venes congressional admonition against proliferation of bargaining units in the health care industry. These technical employees do not share common supervision with each other and do not work separate from the service and maintenance employees . Rather, these technical employees have frequent contact with the service and maintenance employees , share common benefits, facilities, and other working conditions, and, in fact, in some cases, perform the exact same functions and even possess the same skills as employees included in the service and maintenance unit. This Board's decision in Extendicare of West Vir- ginia, Inc., d/b/a St. Luke's Hospital,43 found a sepa- rate unit of technical employees to be inappropriate. Rather than include technicals in the separate unit of LPN's which the Board majority established therein, the Board found that the technical employees shared a community of interest with the service and mainte- 42 134 NLRB 1101 (1961) 43 203 NLRB 1232, 1233 (1973). BARNERT MEMORIAL HOSPITAL CENTER nance employees. The rationale stated in reaching that conclusion was the finding that "technical employees work under conditions substantially similar to those of the service and maintenance employees. ,44 The ra- tionale remains applicable to this case. As in Exten- dicare, all the technical employees are paid ' on an hourly basis, work the same hours, and share the same fringe benefits. They share common dining facilities, timeclocks, parking facilities, grievance procedure, lounge, probationary period, time and length of breaks, recreation, and orientation programs. Further, the technical employees, as in Extendicare, generally inter- mingle with the service and maintenance employees in their work. As in Extendicare, the above facts dictate the conclusion that the technical employees and service and maintenance employees share a substantial com- munity of interest. Surely, in view of both the House and Senate Re-ports" concerning the health care amendments, no less comprehensive unit than a service and mainte- nance unit including technical employees is justified. Identical passages in those reports stated: Due consideration should be given by the Board to preventing proliferation of bargaining units in the health care industry. In this connection, the Committee notes with approval the recent Board decisions in Four Seasons Nursing Center, 208 NLRB No. 50, 85 LRRM 1093 (1974), and Wood- 14 The Board rationalized its inclusion of technical employees in the service and maintenance unit in the Extendicare case as follows The record discloses that the X-ray technicians take and develop X-rays and transcribe physicians' findings. Their skills are developed by attending a 2-year postsecondary school course in radiology. The laboratory technicians perform laboratory-associated work such as blood and urine tests. In addition to possessing a high school diploma, they must complete a 1-year formal education program The lone inha- lation therapist employed at the hospital administers oxygen, operates oxygen tanks, and gives breathing treatments. She is required to possess a high school diploma or its equivalent and to complete 6 months of formal training Thus, in view of the training received and the work performed by the X-ray technicians, laboratory technicians, and inhala- tion therapist, we find that they are technical employees We also note, however, that these technical employees work under conditions sub- stantially similar to those of the service and maintenance employees. For example, all such employees are paid on an hourly basis, punch a timeclock, and share the same fringe benefits Additionally, they share a common dining room and generally intermingle in their work The laboratory technicians perform at least some of their work outside the laboratory, and when in the laboratory they also have contact with the service and maintenance employees The inhalation therapist spends most of her time on the hospital floors. She is under the supervision of the nursing department, which also supervises some of the service and maintenance people (nurses aides and orderlies). Based upon the above facts, we find that the technical employees and service and mainte- nance employees share a substantial community of interest The specialized training and working conditions of the technicals in the instant case are comparable to those in Extendicare 45 S. Rept 93-766, 93d Cong., 2d sess. 5 (1974), H Rept. 93-1051, 93d Cong., 2d sess 7 (1974) 785 land Park Hospital, 205 NLRB No. 144, 84 LRRM 1075 (1973), as well as the trend toward broader units enunciated in Extendicare of West Virginia, 203 NLRB No. 170, 83 LRRM 1242 (1973).' i By our reference to Extendicare, we do not necessarily approve all the holdings of that decision. The obvious congressional concern with possible frag- mentation of units in health care institutions and the reservation expressed about Extendicare were directed notto the inclusion of technical employees in the serv- ice and maintenance unit, but rather to the exclusion of the LPN's from that service and maintenance unit.46 In our view, such congressional approval of the Board's finding of a broad unit of service and maintenance employees, including technical employees, is controll- ing in the instant case. The contrary result reached by the majority herein is at variance with this congres- sional expression of approval and is not "consistent with minimization of the number of bargaining units in health care institutions." We think it improper for this Board in unit determi- nations to place substantial reliance on the fact that hospital employees have been "licensed, certified, or registered" by a state agency or private organization. We do not believe that we can surrender our statutory obligation to decide unit placement for purposes of collective bargaining to either a state agency or a pri- vate organization.47 The majority, however, has adopted a mechanistic rule of excluding "licensed, cer- tified, or registered" employees from hospital service and maintenance units. Such a mechanical approach to unit placement constitutes a departure from the Board's longstanding criteria for deciding which em- ployees have a mutual interest in the objects of collec- tive bargaining. Traditional concepts such as place of work, existence or nonexistence of common supervi- sion, and contact with other employees will no longer be relevant to unit placement in the health care field. In the future, apparently our colleagues will not under- take a meaningful examination and evaluation of all the facts and circumstances surrounding the employment of "technical" employees in hospitals, for their unit 46 This interpretation of the committees' qualification of their approval of Extendicare is acknowledged by the majority of this Board in St Catherine's Hospital ofDominican Sisters of Kenosha, Wisconsin, 217 NLRB No. 133 (1975). Indeed, in view of Senator Taft's statement that "[p]art of the unit findings it can be argued, was overly broad and not consistent with minimization of the number of bargaining units in health care institutions," any other interpretation would seem incredible. 120 Cong Rec S 7310-11 (May 7, 1974) 47 The standards for "licensing, registering or certifying" vary from State to State because there is not unanimity as to what standards serve the public interest We do not believe that we further the interests of a national labor policy by abdicating to state or private agencies what seems to us to be the primary duty imposed upon us by Congress 786 DECISIONS OF NATIONAL LABOR RELATIONS BOARD placement will be determined purely by the label "reg- istered, certified, or licensed." The establishment of a separate technical unit results in the indiscriminate placement of certain employees in that technical unit while placing others similarly situ- ated in the service and maintenance unit. We do not approve such a confused result. The chaotic effect of the new approach to technical employees is illustrated by the unit placement of oper- ating technicians solely on the basis of certification or lack thereof. The certified operating room technicians, included in the separate technical unit, have taken a formal,, accredited; 6-month course given at a hospital. The noncertified operating room technicians, excluded from the technical unit and included in the service and maintenance unit, have also received up to 6 months of training, albeit less formal, however. Although the majority places the certified technicians in the separate unit, there is essentially no difference between the du- ties and responsibilities of the two groups, and even the minor differences, other than a training function of the certified technicians, disappear among experienced noncertified technicians, who, the record reveals, can also function in the more complicated operations. In- deed, other than the training function, there is nothing that certification permits a certified operating room technician to do that an uncertified technician cannot do. Moreover, the operating technicians are paid at the same or lower level than 16 classifications included in the service and maintenance unit. In these circum- stances, we are unable to find any justification for dis- tinguishing between certified and noncertified operat- ing room technicians or for excluding the certified technicians from the service and maintenance unit. We are in agreement with our colleagues that the medical technologists and chemists are professional employees and must be excluded from any unit of non- professional employees. We are also in agreement with our colleagues that many of the Employer's employees are skilled employees having acquired specialized knowledge through in-service training programs. We are not persuaded, however, that the inconsistent unit placement by the majority has any relation to the skills or knowledge of the employees. For example, there is no justification for excluding the psychiatric technician from the service and mainte- nance unit because the employee is pursuing an associ- ate degree. A few courses in psychology hardly qualify her as a specialist in either psychology or psychiatry. It is significant that the psychiatric technician (who trans- ferred from the classification of "case aide") is paid at the same or lower level than 13 service and mainte- nance job classifications. The bulk of her duties consist of completing forms which record information ob- tained from patients and reporting data to the profes- sional staff. Since they have the same duties as the medical record and ward clerks, logic dictates that they be included in the service and maintenance unit. - Similarly, there is neither rhyme nor reason for plac- ing the respiratory therapists in the technical unit and the EKG technicians in the service and maintenance unit. The tests performed by the respiratory therapists are similar to the EKG tests performed by EKG tech- nicians. Indeed, some of the respiratory therapists are now being trained to perform the functions of EKG technicians. We fail to detect any real justification for placing the employees in these two classifications in different units. The majority's placement of the orthopedic techni- cian in the technical unit is another example of the complete disregard for guidelines set forth in Sheffield for unit placement of technical employees. The or- thopedic technician sometimes functions as a morgue attendant who is found not to be a technical employee. An orderly is currently being trained to perform all the functions of the orthopedic technician. The majority includes him in the unit. Another orderly is being trained to perform some of the technician's functions and will assist him. However, the majority takes a con- trary position and excludes him. The Board has long held that job progression is a relevant factor in deter- mining community of interest. The adverse effect on upward mobility programs of these employees and oth- ers similarly situated cannot be minimized by the estab- lishment of separate units for technical employees. We do not believe that the employees included in the technical unit have a community of interest separate from that of service and maintenance employees. The fact that many of the service and maintenance em- ployees are paid higher wages than those included in the technical unit is the best indicator that they too are highly skilled and possess specialized training. The em- ployees found to be technical in most instances work side by side with the employees included in the service and maintenance unit. The similarity of wages, fringe benefits, hours, and working conditions compel the conclusion that we should include the technical em- ployees in a single unit with service and maintenance employees.