Nurse Labor Unions: Do They Have a Place in Healthcare?

Posted on July 30, 2013 by in Nurse Stories

money-bagIn April of 2013, the nurses at Quincy Medical Center in south Boston held a strike over their current union contract with the facility.

The nurses held out for higher wages, prompting the facility to employ replacement nurses for the one day strike.

The nurses picketed outside the hospital, attempted to block the arrivals of replacement workers, and were supported by several unions in the area.

Without a contract for an increase salary, the nurses went back to work the next day and negotiations continued.

Of course, all professions have the right to form unions and take actions to force management to act, but should nurses take part in these squabbles?

Patients depend on us to be there for them, and some may see striking as a dereliction of duty.

Some facilities may take advantage of this, though, and this could lead to poorer working conditions for nurses.

Already, conditions in some areas are deplorable.  As with most things in nursing, you can find strong positives and negatives for the inclusion of unions.

Pros of Nurse Unions

Let’s face it: you can’t trust management.  Even in not for profit facilities, you can be sure that the higher ups are looking for ways to cut costs.

Unfortunately, most of those cuts involve the salaries of hard working nurses as management generally does not understand how difficult nursing can be.

One of the insulting issues from the Boston strike was this quote about nurse salaries: “In today’s economy, nurses sitting by empty beds making $52 an hour is not feasible,” said Quincy Medical Center president Daniel Knell.

Honestly, how many nurses are sitting by empty beds?  Is this quote saying that the nurses are paid too much for the number of patients they have?  How many patients would justify $52 an hour?  Seven?  Eight?  Twelve?

With unions, nurses can come together and use the leverage of their numbers to combat ignorant management ideas of how much a nurse is worth.

Nurses can use the threat of strike, bargain for better conditions, and sometimes leverage for more money.

Money is almost a taboo topic in nursing.  We work because we are called, because we care, because we are givers.

Does that mean we shouldn’t get paid more?

Management that is focused on profit will take advantage of this weakness in the profession and use it to keep costs low at the expense of hard working nurses.

Cons of Nurse Unions

Several negatives also surround nursing unions.

Aside from the professional taboo against trying to improve monetary reward for our work, many nurses object to paying regular dues.

Unfortunately, the majority of unions are ineffective, and paying dues seems like putting out dwindling resources for no benefit.

Even the striking nurses in Boston didn’t get their contract after such an extreme action, and they had to go back to work the next day.

Some nurses would wonder what the point of it was and why they have to pay dues for a system that is at best flawed and at worst completely useless.

In addition, the idea of a strike isn’t well accepted by nurses.  This means that patients are left uncared for, and the idea that less skilled nurses as replacements can tug at a nurse’s sense of guilt.

“Management will be management, no matter what we do.”

Walking out on the facility means walking out on patients, and this is at odds with the nursing code of conduct.

Many facilities actively work to squash any talk of unionizing, and it is possible that such nurses could be targeted for termination if the campaign picks up any speed.

The most damning evidence against unions, though, is that they don’t tend to work very well in healthcare, and nurses often feel it is better to “vote with your feet.”  Essentially, this means leaving facilities that don’t care for their nurses.

With the current hiring climate, though, this method doesn’t seem the most well thought out, either.

Bottom-line about Labor Issues

Like healthcare reform, labor issues in nursing don’t have any easy answers.  Management will be management, no matter what we do.

They will always try to cut costs, misunderstand the role of nurses, and operate from a capitalist perspective.

Expecting healthcare facilities to be different than any other business isn’t only short sighted – it’s naïve.  Unfortunately, the current methods of labor unions are outdated and ineffective.

Maybe they worked when Hoffa was part of the scene, but they don’t seem to translate well to the 21st century or the healthcare paradigm.

Perhaps with the increasing governmental entanglements with healthcare, the hospitals will become less profit driven.

However, it doesn’t seem that health insurance reform will positively impact nurses, and for that reason, someone has to step up for the working nurses of America.

About Lynda Lampert RN

In the nursing field, Lynda has been an RN and seen a lot in the med-surge department. She was also a CNA prior to nursing school. As a published writer, “The Scribe” has been covering the health industry and will be a welcome addition to the Mighty Nurse community.

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12 Responses to “Nurse Labor Unions: Do They Have a Place in Healthcare?”

  1. Profile photo of Brock-MN
    30 July 2013 at 12:40 PM #

    Great insight!

  2. Profile photo of Sally Tarasoff
    Sally Tarasoff
    31 July 2013 at 10:25 AM #

    Nurses need unions. Why? Well, in my 40 years as a nurse I am still waiting to be treated as a professional. When the days comes that I am no longer emptying trash cans and doing housekeeping as well as patient care, and when I am treated on equal footing as a physician, then I might believe a union is no longer necessary. Until then, unions are necessary as a way to give nurses and ancillary hospital staff some bargaining power.

    • Profile photo of Lynda Lampert RN
      Lynda Lampert RN 31 July 2013 at 6:55 PM #

      Hi Sally,

      In the past, as I’ve spoken to nurses, I’ve found many against them. I agree with you, though. Management is still management. If they can make you do something outside of your job description, they will. There are no rules about ratios and the safety of our patients and licenses. Unions are an imperfect machine, though, but I think much more could be done with a union than without.


  3. Profile photo of Jason Hautala RN
    Jason Hautala RN
    31 July 2013 at 12:01 PM #

    I’m not overly impressed with my union, but I would still rather work under a union contract than without it. We have a no strike clause in the contract because we all agree that patients shouldn’t suffer because the nurses all took the day off. We have had to do informational picketing to allow the public to know what issues were being negotiated at their local hospital.

    • Profile photo of Lynda Lampert RN
      Lynda Lampert RN 31 July 2013 at 6:58 PM #

      Hi Jason,

      I think a no strike clause could work, but in some ways, that takes the teeth out of the union. If we have nothing to threaten, then we can’t really leverage management into compliance.

      I was a member of a union when I worked as a CNA, and it sadly did nothing for me. Our conditions were still poor, we didn’t get paid nearly enough, and yet we all still had to pay dues — whether we wanted to or not.

      I don’t know what the answer is, but there are flaws in how the system works now and flaws in unions, too.


  4. Profile photo of Mary Beth Casey
    Mary Beth Casey 2 August 2013 at 6:35 PM #

    I work with the protection of the union which saved my butt when I was falsely accused of snooping a co-workers chart. The initial action was immediate termination, however, with the union, we were able to run the instance and I was charged with failure to secure my terminal. The co-worker looked at her own chart, I had left for the day and did not log off. Would that have been discovered if I didn’t have union protection?

  5. Profile photo of jmearse
    jmearse 2 August 2013 at 11:17 PM #

    I’ve noticed some good things about unions, especially the bargaining power it gives to small-town and rural nurses who, realistically, can’t easily leave and work someplace else. I also appreciate that negotiating vacation time, pay, health insurance, etc. is a big job, and I’m glad that someone is there to do it for me. (Especially since I’m much more of a clinical guy, and somewhat administratively disinclined.)
    I do see some negatives, however. I dislike that some nurses who, quite frankly, aren’t that smart or clinically proficient make a lot of money, simply because they’ve been poor to mediocre nurses for decades. This is all because of the union contract, and mandatory pay raises. I also dislike the inability I have in one of my jobs to negotiate my own wages. In a non-union job I had, I was able to negotiate more based on my education, board certifications, experience, and performance, and I made really good money. (Alas, the military moved me out of that state!)
    I wonder if the modern union could allow for more performance-based incentives, and free up the individual to negotiate raises, etc., while still serving a legal/protective function?

  6. Profile photo of Batya
    Batya 3 August 2013 at 6:54 PM #

    Unions all too often don’t do anything but raise costs in an already weak economy. And in healthcare right now, with reimbursements rapidly declining from insurance, medicare, and medicaid how can anyone afford to be paying out more?

    In the end, the patients will be the ones to suffer….and is it worth that? The only ones in the end that benefit are the pockets of the union bosses…that’s where the money goes. We can band together and make changes on our own. We are all educated and smart enough to push legislators to make changes ourselves.

  7. Profile photo of johniandbrett
    johniandbrett 4 August 2013 at 5:21 AM #

    Just left a position, where the last shift I worked, I spent almost 4 hours in the dining room….because the dietary director cant get her job figured out! Just thinking about, and listening to, patient needs that weren’t being met, was enough for me to give notice. I will do any kind of patient care that needs to be done, But while performing someone elses duties, patient care was neglected!!

  8. Profile photo of BetsyRN
    BetsyRN 26 August 2013 at 11:37 AM #

    As a critical care nurse who has worked with and without a union, let me clear up some misconceptions. Unions have changed along with the nurses that they represent. Like anything, a union is what you make of it. In hospitals where nurses get active with bargaining their contract, using the tools of the contract to benefit themselves and their patients, and use the resources of the union to grow as nurses and patient advocates, great and positive accomplishments follow. For nurses who just pay dues and wait for union reps to solve all of their problems, there is not a lot of success. In the comments there are a lot of common misconceptions about nurses and unions:
    Most union contracts have a no lock-out/no strike clause. A contract must expire in order to strike. No nursing union uses strikes unless there is a complete breakdown in bargaining. It is a last resort action. No strike can be called without a vote of the members. But let’s get off strikes. The best part of being a union nurse is the ability to negotiate better patient care in Labor-management, staffing, health and safety, and unit committees where nurses sit down as equals with management to improve work environment and patient care. Nurses who speak up for patients have their union to back them up. Is it perfect? Again, it is what the nurses make of it, with training and resources from the union. Unfortunately standing up for patient safety sometimes means a nurse must object to an assignment or a practice against his/her own employer. Here is where a union is a must: the “I” word (insubordinate), rolls off too easily from many manager’s tongue these days. Imagine patient safety without the ability of a nurse to question an order or unsafe practice?
    Today’s nurses’ unions are less about confrontation, and more about negotiation, professional responsibility and keeping up high patient care standards. As every union delegate/steward can tell you, there is no way to defend poor work performance. The only thing that can be done is to make sure that the process in addressing poor performance is done in a fair and equal manner. Giving rigged merit raises never got rid of or incentivized positive change in underperforming nurses–they just got 1-2% less of a raise than excellent nurses. Across the board raises do not preclude managers mentoring and improving performance of underachievers and bad nurses. Unions usually take blame for poor management practices. Nursing unions encourage use of Assignment Despite Objection forms, which document unsafe staffing in order to protect the nurse’s license, job and to use in LM committees to improve staffing and patient care. Ask nurses why they form a union and organize and some will say wages and benefits, a legitimate goal. The majority of nurses say to improve their work environment and patient care. It is impossible to have a poor nursing work environment and give great patient care and vice versa. Our patients are linked to us in every way. Unions just don’t take your dues – they provide the vehicle to improve every part of nursing, which is poorly needed. Thank a union nurse if you work in a state where there are any staffing laws, safety laws, no mandatory overtime laws or if the battle for these is still going on. Union nurses are fighting in their hospitals, clinics, schools, jails, communities, and in their state capitols and Washington DC for quality patient care, quality work environments and better wages and benefits for nurses and their patients. Lastly the PPACA has a huge benefit for patients and nurses- but that would take a while to explain: see

  9. Profile photo of Okienurse77
    Okienurse77 4 February 2014 at 7:05 PM #

    It frustrates me to no end that nurses are expected to be “called to serve.” Physicians expect to be well compensated for the care that they provide and so should we! I know that if you ask most Med students, why they chose to be a doctor, they would say, “it was my calling.” rather than “for the money.” So why do we assume nurses should feel shame for wanting to be better paid to do something we love? I believe this expectation is sexist and outdated. I for one will admit that I do this job because I like caring for people. I also do it for the money and flexibility of schedule. If I just wanted to fulfill my calling, I would be better using my skills with the red cross or other service organization. I am a professional healthcare provider. The keyword being professional, I want the best work environment, benefits and pay, that I can get, while also providing the best quality of care and compassion I capable of.

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