Are nursing unions necessary?

Are nursing unions really necessary? I am trying to look at this from all angles of medicine. The first point of view I am going to take is that of being a patient. I have been very fortunate in my times as a patient to be surrounded by amazing, educated and capable nurses. A good nurse is worth their weight in gold. Nurses are not only the number one patient advocates but, they are the eyes and ears of the physicians. Most of the nurses I have come across in the past 11 years are great but, there are those few that made me wonder how they kept their license but, they did lose their jobs. So, as a patient, does a union make it harder for hospitals/clinics/etc. to fire bad nurses? The reason I ask this is because I was married to a union guy. I have a ton of friends that are union members but, none of them medical. I hear them make fun of the companies they work for saying, “they can’t fire me, I’m union” that has always made my skin crawl! What the hell did they mean by that? The way I was raised if you were not productive, then you simply, got fired. Why would a company continue to pay a lack-luster employee? So as I was reading about the new national nurses union which empowers 154,000 nurses, are the risks the same for not being able to get rid of bad nurses?

Ok, angle number two is going to be that of a nurse. Let me just start by saying that, there are non-unionized nurses where I practice. The number one complaint I hear from my friends that work on the floor is the staffing ratio. Too many patients for too little nurses, this does nothing good for anyone involved. The nurse is overworked and is more prone to make an error. The patient is put at an increased risk from overworked staff; you sure don’t have to be a medical professional to know a small medical error may lead to a huge problem for the patient, sometimes death. A medical error by a nurse means trouble for the hospitals. After all, it’s the hospital that hired the nurse. The attending physicians are drug into this mess as well; after all it was their patient. So in my little simple mind correct me if I’m wrong here but, wouldn’t it just make more sense for a hospital to provide ample staff to ensure the safety of their patients? Would this not lead to an improvement for all? Fewer errors, less lawsuits, lower malpractice coverage and nurses that are doing what they were trained to do, take full care of their patients! Wouldn’t it make sense that if a nurse was caught using drugs that they stole from the hospital they would lose their license? Simple, if you are a dumbass and can’t do your job, or maybe you are late all the time putting immense stress on the staff covering your duties you uh…GET FIRED?

Third angle, MONEY! That being said, nurses from this area make approx 3 times more a year if they work agency to cover strikes. I know many nurses that went agency to work the strikes in California, they banked. But agency nurses that fill in during strikes would not make 3 times the money if, well, there were… no strikes. I know agency nurses that work in specialty areas that make more than the full time hospital employees, usually 1 ½ times-2 times more. Let’s take the operating room for example; it takes a minimum of six months to train a nurse, to cover operating room call. So if a hospital is short handed, it makes more sense for them to pay more to a nurse that is already trained to make up for the shortage until the position can be filled or, a full time staff nurse can be trained to fill that specialized spot. So how much more do unionized nurses make versus non-unionized nurses? I have no idea, I know no union nurses.Well, this could ramble on forever and I don’t have an attention span that long. I was just wondering what ya’ll thought. Are nursing unions really necessary?

  • 10 Comments...Your thoughts?


  1. Jane says:

    Well…I have never worked in a union position. I do often wonder if unionization would enhance safety practice, for example: How many shifts do I work without eating lunch till 3pm? I would not mind trying a nurse union if there were one close enough to me, not for the “I can not get fired” aspect but for the safety and the theory of nurses advocating for each other.

    • Jane I can surley tell your that it is not umcommon at all to get a 3pm lunch here either. With admits and discharges coming at all times of the day, we cannot control what time the dr’s round to discharge thier patitents but, the docs can’t control when they get called in to admit a patient in the middle of clinic. Again, I think it falls back to the responsibility of the hospital to ensure proper staffing. If the are seeing a huge number of admits on a certain day, then have some on call staff and rally the troops. I’ll have to see if I can find some union nurses to ask if thier staffing ratio is better. Thank you for your insight, I really appreciate the feedback.

  2. Dr Dean says:

    I agree with your points about being able to fire a “bad or unsafe” nurse. The other issue with numbers of patients per nurse is also a big concern of mine-and I fear will get worse with the new health care reform, as it sounds as if payments to hospitals may get cut.
    Since I have never worked in a hospital with a union, I can only speculate. The next few years will definitely be interesting….great post!

    • Dr. Dean, I too am greatly concerned about how the healthcare reform bill will cut the hospital reimbursement, only increasing the problem of understaffing. I also do not want to see an increase in physicians who change careers due to being overworked and underpaid. After all it’s not like doctors have the privlidge of working bankers hours. Most docs carry a pager 24/7 and can’t get through a family dinner without the thing going off. Great doctors and nurses are what have given us the ability to offer such advanced treatment.

  3. hello there: I’ve read most of your article. I’ve been a nurse for almost 19 yrs now, and have done almost every type of nursing. I must say that first, I’ve had some great nursing instructors and some LOUSY nursing instructors. That can go for coworkers and bosses alike, as well as institutions. I am still a practicing nurse. I have worked in both a unionized hospital and many many non collective bargaining hospitals. Let me start off with the collective bargaining.
    I was a nurse for about 1 yr, when my hospital had nurses who wanted to organize. At first I too was ambivalent. Soon I got caught up in everything, but not for the reason you were worried about. Let’s be honest here, nothing is ever guarenteed in life, especially a job! So I joined, and later became treasurer of my union. To be fair unions don’t protect “bad nurses” they are the nurses advocate for unfair punishment. Here’s an example: You are asked by a co worker to trade days. You do so and let your boss know of this in writing, as does your coworker. You go on vacation, only to return to see your name is on the schedule to work on the day you were scheduled off. Your co worker also sees this. NOW you have given your boss your copy of the trade, and your co worker also has a copy. You see the day is over staffed. Again you take a trip out of town, upon returning you get flooded with phone calls from your co worker wondering if you’re coming in to work the night you traded for off….you don’t show up…after all they have it writing, the floor is staffed, and everyone knows you traded right? Except you have a boss and co worker (unknowing to you) out to get you. You return the next day prepared to work, only to find out you will be disciplined. …Long story short. My boss had no idea this gal had it out for me, neither did I. I did have union representation, not very good, but I prevailed to the end. My grievance went all the way to step 3, before my co worker showed everyone the slip that stated yes indeed I had the night off. I had lost my copy, and conveniently so did my boss. I eventually went to another floor, to get away from this nurse who had it out for me. Now there were several things I could have done, but I wasn’t too well at the time. So the union did help me in preventing an unfair and unjust punishment. As a grievance rep, I did the same. I also helped those get vacations they deserved as well. Unions bargain for vacation time, wages, benefits. It’s not all bad! It’s too bad the only side you saw to a union was that in your words, you “wondered if it protected bad nurses” As nurses we eat our young, so a bad nurse? Really, I think labeling nurses good, bad or what ever is sometimes in the eye of the beholder. Now non unionized places. I can only speak from an agency nurses point of view…and as a whole, alot of staff nurses seem plain miserable. That is because of working conditions and pay. There are some non unionized hospitals that were pleasant to work at, and some that weren’t, and that’s as far as I will go. There are downsides to working in a collective bargaining unit. People have their own agenda, but that’s everywhere. I could go on, but I’ve said quite enough. Happy New Year.

    • Carole, thanks so much for your comment. Did you make more as a unionized staff nurse? As a grievance officer did you ever see a greivance in which you thought the nurse was wrong? I find this all so interesting, like a kid in a candy shop of knowlegde lol. Do union nurses have to pay dues like labor union members? As far as your co-worker being a sneaky snake bitch, that’s one of the people that should be fired. If an employee cannot work in a professional environment and keep thier personal grudges out of business, especially going so far as to sabotoge..they should be FIRED!! I’m sorry you had to go through that, I’m curious was there any discipline to those who caused the problem?

  4. Dan says:

    If Hospitals do the right thing by their employees there is never a need for unions. I’ve never been a big fan of unions because I think they have over-reached. I’ve changed my mind. As a nursing student/intern I see nurses who are over worked on a regular basis. The hospitals default position is to cut staff as census drops with out regard to acuity. If you have patients that all you do is give tylenol to, then you could probably hand 6 to 8 patients (exaggeration). But sometimes 2 very sick patients are too many. Management frequently says “ask for help if you need it” however what actually happens is an unspoken and unfavorable judgement put upon the nurse that frequently asks for help. In other words “deal with it”.
    Another huge factor for my area is the job market. There are 6 colleges that offer RN programs within a 75 mile radius. The area has a history of poor economic conditions with good jobs at a premium. The hospitals realize that they do not need to retain a lot of veteran med/surge nurses because every 6 months there will be roughly 300 graduate nurses looking for their initial work experience. I think the result is an environment set up to burn out the nurses. The result is a less expensive nurse for the hospital, a high turn over ratio and a high rate of burn out. Until the cost of highering and training new nurses effects the bottom line adversely I do not expect this condition to change.

  5. Patrick Barr says:

    Come work as a nurse in South Carolina and you will stop asking whether or not a union is necessary. I’ve been a nurse for over thirty years and have worked in several states but the Carolinas is by far the worst. You are constantly reminded that this is a “At will state” and that you may be fired any time / any reason. Most hospitals here have a (mandatory), yearly release signed by nursing staff that in effect states that we realize that being in an (At Will) state that we expect to be fired at any moment with little to no recourse. That being said, not all nursing positions in all hospitals or doctor’s offices are this oppressive but I guarantee you and anyone else considering working here that there is a pervasive feeling that we work at the pleasure of big business. That when you are interviewed for a position, accepted with open arms to make use of your talents that from day one you will in some small / large way feel deceived. The Board of Nursing is nothing more than a collection site for your monies every two years and there is (absolutely) no support for those of us that do come in on time, come to work ready to work, cause no problems as a team member and our only agenda other than a bi-monthly paycheck is to be respected for what we are, (NURSES). So, yes, nursing unions may not be perfect but they do exist for the sole purpose of protecting nurses when no one else out there gives a damn. Yes to unions but not in South Carolina, here unions for nurses are illegal and our voices are never heard.

  6. Tonya says:

    Hi i’ve been a nurse for 3yrs. I live in Louisiana and we don’t have unions. Do to the low pay I definitely think we need them. I work agency and prn but sometimes I get cancelled. My family and I are moving to another state because of better wages, benefits,and pay. Most hospices is 6 to 1ratio med surge 5 to 1 Tele 2to 1 ICU but the nurse is ultimately responsible for everything and I so burned out where I’m thinking about leaving nursing altogether


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