Unions - Good or Bad??
With the shortage of nurses, I have seen many hospitals unionize. Unionization is a great way for nurses to have a voice, and get critical problems addressed by management. However, as a recruiter I have first hand knowledge of some of the shortcomings of unions that you all should know about if you are thinking about unionizing at your facility. I am not anti-union. The purpose of this post is to educate nurses on the positives and negatives of unions so that nurses can make more informed decisions.

Why form a union?
The top two reasons why employees form a union is low pay and poor working conditions. In the nursing profession, poor working conditions are usually associated with the shortage of nurses. This makes the nurse to patient ratio difficult to manage. On wages, basic economics tells us that when the supply of nurses goes down and the demand for nurses increases, then the price for their services should go up. The average wage for nurses has been increasing by 10-25% a year for the last several years. The challenge is that many hospitals have seen their profits decrease, and until recent years, they have become accustomed to giving 3-5% cost of living increases. So from an employer's perspective it may seem unreasonable to give 10% increases if they are used to giving 3-5%. Eventually employees start to receive job offers for more money at other facilities where there are more aggressive annual salary increases, and the perception that your employer has low pay all starts there.

It is becoming more and more popular for nurses to form unions to attempt to get their employers to resolve these issues. The problem is that unionizing doesn't solve these problems.

Will forming a union mean more money?
More often than not, unions initially get a substantial pay increase through their collective bargaining efforts. However, unions also tax employees with union dues. So your take home pay may not be increase as much as you would think.

On a long-term basis, unions can mean less money. Unions negotiate through collective bargaining agreements. They often times go for several years, and are so rigid that they can be prohibitive to hospitals that want to improve wages. For example, I was recruiting EEG techs at a facility in Minnesota. My client was paying approximately $5 below market. I advised my client to increase the compensation, so they approached the union about wanting to increase the wages for EEG techs. The union said that the wages would only be approved if the increase applied to every employee in the hospital. Obviously management balked at the offer, and all of the EEG techs have quit since that time. The facility is now fully staffed by traveling EEG techs.

Collective bargaining agreements are also too rigid when it comes to annual performance increases. Lets say your union negotiates annual pay increases over the next three years at 8% a year. If the market for nurses in your region has pay increasing in the 12-15% range, then as time progresses your job will slowly become less and less competitive. Over a long term basis, healthcare workers earn less in unions than in a non-union environment.

Will forming a union mean better working conditions?
I don't think so. If the poor working conditions are attributed to the nursing shortage, then how will forming a union increase the number of nurses in your area.

You can lobby for your employer to increase the nurse/patient ratio, but look at the state of California to see that it only makes matters worse. The ratio of travel nurses to permanent nurses in California is higher than anywhere else, and it is only pulling resources from other states. What happens 5 to 10 years from now, when the shortage of nurses is even more strained? If there are 3.5 million nurses in the US, and 4 million openings, then a union is not going to solve your problems.

Are unions good or bad?
Now having made the above points, I want to clarify that there are many good things that unions accomplish. Unions can be very effective in establishing communication and protocols between employees and management. Bottom line, the success of your union depends on the strength of union management and the unions understanding of the healthcare industry. They must have experience working in industries that have experiences dramatic shortages.

My suggested alternatives...
Unions were created to give the employees leverage to negotiate with. Nurses don't need this leverage because they already have this leverage. There are enough nursing jobs out there that nurses can vote with their feet.

If you don't want to look for a job elsewhere, then perhaps you should create a coalition rather than a union. Here is how a coalition works. As employees, you get together with the sole purpose of working WITH management to resolve matters. Work with management to create programs where you are educating young people on why they should enter the nursing profession. Talk to local community colleges about starting nursing programs in your area if there at not already some.


These are just my thoughts. I am sure that many of you have some strong opinions in regards to this topic, so please add your two cents. If you disagree with me, please be vocal about your opinion...but let's make this a healthy discussion rather than a mud-slinging argument.