New National Nurses Union Forms — But What’s It Mean to You?

By Peggy McDaniel, BSN, RN

Yesterday a new and powerful union was formed. The National Nurses United brings over 150,000 nurses together by combining the California Nurses Association/National Nurses Organizing Committee with the Massachusetts Nursing Association and some members of the United American Nurses.  The new “superunion” intends to focus both on influencing health care reform and on improving quality of care through such efforts as extending California’s patient ratio law into other states.

I have never worked in a union-supported hospital, nor have I ever belonged to a union. My father was an electrical engineer and although he was a union member, he always talked about the “union guys” who worked as little as possible. I remember his frustration at members who took advantage of the positive conditions promoted by unions. When I was a newly employed nursing graduate, one of my friends was a card-carrying pipefitter. He bragged about not doing any work for days on end because there were no laborers around to carry his materials! 

As a hardworking staff nurse, I was angered by his complacency. I couldn’t imagine not clearing away a patient tray if the nurse’s aide hadn’t had time. I approached my nursing role as a team member focused on taking care of the patients—sometimes to my own detriment, since I was one of “those” nurses who often skipped breaks to complete tasks or charting. That said, I have seen the good that unions have done for nursing, especially around working conditions and benefits.

Given the current push to reform health care, this new union could make a difference for both nurses and our patients. As a nurse now focused on quality improvement, I would like to see nursing unions bring out the best in nurses by promoting compliance to evidence-based best practices and supporting professional development. There is now evidence to support IV therapy teams in hospitals and appropriate staffing ratios.  Since the evidence is there, let’s push to make these a reality in a majority of hospitals instead of only a few. At the same time, let’s hold our fellow professionals accountable to provide safe care 100% of the time, down to the idea that hand hygiene is not optional. 

Are you part of a union? Do you have a story to tell about being a union member? What do you think this new union could do to promote the state of nursing and what part should it play in our current health care reform process?

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Senior editor/social media strategy, American Journal of Nursing, and editor of AJN Off the Charts.


  1. Lyn Starrs February 16, 2010 at 1:27 pm

    Professionals have professional organizations– if nursing is to ever be considered a profession we need a strong professional group that represents professional registered nurses preferably with a BSN. This is why nursing doesn’t have power as a profession we don’t even have basic educational requirements to be a professional registered nurse. Sad but true — go down the road to unionization and it will harm our aspirations to be a profession and scare away the brightest and the best from joining.

  2. Barbara Lara December 19, 2009 at 11:12 am

    I agree that tere are corrupt and/or lazy folks out there. RN’s DO need help getting some type of protecttion against unscrupulous healthcare systems whose only concern is the bottom line. We get a wage freeze while administrators do not. I’ve been a union family member for many years..father, husband, brothers, and children, and know that they do get the support they need. Bad staf can be weeded out by good managers. I vote union YES!

  3. […] we noted earlier this week, several major nursing unions have united to form a “superunion.” The […]

  4. Kathy December 17, 2009 at 10:29 am

    I have seen what the Unions have done for GM and they are bankrupt. I think the Unions have wanted to get a foot in the Healthcare field for years, as it is lot of money that would come thier way.

    Nursing should be able to make changes using the evidence out there to support the claims of better staffing etc. I am not i favor as once a union is in it is hard to make any changes.

  5. RN Jack December 16, 2009 at 2:42 pm

    The author is advocating for professional status not a union. Nurses have the power and strength to change the healthcare debate if we would just present the information and evidence we have to the public and stop the infighting. We must also agree to hold each other accountable to the rules we have already set forth.

  6. […] we noted earlier this week, several major nursing unions have united to form a “superunion.” The […]

  7. RNMark December 9, 2009 at 4:31 pm

    Union NO!

    I cannot support the idea of unionized nurses. Having worked in a union hospital, it became apparent within a few days that anyone with any ability to be exceptional became a non-union “Manager” as quickly as possible. Union nurses were proud of their protection from having to make decisions. Being late to work was the only matter of discipline that really had any teeth.

    Unlike their ancestors, the European trade unions, it took only a dues check off card to become a member. In the best unions in Europe and America, becoming a union member involved proving that you were competent and capable through an apprenticeship that included many hours of supervision by journey-workers. In the US, the International Brotherhood of Electrical Workers partners with industry to make sure union electricians all get the latest training and education. The IBEW itself weeds out inept or weak workers, because the the IBEW’s very reputation is at stake.

    I simply don’t see that model coming to the nursing profession. If it were to happen in the US, it would mean that a union nurse was continually proving to his or her union brothers and sisters that he or she was worthy of the title. Hiring a union nurse meant hiring the union and “union nurse” would be the highest level of accreditation. But that model would demand much more in the way of the union itself and the collective efforts of the members to ensure that they always represented the highest ideals.

    Ironically, this would also make mincemeat of “Magnet” designation and a lot of certifications, because “union hospitals” employing proven journey workers would inherit the union’s standards for membership after apprenticeship. A trade union following such a model would come with mechanisms for peer review and self governance.

    Unfortunately we are talking about building mindsets that will take generations to foster, an elaborate and reliable infrastructure, and a commitment to shared ideals that our culture has sort of “bred out” of us in exchange for “freedom to be you and me”. Most Americans would chafe at “conforming” to any ideal, and pride in craftsmanship has become a quaint memory.

    So the union of today is going to be a nothing more than a layer of bureaucracy that pretends to battle “the evil selfish managers” while being very willing to throw individual members under the bus.

    With health care costs out of control, I’d rather take my chances with smart, savvy hospital leaders that come from my background as a nurse. I really don’t think that I need a retired, out of touch union leader getting between me and the people who actually do run the place.

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