What is a union? A union is an organization of individuals who work together who use collective bargaining to prevent the employer from doing what workers do not want, and influencing the employer to do what workers do want. This includes issues that the organization can negotiate with including wages, benefits, and working conditions. Healthcare unions have been around for quite a while and have had a major impact on employees, and patient outcomes. We believe individuals should have the option to choose whether to participate in a union, and that there may be more disadvantages than advantages involved. In this paper we will be discussing the major disadvantages of joining a healthcare union, and how they impact the healthcare professional and the patients involved.
Workers unions have been a part of this country since the early eighteenth century, and the industrial revolution era in Europe. The workforce in this time was growing tremendously in numbers, and these people needed fair representation to maintain their basic rights. One of the most famous unions was founded in 1886; the American Federation of Labor (AFL) and is credited for successfully negotiating worker’s wage increases as well as increasing workplace safety. It is no surprise that workers in other professions other than one reason we believe unions to be unfavorable to nurses are the ethical issues surrounding them. If the union decides or is called on to strike, and the nurse is part of that union, they must strike, whether they want to do so or not.
This creates an ethical issue of walking out on patients, and having replacement nurses care for them, who may not be familiar with the hospital or the care needed to maintain favorable patient outcomes. Hiring replacement nurses during a strike also significantly increases costs to the hospital, as they pay these workers more than they pay their regular employees. According to a study on strike activity and patient-care outcomes, strike activity increases patient mortality rates by greater than 18 percent. Knowing there is a possibility of having to walk out on patient care creates an ethical dilemma for the nurse. One way this could be mitigated is by allowing nurses the choice to participate in union strike activity, instead of making it a mandatory action.
In any work environment, joining a union promotes greater job security for all employees. This job security in healthcare settings however, especially with employees who work directly with patient care, can become very dangerous when there are incompetent employees. It is a nurse’s duty to protect their patients and keep them safe. Unfortunately, not every nurse practices this duty on a day to day basis, and according to Staff, “Union procedures can make it difficult to fire nurses for bad behavior or incompetence.” Before an employer can fire a union employee, they have to make sure they have “just cause.” The Bureau of National Affairs has distinguished seven tests in order to determine if any employer has correctly handed out discipline before firing a union employee.
There are goals in a union, and for some nurses, those goals may not apply to them. In a union, wages are fixed in a contract. This may not drive nurses to work harder because their high performance will go unrecognized. One nurse could be busting their butt, while the other is not necessarily going above and beyond; however, they are getting paid the same wage. This can cause friction among the work environment. Every aspect of their work conditions will be run by the union.