Unions in healthcare

Is there a need for unions in healthcare?

Every workplace has its own administration that sets out the standards, rules and regulations that are observed by the workforce. Despite the contract agreements between the employer organization and the employee, several disputes arising require a group in order to settle the scores. Salary increments and attractive benefits are just but some of the things that have seen the birth of unions in various workplace settings including healthcare sector. However, unions have been met with mixed reactions in some workplaces where employers have suppressed them. In healthcare, the dominant question still remains; is there a need for unions? Apparently, despite all the benefits accrued to formation of healthcare unions, they still come with disadvantages as they may interfere with the proper running health institutions to the point of making them to increase their costs at the expense of giving quality healthcare.

Elimination of favoritism and discrimination

Most healthcare institutions in the current world have employees from different ethnic backgrounds. In a country like the United Sates of America, there are Hispanics, African Americans, Asians, whites and Latinos. In fact, a good percentage of nurses in the United States healthcare institutions are African Americans from the Diaspora. They have always been subjected to racism due to their skin color. Other races perceived as “inferior' have admitted that they have endured mistreatments in the hands of their seniors from the “superior” race. It has been recorded that some patients have spent long periods in the hospitals queuing waiting for service just because some of the people from a certain race have to see the doctor first without using the rule of first-come-first -serve. This shows the reason why we need unions to avoid such cases of favoritism and discrimination.

There exists a positive relationship between unionization and safe standards of care

In any organization, management and staffing determines the outcome from the employees. Where there are unions, it's common to find that the management and the rest of the workforce have a considerable output from their departments as there is coordination and effective communication. It's very important for all healthcare institutions to have better and highly rated patient outcomes. Research shows that unionized healthcare institutions always have better patient outcomes (Campanile, 2010). In a unionized healthcare institution, there is supervised management practices and better staffing. This thus improves patient outcomes at the end of the day. There is always a positive relationship between safe care standards, effective patient advocacy and unionization. It's agonizing to learn that some of the patients in the institutions have contracted other dangerous diseases and injuries due to lack of proper safe standards of care. There are some patients who have even died and others face the dire risk due to absence of ample standards of care. Some of the private institutions have failed to guarantee these as well as some of the federal government institutions. However, this is not usually the case in unionized institutions where unions fight for safe needles and related measures. This has ensured that patients are offered the relevant standards of care.

Setting of nurse-to-patient ratio

In fast growing economies like that of United States of America, workers in different institutions have to work for overtime hours. At times, doctors and nurses may be overworked and effective performance may not be garnered from them in these sensitive working environments. A tired nurse or doctor may not treat a patient the same way a sober and fresh doctor /nurse can. Thus, it's important that our institutions should embrace unions so that mandatory overtime can be limited. It will increase the quality of treatment offered to our citizens. Apart from limitation of nurse/doctor's overtime, there's also the issue of nurse/doctor-to-patient ratio. Sometimes the employer or those in the top management levels want to focus on the quantity at the expense of quality. In most of the institutions especially the unionized ones, the focus is on the number of patients attended. This dictates the reason why we need unions in health care because its only unions that has the capacity to push for setting of nurse-to-patient ratio. If we decide to wait for goodwill or benevolence from the employer, we may not get there.

Lower cadre employees like nurses are involved in organizational decision making

Employees in health institutions are required to be conversant with the goals, mission and vision of the respective organization. All the activities that are carried out within the organization affect all the workers in one way or the other irrespective of their level in the organization's hierarchy. Some top management organs in our institutions set policies, strategies and decisions that are supposed to be followed by all the workers in these institutions without consulting their subordinates. Lower level employees like nurses and other subordinates may not be comfortable with them. Grievances from one of the employees may not be heard if compared to an institution that is unionized. Thus, unions in healthcare help to increase on the organizational input for lower cadre employees in decision making (Huston & Marquis, 2008).

Workers in healthcare institutions also need better pension benefits

A general study on unionization by federal Bureau of Labor Statistics in 2008 showed that unionized workers in any organization have greater probability of receiving pension benefits and health care cover compared to nonunionized counterparts (Walter &Madland, 2009). Statistics from the same bureau show that its only 52% of nonunion workers who had healthcare insurance compared to 79% of unionized workers. It also includes record findings that union workers are more likely to have paid personal leave and retirement (U.S. Bureau of Labor Statistics, 2008). These are benefits that are supposed to be earned by all in the nation's workforce despite the industry category one is in. Some of the drugs that nurses and doctors use to inject treat patients may be dangerous. Thus, they also need to have health insurance schemes to cater for any emergencies in the workplace or after their retirement. Unions can negotiate with the institutions for these benefits better than individuals. Employees in healthcare institutions are thus able to request for these benefits in a better manner if they have a union. A union has the power to negotiate, bargain, power to change things, achieve goals for the employees and win improvements for the employees themselves and the people they serve.

Healthcare unions bring respect and dignity

Most of the managers in the healthcare institutions are twisted by greed, arrogance and power that commonly harm their view. For such people, it results in character defection that makes them to lose sight of respecting the precious gift of humanity. For all us of to be, to cherish and exist in ourselves and respect it in others, we need to have unions that can voice the concerns for nurses who are mostly mistreated and disrespected. If the managers understand that nurses have a body that is capable of fighting for their rights, respect and dignity will be there within the institutions. The labor spirit never allows itself to be slapped by anybody through abuses in the form of abusive and dysfunctional work environment. All labor deserves respect.

However, unionization in healthcare institutions does not bring with itself benefits all the time. There are good reasons as to why some people are against formation of unions.

Promoting welfare state

In a vibrant economy like United States, cultural and societal factors explain a great deal why we don't need unions. It's always good to have systems that are fostering trust amongst the citizens. The interests of some unions go an extra mile where they may end up seeking for better conditions in the workplace yet their performance does not match with the benefits they are paid. Perhaps the major reason why most people distrust unions in healthcare is because mostly, they aim to promote the welfare state. By doing this, they end up undermining other attributes in the society like the American free enterprise system.

There are some actions in healthcare institutions that require individuality. Once a union is formed, it means that all decisions that are to be made have to engage all the stakeholders. It requires the management to call the union to represent other workers in such a meeting. It therefore translates that unionization drastically reduces individuality. A decision that may be made by one manager alone requires all to be notified. Due to the presence of different groups in the institution, other members of the union may outvote a decision made by one of them. This shows that in unionized institutions, room for creating personal judgments is limited. There are cases where some employees are not members of the union. They are not taken into consideration that since they have not joined these unions, they will not pay the union dues. All employees are obliged to pay the union dues.

Unable to represent concerns for nurses

Not all nurses are well represented by unions. Concerns for all nurses are not well catered for by the existing unions in our health care institutions. This is because they restrict accepting membership students not unless when one is working in a recognized healthcare institution. To add, nurses have become more specialized in their roles though the unions have not been adapting to support this and this is the reason why many people are against the formation of unions in the healthcare system. Perhaps the major blunder for unions is being adamant in adhering to the famous and rampant bumping process (Lamont, 2008). This is a situation where senior nurses from a given agency displace other nurses who in terms of experience and education are senior to them. A good example where this happened irrespective of the existence of unions is Operating Room Nurses of Alberta.

Addressing critical issues of nursing

A good example where unions have failed to address issues in nursing is in the autonomy of practice. Self-governance with full responsibility is the only way in which nursing can enjoy autonomy of practice. However, unions have always been adamant for governments and employers to give self-management responsibilities to nurses. Unions have been against this move despite being stated that it can make improvements in nurses' worklife satisfaction.


Organizational culture is one of the aspects that unions destabilize. A good example is where the union discourages certain behaviors or actions for all members in the workplace. This may be a behavior that is so desirable in organization's culture. Moreover, employees may end up becoming more loyal to the union than to the whole organization. It therefore means that communication within such an organization will break down. The long-term effect of this comes in an organization where previously employees knew that the culture of their organization call them to work together always. Most of those who run these unions are commonly pursuing their self interests. The amount of money paid by the employees as union dues are mostly high irrespective of whether they are members or not. The grievances that they take forward for implementation are mostly left untouched since some of the leaders work with managements to derail the outcome. Thus, it's prudent to assert that these unions rarely help employees.


Campanile, C. (2010). Unions will dodge O's health tax. Retrieved from http://www.nypost.com/p/news/national/unions_get_pecial_treatment_in_health_AB053CwqPIJlIxXAm37DOM
Huston, C. J., & Marquis, B. L. (2008). Leadership Roles and Management Functions in Nursing: Theory and Application. Philadelphia: Lippincott Williams & Wilkins.
Lamont, S. C. (2008). Should Nurses Be Unionized? Retrieved from http://www.thuntek.net/~sclamont/nursescott/essays/should%20nurses%20be%20unionized.htm
U.S. Bureau of Labor Statistics. (2008). Union Workers Have Better Health Care and Pensions. Retrieved from http://www.aflcio.org/joinaunion/why/uniondifference/uniondiff6.cfm
Walter, K., & Madland, D. (2009). Unions Are Good for the American Economy. Retrieved from http://www.americanprogressaction.org/issues/2009/02/efca_factsheets.html

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