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A Case against the Unionization of Registered Nurses in Hospital Term Paper

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Updated: Jun 11th, 2019


After decades of slow activity, labor unionists have started to revitalize the labor movement in states all over the US. Through organizations such as the American Professionals Union, labor unionists have tried to attract greater membership by encouraging various professionals to unionize. One industry that has received the attention of unionists is the health care industry.

The American Professional Union has approached many hospitals with proposals that the staff should join the union. The registered nurse in our hospital have received such an invitation. Presently, the American Professional Union is engaged in activity aimed at encouraging our nursing staff to unionize. The union leaders emphasize on the gains they have achieved on behalf of workers in their bid to recruit new members.

With focus on the merits of effective collective bargaining, labor unionists are able to attract a huge following among the nursing workforce. However, unionization has a number of significant negative impacts making it undesirable for our hospital. In this plan, I will highlight the major demerits of unionization in order to underscore why the registered nurses in the hospital should remain union free.

Why our Hospital Should Remain Union Free

Unions reduce the efficiency of the hospital by infringing on the tasks of the management. In a non-unionized setting, management reserves the right to make major decisions concerning the workplace and the duties of the nurses.

Clark (1999) documents that unionization results in a profound change in the nature of the employment relationship. In a non-union setting, management exercises a monopoly in the setting up of rules that govern the workplace practices. Things are different in the unionized setting since the workers and the union involve themselves in setting the terms and conditions of employment.

The union can also influence the day-to-day operations of the workplace. Ideally, the collective bargaining units employed by unions are meant to limit employers’ capability of making unilateral actions. However, most unions overstep their boundaries and intentionally conflict with management.

Too much interference from the union will prevent the hospital’s management from carrying out its duties efficiently and this will have a detrimental effect on the quality of services offered by the hospital to its clients.

Unions may lead to a reduction in the productivity of individual nurses in the hospital. Individual motivation plays a critical role in the level of personal productivity. Most nurses are motivated to work harder since they want to gain some personal benefits or attain promotions. The union seeks the same rights and benefits for all nurses regardless of their contribution to the hospital (Clark, 1999).

A nurse who is interested in his/her job and works very hard is given the same treatment as one who sees nursing as simply a job that brings in a paycheck. The union also offers protection for nurses making sure that they cannot be fired except for blatant misbehavior.

Nurses therefore lack the motivation to demonstrate greater enthusiasm in their work since they are treated in a uniform manner and protected from being fired due to poor individual performance.

Unions are likely to delay the career advancement of an individual nurse. Most nurses are very driven and they are keen to advance through the ranks due to their competence and proficiency in the work setting. To these motivated nurses, promotions are something that the individual works hard for and achieves through merit. Joining a union will have an adverse effect on the professional development of such nurses.

Clark (1999) reveals that in most unions, promotions are based on seniority instead of objective assessment of the employee’s ability. This assertion is corroborated by the revelation that unions ignore motivated nurses since they strive to ensure that seniority and not skill brings promotions (Genevieve et al., 1995). Unions therefore act as a hindrance to personal advancement for registered nurses.

Unions increase the expenses incurred by a nurse since regular payments have to be made to the union. Nurses have to pay membership fees and keep making monthly contributions that are deducted from their pay (Roussel, 2011). This obviously leads to a reduction in the net pay that a nurse earns in each period.

Nurses would have the advantage of retaining the money they pay as a contribution to the union if they choose to remain union free. The money that nurses pay to the union is not properly used since they often do not utilize the services of the union. While the major incentive offered by most unionists is that nurses will have an avenue to voice their demands, few nurses submit their demands to the union.

Research indicates that the demands issued to the union often come from the top union officials (Roussel, 2011). A marginal number of the nurses who make up the union voice their demands through the union. Nurses therefore end up paying for services that the majority of them never get to use.

Unionization does not accrue similar benefits for all the nurses who decide to join a union. Instead, unions in the US are structured such that most of the advantages are offered to older workers. Budd (2010) demonstrates that the negotiating agendas and representation strategies offered by unions often favor older rather than younger workers.

Budd (2010) acknowledges that unions often favor middle-aged and older members who make up the bulk of the union members. Younger workers do not gain significant advantages by joining unions since their concerns are often neglected. In addition to this, few nurses are involved in the affairs of the union they belong to.

Research indicates that few nurses attend union meetings regularly or even vote in the bargaining units or participate in the elections of the union leaders. Roussel (2011) demonstrates that most nurses fail to exercise their responsibilities in the collective bargaining efforts of their institutions. This non-involvement makes it redundant to join a union since one does not play a part in the running of the movement.

Unions create an adversarial relationship between the workers and the management. Roussel (2011) reveals that union officials have a vested interest in maintaining a combative relationship with management even when there is no real need for them to adopt such an aggressive stance. Social-psychology research demonstrates that unionization leads to the drawing up of a battle line in the hospital organization (Roussel, 2011).

The nurses are united by creating an outside enemy and this in most cases is the hospital administration and management team. Genevieve et al. (1995) reveal that unions result in the unity of nurses as they set aside their differences and “focus their collective energy on the perceived enemy” (p. 82). The good relationship currently enjoyed between the nurses and the hospital management is likely to suffer once the nurses are unionized.

Unionization might prevent nurses from acknowledging and dealing with other significant problems that face them. One major problem identified in nursing pertains to how nurses treat each other. A report by the Center for American Nurses (2008) reveals that most of the nursing problems are not caused by the hospital administration but by the manner in which nurses treat one another.

Nurses are some of the professionals who engage in frequent lateral violence against each other. By definition, lateral violence is intra-professional violence that is typified by gossiping, emotional abuse, bullying, and social exclusion by peers. Lateral violence within the nursing profession can also involve sabotage, withholding information, and undermining activities of a fellow nurse.

Practices such as lateral violence and bullying lead to work dissatisfaction especially by new nurses. These nurses enter into the profession with idealized images of what nursing entails but the actual reality of the workplace gives them a “rude shock”. Unions create a perception of unity among the nurses and any issue amongst them is downplayed.

Genevieve et al. (1995) assert that the illusion of common ground among nurses acts as a distraction from more crucial issues such as how nurses treat each other. A non-union setting would provide the best environment for nurses to acknowledge the issues they face amongst themselves and take appropriate corrective action.

Unionization might have a negative effect on the professional image that nurses have sought to cultivate over the image. Nurses have over the decades succeeded in improving the image of their profession. In the past, they were viewed as lower helpers to their medical counterparts within the health care system. Today, nurses are rightfully regarded as professional equals to their counterparts in the healthcare industry.

Their competence and professionalism in the field is unquestioned. Genevieve et al. (1995) warn that by embracing unions, nurses are likely to take on a blue-collar worker image. This is not an idle warning since unions have traditionally represented blue-collar workers against management.

Nurses have worked hard over the years to earn their professional title. Unions can only degrade this image and put nurses on an equal footing with assembly-line workers and other blue-collar employees who rely on unions for collective bargaining.

Unions result in nurses obtaining the wrong kind of power. A major selling point of unions by their advocates is that they will empower nurses and strengthen their position within the workplace. It is true that the union offers power but this power is not based on desirable attributes. Genevieve, et al. (1995) state that the union power is based on intimidation, manipulation and fear.

This statement is reinforced by the fact that unions threaten to call a strike and paralyze the operations of the organization if their demands are not met. Once a strike has been held in a hospital, there will be lingering bad feelings between the nurses and the management even after the strike is settled. Many nurses prefer to leave the hospital in order to escape the negative atmosphere caused by the strike.

The ones who remain have to deal with an environment of mistrust and poor communication with the management. While it is true that nurses need to be empowered in the health care industry, unionization is not the way to go about getting the power. Nurses should seek avenues which provide them with power that comes from their ability to influence through respect and authority.

The autonomy of the nurses will be infringed upon once they decide to join a union. Unionization requires the workers to relinquish their power to the union, which will in return bargain on behalf of the nurses. In most cases, a single person or a small group of individuals influences the decisions of the union.

Herman (2010) notes that there is a growing trend of authoritarian control within the labor movement today. Instead of offering nurses the autonomy, democracy, and union power that they promise, unions have turned into hierarchical organizations with those at the top imposing authoritarian control and obliterating local autonomy.

Herman (2010) warns that members of a local chapter of the union risk being dominated by the national chapter of the union. The issue of autonomy has been responsible for the many inter-union fights experienced over the last decade.

Herman (2010) documents that on December 2009, members of the Massachusetts Nurses Association went to court in an attempt to stop an affiliation with the National Nurses United (NNU) since they feared domination or infiltration.


Unions are gaining a foothold in the health care industry and many nurses have been enticed to join unions. An argument offered by unionists as they seek to recruit nurses is that they will curb on the authority of imperious management. While such an action would be positive for the nurses in the hospital, this is not the role that unions play.

Unions take on a combative stance against management and this reduced the effectiveness of the healthcare provider. Unionization therefore has a detrimental effect on the health care industry.

Instead of joining the union, the nurses should increase their participation in the affairs of the hospital through the available mechanisms. This will foster greater nurse involvement in the decision making process of the hospital and lead to good outcomes.

Unions often concern themselves with bargaining for better remuneration and work conditions for the workers. Nurses in the hospital have many other avenues that they can use to raise their concerns about salaries and working condition issues. Health care providers endeavor to ensure that their workforce provides the best possible care for patients.

There are mechanisms in place to resolve conflict and negotiate desirable employment conditions within the hospital. By making use of such mechanisms, nurses are able to resolve issues in the most productive manner and continue serving patients. The union is therefore unnecessary since it will only create a rift between nurses and the management staff in the hospital.


Unions are making a significant comeback in many professions in the country. The nursing profession has been targeted by unionists who seek to recruit many registered nurses into their ranks. Based on the points raised in this paper, it is clear that unionization will have many negative effects on the hospital and the nurses.

As the human resource director of the hospital, I am of the opinion that the registered nurses in our hospital should remain union free. Undoubtedly, the American Professionals Union has presented unions as the most effective tool that nurses can use to attain desirable goals in their profession.

It is my hope that the registered nurses in our hospital will overcome the temptation to unionize and instead choose to remain union free. Such a decision will not only benefit the nurses and the hospital in general but also the greater community that our hospital dedicatedly serves.


Budd, J.W. (2010). When Do U.S. Workers First Experience Unionization? Implications for Revitalizing the Labor Movement. Industrial Relations, 49 (2), 209-225.

Center for American Nurses (2008). Lateral Violence and Bullying in the Workplace. Web.

Clark, K. (1999). The Impact of Unionization on productivity. Industrial and Labor Relations Review, 33 (4), 451-469.

Genevieve, C., O’Rourke, K., Salley, B. (1995). Fight unions, not unity. Favor unions and unity. Nursing, 15(9), 81-83.

Herman, B. (2010). Unionization of the nurses in the US: worker power, autonomy, and labor democracy. The Journal of Labor and Society, 13(1), 297–307.

Roussel, L. (2011). Management and Leadership for Nurse Administrators. NY: Jones & Bartlett Publishers.

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