MSN WK11 Walden Unionization & The Nursing Profession Discussion

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Week 11 Discussion

Unionization and the Nursing Profession

Maria Zenitha Keating

Unionization and the Nursing Profession

The United States health care system has become more and more complex causing a serious threat to patient care and patient safety by employees engaging in collective bargaining, unionization, and employment laws (Marquis & Huston, 2017). Manthous (2014) strongly believed that physicians, nurses, and other healthcare professionals play a vital role in protecting patient safety and maintaining quality patient care through collective action, but worries that unionization and collective bargaining might threaten patient care and safety due to the pursuit “self-interest” for the workers. It is part of the leadership and management of the organization to understand that the management and the employees have to meet halfway in order to become effective. According to Marquis and Huston (2017), employees have the right to participate in union organization, and leader-manager must not interfere with this right. It is just right for the nurses, doctors, and other healthcare professionals to speak out their voices to be heard by the management. According to Marquis and Huston (2017), if the management is deaf to the workers’ needs for compensation, engaging in the union might facilitate better compensation and benefits. Both argued about the possibility of creating an organizational climate where labor and management can work together to accomplish mutual goals which are patient-centered. As a nurse, leader-manager part of my leadership roles will be (1) awareness of my own attitude and value regarding collective bargaining and law of employment, (2) accepts the reasons why people seek unionization, (3) create an environment wherein employees feel that they are important and needed in the organization, (4) a nurse leader-manager should be a role model, and (5) should not be judgemental in all his dealings with all his employees.

Reflection on Personal Experience Working in a Unionized Organization

My previous employment was a not-for-profit organization with a real autocratic style of management. Almost 80% of the total number of staff nurses were union members. The management was very strong in its implementation on quality patient care and patient safety (as they claimed). The management came to talk to the whole nursing staff regarding their plan of reorganizing the whole unit. This specific manager wanted to change everything in the unit. For decades, the unit has been operating on a 24 -hour-seven. The management came up with an idea to cut down expenses by removing the nights in the unit. It was a stressful process because most of the nurses were depending on the night shifts for more money. We organized ourselves (union members) and voted a chairperson to represent our group to the management. We contacted a union representative to support and uphold our case. It was a long process. It took more than 24 months to settle the issue. There was a time that the group suggested a semi-“strike” and we up with an idea of “no overtime” instead of strike or slowdown. According to Ash, Seago, and Spetz (2014), the union’s “stick” in negotiating with management is work-to-rule. It should not involve a strike or slow down as it has the potential to jeopardize patient health (Ash et al. 2014) In the end, the decision was in favor for the management. All of us felt like we fought for nothing. Personally, I did not feel like our union was strong enough to protect us or support our rights. I ended up withdrawing my membership because I was so disappointed with their performance. As a result of the drastic changes made to the unit, many nurses left the unit and looked for another “greener pasture” in the nursing field.

Transitioning from Collective Bargaining to Managerial Post

According to Marquis and Huston (2017), a nurse leader-manager is technically the hospital’s supervisor and under the law is prohibited to form or participate in a union. But it should not stop the manager to encourage his subordinate to form their union. As a manager. I should be aware of the labor relations laws that govern the labor, the equal pay act, equal employment opportunities laws, civil rights act, age discrimination and employment act, sexual harassment law, legislation affecting American with disabilities, veteran readjustments assistance act, and the occupational safety and health act. I should be more acquainted with all these laws so that I will be more effective in this endeavor.


Ash, M., Seago, J.A., & Spetz, J (2014). What do Health Care Union do?: A response to Manthous. Medical Care, 52 (5), 393-397. doi: 10.1097/MLR.0000000000000124.

Manthous, C.A. (2014). Labor unions in medicine: The intersection of patient advocacy and elf-advocacy. Medical Care, 52(5), 387-392.

Marquis, B.L., & Huston, C.J. (2017). Leadership roles and management functions in nursing: Theory and application (9th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.


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