Nurse Unions: Are the Benefits Worth the Costs?

Like a wide range of unions across the U.S. economy, nursing and healthcare unions are suddenly in the sights of employers desperate to cut costs. This is hardly surprising given the dire financial condition of many medical centers and healthcare systems; a 2009 Thomson Reuters study found that the median profit margin of U.S. hospitals fell to zero percent. But these financial woes put healthcare unions and their memberships between a boulder and a hard place. Should they continue to struggle for improved benefits, pensions and working conditions, or face the fact that cash-strapped systems have no more to give?

An online Nursing Impact editorial spotlighted the conundrum: “If union members stay tough they can come out winners in negotiations. However, sometimes unions need to give a little for the sake of the organization. After all, if the organization goes belly up it really doesn’t matter what the union membership wants. At the end of the day negotiations are about bringing the best win/win that can be obtained to both sides of the negotiation table. Creating a win/lose doesn’t do anybody any good.”

To unionize or not to unionize

Across the country and in a variety of industries, union membership is declining. According to the U.S. Bureau of Labor Statistics, in 2010 unionized employees fell from 16.6 to 14.5 percent of the overall American workforce. Conversely, in healthcare, and especially in nursing, the percentage of unionized staff continues to increase and has been the fastest growing union segment for the past decade. Currently, more than 15 percent of all hospital workers belong to unions, representing 3 percent of all U.S. union members, according to a report by Patterson Partners.

There is good reason that nurses and other healthcare professions remain so supportive of their unions. The BLS reports that unionized RNs earn 16 percent more than their nonunionized counterparts; nurses’ aides 22 percent more; diagnostic technicians 31 percent more and other healthcare support personnel 33 percent more.

And healthcare unions across the country are still effectively flexing their muscles. For example, in a walk out organized by National Nurses United last June, more than 12,000 nurses walked off the job for a one-day strike at 14 Minnesota hospitals. Since then, strike notices against hospitals have been issued by nursing unions in California, Massachusetts, New York, Pennsylvania and Maine, with the parties reaching agreements prior to work stoppages.

But in an age of disappearing revenue for health systems, can unions continue to effectively represent you?

3 issues to consider

1. You’ll probably pay union dues as a percentage of your gross monthly salary, often 2 to 3 percent. But, as we noted above, unionized RNs earn an average of 16 percent more than their nonunion counterparts.

2. Your union dues pay for more than just walk outs. They often fund child care, health insurance plans, pensions and lobbying for issues like decreased nurse-patient ratios.

3. Unionization and the higher costs that inevitably accompany it could send a struggling medical system over the cliff into bankruptcy.

It seems clear that, as healthcare systems fight to survive and unions scramble to retain their powers base, healthcare workers will continue to struggle with the unionization issue.

By James W. Peters

James W. Peters has headed communications, marketing, public affairs and government relations functions for major health systems in Maine, California and Rhode Island. He is the co-author of  “The Nature of Health: How America Lost and Can Regain a Basic Human Value” (Radcliffe, 2008).

©, Dice Holdings Inc., 2011

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