Labor unions have been around for more than a century. Only more recently, has unionizing the healthcare industry regained public interest. The Covid-19 Pandemic and with it all of the nursing and healthcare issues that have risen to the surface have renewed and energized interest in nursing unions. There are many pros and cons to nursing unions and what gains they make for nursing, as well as mixed opinions on how unions benefit the nursing profession.

Nursing unions give nurses the right to advocate collectively so that we can focus on what we do best, which is caring for our patients. (2). Some are exclusive to organizations, and some represent the nursing industry. Many unions (1) fight for fair contracts, higher wages, offer job security, safer working conditions, improved benefits, provide collective bargaining, all the while protecting nurses and their rights.

Unions use their leverage to negotiate enforceable contracts and are successful through strength in numbers. They also have specific processes (3) to address grievances and complaints which can protect healthcare workers from violence and facilitate improved outcomes. Some unions provide educational subsidies to nurses who want to improve their skills and knowledge, as well as group advantages and discounts.

Another key benefit of joining unions is that many provide legal representation for members. This can be instrumental should the registered nurse face litigation or disciplinary actions where legal representation would be present to be sure they are treated fairly. There are also nursing unions that lobby on a government level to provide improved legislature on policies that affect the nursing work environment and practice.

 There are many benefits to joining a nursing union, however, it may not be the best decision for everyone. There are membership dues that are a requirement that reduces pay and these funds can be used for political purposes within the union in any way the leaders see fit.

Senior union members often get preferential treatment in many circumstances which can cause feelings of unfairness to arise among members. Sometimes disputes must go through a mandatory mediation process, which can create a bigger problem than what was initially being escalated.

Nursing unions can also make it more difficult to fire or terminate (3) a nurse for bad behavior or incompetence, which can be very concerning. Mandatory striking, often without pay, is also a requirement in most unions. Nurses can experience revenge (1) from their colleagues should they refuse to strike. 

The Covid-19 Pandemic has identified root problems that are not new to the nursing profession but have been amplified by the pandemic, many of which have now gained public attention. The pandemic has refueled the purpose of unions and added additional grievances to the lengthy list of issues that unions fight for. For these reasons, there has been a renewed interest in establishing and maintaining nursing unions.

Unions can not only benefit nurses but also the healthcare system by encouraging much-needed change. Some studies (4) have found that unionized organizations have increased productivity for the employer with improved training, less turnover, up to 20% higher pay scales, and a lengthier stay in the workforce.

Many studies have also found that unionized organizations have better patient outcomes (4). However, broader study results tend to be inconclusive or contradictory (3). Various studies over the years have tried to determine a correlation between nurses' unions and higher job satisfaction, better patient outcomes, improved safety, and working conditions yet results remain conflicting. 

Nursing unions have and continue to fight for the rights of nurses, but also have a price. They can be incredibly resourceful and beneficial, but there are also downsides to consider and weigh when choosing your options.

Research on this topic is controversial as well as evidenced by the conflicting data, but one most nurses should look into and especially when deciding if it’s the right fit for you and to help you make an informed decision.