Should Nurses Be Unionized?


Soliant Nurses Discussion UnionsAccording to the Washington DC-based Department for Professional Employees union coalition, 18 percent of RNs and 10 percent of LPNs and LVNs in the U.S. are union members.

What’s more, unionized nurses can earn an average of $200-$400 more per week than non-unionized nurses.

So why not join a union? It turns out, doing so is a more complex (and personal) issue than just signing up and cashing-in on the extra pay (if applicable) and other benefits – real or perceived.

Here’s a quick look at some of the upsides and pitfalls of having such representation:

Pros to joining a nursing union:

  • A union has the power and strength of numbers to negotiate enforceable contracts that identify working conditions (like acceptable nurse-to-patient ratios), the role of nurses in fixing standards of care, when nurses work overtime, pay scales, benefits, procedures for vacation-scheduling and other time off, etc…
  • Through a union, you can support efforts to enact improved laws that regulate hospitals and other healthcare environments and to create government-funded programs to fund and promote nursing education
  • Some legislative agendas include bans on mandatory overtime, mandating safe nurse-to-patient ratios, and requiring employers to protect nurses from violence and harassment on the job
  • Many union members enjoy the benefit of direct representation by union staff in the workplace. (This is especially valuable when disciplinary actions are being taken or when working conditions come up that require labor-management negotiation)

Cons to joining a nursing union:

  • From time-to-time, employers experience conflicts of interest with a nursing union. For example, management can’t make changes on employee pay scales and benefits without consulting the union, and nursing strikes that go against such measures can take a large toll on patient care
  • Employers can’t easily fire a union nurse (bad for management, good for front-line nurses, whether they’re in the wrong or not) whose performance falls below standard without consulting the union, which supports the nurse
  • Most unions charge membership dues, which is a deflation in real wages (if you pay the union $80 per month, that’s $80 less in take-home pay)
  • Unions can use membership fees for political purposes. Even if you opt out of having a portion of your dues going to support a specific candidate, the union can use your dues as the collective means to gain influence, even if that influence is against your personal views
  • According to many comments from nurses – both unionized and non-unionized – unions entrench seniority. Nurses with low seniority tend to get the last options for holiday bids and other time off, are easily pulled into other units, and can be cancelled during low census
  • It can also be difficult to advance your career on merit or increased education when competing with unionized nurses who have greater seniority


You could argue that union collective bargaining has both positive and negative aspects. On one hand, nurses waive the responsibility of working directly with employers to create pay scales, benefit packages, nurse-to-patient ratios and role definitions that favor nurses (spelled out in the form of a binding contract.)

However, collective bargaining can also reduce pay down-the-road. Once the union and the hospital agree on a pay scale, it can be locked in for years, making raises hard to come by until a new contract is negotiated.

What do you think? Are you part of a nursing union (or not)? Tell us your reasons in the comment section below.


An interesting study on the impact of nursing unions on wages

Some specific disadvantages of joining a nursing union

More pros & cons of joining a nursing union

List of U.S. nursing unions

The original statistics from the Department for Professional Employees on nursing unions

Tera Rowland
Contributor Tera Rowland

Tera Rowland is the vice president of Soliant and has worked in the healthcare staffing industry for almost 20 years in public relations, social media, marketing and operations. In addition to Soliant, Tera worked at the Mayo Clinic as an internal communication manager and for the Children’s Miracle Network. She is a member of the American Marketing Association and the American Staffing Association. Also, Tera has served on the board of directors for the Jacksonville Women’s Leadership Forum as part of the communication committee. She has a Bachelor of Science degree in Public Relations as well as a Master of Business Administration in Marketing from the University of North Florida and has been published in the Huffington Post, Healthcare Finance News, Healthcare Traveler Magazine, and Scrubs Magazine. Make sure to read the rest of Tera's blogs!