Nursing Labor Movement

Introduction to the American Labor Movement:

Dating back to the beginning of the industrial revolution, the American Labor movement in the United States began its existence due to poor working conditions and exploitation during the beginning of that time. Labor unions in the United States today function as legally recognized representatives of workers in numerous industries, but in recent years have seen their greatest growth among service sector and public sector workers. Activity by labor unions in the United States today centers on collective bargaining over wages, benefits, and working conditions for their membership and on representing their members if management attempts to violate contract provisions. Although down from the peak membership they achieved in the third quarter of the twentieth century, American unions also remain an important political factor, both through mobilization of their own memberships and through coalitions with like-minded activist organizations around issues such as immigrant rights, trade policy, health care, and living wage campaigns. (Labor, 2007)

Labor unions have had a long history of using their most powerful weapon, strikes, to fight their battles. Even today, with the diminishing numbers of union members, strikes appear in the news sporadically. The most common reason for organized labor to walk off the job and strike are wage-related issues. (Labor, 2007)

In the profession of nursing, the common reasons for nurses to strike are patient care demands, benefits and wages. Despite differences in economics, politics, culture and health care systems across countries, nurses around the world face very similar problems and hold very similar priorities. Understaffing, safety and health, mandatory overtime, privatization, floating and the assignment of nursing assistants are seen as serious problems. (Challenges, 2003)

Nursing Labor Organization History

Since the late 1800s, nurses around the world have been organizing to promote the interests of their profession and its members. Most of the earliest nurses' organizations took the form of professional associations, with trade unions being a more recent development. (Challenges, 2003)

Most nurses' associations were originally established to set professional standards for training, licensing, and practice. The American Nurses Association (ANA), for example, was founded in 1897 "to establish and maintain a code of ethics; to elevate the standard of nursing education; to promote the usefulness and honor the financial and other interests of nursing" (Challenges, 2003)

The earliest nurses' associations pursued their goals by working with government agencies, educational institutions and other professional associations in the health care field. Over time, most have adopted collective bargaining and many have resorted to strikes or other forms of industrial action as additional means of moving their profession forward and protecting the interests of their members. (Challenges, 2003)

Many nurses traditionally opposed unionizing. It was looked upon as being "blue collar", or "non-professional." There was always the fear that striking, to obtain sane working conditions, would remove nurses from the bedside, thus not even allowing the provision of poor care. In addition, the employees of many state institutions and hospitals were forbidden by law to strike, which undermined the power of unions to flex collective bargaining muscle. Labor laws, initially, were prohibitive and denied nurses the opportunity to form separate bargaining units. But nurses moved forward to consolidate their labor force, and gain additional leverage. (Rise, 1995)

In 1974, the Taft-Hartley Act was amended by Congress allowing non-governmental, not-for-profit, hospital employees the right to unionize. The National Labor Relations Board (NLRB) had fought hard for these changes, and continued to fight for nurses to have the right to form their own separate bargaining units. Having an independent bargaining unit would allow nurses to concentrate on issues specific to the their own profession - as opposed to incorporating issues specific to other hospital departments such as clerical workers and housekeepers. (Rise, 1995) As of 1991, the Supreme Court affirmed eight bargaining units per hospital allowing nurses to form separate units for collective action. The American Hospital Association (AHA), composed of administrators and physicians, have opposed any legal action which could possibly benefit nurses. This is why it took so many years, and court battles, for the NLRB to win us these rights. (Rise, 1995)

Today, there are nurses' associations in more than 124 countries around the world (ICN, 2002). In some cases these unions represent only nurses. In other cases, nurses may belong to a union that also represents other health care workers, ranging from physicians to nurses' aides/assistants. A less common, scenario is where nurses belong to a union whose members primarily work in a non-health care industry or industries. (Rise, 1995)

Recent changes in healthcare have subjected nurses to the effects of cost cutting, shuffled duties and reorganization, not to mention a chronic nursing shortage. Two AFL-CIO affiliated unions actively pursuing nurses are the Service Employees International Union (SEIU) and the United Food and Commercial Workers Union (UFCW). In the years during and following the Great Depression, the SEIU union was the first in the country to help other service workers like hospital caregivers and public employees unite together in a union, paving the way for the modern SEIU's three core industries: property and public services, and health care. (SEIU, 2007)

The Nursing Shortage Issues and its Effects

In the profession of nursing it is the nurses job to treat the human responses to illness and disease. In doing so nurses also promote health, prevent illness, educate their patients, and promote a safe environment. "Safety" is defined as "freedom from the occurrence or risk of injury, danger, or loss" ("Safety", 2007). There are four main principles of ethics to which health care providers must abide. Those principles are beneficence, nonmaleficence, respect for autonomy, and justice (Ellis & Hartley, 2004). While all of these principles are equally as important as the other, the nursing shortage today may have the greatest impact on the principles of beneficence (the obligation to do good, not harm) and nonmaleficence (the obligation to avoid causing harm).

The current nursing shortage is a result of significant nurse layoffs that occurred in the 1990's due to changes in hospital management