Saturday, August 12, 2006

Travel Nurses & Unions

Now there's a controversial topic ;)

Mention Nurses and Organized Labor in some circles and you just might get treated like the proverbial guest at a banquet who just vomited on the host. But, the topic is one that deserves a fair look. Recent news headlines linking a serious medical error (wrong surgical site) to temporary nurses hired during a strike highlight one of the facts about travel nursing. Some of our compatriots do accept assignments to hospitals that are involved in nursing strikes. And when that happens they are likely to get blamed for all sorts of things. Some of them are not fair or appropriate.

But, the question arises... and it is one that is central to the Nurses and Unions debate. "Should nurses accept assignments as temporary workers at a hospital that is on strike?"

One side of the argument says that it’s about patient care. Nurses who care about patients shouldn't be striking and if they wanted better working conditions there are better ways to achieve them.

Yes, says the other side...but what if patient care is jeopardized by a hospital administration that refuses to listen to nurses and won't consider any alternatives to the current way they are doing business? And when nurses don't support nurses it just allows the hospital to keep doing business as usual.

Opponents of temporary nurses say they weaken the nurse’s ability to bring hospital administration to the bargaining table. That nurses don't strike over issues like better wages as much as they strike over working conditions, patient safety and the right to have more say in the environment of care. Hospitals with high burnout rates and poor job satisfaction are more likely to find themselves in the midst of a strike and that temporary nurses help these "bad hospitals" to stay bad. One recent study even supports the argument that unions improve patient outcomes

Those who support temporary nurses point to patient safety...who will take care of the patients when regular nurses walk off the job? They point out that if the strike is completely successful the resulting loss of income could be the figurative equivalent of "killing the goose" causing loss of jobs and income. Another point is that by filling in as temporary workers they assure that jobs will still be there for the permanent staff once the current dispute is over.

So, why do nurses decide to join unions? According to the SEIU (a union that represents nurses) there are a variety of reasons including safer staffing, higer wages, better benefits, a voice in hospital policies and political clout.

If unions are so much better then why don't nurses join them? Nurses don't join unions for a variety of reasons. Some believe that the Union vs. Management "struggle" creates an adversarial environment instead of a collaborative one. Others perceive the union as being “greedy and only there for the dues”. There is also a belief that nurses are a special group and that “petty issues” should not be allowed to interfere with the true calling of nurses – Patients. In fact, for many years it was believed that “professionals don’t go on strike”.

So, back to the question – Should nurses accept assignments as temporary workers in a strike situation? That, like so many complex issues in nursing, is really up to the individual nurse. I certainly won’t presume to dictate to my colleagues…after all that’s management’s job. ;)

This article ran in the most recent edition of The Travel Nurse Journal. The back issues are found at

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