Is it ethical for nurses to go on strike?

lindarn · Mar 1, 2008

Hi,
We are a group of nursing students in Canada writing an ethical dilemma paper and we would like to know your opinions on the following issue:
The nurses at a large hospital have been doing negotiation for months but since they haven't obtained any positive results they are deciding to strike for better pay and working conditions. A new graduate nurse is not sure about what to do, or how to vote.
We have learned that in Ontario it is illegal for hospital nurses to strike.
So, our question is: If all or most of the necessary steps to seek negotiation have been taken, to what extent do you think it would be ethical to have an illegal strike? Would the purpose of an illegal strike outweight its consequences?

Is it ethical for nurses to be overworked, made to take care of upwards of 10 patients? Being unable to meet the needs of any of them? Is it ethical for CEOs to make a thousand times what the average nurse is earning? After all, patients go to a hospital to be taken care of, and receive, PROFESSIONAL NURSING CARE, not administrative care. That administrator contributes nothing to positive patient outcomes, unlike nurses.

So why is it that nurses have to fight tooth and nail to receive wages, benefits, and working conditions that make positive patient outcomes. THAT is why it is ethical for nurses to strike if that is their only weapon to achieve wages that reflect that nurses have on positive patient outcomes, reflect the job of patient advocate, that nurses are required to be by the nurse practice act. Also, that wages reflect the negative aspects of the job of RN. The difficulty of the work, the effect of the hours that we work on ourselves, and our families, the risk to us, the list goes on.

No, it is not unethical for nurses to strike.

Lindarn, RN ,BSN, CCRN

Spokane, Washington

Iam46yearsold · Nov 21, 2008

I feel it is unethical for nurses to go on strike. Legally it isnt so. Just my beliefs that strikes are unethical.

Chico David, BSN, RN · Nov 26, 2008

Nurses are called - and in California at least, legally required - to act as patient advocates. It's possible to construe that very narrowly, and apply it only to the patient we are caring for on a given day. But it is equally possible - and in my mind correct - to construe it broadly. In my mind, the real meaning of patient advocacy is to advocate for the healthcare needs of the community we serve. And a part of that is that there should be an adequate number of adequately skilled and competent professionals to care for our patients - which inherently means adequate compensation, since without that the caregivers won't be there. So nurses are upholding the highest traditions of our profession when we stand up for ourselves and demand decent wages and working conditions. Said another way, working for less than you are worth - including working after clocking out, skipping breaks and lunches to save management money and working for substandard wages - is demeaning to our profession and lets down ourselves, our patients and our co-workers.

Ethics is an imprecise science - if we make a conscientious effort to behave ethically it sometimes means choosing between two bad choices.

Strikes should always be a last resort and used with great care, but they are sometimes the lesser of evils.

And on your individual case, an illegal strike should really be a last resort, for lots of reasons. As one who has a very few times been forced to break the law as a matter of civil disobedience to uphold a principle, I am very sensitive to the value of upholding the law. If we break the law just for our own convenience, we lose the moral high ground when we are forced to break the law as a matter of conscience. My personal belief is that one has an inherent right to withhold your own labor, so laws against striking are immoral laws, but I would still go very carefully and thoughtfully in considering breaking such a law.

mdfog10 · Nov 27, 2008

Is it ethical to stand by when a son is beating his father on the street? I was on my way home from work and was horrified to witness this event . Even worse was all the onlookers presumably doing nothing but watching. I called the Police. I really don't think it is any different for nurses working in hospitals. In the intense corporate environment hospitals have become, we see injustice every day. I am assigned post surgical patients with very acute needs. I am not on the factory line , but I feel like I am. I am expected to care for these patients with a smile and complete 100% accuracy. My hospital completely disregards our need for safe break coverage , factoring true patient acuity in the staffing grid, and the time it takes to provide safe and compassionate care. I have been at the bargaining table. We have provided evidence of unsafe and potential unsafe situations, time and again. The hospital team shows polite disregard to complete ignorance and denial. The only thing that forces them to truly listen is the threat of a strike. Nurses need to own their responsibility as patient and nurse advocates. United we can change the way care is delivered. :nurse: :nurse: :nurse:

Iam46yearsold · Nov 28, 2008

. So nurses are upholding the highest traditions of our profession when we stand up for ourselves and demand decent wages and working conditions.

I do not see where striking for higher wages is an example of patient advocacy. You are advocating for yourself solely to line your pockets.

I do see it as upholding the highest tradition of capitalism. So let us be honest with ourselves.

mdfog10 · Nov 29, 2008

wages that reflect your education, training and responsibility are important. I believe in "you get what you pay for". Plenty of well intentioned nurses and teachers simply cannot continue in these professions that do not allow them to support their familes. When I was in high school and I told my english teacher I wanted to be a nurse, she told me it was a vocation. a calling. When I attended a private University I left with over $20,000 in debt ( I stopped counting). When I went to my Fireman's credit union ( as my father and brothers were firemen) for a loan, my loan agent/fireman thought I earned much less than him. Because I am fortunate to follow in the footsteps of a heavily unionized environment I earn the same as my brave firefighters. We are intrusted to care and protect life, we are at risk for HIV, Hep C, physical attacks and more. We tend to our fellow citizens at their most vulnerable and trying times. As I always recognize that my fellow fire and police place their lives on the line every day, we as nurses save lives everyday. What keeps me going is the compassion, patience , and experience I offer my patients. After 20 years of nursing, now more than ever, I have to fight to get to my patients and advocate for them. I remain at the bedside because I believe in our duty to protect and advocate for those who expect that from us. If we leave the bedside who will be left for us and our families ? Robots? Nurses or unlicensed staff with an assignment that is impossible? Wake up--hospitals across our nation continue to reap massive profits while we don't get breaks, work overtime and face constant criticism from management. Oh yeah and 100,000 patients are killed in hospitals every year. :redbeathe:redbeathe:redbeathe

THAT Nurse., MSN, RN, APRN · Nov 30, 2008

Oh yeah and 100,000 patients are killed in hospitals every year. :redbeathe:redbeathe:redbeathe

Killed? Don't you mean die?

Iam46yearsold · Nov 30, 2008

wages that reflect your education, training and responsibility are important. I believe in "you get what you pay for". Plenty of well intentioned nurses and teachers simply cannot continue in these professions that do not allow them to support their familes. When I was in high school and I told my english teacher I wanted to be a nurse, she told me it was a vocation. a calling. When I attended a private University I left with over $20,000 in debt ( I stopped counting). When I went to my Fireman's credit union ( as my father and brothers were firemen) for a loan, my loan agent/fireman thought I earned much less than him. Because I am fortunate to follow in the footsteps of a heavily unionized environment I earn the same as my brave firefighters. We are intrusted to care and protect life, we are at risk for HIV, Hep C, physical attacks and more. We tend to our fellow citizens at their most vulnerable and trying times. As I always recognize that my fellow fire and police place their lives on the line every day, we as nurses save lives everyday. What keeps me going is the compassion, patience , and experience I offer my patients. After 20 years of nursing, now more than ever, I have to fight to get to my patients and advocate for them. I remain at the bedside because I believe in our duty to protect and advocate for those who expect that from us. If we leave the bedside who will be left for us and our families ? Robots? Nurses or unlicensed staff with an assignment that is impossible? Wake up--hospitals across our nation continue to reap massive profits while we don't get breaks, work overtime and face constant criticism from management. Oh yeah and 100,000 patients are killed in hospitals every year. :redbeathe:redbeathe:redbeathe

Nursing does not let you support your family, where is this. Nurses make a decent living. In nearly 25 years I have completely paid off my home loan, Improved my home with Solar and Wind power. And sell the extra electricity back to TXU. I have a small Year round farm that produces nearly all of the produce I need. The extra is taken to a shelter. I think we as nurses do well.

we kill 100,000 patients a year, where did you get these numbers from. I cant even imagine where.

Hospitals with their massive profits, are you confusing them with Big Oil. I do not know where you getting your facts but I am confused.

Iam46yearsold · Nov 30, 2008

Killed? Don't you mean die?

either way sounds strange to me.

allnurses Guide · Nov 30, 2008

in its report to err is human: building a safer health system, the institute of medicine (iom) estimated that as many as 98,000 hospitalized americans die each year--not as a result of their illness or disease, but as a result of errors in their care (iom, 2000).

this alarming number, which reflects only deaths occurring in hospital settings, exceeds the numbers of fatalities due to motor vehicle accidents, breast cancer, or aids. moreover, this figure does not reflect the many patients who survive, but sustain serious injuries.

http://www.nap.edu/openbook.php?record_id=10851&page=1

more studies document preventable deaths in hospitals:

there were [color=#33659b]270,491 actual inhospital deaths that occurred among patients who developed one or more of the 16 patient safety incidents (appendix d). using previous research, we calculated that [color=#33659b]238,337 were attributable to patient safety incidents and [color=#33659b]potentially preventable (page 4):
[color=#33659b]http://www.healthgrades.com/media/dms/pdf/patientsafetyinamericanhospitalsstudy2008.pdf

http://www.consumeraffairs.com/news04/hospital_errors.html

http://stcloud.injuryboard.com/medical-malpractice/arizona-state-university-study-finds-medical-errors-kill-thousands-of-americans.aspx?googleid=250590

Freedom42 · Nov 30, 2008

Hi,
We are a group of nursing students in Canada writing an ethical dilemma paper and we would like to know your opinions on the following issue:
The nurses at a large hospital have been doing negotiation for months but since they haven't obtained any positive results they are deciding to strike for better pay and working conditions. A new graduate nurse is not sure about what to do, or how to vote.
We have learned that in Ontario it is illegal for hospital nurses to strike.
So, our question is: If all or most of the necessary steps to seek negotiation have been taken, to what extent do you think it would be ethical to have an illegal strike? Would the purpose of an illegal strike outweight its consequences?

Any reasoned response to your questions requires looking at the nuances of the particular situation.

Compensation is not the only reason that workers go on strike. Nurses at Eastern Maine Medical Center, for example, staged a one-day strike last year to draw attention to what they contend were unsafe conditions for patients. They gave ample notice to management before they staged the strike so that replacement nurses could be brought in to care for patients. In this case, both the rights of the nurses and the safety of the patient was maintained. That certainly seems ethical to me.

Would the purpose of an illegal strike outweigh its consequences? In this country, it is not illegal for nurses to go on strike. So, removing the question of legality from the equation, that presumes the consequences. That nurses go on strike does not necessarily mean that negotiations grind to a halt. If by consequences you mean jeopardizing patient safety, that can be addressed, as mentioned above. If by consequences you mean the loss of jobs when an employer moves to lock strikers out, yes, I do believe that the purpose of the strike can outweigh its consequences. Would you want to work for an administration that continued to ignore your concerns about patient safety or, for that matter, compensation? Nurses have obligations as professionals and rights as workers.

Two points regarding points made earlier in this thread: I'm a bit surprised that the figure of 100,000 hospital-caused patient deaths per year (or 98,000, more accurately) is questioned. This figure has been out for a decade and is generally accepted. Though it's been some time since I looked at the actual report, I believe the researchers found that medication errors by nurses are responsible for about 5,000 deaths.

As for the notion that hospital profits are questioned by some, you've got to be kidding. Just Google "hospital profits" and watch the dollar signs.