Can a nurse's union succeed in a Right to Work State?


Hello All.  I wanted to ask if anyone here knows of a case where someone has made a nursing union succeed in a right-to-work state.  I work in Idaho, where just like in most right-to-work states, large corporations thrive due to their ability to run roughshod over their employees with the full support of the state government.  For me, the question isn't whether or not I want a union, I 100% want one.  I am fed up with increasing ratios, increasing workload, and retaliation against anyone who speaks up about patient safety concerns.  I am not the only one who wishes we could organize.  Even many of the more political moderates like myself as well as conservative coworkers I have are even starting to express support for the idea. 

Unfortunately, I just don't see how we can succeed with one. It is a right to work state, so anyone can choose not to be a part of it.  I work on med/Surg, and our floor almost without exception wants unionization, as well as PCU, ICU, and ER (in short, all the floors that are getting progressively more screwed each year).  Our L&D, postpartum, and pediatrics floors oppose it since they all have pretty posh conditions on their floor d/t having such high reimbursement, and they think that the hospital will gouge their floor to meet our demands (which I have to admit is a likely valid fear).  I would say that on our Med/Surg, PCU, ICU, and ER, I would make an informal guess that about 75-80% would support unionization, while in the other mentioned departments about the same percentage are opposed.  Much as we would love to have one, I just worry about it causing a lot of ugly infighting and hostility that I just don't know if I have the stomach for. 

Most of the stories I hear about successful nurses unions come from states like California, new York, and other similar ones that have stronger union protection laws.  Does anyone know here about any examples of nurses that have had successful unions in right to work states?  Or does someone knowledgeable on the subject think that we have a chance given what I've explained above?  As much as I want one, if we simply have no chance I don't want to start the fight.  

klone, MSN, RN

14,588 Posts

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership. Has 17 years experience.

First, do you mean "employment at will" state? Because "right to work" and "employment at will" are two entirely different things, and people frequently get them confused.
If you are in a "right to work" state it means that there is legislation stating that no individual is forced to join a union or pay union dues as a condition of employment. Basically, you cannot be forced to be in your employer's union if you work there.

"Employment at will" means that you can be fired for any reason, or no reason, as long as it is not due to you being in a protected class. Pretty much every state has some type of "employment at will" agreement, with some states having exceptions in certain circumstances. And yes, unions can and do exist, even thrive. Because there is also a law that forbids employers from firing employees for trying to organize. You just need to know the laws. Avoid talking about organizing during work hours. Keep union materials in the break room only. Plan activities outside of work. This might help: can't be fired,for engaging in these activities.

And now that I've reread your post a little more closely (forgive me, lack of coffee) I see you DO mean "right to work" state. Think of it this way - even in NON-right to work states, if there is not currently a union and you are wanting to form, you will still have those same challenges and hurdles to overcome with not everyone being initially on board. You just need to have some very compelling arguments and data for your coworkers on why this would benefit all of them. And you don't need to convince them all, just the majority.

Home Health Columnist / Guide


11 Articles; 17,864 Posts

Specializes in Vents, Telemetry, Home Care, Home infusion. Has 46 years experience.

YES, there are nursing unions in right to work states.

See which states have Right to Work laws  ... note that website lists union dues required if union established as "forced unionism" state.

Right-to-work laws prohibit compulsory union membership. Also known as Workplace Freedom or Workplace Choice,  these laws grants workers the right to choose whether or not they'd like to join a union in their workplace.  Right-to-work States: What Employers Should Know

Wiki: Right-to-work law

Living in the NE US,  I'm most familiar with active unions in many professions.

When PA nurses needs were not effectively being met in late 90's, the Pennsylvania Association of Staff Nurses and Allied Professionals- PASNAP    "the union we wanted didn't exist, so we created our own" in 2020 spearheaded in Delaware County, PA where I lived with nurses from Crozer Chester Medical Center.   They are now the LARGEST in eastern PA with 25 local union groups.   SEIU Healthcare Pennsylvania  is the other large nursing union in PA, part of the national union SEIU  Healthcare located in many states.

PASNAP has become so successful that several hospitals professional employees: pharmacists, PT/OT/ST/Social work, CRNA's, Nurse Practitioners, Paramedics formed unions under their umbrella. Their website under "local pages" lists all collective bargaining agreements (CBA) which may be helpful to review to see what issues negotiated and dealt with in a contract.

Wisconsin is a right to work state after law passed in 2011, even though a nursing union existed prior to that time: After Strike Threat, Wisconsin Nurses Get a Possible Path to Union Recognition

National Nurses United started in California and has expanded across the US  via their National Nurses Organizing Committee  in which several states are right-to-work


NNOC now represent nearly 130,000 RNs in about 300 facilities throughout the nation, including Alabama, Arizona, California, Colorado, Florida, Georgia, Iowa, Illinois, Kansas, Kentucky, Maine, Missouri, Nevada, North Carolina, Ohio, Texas, Virginia, West Virginia, District of Columbia, and Puerto Rico.

This 2022 website article provides A Comprehensive Guide of State-by-State Nursing Unions

Hope this info helps.  It is a long path to organize, then after facility recognizes nursing union takes about 2 years to secure a first contract.  A nursing union is successful when NURSES realize THEY are the union and are actively involved in keeping it functioning.

TriciaJ, RN

4,307 Posts

Specializes in Psych, Corrections, Med-Surg, Ambulatory. Has 42 years experience.

I'll tell you why conditions are more cush on some floors.  It's not only about reimbursement.  It's a good way to keep staff pitted against one another.  If your hospital was an equal opportunity screwer, they would be screwed themselves.

You can have what is called an "open shop" where union membership isn't mandatory.  It's not optimal but at least gets a foot in the door.  The caveat is that everyone still gets equal representation and the non-members tend to file the most grievances.