Safe patient care... are unions the answer?

[Simonesays, BSN, RN]

I have been thinking a lot about what it means to be a bedside nurse in the US health care system and how we can better advocate for our patients and ourselves (in terms of better nurse-patient ratios, training, compensation, nurse retention, education etc). Large-scale unionization seems to be one way of achieving these things (see California).

So here are my questions:

Would you be willing to join a nursing union in your state? Why or why not?

Secondly, do you think that more optimal working conditions would prevent such a seemingly high number of new graduate (and experienced) nurses from leaving bedside/community nursing to become NPs?

This is just me being curious so thanks for any responses!

[Ruby Vee, BSN]

I have been thinking a lot about what it means to be a bedside nurse in the US health care system and how we can better advocate for our patients and ourselves (in terms of better nurse-patient ratios, training, compensation, nurse retention, education etc). Large-scale unionization seems to be one way of achieving these things (see California).

So here are my questions:

Would you be willing to join a nursing union in your state? Why or why not?

Secondly, do you think that more optimal working conditions would prevent such a seemingly high number of new graduate (and experienced) nurses from leaving bedside/community nursing to become NPs?

This is just me being curious so thanks for any responses!

I have joined nursing unions in three states. In every instance, the union has achieved a contract for registered nurses that improved nurse/patient ratios, eliminated floating outside your care area without consent and special training, limited or eliminated mandated overtime, improved compensation for overtime (double time after 12 hours, plus time and a half for your NEXT scheduled shift), lessened the weekend obligation, provided additional education hours, outlined a grievance procedure and a disciplinary process that allowed the employee to bring a union officer to scheduled disciplinary meetings. They also improved employee health insurance, family leave and brought other benefits as well.

Experienced nurses who leave the bedside have usually carefully considered their options and are leaving because they understand how the NP role is different from the bedside nurse role and believe they would enjoy the different challenges. New nurses who leave (or refuse to work at) the bedside have different motivation. Many of them have not even completed a year at the bedside and thus have not adjusted to the change in role from being a student to being a nurse. This will be unpopular, but I think contracts mandating a year or more at the bedside AFTER orientation would help keep nurses at the bedside. After a year, a nurse becomes more competent at the bedside, grows into her role and often begins to enjoy her job.

[Simonesays, BSN, RN]

Thanks for your reply, Ruby! I always love your insights :) I can't say I fully appreciated being a part of a union when I was in one. But now that I'm not, I am more acutely aware of their advantages in our industry.

I'm definitely lucky to work where I do. And when I listen to coworkers discuss their previous work environments, I feel even luckier to be where I am. Part of the reason that my current work environment is so great is that there is a push/financial incentive for furthering one's education. However, this also means that a lot of smart, driven, and compassionate nurses leave the bedside environment to become NPs. And, yes, this is a good thing overall. We want these types to be our NPs. But I sometimes wonder what the health care system will be like in the future if we aren't able to make non-advanced practice nursing more of an appealing long-term option. Especially considering the increased complexity of many of our patients.