EFFECT OF UNIONS

Effect of Unions on Nursing in Hospitals

Effect of Unions on Nursing in Hospitals

Introduction

Unions that represent health professionals have become increasingly important in the employment and political landscape of the USA. Nearly 21% of registered nurses (RNs) in the USA were unionized in 2003. In recent years, nursing unions have claimed credit for wage increases across the USA, hospital worker safety improvements, implementation of minimum nurse-to-patient ratios in California, and the introduction of federal minimum staffing legislation in Congress. Hundreds of research studies have established that unionized workers in any sector earn more than their non-union counterparts, and this finding has been corroborated in studies of nursing employment

In addition to raising wages, unions may also affect the structure of wages paid to workers. Researchers argue that unions compress the wage structure as an expression of solidarity and worker preferences. In this paper, we examine the impact of unionization on the wage structure of hospital-employed RNs in the USA. We focus on two factors: wage differentials associated with age, gender, education and experience; and unexplained variation in wages, measured as residual wages. We find little evidence that unions have an effect on the wage structure of RNs.

Discussion

In the past decade, there has been resurgence in union activity in the health care industry in the USA, particularly in hospitals. Of 2·4 million RNs employed in the USA in 2003, unions represented about 472,000, or nearly 21%. This rate is over five percentage points higher than for all workers in the USA. Membership of hospital-employed RNs in unions in the USA was stable at about 18% from 1983 through the mid-1990s, and grew rapidly since that time. The apparent volatility in the rate of unionization reflects sampling variation; the error bands are wide enough to make the spiky series consistent with the smoothed results, which are available from the authors on request. During the first six months of 2000, health care unions, including unions for nurses, service workers and other healthcare employees, won organizing elections at a rate of 61·7%, compared with a 33·9% rate for manufacturing.

Figure 1. Per cent of hospital-employed registered nurses who are union members.

Unions represent the collective interests of employees in negotiating the terms and conditions of employment with employers and thereby affect many aspects of the employment relationship. Unions typically seek better working conditions for their members, including higher wages, more employment security and improved terms of hiring, promotion and layoff. They bargain with employers over the distribution of profits (or net revenues in the case of non-profit or public entities). Many studies of workers in all industries have found that unions are associated with higher wages and fringe benefits. Research on nursing employment also has found that unionization is associated with higher wages. Some studies find that unions affect wages received by non-union workers (Staiger, 2010).

Because unions bargain for wage contracts that affect all nurses in their bargaining unit, they also may address differences in earnings that arise from differences in seniority, education or other ...