Taking a Seat at the Table: Why Nurse Unions are Necessary Today

By Karie Pinnix

Nurses have been front and center of every medical crisis, and after the COVID-19 pandemic, nurses were recognized as frontline heroes. However, more nurses are stepping up and admitting that although they were able to save lives, the pandemic exacerbated unequal workplace conditions, which made their job harder, longer, and more stressful.

As a result, a safe space nurses joined to advocate for their needs was nurse unions.

Nurse unions have existed since the 20th century, but it wasn’t until 2005 that union membership among nurses started to increase, according to a 2010 article in the Journal of Clinical Nursing

Since then, more nurses have become advocates to eliminate workplace violence, uneven nurse-to-patient ratios, and unfair hiring practices within the health care system. This is certainly true with the recent strikes in New York, California, Minnesota, and the U.K.

Strikes for Safe Staffing and Fair Contracts

Although hospital executives and management have set standards such as how many nurses can be hired and what benefits they get, nurse associations like National Nurses United (NNU) have fought to protect nurses’ safety when these contracts don’t reflect nurses’ needs in the workplace.

One issue that has been a significant cause of nursing strikes across the United States is safe staffing.

Many hospitals are faced with uneven nurse-to-patient ratios, which diminishes the quality of care among patients. This leaves nurses to make up for the lack of staff in hospital units through increased hours and fewer mandated breaks–and in turn, that can lead to more medical errors.

California is the only state to have mandated minimum nurse-to-patient staffing ratios in all hospitals. Therefore, many would think that having a law to prevent understaffing already existed. Still, according to the president of National Nurses United, Zenei Triunfo-Cortez, RN, this was not the case.

are looking to change that. In other affiliate states with NNU, nurses who are part of the organization also hold rallies to build awareness of the need for safe staffing and legislative laws protecting nurses’ right to organize.

“We will not stop until working conditions are a lot better for all of our nurses, no matter which state you are in, and it doesn’t matter which area of practice you are in. We’ll make sure that our nurses are well provided for in all areas,” says Triunfo-Cortez.

Ethnic Minorities and Nurse Unions

Nurses from minority backgrounds make up almost 20% of registered nurses, according to the American Association of Colleges of Nursing. Sadly, their representation among the nursing community compared to the population of BIPOC Americans remains small.

“They went to college together, got their nursing degrees, and all wanted to serve their communities. They stuck it through the pandemic,” says Barcott. “Then, when things didn’t get better after the pandemic slowed, they realized that the hospital wouldn’t address the staffing issues. They were continuing to go on as if the pandemic was still here.”

Zenei Triunfo-Cortez, RN, is the president of National Nurses United

“Since beginning my nursing career, we have always fought for safe nurse-to-patient ratios. It was a lot of work, persuasion, and real-life stories about what happens to us every day in our work life that helped us show legislators that we need this because this is what’s happening in our lives day in, day out.” However, there is no nationwide federal law for safe staffing. Triunfo-Cortez and other union nurses at NNU

Many nurses of color feel discouraged in their workplace if their fellow nurses don’t look like them, so it’s no surprise that they can leave their jobs faster if they don’t receive support when they’re overworked.

Julia Barcott, the chair of economic and general welfare at the Washington State Nursing Association (WSNA), has seen this happen in her workplace. Barcott is an ICU nurse at the Astria Toppenish Hospital in Toppinish, Washington, an area with a large population of Hispanic, Filipino, and Indigenous tribes. She adds how she mentored four Hispanic and Indigenous bilingual nurses who experienced understaffing during the COVID-19 pandemic.

Barcott explained that these nurses eventually left their jobs, despite receiving signon bonuses.

“You want to have racial equity and have people that look like yourself if you’re a patient that understands your customs and beliefs,” says Barcott. “These four young women were like that. They were a huge asset.”

Chronic workplace conditions such as these are some of the reasons why nurses of color join unions. However, systemic racism has also factored into why BIPOC nurses can be disillusioned with the profession.

Dealing with discrimination as a nurse in the early 90s is why Triunfo-Cortez, a Filipina, decided to become involved with unionizing.

“I was applying for a transfer and was bypassed because the manager told me she could not hire more Filipinos. And so, at that moment, I thought, why should you look at the person’s ethnicity? You have to be looking at the qualifications, right?” says TriunfoCortez. “And so I became involved thinking that nurses need to speak up because this is modern history, and there’s still apparent discrimination happening.”

When nurses of color get involved with unionizing, they provide unique views on chronic health care challenges that others may not have. BIPOC nurses can also gain more accurate representation in a health care system where white-dominated opinions can be at the center.

Nursing Shortages

Don’t Exist

While nursing unions can help bring awareness to unfair nurse-to-patient ratios and workplace violence, they also bring light to long-held beliefs about the health care system–like nursing shortages don’t exist.

“What we have is not a staffing shortage, but a shortage of nurses who do not want to work under unsafe working conditions because we do not want to be blamed for bad outcomes of our nursing care,” says Triunfo-Cortez.

Barcott mentions that some people with nurse licenses aren’t practicing as a nurse at all because of understaffing.

“There’s like 150,000 nurses in Washington. Less than half of those are working right now, but many of them are the ones that have active licenses. They are not willing to work in the conditions that are occurring now,” Barcott says. “They would rather not work as a nurse or take time off because they’re burned out, or they go do something different.”

Hospital executives and management often think of profits and business expenses more than the harmful conditions nurses experience daily. Some employers believe that to solve this retention problem. Then they need to direct more funds toward hiring new nurses.

For example, Barcott explains that it costs around $100,000 to orient a new nurse over six months. However, when hospital management and financial officers don’t address chronic workplace issues, these nurses leave faster, causing this cycle to repeat.

Nursing unions see this issue, which is why many lobby for legislation for fair staffing and safe workplace practices.

In Washington, the WSNA pushes for state laws to be passed supporting safe staffing standards, enforced rest breaks, and functional staff committees. Like the WSNA and the NNU, the New York State Nurses Association (NYSNA) educates union nurses on worker rights. It helps them bargain for health benefits, higher wages, and paid holidays.

Using Unions to Make a Difference

When nurses of all demographics sit at the table to discuss fair workplace conditions, everyone, including patients, benefits from a better quality of care.

“It’s uplifting to know that most of our nurses are real and true patient advocates, not just by word, but in action as well,” says Triunfo-Cortez. “When you think alike and know that your goal and your mission are the same, then you will do everything in your power to achieve those goals because we know that if we all work together towards a common goal, it would be for the betterment of everyone.”

After the pandemic, more people now see that nurse unions exist and are here to stay. People not working in health care are picking up protest signs, while hospital management sees that there’s strength in numbers.

“I think that’s why membership is starting to go up in a lot of areas where essential workers were put in that position because that was the only that’s the only way we can collectively band together and express the needs of our patients. And it was only a matter of time,” says Barcott.