Registered Nurses Union essay

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Many factors affect the outcome of the nurses’ work in regards to the patients’ health. Unionization of the registered workers union has brought many changes to the health sector. There are claims that the hospitals that have nurses’ unions are having positive results of acute myocardial infarction as compared with hospitals that do not have any union. However, these facts are not well established and the study, done in California, seeks to establish, whether these facts work, and how the unions affect the outcome of the work, done by nurses. The hospitals with unions may be having some unique operation tactics that other hospitals lack, and this may be attributed to the changes, caused by the unions. Though some people and labor unions claim that the nurses in the unions compromise the safety of their patients, the registered nurses claim, otherwise, and have in the recent years done a lot to change this perception. 

Analysis, carried out on how the mortality rates of the patients, suffering from heart problems, has not shown a connection between the unionization of registered nurses and the outcomes from the cases. The samples from California hospitals, however, show that the mortality rates are lower in unionized hospitals. The advantages that nurses get from unionized hospitals may be the reason for the positive results, though there are some cases, where the results are the same for all hospitals. The nurses union provides an umbrella that protects the interests of the nurses and advocates for better treatment of their members. The union provides a forum, where nurses can speak in one voice and make a collective bargain on issues, affecting them. The patients also benefit from the collective bargaining because the good working conditions of the nurses guarantee them to be with quality care (McClellan, McNeil & Newhouse, 1994).

Research studies reviewed

There are many studies, carried out by different unions, to determine how the unions affect the outcome of the health of the patients. The study on work organization and productivity of nurses, who are in unions, is the first one. It identifies how the different organizational structures affect the productivity of the nurses. The study established that the higher the number of patients a hospital receives the lower the mortality rates. This is because high numbers of patients means more job and experience, which increases the expertise of the nurses.  The technology, used in the hospitals, do not directly affects the outcome of the heart attack case, but the care, bestowed in the first 14 hours, does a lot to correct the problem. The other factor, determining the outcome of the case, is the control and autonomy the nurses have over a situation.  The unions have a direct effect on the organization of the hospital, and the first one concern the bargaining union that nurses get from being a part of a union. The union determines, how the workers will work, because they control, how the management organizes the schedule of the nurses.  The other effect of unions on the organization is the productivity of the workers in terms of the pricing strategies applied (McClellan, McNeil & Newhouse, 1994).

The other study carried out is the effects of wages and the seniority of a nurse in the hospital. The registered nurses union has a higher wage rate, when compared with other lower unions. The nurses in this union have a higher salary and this makes the quality of their work higher, as compared with other unions. This is because high wages prompts the employers to look for nurse with high qualification and with good nursing practices, which in turn lead to a high quality service delivery. The seniority of nurses in unions arises from the union systems that raise the salary of their members and create good working conditions for the nurses. The registered nurses unions have a long tenure, when it comes to nurse’s turnover, as compared with hospitals with no unions. This is because the registered nurses unions provide a guarantee of high wages and seniority, which keeps the nurses in a hospital for long periods.

The study on communication effect on the mortality rates showed that the formal communication in unionized hospitals increased the delivery of vital information from the nurses to the management, which, in a way, helps to reduce the number of mortalities in a hospital. The informal communication between members of a union and the hospital management can also protect employees from unfair dismissals, when the nurses complain about how things are done in the hospital. This way, the nurses can tell the management what needs to be done to improve the services, given to their patients (Seago & Ash, 2002).

The staffing levels in unionized hospitals are high as compared to hospitals with no nurses unions. This is because unions negotiate for more nurses to work in the facility in an effort to increase the level of care to patients. However, if the unions negotiate or demand high wages, the hospitals may quit hiring nurses or slow down the rates of hiring them.

The study of the confounding factors that may play a role in determining the rates of heart attacks and services, offered by the unions. The environmental factors, different hospital characteristics, and the patient’s characteristics determine the outcome of the care, bestowed on the patient with a heart attack. To make sure, the study produces the desired outcomes on the relationship of the nurses unions and the outcome on patients with heart attack, the other variables will have to be under control. The variables in this case include the patient’s characteristic, which is dependent on the patients’ age, sex and race. The severity of his or her condition also determines the outcome of the care given. The patients, going to urban hospitals, which are unionized in most cases, tend to have the average characteristics of a patient, and their outcome differs considerably from those treated in rural settings. The hospitals, operating under profit terms, will have a less positive outcome from the heart attack cases, as compared with the nonprofit hospitals because they provide quality care through registered nurses (Nurses and nursing in Queensland, 2009).


The presence of unions in the hospital sector has had many effects on the quality of care given to patients with heart attack. Nurse, working under unions, tends to have advantages over the other nurses working solo. The research, done on the relationship between the unionization of nurses and the outcomes on the acute myocardial infarction, needs to consider different variables that affect the relationship of these two things, in one way or another. The sample hospitals and patients, picked for this research, come from the acute care hospitals in the different parts of California. The mortality rates in hospitals with unions differ in slight percentages in the mortality of patients with heart attacks. This is because the nurses in unions have a good working environment and are ensured of their job security, which gives them the confidence to make any decision that will help to save the life of the patient. The study, which took three years, has a limited number of variable outcomes, and has to consider hospitals with large cases of heart attack for the results to be consistent. The technology, used in hospitals with unions, showed that the presence of unions in hospitals leads to a reduced percentage of mortality in all AMI cases.

The registered nurses unions have more discharges of patients, suffering from heart attacks, when compared with non-unionized hospitals. The unionized hospitals also have complex technology services for heart attack cases. This technology may improve the quality of treatment that patients receive one way or another, but it does not guarantee their recovery, because the care, given to patients during the first few hours of the attacks, determines his or her survival rate. The results from the study on the effects of technology and the presence of a nurse union in a hospital shows a higher percentage of recovery, though the credit is not attributed to the technology but to the actions of the nurses in giving the patients high quality care with the help of technology (Seago, & Ash, 2002).


The results from the study do not give out a clear picture of, whether the variables and the presence of nurses affect the outcome on the patient’s health and safety. The different factors, affecting the unions in hospitals, may affect the outcome of the patients’ mortality. The establishments of unions in high quality hospitals may be much easier, as compared with low quality hospitals. The selection of hospitals with registered nurses unions has to be random for it to be a controlled variable in the study. The hospitals with high quality capacities may have a higher advantage due to their abilities to pay the high wages, demanded by unions. This means that the registered nurses unions will go for the high quality hospitals that are able to provide their high wages, and this affects the outcome of the patient care. The concept of the outcome of the union may depend on the quality of the hospital because unions, working in low quality hospitals, may strive for making their conditions better, and end up improving the conditions of the patients. The other nurses in the high quality hospitals may not get the credit for the positive outcomes because the hospitals directly cause theses positive outcomes (Register, 1988).

The results maintain that the positive outcomes in unionized hospitals come from the advantages that the registered nurses have in the hospitals. These nurses do not suffer from discontent that guarantees the positive outcome of the patient. Although there are no data, on how the activity of the unions in hospitals relates directly to the positive outcomes, one may say that the results of the research is biased, but consideration needs to be taken on the analysis of causality cases, and the working mechanisms, used in hospitals. The environmental factors in hospitals, affecting the work of the nurses, play a role in determining the outcomes of patient care. Good salaries and working environment produce a higher positive outcome than the environment with poor working conditions and low salaries. The presence of a R.N union may be one of the factors that help to create stability among nurses and give nurses autonomy over their choice of care. The union also helps to create an environment, where the management and the nurses collaborate, as they work towards providing patients with the best services, in terms of care and treatment. The hospitals that operate between the private and public lines may not have the same results as those hospitals, operating in a well-defined environment. These hospitals may have to choose on the mode of operating if they want to have a positive outcome. The practices in hospitals with nurses’ unions may be one of the reasons, causing the positive outcome. These hospitals utilize life saving practices and they include unions in making this practice a success. 

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