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Engaging is an important way for nurses to achieve policy changes that will positively impact the workplace culture of safety and patient safety. Although only 10.7 percent of American employees were members of labor unions in 2016, 18 percent of registered nurses belonged to labor unions, and this likely reflects the ability of the unions to provide job security, better working conditions, and guaranteed wages (Gerardo, 2017). The fact that nurses are members of labor unions in numbers that are almost double those of the regular workforce in the United States implies that nurses’ unions have something important to offer.

One of the most important things that nurse unions have to offer is the promise of better working conditions for nurses. Nurse unions lobby and advocate for safety rules that impact nurse-to-patient ratios, the number of hours that a nurse can be required to work, and better protocols and rules that impact safety. These types of safety issues impact nurses and patientst. For example a recent study of nurse staffing and nurse-to-patient ratios that involved nine different European countries found that increasing a nurses’ load of patients by just one patient was associated with an increased probability of the patient dying within 30 days of admission to the hospital by seven percent (Aiken et al., 2014). This means that issues such as cutting nurse staffing in the interest of saving money hurts not only the nurses, who must work harder and provide less care to patients, but it also hurts patients.

 Nurse unions have the power of numbers. Nurses can and should join nurses’ unions in order to receive benefits of not only better pay and wages, but to also receive better working conditions. These working conditions affect not only the health and wellbeing of the nurses themselves, but they also affect the health of patients that the nurses are caring for. Therefore, it is the right thing to do for nurses to join labor unions. There are two Masters Essentials that this issue can relate to: Quality Improvement and Safety, and Health Policy and Advocacy. This 

is because labor unions can impact the culture of safety in the workplace. As well, by advocating for better working conditions for nurses, one is also advocating for better patient outcomes.


 Aiken, L. H., Sloane, D. M., Bruyneel, L., Van den Heede, K., Griffiths, P., Busse, R., … RN4CAST consortium,  for the R. (2014). Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study. Lancet (London, England), 383(9931), 1824–30.

Gerardo, P. (2017). Should I join a nurses union? Pros and cons. Retrieved from

2)  Sandra

 Nurses Unions

Unions are essential tools in ensuring safe working environments. Unions ensure a collective bargaining power for the workers hence ensuring nurses get their dues in time and reasonable wages are paid. Nurses work hard to ensure safe and quality healthcare. However, the management cannot be trusted in creating an enabling environment for nurses who work tirelessly in our health care facilities. With unions, nurses use their numbers to demand for a pay rise or allowances which might be difficult without the union (Silver, 2013).  Although there are claims that the unions represent unprofessionalism in healthcare, it is not possible to leave a facility just because your demands are not met like in most cases. Therefore unionized nurses need to be allowed and nurses must be willing to join the unions so that their voice can be heard by the management.

An organizational culture that supports safety is paramount in ensuring safety at workplace. Safety culture is therefore the way an organization does things and how they collectively value safety at workplace. Unions affect the way in which nurses interact with the management. Most unions are focused on ensuring that employees or the union members receive fair wages and safe working environment. A unionized nurse therefore promotes a workforce culture of safety by ensuring that the management offers good working conditions for the nurses. The most appropriate MSN Essential is Essential III: Quality Improvement and Safety. The essential requires that the nurse performance be related to quality by ensuring safety of the patients. Also, the nurses need a safe working environment so that they can be able to execute their duties.


Silver, J. (2013). Just a union– of nurses. Winter Park, FL: Legacy Book Publishing.