Comparing Nursing Infrastructure and Outcomes

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Employers and employees usually have different interests and ideology towards work. As a result, it is imminent for these two parties to agree upon specific terms and conditions that regulate their work relationship to ensure that work is conducted in an effective and efficient manner. Collective bargaining is an approach that has been used for over a century now to protect the rights of both these parties. Huston (2013) defined collective bargaining as a negotiation approach by employers on one end and a group/groups of employees on the other end that aims at arriving at an agreement that regulate the working conditions within a specific entity, industry, or the entire labor force of a given nation. In the course of these negotiations, employees are usually represented by trade unions to which they are members of. In most cases, the agreements that are arrived at through collective bargaining mainly focus on wages, working conditions, health and safety issues, employee benefits and so on.

Beatrice Webb coined the term collective bargaining in 1891 (Schumacher, 2011). It is during this era that trade unions had been developed and aimed at fighting for the rights of employees at the workplace in Britain during the industrial revolution era. During this era, employees used to work for long hours in poor working conditions earning minimal wages and enjoying little or no benefits. Through trade unions however, their grievances were heard and employers responded to their demands. In the United States, collective bargaining is stipulated under the Wagner Act of 1935 that gives employees who work in the private sector the rights to organize and join trade unions as a means of collective bargaining (Cutcher, 2011). Depending on the nature of demands and the industry in which employees work in, the following types of collective bargaining are present:

  1. Distributive Bargaining
  2. Integrative Bargaining
  3. Productive Bargaining
  4. Composite Bargaining

As asserted earlier, the Wagner Act of 1935 stipulates the legal framework of collective bargaining in the United States. Through this act, employees have the liberty to organize trade unions, engage in collective bargaining for specific demands, and so some extent organize strikes in events whereby their demands have not been met or have been ignored (Clark, 2011). The main aim of this Act is to protect the rights of employees who might be victims of inequality in bargaining power with their employers who in most cases are organized as corporations. To overcome this inequality, the Act supports the organization of trade unions by employees as a means of collective bargaining. This Act also clearly stipulates unfair labor practices by employers, employees and trade unions. This includes acts by employers to prevent employees from organizing or joining trade unions, to interfere with the running and operations of trade unions, to discriminate employees who have lodge complaints against them, or to refuse to engage in the collective bargaining process. This act is also responsible for the creation of the National Labor Relations Board (NLRB). This board plays a critical role in the collective bargaining process such as making it mandatory for employers to engage in collective bargaining with trade unions (Havens, 2012).

National Labor Relations Board (NLRB)

The NLRB is the institution that has been given the right be the constitution of the United States to enforce the Wagner Act of 1935 (Havens, 2012). Ideally, employers and employees through their trade unions can engage in collective bargaining by themselves. However, there are collective action problems that might develop in the course of negotiations that might affect the overall process of collective bargaining. To avoid this, the NLRB has been given the mandate to assist employers and trade unions in the process of collective bargaining and to some extent bear some of the litigation costs that are incurred in the course of this process. Additionally, the NLRB also prosecutes individuals and parties that have violated the stipulations of the Wagner Act of 1935. As asserted by Havens (2012), the NLRB is actively involved in the process of preventing as well as remedying acts that are inconsistent with the Wagner Act of 1935.

The NLRB also has the mandate to conduct elections for the formation or decertification of trade unions at the work place. At the same time, this board also investigates charges that have been filed by employers, employees, and trade unions to determine whether or not unfair trade practices have been practiced. In an event where a charge is determine, the NLRB usually encourages the parties involved in the dispute to resolve the issue through settlement due to the fact that the resolution through litigation is usually costly, time consuming, and might negatively affect the relationship between the parties. The NLRB also has an adjudicative mandate to decide cases and enforce orders that relate to collective bargaining issues.

Union Organization in the Nursing Industry

Nurses in the United States have the rights to organize or join trade unions as a means of enhancing their power of collective bargaining with their employers. American Nurses Association and the National Nurses United are examples of trade unions that fight for the rights of nurses in the United States. The main aim of these trade unions is to fight for high standards of nursing within the nation, ensure that nurses are compensated effectively for their services, promote a safe working environment, and advocate various issues that affecting the nursing community (Huston, 2013). As stated earlier, employees have the right to form or join a trade union. However, most managers try to avoid a situation that might lead to the unionization of its employees. While it might be of their best interest if their employees do not unionize, managers are prohibited by the law from preventing their employees from unionizing. Managers however have been provided by the law with avenues through which their can air their reasons for not being in favor of the unionization of their employees. For instance, they can engage in dialogue with their employees and strive to arrive to a consensus.

In the United States, trade unions have been influential in giving nurses the opportunity to air their grievances, negotiate for better wage rates and working conditions, protecting the interest of nurses through collective action, preventing disputes and enhancing the relationship between nurses and their employers, guaranteeing job security and so on. However, for the process of collective bargaining to be successful in a healthcare institution, nurse managers need to collaborate with trade unions. In this respect, they need to recognize these unions, provide a favorable political climate for their operations, employ fair managerial policies and practices, and develop a positive attitude towards the unionization of their employees (Buerhaus, 2013).


Buerhaus, P. (2013). Implications of an Aging Registered Nurse Workforce. Journal of the American Medical Association, 283(32), 2848–954.

Clark, P. (2011). Healthcare Reform and the Workplace Experience of Nurses. Industrial and Labor Relations Review, 55(1), 133-48.

Cutcher, G. (2011). Collective Bargaining in Small Firms. Industrial & Labor Relations Review, 49(2), 195-212.

Havens, D. (2012). Comparing Nursing Infrastructure and Outcomes: ANCC Magnet and Non-Magnet CNE’s Report. Nursing Economics, 19(6), 258-66.

Huston, C. (2013). Professional Issues in Nursing: Challenges and Opportunities. New York: Lippincott Williams & Wilkins.

Schumacher, E. (2011). The Earnings and Employment of Nurses in an Era of Cost Containment. Industrial and Labor Relations Review, 55(1), 116-32.

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