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Pros and Cons of Nursing Unions

Pros and Cons of Nursing Unions

The debate on union vs. non-union has gone on for years, amongst nurses. Unions were initially formed in the U.S. for workers to unite and demand improved working conditions, pay, and other factors. So should nurses join unions? We break down the pros and cons.

pros and cons of nursing unions

Pros of nurses joining unions  

Wages and pay increases

Union hospitals typically have higher pay scales for nurses. According to Nurse.org, union employees’ median weekly earnings are roughly 20% higher than the pay of non-union members. Sources, such as Soliant Health, claim unionized nurses can earn an average of $200-$400 more per week than non-unionized nurses.

Better benefits

In addition to wages, labor unions help to negotiate the benefits package for their nurses. A unionized facility allows for better medical coverage, more vacation time, sick pay, education reimbursements, pensions, etc. These benefits are potentially available at a better value than nonionized facilities.

Better working conditions

A nursing union represents its members’ interests. Nursing unions are advocates:

  • For higher nurse-to-patient ratios
  • For safer workplaces and safety protocols for nurses
  • Against mandatory overtime and schedule changes

Many unions work to improve the laws that regulate healthcare facilities.

Addressing grievances

Unions have specific processes for addressing a grievance with your employer. These processes ensure your grievances or complaints are addressed without worrying about retribution or retaliation for your employer or supervisor. Interestingly, the union includes its nurses in the process by actively working with all parties involved to facilitate the best resolution. 

Job security 

Most unions negotiate a contract that prohibits their members from being fired without a cause. This ensures that you can’t be fired on without reason, like at-will employees. Some unions negotiate so that your wages and benefits can not be cut at your manager’s discretion. 

pros and cons of nursing unions

Cons of nurses joining unions

Mandated strikes

Strikes are sometimes necessary to gain better working conditions. If your union goes on strike and most members vote for it, you’re required to join the strike. When a strike is happening, you won’t receive pay because you’re not working. If you disagree with the strike and decide to keep working (cross the picket line), your membership can be disrupted or canceled.

Seniority over performance

How many times has a senior nurse received a promotion or position over you, and you know you were the better fit? Well, with union seniority overrides performance. Unions don’t have a measurable standard of talent or skill to determine rewards. You may be the best nurse, have awards and accolades, but advancement is granted to those with seniority when it’s time for a promotion. The same is true for wages. Earnings are determined by the amount of time you’ve remained employed. 


Dues need to be paid. There may be an initiation fee, and then dues are usually based on a percentage of what you earn. It’s important to know that currently, there are 25 states with “right-to-work” laws that guarantee that no person can be compelled, as a condition of employment, to join a labor union. In these right-to-work states, nurses aren’t required to pay dues to receive union benefits. 

Less control over your work schedule

While it’s beneficial not to have your schedule altered, there’s also a con. If you want to change your shift or reduce your hours, your employer must first go through the union to approve the alteration. If you want to change positions, your job might have to post a job opening for your position before going to the new position you want.

Whether you decide to join a union or not, consider all of the pros and cons. Make the best decision for yourself and your nursing career.   See this list of nursing unions by state and learn more.

Do you think the pros outweigh the cons,  and joining a union is worth it? Why or why not? Leave a comment and let us know your thoughts!

Portia Wofford

Portia Wofford


Portia Wofford is an award-winning nurse, writer, and advisor for nurse writers. After dedicating her nursing career to creating content and solutions for employers that affected patient outcomes, these days Portia strives to empower nurses to use their voices to start freelance writing businesses--while empowering health-related businesses to grow their communities through engaging content that connects and converts. Follow her on Instagram and Twitter for her latest.


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