The long-term care staffing crisis is showing no signs of abating. And with America’s ever-growing aging population requiring increasing levels of assistance, long-term care facilities are struggling to keep up with the demand for services.
The proposed federal minimum staffing rule—which received opposition from long-term care providers—is currently on hold. Regardless, the greater issue is that too few nurses are caring for seniors in our long-term care facilities.
The staffing crisis and the role of unions: According to a survey, 30% of the 14,000 nursing homes surveyed reported staffing shortages in March 2022. Furthermore, another survey by the American Health Care Association (AHCA) noted that more than 8 in 10 nursing homes are facing staffing shortages. So what role do unions play in this? For that, we will have to look to New Zealand.
In New Zealand, unions play a crucial role in bringing attention and action to nurse staffing issues. They collaborate with, lead, pressure, and influence healthcare organizations and the government to provide optimal staffing that maximizes patient outcomes, requires reasonable work effort from staff, ensures necessary resources, and promotes efficiency and productivity.
A journal on the topic notes that such unions are legally empowered to collaborate, lobby, protect, and apply pressure on behalf of their members, making them effective advocates for nurses. One such union is the New Zealand Nurses Organisation (NZNO), which plays a vital role in advocating for nurses’ interests and working towards a more sustainable and efficient healthcare system.
What does a successful nursing union look like? The following is part of the protocol of New Zealand’s nursing unions, ideas from which America’s nursing unions could benefit:
- Clarity in staffing goals: Unions should be unambiguous about their staffing objectives and ensure they align with the interests of both nurses and patients/residents.
- Evidence-based proposals: Supporting proposals with data and research is crucial in making a compelling case for improved staffing ratios and improved salaries.
- Valid mechanisms for determining staffing: Unions should be confident that the systems used to determine staffing ratios are accurate and effective.
- Wise use of industrial influence: Leveraging union power wisely is important to advocate for better staffing ratios and better pay without causing unnecessary disruption to the care of nursing home residents.
- Strong membership support: Unions need a high level of commitment from their members to ensure the staffing agenda is effectively pursued.
- Effective stakeholder relationships: Developing and maintaining healthy relationships with other parties and stakeholders in the healthcare system is key. A nurse union must do so to foster collaboration and progress.
Are unions actually effective? Research demonstrates that unions do have a big impact, as nurses who are part of a union enjoy a significant 13 percent wage boost compared to their non-unionized counterparts. This wage increase not only acknowledges the value of nurses in the healthcare system but also helps to attract and retain skilled professionals in the field.
Interestingly, the benefits of a strong union presence extend beyond its own members. In cities with a robust union presence—such as San Francisco, San Jose, and Sacramento—even non-unionized nurses receive higher wages. Moreover, the influence of unions goes beyond just wages, as nurse-to-patient ratios are found to be 18 percent higher in cities with the highest levels of nurse unionization compared to those with the lowest. Clearly, strong nurse unions play a vital role in promoting the well-being of both nurses and patients alike.
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