Study: Unionization and Staffing Regs Could Improve Nurse Retention

Employment data makes it abundantly clear that nurses are leaving their jobs in ever increasing numbers. Just look at any healthcare jobs board and you will find a seemingly endless list of registered nurse jobs. It is a problem we have been talking about for many years, a problem that has only been amplified by the COVID pandemic. So, what’s the solution?

The results of a recently released study suggest two things: unionization and staffing regulations at the state level. The proposed changes answer the biggest problems driving nurses away from their chosen field. Those two things are moral distress and safety.

Nurses Are Overworked

A big part of the study, conducted by researchers at the Illinois Economic Policy Institute and the University of Illinois at Urbana-Champaign, was an understanding that nurses are overworked. That much really isn’t a matter of debate. Being overworked leaves nurses feeling like they cannot provide the kind of care they are otherwise capable of. This leads to moral distress and, in some cases, unsafe conditions for both patients and nurses.

Researchers measured several metrics, including how and when nurses cared for six or more patients simultaneously. Six seems to be the threshold in terms of whether a nurse can provide safe and quality care. Ideally, registered nurse jobs would be designed to allow for the highest quality care by not giving nurses too many patients at once. But when nurses are in short supply, those on the front lines need to care for more patients.

The Staffing Regulation Proposal

Among the study’s proposals is one that suggests staffing regulations. Researchers pointed to a number of states that enacted such regulations in the wake of the pandemic. In each state where regulations limited the number of patients a nurse could care for, moral distress fell. So did the likelihood that nurses would leave their positions within the next year.

In simple terms, it would appear as though registered nurses do not want to leave their jobs. They love what they do. They have a sincere desire to take care of sick people. The problem is they feel as though they cannot give patients the kind of care they want to. Why?

Interestingly, 93% of the nurses surveyed for the study reported an inability to take the ethically right course of action on behalf of patients because of “organizational and institutional constraints.” In other words, their employers have rules and policies in place that prevent nurses from doing what they believe is ethically right. That is both amazing and unacceptable.

Unionizing Could Make a Difference

Researchers concluded that many of the issues related to moral distress could be solved through unionization. By unionizing registered nurse jobs, the industry would give nurses a real voice in how healthcare facilities are run. It would give them a voice in determining how patients are cared for.

Of course, addressing moral distress through unionization would require a union and leadership whose sole purpose for existing is not getting nurses more money. According to the research, it is not about the money anyway. Nurses certainly won’t balk at being paid more, but it’s clear they are already willing to walk away due to moral distress and safety issues. Money alone is not going to solve that problem.

No doubt that registered nurse jobs across the country are waiting to be filled. Meanwhile, untold numbers of nurses are considering leaving the profession. If staffing regulations and unionization can reverse that trend, both are worth looking into. Eventually, something will have to be done to answer legitimate nurse concerns.


Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

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