Despite such advantages, most nursing managers and academics—and even many working nurses question the appropriateness of collective bargaining in health care settings. The harshest of these critics play on nurses’ class and status anxieties and socialization in selflessness, according to Darlene and Paul Clark, Penn State University professors who’ve studied this phenomenon. Darlene teaches in the nursing school, where she tries to introduce her students to the subject of organized labor. RNs- in-training often equate unionism with being blue-collar and not really professional. “They go to nursing school to become professionals,” Clark points out. “They are taught in most schools and in most organizations that they don’t want to be seen as blue-collar, so if unions are blue-collar, then why would we want to do that?” In addition there is the concern that if you’re in a union you might have to strike, an action that many nurses view as tantamount to abandoning their patients.
According to Clark, this feeds another worry, that labor-management conflict might erode public support for nursing. As the polls show, nurses are highly trusted, far more than lawyers, businessmen, and people in most other occupations. Many in nursing believe, however, that their profession’s favorable rating is so rooted in an image of selflessness that any behavior contrary to that image would cost nurses dearly in terms of public esteem. Opponents of unionization play on such fears. They invariably depict nursing unions as strike-happy, as if some RNs were eager to spend their days shivering in the cold as they walk in front of hospitals with picket signs and no paychecks. In fact, such scenes are relatively rare and RN bargaining units have to be pushed to the brink before they walk out—in the United States at least. When they do go on strike, it’s often because working conditions or management demands—related to overtime, scheduling, or staffing—are jeopardizing patient care. As Clark notes, when the issues involved are framed and explained in terms of their impact on patients, nurses’ strikes often receive an impressive degree of public support.