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Unionization and Magnet Accreditation in Healthcare


I myself have never partaken in the union organizing process. Yet, literature research has made me quite knowledgeable on the subject and recent trends and dynamics. It seems that there is a clear rationale behind unions. Through starting, joining, or choosing to be represented by one, workers and employees execute their right to improve their working conditions and eventually, their lives. No wonder why the trend has recently spread far beyond the Anglo-Saxon countries where collective bargaining and corporatist policy-making take origin. Another prominent characteristic of union organizing is the collaboration with global and national social justice movements in an attempt to leverage power and fight for the right causes. This essay investigates the process of union organizing in healthcare and provides a description of the steps needed to be undertaken. Besides, it elaborates on the particularities of Magnet accreditation and what it means for healthcare facilities that decided to pursue that goal.

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Unionization in Healthcare

A common definition for the unionization process is the process of organizing the employees of a particular entity into a labor union. The latter later acts as a mediator between the said employees and the managing board of the company. Negotiating humane work conditions is extremely important in the medical field. Health workers are assigned an ever-expanding set of roles; they carry a burden of heightened responsibility every day and are prone to burnout depression. In spite of an observed union membership decreased in the United States, the field of healthcare has been expressing more interest than ever. For instance, the US national average for union membership is 13.1%, and yet, every fifth nurse (20.4%) has joined a union or partaken in collective bargaining (Dube, Kaplan, & Thompson, 2016). Statistically, nurses in unionized facilities are receiving higher salaries and reporting increased job satisfaction. Moreover, unionized hospitals have seen an improvement in patient outcomes, which may be attributed to nurses’ higher engagement and commitment to their roles.

The question arises as to how employees go about forming a union. Today, the unionization process typically spans over the following few simple steps:


The process of unionization starts off with sharing the idea with colleagues and coworkers. It is better to pinpoint a few clear problems that a particular company is plagued with. For instance, when it comes to healthcare, these are often inadequate working hours and an insurmountable amount of workload. Someone needs to become a pioneer and start a change by persuading others that a creating committee would be an efficient measure in tackling the issues in question.


The next step would be researching one’s rights to organizing in a particular state or country. In the United States, employees have the liberty to organize, wear, and distribute campaign materials. However, it is better not to discuss the subject matter during work hours.


Once a committee is formed, it is important to form a comprehensive list of demands. Employees are advised to abstain from making top-down decisions and vote on each issue so that no one is dismissed. Being elected as the leader of a union typically takes winning at least 50% of voices. Once the policies have been clarified and employees are given proper titles, one can file an application to the National Labor Relations Board. The Board will conduct an investigation to figure out whether a newly formed union is legitimate and has clear goals.


If a union is approved by the NLRB, the next step is to start negotiations with the managing board. This is where the real work starts, and union members should be aware of the fact that the process can be time-intensive. Negotiation requires a clear agenda and the ability to stand for what one believes in (Holgate, Simms, & Tapia, 2018).

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Magnet Accreditation

The American Nurses Credentialing Center (ANNC) launched the Magnet Recognition Program in 1993, and since then, it has become an industry-standard credential. In a nutshell, the program allows nurses to recognize and foster excellence in other nurses. As of 2019, the key eligibility requirements for Magnet accreditation are:

  • Having one staff member serving as CNO with a Master’s degree and Baccalaureate in nursing;
  • Three-fourths of nurse managers having a BSc in nursing;
  • Compliance with all federal laws related to registered nurses.

According to dit Dariel and Regnaux (2015), only 8% of US hospitals meet the eligibility requirements for Magnet accreditation. At the same time, the program not only positively influences patient outcomes but also increases nurses’ job satisfaction. In the case of my current facility, the program could be implemented through the promotion of continuing education among nurses. This could imply measures spanning from offering higher salaries to those in the possession of a required degree to partially funding going back to school.


Unionization is a powerful yet often neglected tool, using which employees can negotiate adequate working conditions and benefits. It is especially relevant for the medical field where an increased workload, burnout, and turnover rates have become sad characteristics. Yet, forming unions should not be seen as a panacea, as for the most part, there must be a certain institutional framework in place. The unionization process is complex and can be broken into a few steps including preparation, research, campaigning, and negotiation. One of the best programs for promoting better working conditions and excellence in nurses is Magnet Accreditation. Unfortunately, at the moment, only a small number of hospitals meet the eligibility criteria.


dit Dariel, O. P., & Regnaux, J. P. (2015). Do Magnet®-accredited hospitals show improvements in nurse and patient outcomes compared to non-Magnet hospitals: A systematic review. JBI Database of Systematic Reviews and Implementation Reports, 13(6), 168-219.

Dube, A., Kaplan, E., & Thompson, O. (2016). Nurse unions and patient outcomes. ILR Review, 69(4), 803-833.

Holgate, J., Simms, M., & Tapia, M. (2018). The limitations of the theory and practice of mobilization in trade union organizing. Economic and Industrial Democracy, 39(4), 599-616.

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