National Nurses United: Collective Nurse Power Can Ensure Health Justice

Today, National Nurses United affirms our position that unionization and collective nurse power are the best defenses against systemic failures. The recent high-profile case against former nurse RaDonda Vaught has shaken the entire nursing profession, offering important lessons about what it takes to protect patient safety in a corporate health environment.

An individual error that happened within a context of systemic failures resulting in a patient's tragic death, the story is a reminder of the necessity of collective action in protecting individual patients and nurses within failing systems.

When vigilance falters, the world may never have satisfactory answers to questions seeking to understand how a terrible mistake could’ve happened. But it remains important to question many aspects of this case, such as why administrators failed to report the error through the well-established proper channels.

This example of systemic failure is emblematic of a larger problem in this case of a patient’s death. Nurses are all too familiar with the state of constant vigilance that is necessary when working in the U.S. health care system. Ultimately, nurses are accountable for the care they provide. But the fact that hospital systems have spent decades eroding the support systems around nurses means that this vigilance is both more important — and more demanding — than ever in an era of moral distress, fatigue, and desensitization.

Nurses are short-staffed due to hospital bosses’ refusals to create high-quality staff positions that provide nurses the opportunity to become experienced, dedicated members of a health care system, collectively caring for their communities through strength in numbers. This is a national staffing crisis that has patient safety implications because safe staffing is one of the most effective ways to prevent medical errors. Unsafe staffing, which has become standard operating procedure in most facilities, endangers the lives of patients and nurses.

Nurses are always fighting to make facilities safer for patients, and unionized nurses are well-positioned to lead this fight. Nurses have a moral and legal obligation to object to unsafe practices, and union nurses have contractual rights and protections to do so without fear of retaliation for being effective patient advocates, even if it means disagreeing with management. Collective bargaining and union contracts are often effective ways to address bad hospital policy, including issues like floating nurses or technological processes, and can prevent systemic failures from causing patient harm in the first place. And organized, unionized nurses can stand collectively against the systemic forces that would prefer to isolate them and force them to fend for themselves as individuals.

Somewhere between an individual’s constant vigilance and the industry’s systemic failures, there is a path forward where nurses collectively support each other to ensure their patients’ health and safety despite failing systems. Patients deserve that future, one where bedside caregivers are properly staffed, supplied, and supported to provide the best care.

Unionized nurses across the country are fighting for and winning ways to prevent these dangerous situations. And prevention, not criminalization, is the key to providing nurses the necessary support to stop medical errors before they happen, ensuring that patients get the best care they possibly can. Locking nurses up for mistakes is not a form of justice. But nurses joining together to demand a safe industry for their patients and for themselves has the potential to create more just systems for all. To err is human, but to work together to prevent error is divine.