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  1. Seago, Jean Ann PhD, RN, FAAN
  2. Spetz, Joanne PhD
  3. Ash, Michael PhD
  4. Herrera, Carolina-Nicole MA
  5. Keane, Dennis MPH


The objective of the study was to examine whether unionization is associated with job satisfaction among RNs in the United States using nationally representative surveys of RNs. Factors that predict job satisfaction for RNs in healthcare continue to be of great concern to nurse administrators and managers because job satisfaction remains an important aspect of nurse retention. In addition, the notion of having unions for RNs has also gained prominence on the national stage. The relationship between RN job satisfaction and having an RN union has rarely been studied, but in 2 studies, a paradox was found; hospitals with RN unions had higher job dissatisfaction but greater retention. This study will test the relationship between having an RN union and job satisfaction with data that are both more recent and nationally representative. We analyze the public-use data from the 2004 and 2008 National Sample Surveys of Registered Nurses. In both 2004 and 2008, union representation was negatively associated with job satisfaction, although this relationship was not statistically significant in 2008. Some nurse administrators and executives would not be surprised by this finding. However, although union nurses may express more dissatisfaction, they may also be more vocal and less fearful about voicing concerns. If managers can harness this ability of the nurses to be articulate and outspoken, working with unions and union nurses can be productive and satisfying.