Effects of hospital restructuring and downsizing on nursing staff: the role of union support

The healthcare system underwent considerable restructuring and downsizing in the early to mid-1990s as governments cut costs to reduce their budget deficits. Studies of the effects of these efforts on nursing staff and hospital functioning generally reported negative impacts. Healthcare restructuring and hospital downsizing was again being implemented as governments struggled to once again reduce deficits. The present study examines the relationship of union support during hospital restructuring initiatives with a range of individual and unit/hospital outcomes in a sample of nursing staff working in healthcare settings (hospitals) undergoing significant restructuring and downsizing. Data were collected from 289 nursing staff in California hospitals. Nurses reported a relatively large number of restructuring and downsizing initiatives during the preceding year. Levels of union support had a significant relationship with hospital functioning, but not with nursing staff work and well-being outcomes. Although union support has not shown many benefits for nursing staff during hospital restructuring and downsizing given their focus on adherence to collective agreements, nursing unions can play a larger role here. The present study adds to our understanding of the potential benefits of union support during the current hospital restructuring and downsizing, and highlights the role of union leadership and management