Why Leading in a Unionized Environment Has Become More Complicated

By Rose O. Sherman, EdD, RN, NEA- BC, FAAN

A colleague of mine has to relocate for family reasons. She is currently a CNO in a non-unionized environment in a right-to-work state where few hospitals are unionized. She has no personal experience leading in a unionized environment at any level. She now plans to move to a region where most hospitals are unionized, and there has been some strike activity. She recently applied for a CNO position in an organization that she felt was a great fit. She went through the interview process but was not selected. Very disappointed; she asked the executive recruiter what had led to her elimination as a candidate. The recruiter told her that the selection team felt her lack of leadership experience in unionized environments was problematic for them.

When she contacted me, I think she expected me to commiserate with what she saw as an unfair decision. She told me that, as part of the interview, she assured them, “I am smart, and I am a quick learner.”  My response was more nuanced than she expected. I told her that part of one’s success in leadership is dependent on the context of the environment in which you lead. You can be very successful in some environments and less successful in others.

I believe this organization had legitimate concerns about her lack of experience working with unions. Rookie mistakes at the executive level can lead to costly union grievances. In today’s healthcare and corporate landscapes, the “rules of engagement with unions” have shifted significantly, moving beyond traditional contract negotiations into deeper issues of culture, technology, and social dynamics.

Despite the reality that one in five nurses now work under a union contract, bringing yourself up to speed can be more challenging than you think. At the national level, there is also a notable lack of resources or leadership courses tailored for nurse leaders in these environments, with most nurse leaders acquiring these skills on the job. Without these resources, health systems rely on their nurse executives to coach their frontline managers in how to effectively work with unions – something you can’t do if you have had no experience with it yourself.

The recent nursing strikes in New York City have highlighted just how complicated and fraught with controversy contract negotiations have become. None of the leaders involved (nor the nurses themselves) ever expected a strike lasting more than 40 days. As I work with leaders in unionized environments across the country, I realize how much the landscape has changed since I myself was an executive leader working in partnership with unions at five VA medical centers. There are five key areas that illustrate what has changed and why modern union leadership is more complex:

1. The Complex Intersection of Providing Staff with Psychological Safety in a Grievance Culture

In the past, union environments were often viewed by leaders through a transactional lens. Nurse leaders followed the union contracts to the letter. Today, leaders must balance strict labor agreements with the need to provide younger staff who have a lower baseline level of mental with psychological safety. How do you foster an environment where staff feel safe to speak up about errors or concerns without it being perceived as a “disciplinary” interaction that triggers formal union representation? Leaders now have to be experts in “soft skills” while operating within “hard” contractual boundaries. This is very challenging, leaders tell me.

2. The Shift in Nurse Priorities from Strictly Economic to Work-Life Balance

Traditional unionism focused heavily on wages and benefits. Unions today put much of their focus on staffing ratios. However, the post-pandemic workforce (particularly younger generations) is prioritizing flexibility, autonomy, and mental health. Many rigid union contracts were not designed for “flexible scheduling” or “work-from-home” arrangements. Leaders are now caught between a workforce demanding individualized flexibility and a collective bargaining agreement that mandates standardized treatment.

3. Rapid Technological Integration into Nursing Work

As AI and digital tools are integrated into workflows, the definition of a “job description” is changing faster than contracts can be renegotiated. Implementing new technology can be seen as an “alteration of working conditions.” Leaders must navigate the delicate balance of driving innovation and efficiency without triggering unfair labor practice (ULP) charges or resistance based on perceived shifts in the scope of practice. This is making innovation in care delivery very difficult in many settings. It is not unusual for me to hear System CNOs now say that their unionized environments are the last to be selected for innovation pilots.

 4. Communication in a Social Media Era 

Social media and internal messaging apps have democratized information. Employees often hear about union-management “news” via TikTok or group chats before official leadership can provide context. It has become routine for frontline staff who cross picket lines and nurse leaders to be cyberbullied during strikes. Nurse leaders in unionized environments must maintain “direct-line” relationships with their teams to build trust, but they must do so without “direct dealing”—the legal pitfall of bypassing union leadership to negotiate with employees. Managing this “information vacuum” requires high-level communication agility.

 5. Generational Clashes about Union Priorities

As contracts are negotiated, nurse leaders must consider the needs of all generations in the workforce today. While seasoned staff may see the union as their advocate on staffing and other issues, this is not true across generations. There is a growing gap between veteran staff who value seniority-based systems and newer staff who may want merit-based recognition and don’t plan to stay long enough to benefit from the seniority features in a contract. Leading in this environment means managing a fragmented workforce, with the union itself facing internal generational tension. Leaders are no longer just managing a contract; they are managing a diverse social ecosystem.

Nurse leaders sometimes ask me what I see as notable gaps in leadership science and education today. Working effectively with union partners is always in my top five. We don’t discuss lessons learned with each other. We also don’t write about it or research it. In ten years as editor of Nurse Leader, I never received a manuscript on this topic. So, as I thought about my friend’s dilemma, I could definitely understand both viewpoints about the value of experience before taking a CNO role in a unionized environment. Unfortunately for my colleague, there is no nursing boot camp to teach this – at this point, it is all lived experience and very challenging at that.