Review of “Do Strikes Kill?”

In I-O Psychology, Patient Safety, Resiliency, Safety climate on May 6, 2011 at 9:25 am

Healthcare workers have had the right to strike since 1974. By 2008 there were over one million hospital union workers.  While other industries had declining union memberships, hospital employees’ unionization is growing (Gruber & Kleiner, 2010).

Do Strikes Kill is the provocative title of a working paper by Jonathan Gruber and Sam Kleiner (MIT and Carnegie Mellon).

All hospital employees are imperative to providing safety in a hospital environment, but the authors looked at nurses in particular. They cite Kruger & Metzger (2002) when they describe that nurses function as “the surveillance system of hospitals for detection and intervention when patients deteriorate, and are viewed by many patients as more important to their total recuperation process than their own attending.”  Another CEO was quoted as describing nurses as “the heart and soul of a hospital” (Gruber & Kleiner, 2010).

Given this integral role for nursing, the authors sought to determine the impact on safety and quality in the events of nursing work stoppages. They looked at data over a 20 year period in New York State.  For patients admitted to hospitals during a nursing strike, the authors found MORTALITY increased by 19.4% and readmissions within 30 days increased by 6.5%.

I recommend purchasing this relevant study for $5 at the National Bureau of Economic Research website:

To understand the safety implications for your own institutions, it is important to look at the details of this study and not just the overall results.

At one time, Industrial-Organizational psychologists were employed as union “avoidance consultants.”  They had success through improving the work environment for employees.  While labor lawyers can be a resource for a hospital in interpreting labor laws, an Industrial-Organizational Psychologist can combine theory and practice to improve culture, employee satisfaction, teamwork, front line empowerment, training, leadership approaches and development, quality and many other workplace happiness indicators.  It’s the right thing to do but also Happy Employees aren’t likely to strike.

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