Nurse practitioners want fair wages – just don’t say the word union

The Ontario government recently tabled a budget which included a two year wage freeze for all public sector employees. This announcement has frustrated some Ontario nurse practitioners, many of whom have not had a wage increase for several years – despite increased responsibilities and significantly enhanced scope of practice.

In Ontario, hospital-based NPs generally earn more than community-based NPs, and the size of hospital budgets means pensions can be offered as well. Discussion has been ongoing as to how NP compensation issues can be addressed and who is best positioned to do this. Among the ideas being discussed is the notion of (gasp) unionization.

It would be amusing, were it not so sad, to witness this gradual and reluctant dawning realization among Ontario NPs that through collective action and strength NP value could be recognized and fairly rewarded. One of the beefs continually raised by NPs is the fact that experienced hospital RNs working at the top of a unionized pay scale can make as much as or even more than NPs, particularly with shift differentials factored in. NPs will bemoan the fact they left their RN jobs, returned to university, got more education, only to not make more money. This is often put forward as an unfairness that “the government” should fix.

It seems to me that nurses have a persistent and longstanding tendency towards magical thinking when it comes to governments. We seem to think, for example, if nurses point out that homelessness and poverty are bad for people’s health, that governments will increase funding for housing or social assistance. Ha ha ha ha ha – good one! Or if nurse practitioners work with more skills within a larger scope of practice with more responsibility for our patients, that governments will give us more money – LOL!

We debate the fact we need to be financially recognized for advanced knowledge and increased responsibility – fair enough. But then NP message boards and blogs will go on and on about how can this be accomplished without unionizing!

The great divide between the professional classes and the labouring classes is certainly illustrated well in this instance. Nursing has endeavoured mightily to leave behind our military origins, steeped as they were in silence and obedience and on the job training. We have spent decades shaking off the mantle of physician handmaiden through increased education and university degrees. As some of Ontario’s highest educated nurses, could NPs be equating unionization with a step backwards in this journey towards enhanced professionalization?

It is interesting that other professional unionized groups seek the benefits of unionization without calling their bargaining agents unions. Witness Ontario teachers, who are represented by a “federation” or the physicians and RNs represented by what they prefer to call “associations.” To me this is all part and parcel of a classist worldview wherein the so-called professionals see themselves as something other than labour.

I have worked with many nurses over the years who resent having to belong to a union, or who look down on unions in general, or who even blame unions for the economic crisis. (Don’t get me started on the colossal ignorance this shows of even the most basic understanding of capitalist economics).

Sometimes I remind them that even though they don’t “like” unions or “believe in” unions or belong to a union, I bet they like their 40 hour work weeks and their lunch breaks and their sick days and their maternity benefits – all of which we have thanks to, and only thanks to, the union movement. Not nice governments which look after their people. Not nice professional organizations that look out for their members. But unions – whose members fought, sometimes with their lives, so all workers, including nurse practitioners, would be treated with basic dignity and respect.

The comments section is closed.

  • Kate west says:

    How would one start an NP “association” in their hospital? Or would it be for the state? Would you also include PA’s?

  • Alice Jones says:

    A concern for many Nurses and Nurse Practitioners is the fact that “Nursing Unions” although necessary have not moved with the times. Of course all Nurses are dedicated health care professionals. Nowadays though, nurses come with anywhere from a diploma to a Bachelor, Masters and Doctorate degrees. Unions have for the most part remained in the dark ages and still perpetuate the nurse as a “victim” rather than a well educated professional. Many nurses don’t want to be associate in that context. It is time for “unions” to recognize this fact if they want to remain relevant in the future. The old saying “united we stand, divided we fall”.

  • Jennifer Dee says:

    I for one agree that Nurse Practitioners can and should be rewarded fairly. I have witnessed the power of one dedicated professional who not only was the first person to provide proper pain control to me but actually cared every day what my health status was. I would like to see the system use NPs in ways that not only allow them to use the full range of knowlege, skills and abilities that they have but will treat them fairly and compensate them appropriately with or without a union.

    I wonder when the word union became so dirty that no one wants to belong to one. It is the politics of divisiveness that relies on those with substandard working conditions to belittle those who do belong to unions. Unions are not the only reason our economy has so many challenges and until we search for real solutions it will always be easy to pit one group of workers against others.


Kathy Hardill


Kathy Hardill, MScN, RN(EC) is a Primary Care Nurse Practitioner who has been providing health care to people experiencing poverty, homelessness and other structural vulnerabilities for more than 30 years. She is a founding member of Health Providers Against Poverty and the Street Nurses’ Network in Ontario.

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