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I take exception to the anti-union position of your editorial titled "Professionalism" (September 2003: 394–396). You state that unions destroy the ideals of professionalism because trade unions can’t be patient centered. You don’t mention nurse managers who cut staffing to the bone so they can receive bonuses for meeting their budgets. They’re not really patient centered, either. Most nurse managers today are merely yes-men for profit-centered hospital administrators.

If staffing and resources are in short supply and working conditions have deteriorated, doing the best we can with what we have indicates a conservative, if not reactionary, approach. Yet, you call this professionalism. It seems that a patient-centered approach can only evolve from a united group of bedside nurses who are seeking to improve working conditions. Better environments for nurses would impact patient care in a positive manner.

Professional nursing organizations do little to improve the lot of nurses or patients. They engage in fluff activities rather than seeking substantive change. I’ve yet to hear of a professional organization helping a nurse who was unjustly terminated. In Texas, the president of the Texas Nurses Association threatened to secede from the American Nurses Association because one of its resolutions looked "pro-union."

Anti-union statements help a certain elite group of nurses, ie, managers, leaders in professional organizations, and some educators, but such pronouncements do nothing to improve patient care.

Andrew J. Sivak
LaVernia, Tex

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