A small group of nurses at a large community hospital were unhappy about their work environment and met daily during lunch to discuss the situation. A recent change in the hospital’s senior management was causing a high level of uncertainty and anxiety among the nursing staff. The nurses felt overworked. They were being asked to forgo their break times, work overtime, and take extra on-call work because of the hospital’s hiring freeze (which included nursing positions) and the high daily occupancy rate with sicker patients. Their wages and benefits had been stagnant, with no salary increases for the past 2 years, and the cost of living in their community had increased by 10% during this period. They felt that they were falling behind economically. In fact, a few nurses complained that they could no longer afford to send their children to private schools.

The nurses saw the situation as management requiring them to do more work with fewer resources and with no appreciation or recognition of their efforts. In addition, because of recent layoffs of support staff, the nurses were losing precious time caring for their patients each day as they hunted for needed medications and supplies. The nurses felt that these “hunting and gathering” activities threatened patient safety because they took the nurses away from the bedside. The nurses also were tired of the physicians’ verbal abuse and disruptive behaviors. Whenever the nurses approached management about these matters, they perceived their concerns as falling on deaf ears, since no changes were ever made.

Feeling that they had no other choice, the nurses contacted a labor union. The labor union began an organizing effort in the hospital shortly thereafter, waging an aggressive campaign over a 6-week period. There was tremendous peer pressure, as some of the well-respected members of the nursing staff became active leaders for unionization, although they had not been among the initial group of nurses who had first contacted the union. The election was held, and the union was voted in by two-thirds of the nursing staff. In the weeks that followed, the original group of nurses remarked that they were surprised by the union’s victory; they had only wanted to scare management into making changes to their work environment.

1. Using Maslow’s Hierarchy of Needs, diagram the nurses’ issues within each level.

2. Explain why the nurses were motivated to contact the labor union using Herzberg’s Two-Factor Theory.