While some journals offer the credit for free, others charge 10 or more and in addition to the inconvenience of needing to tear out a post test form and mail it in the nurse has no official record of having taken and passed the course.Obtaining continuing education hours through professional journals is costly and inefficient in that the cost of the journal itself must be taken into consideration along with the cost of the course if there is one, and the time and expense of mailing in addition to the lack of official record of completion and lack of central maintenance of all credits accumulated by the nurse.The thesis presented in this article is that traditional and non-traditional CB strategies empower nurses to find such a voice and gain control over nursing practice. If you are like many of the more than 80% of nurses (Carlson, 2003) who are not a part of a collective bargaining unit (CBU), you might respond with "strikes," and "aggressive, unprofessional behavior." While even CBU nurses might agree to a dislike for strikes and the accompanying picket lines (Fitzpatrick, 2001), these nurses certainly are not likely to agree that organizing for collective bargaining (CB), nor strikes for that matter, are unprofessional (Ketter, 1997).This article describes the current shortage; discusses how CB can be used to help nurses find a voice to effect change; reviews the American Nurses Association’s (ANA's) history of collective action activities; explains differences between traditional and non-traditional CB strategies; and presents a case study in which both strategies were used to improve the present patient care environment. Rather, unionized nurses are likely to point out that in the current health care environment, CB strategies may be the only effective means for nurses to gain control over their practice and "attain professional as well as personal and economic goals" (Breda, 1997, p. Control over practice means nurses have "a voice in decisions that affect the patient care environment and their ability to deliver quality care" (Fitzpatrick, 2001, p. Such control requires an organizational structure that promotes organizational autonomy, which is "the freedom to take the initiative in shaping unit and institutional policies required for patient care and accessing the organizational resources required for providing care" (Hinshaw, 2002, p.92).
Even more worrisome, many disaster experts say last year's terrorist attacks dramatized the possibility that a chemical, biological or nuclear attack could overwhelm the nation's nursing work force.Acquiring organizational autonomy and control over nursing practice, through a combination of traditional and non-traditional collective bargaining (CB) strategies, is emerging as an important solution to the nursing shortage crisis.For the past 60 years, nurses have improved their economic and general welfare by organizing through traditional CB, particularly during periods of nursing shortages.Only 1% of nurses in this country have a doctoral degree.However, the IOM (Institute of Nursing) have released The Future of Nursing report, created together with the Robert Wood Johnson Foundation, in which they summarized the findings of their two year study in the field of health care and nursing.