Strikes and Nursing Care

By Milka Ogayo Moderator | 23 Feb, 2017

Most of the time the nurses feel their needs are not met by the employer and have pursued dialogue to address them in vain, they resort to picketing.

The wards are closed and all patients get discharged home. This affects the Intensive Care,New Born and Trauma Care Units among others, that provide very crucial health services. The situation is quite pathetic as some patients can only afford services in public facilities that may be the culprit.

What it the policy of ICN on strike and nursing care?

How is the policy enforced across the globe?

Who takes note of the compliance?



Milka Ogayo Moderator Replied at 4:31 AM, 23 Feb 2017

What is the policy of ICN on strike and Nursing care?

Elizabeth Glaser Moderator Emeritus Replied at 5:29 AM, 23 Feb 2017

Dear Milka,
The most recent strike policy from the ICN position statements is 2004, which seems out of date.
But here is the link and a copy of the document.


Attached resources:

Milka Ogayo Moderator Replied at 8:11 AM, 23 Feb 2017

Thanks for these links Elizabeth!

I'm going to share them out with the nursing fraternity in my county.

Maggie Sullivan Moderator Replied at 7:22 PM, 25 Feb 2017

Milka - is there currently a nursing strike where you are? I tried to see if the WHO also has anything on this topic, but it doesn't seem like it. Keeping track of these strikes globally (the motivations, the length, the impact, the outcomes) would be an incredible service to nurses collectively. It would also draw more attention to how functional (or not) a region's healthcare system/infrastructure is. I would love to hear more if there's a strike going on in your area - even if it's already concluded.

Milka Ogayo Moderator Replied at 3:42 AM, 27 Feb 2017

Hi Maggie thanks for your interest in this topic.

There is no nurses strike as we speak but we have had strikes in the recent past which also happens in other settings

The main feature in the strikes I have witnessed is that the unions call the shorts and determine the direction the strike should take.
As we all know, unions speak loudly for the employee but who speaks for the poor patient that needs life support and can merely afford the subsidized costs of the government hospitals.

I believe our main aim as nurses is to preserve lives as much as is possible or provide a conducive environment where someone would die in a dignified way.

I am very cognizant of labor relations issues that must be addressed for work to go on well. But when all is said and done, is there a balance between the employees welfare and that of the clients in the period of strike as it were? I need to hear from colleagues about their experiences and way forward

Malcolm Brewster Replied at 8:13 AM, 27 Feb 2017

Hi Maggie,

I can share some personal observations of a strike which occurred in Swaziland a few years ago. In this instance the grievance was not one that workers / unions had with management. The unrest occurred because of non-payment of wages to all staff at the hospital by the government who responsible for meeting this expense (I believe it was a national issue but I am not sure about the scale of industrial action other than at the one hospital where I was a volunteer).

My impression, following discussions with various staff, was that they were committed to their work which was to provide an important service to the communities in which they and their families lived. They just needed to be paid. The hospital staff and management devised a new division of labour so that the essential hospital services were maintained whilst freeing up sufficient man-power to undertake the additional work involved in mounting a public protest. Doctors, senior nurses and voluntary staff kept the A&E, ART & TB Outpatients and pharmacy operating, and cared for those inpatients who could not be sent home. All other staff joined the protest. The industrial action lasted about 3 days and stopped as soon as the wages were paid.

During my time at the hospital I became aware that nurses, and other hospital staff, were amongst a minority who had a reliable income in some communities. As a result it was not unusual to find that some would 'adopt' less fortunate families and regularly assist them with supplies of food. I was aware of one case of a nurse saying that she could not provide food for her neighbour's family when her wages were not paid as she was not sure how long she would be able to continue feeding her own family. Fortunately the problem was resolved within a few days.

My observation was that this industrial action was motivated by a sense of community and the need for the community to have money coming into it via it's members who were nurses (or other employees) at the hospital.

Maggie Sullivan Moderator Replied at 9:26 AM, 7 Mar 2017

Thank you, Malcom, for your post. I wonder if the primary reason for nursing strikes in low and middle-income countries is due to non-payment of wages. It occurs to me that perhaps the nursing profession bears a much higher burden of injustice prior to striking, since their actions directly impact the sick and suffering. I assume strikes in other professions (i.e. teachers - though also negatively impacting education of children, mechanics, electricians, etc.) do not necessarily have to wait until conditions are so dire, as nurses might, since their striking will not result in immediate negative health outcomes. Because of the vital nature of the work done by nurses, they are likely more inhibited/discouraged from striking. Arguably, it seems unfair that my mechanic colleague is "able" to strike for lesser injustices than I am, just by the very nature of how our work differs. This line of thought leads me to wonder if nurses are generally expected to tolerate a greater degree of work-related injustice than other organized professions.

Elizabeth Glaser Moderator Emeritus Replied at 4:30 PM, 7 Mar 2017

Recently here in Malawi, the nurses went a long stretch without any pay. The hospitals are grossly understaffed, for example at our 1000+ national referral centre, only about 40% of the nursing positions are filled.

The colleges and universities have been graduating nurses but the MOH has had a freeze on new hires for quite sometime now.

So new nurses are looking for work but cannot get hired, the facilities have many nursing positions open but are not allowed to filled them with the new nurses looking for work, and staff that are working in the facilities do not always get paid regularly.

So am I surprised that nurses go on strike? No, but I am surprised and impressed that despite everything, many nurses and allied health professionals still show up to work.


Milka Ogayo Moderator Replied at 8:18 AM, 9 Mar 2017

The issue of whether nurses should completely abandon patients during strikes has remained quite controversial.

The law recognizes industrial action by employees when grievances are reasonable and dialogue has failed but fails to clarify the limits, in terms of issues that are moral in cases of practical setting like for nurses. The closest the law has come in balancing the act is to compel employees to give a strike notice which allows the managers to discharge the patients before the strikes begin. This works to an extent if its a section of nurses and not all the public health facilities in a country; some patients may not be able to seek alternative care that is only available in private facilities.

Because this issue has remained controversial, there are suggestions that nurse trainees be taught about ethics of health care professional's strikes and other strategies of sorting out conflicts to strengthen professionalism.

Since ICN has membership across the globe it can give a generally practical guidance on the same- this is my personal opinion.

Attached resources: