Nurses did not have any benefits. Nursing is regarded as a dedicated calling not an economic pursuit.
Collective bargaining is a tool for addressing workplace concerns.
But employers did not negotiate fairly with nurses and their associations. In 1967, Iowa Nurses Association organized its first unit of registered nurses under the direction of Edith Ruppert. At the same time Rachel Buck recognized the relationship between working conditions for nurses and the quality of patient care delivered. Nurses are different in that they direct others in the work place in the interest of the patient, while supervisors direct others in the interest of the employer. In 1994 ANA entered into a National Partnership with the United States Department of Veteran Affairs and four other unions representing VA employees.