Ironically, when restrictions on CRNA practice become severe enough, the National Labor Relations Act may offer a unique solution. Whether formation of a labor union by CRNAs is appropriate or not is best left to the judgment of the CRNAs involved. In some instances, formation of a union would not be helpful in resolving disputes with hospitals or professional staff. In other instances, for example in communities where nurses or groups of physicians already are organized, the community may already have accepted the idea of unions representing professions. When Congress amended the labor act to cover employees of non-profit healthcare institutions, it expressed concern about the harm the public would suffer from multiple bargaining units in hospitals.
Nurse anesthetists have special credentials and unique practice settings.
In many hospitals, nurse anesthesia is a separate unit. Payment for CRNA services often is independently computed and paid to the hospital. Very few other nursing groups directly compete on a financial basis with the medical specialty that often supervises them. For this reason, it might be expected that nurse anesthetists interested in forming a collective bargaining unit would be recognized separately. Separate recognition of nurse anesthetists as their own appropriate bargaining unit has been extremely difficult, because of the Congressional restriction on proliferation of healthcare groups.