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Published online by Cambridge University Press: 27 April 2021
The American Nurses’ Association (ANA) and its affiliate state nurses’ associations (SNAs) claim to represent the interests of all registered nurses in this country.’ In reality, an uneasy schism of professional ideology has developed within these organizations. The ANA believes that the state and district nurses’ associations are qualified to act and should act as the exclusive agents of their respective memberships in the important fields of economic security and collective bargaining. In fact, in 1977, 100,000 registered nurses, then somewhat less than 10 percent of all working RNs, were under union contract through an SNA. Yet the leadership in the ANA and SNAs is dominated by nurses who are either supervisors or educators in their daily professional roles. The ANA has identified the director of nursing in any given hospital as the legitimate leader of that nursing staff: “Nursing administration has the responsibility and authority for the quality of nursing practice within the health care organization.” Yet the collective bargaining process itself often pits nursing staff against nursing leadership within a given facility.