A last resort? A scoping review of patient and healthcare worker attitudes toward strike action

Abstract

While strike action has been common since the industrial revolution, it often invokes a passionate and polarising response, from the strikers themselves, from employers, governments and the general public. Support or lack thereof from health workers and the general public is an important consideration in the justification of strike action. This systematic review sought to examine the impact of strike action on patient and clinician attitudes, specifically to explore (1) patient and health worker support for strike action and (2) the predictors for supporting strike action and the reasons given for engaging in strike action. A systematic scoping review was employed to identify all relevant literature, followed by a textual narrative synthesis.A total of 34 studies met inclusion criteria. Support for strike action was largely context-dependent. A range of factors impact support for strike action; broader cultural and structural factors, such as unionisation and general acceptance of strike action; systemic factors, such as the nature of the healthcare system, including infrastructure and work conditions; the strike itself and a range of individual factors, the most notable of which was being a student or in an early career stage. There were also some surprising results, for example, during doctors strike, nurses were provided with the opportunity to expand their role, which led to greater professional autonomy and job satisfaction.

Social media opposition to the 2022/2023 UK nurse strikes

“…We found some correlations (e.g., affordability and impact on the NHS; or the political nature of strikes and general antistrike/antiunion sentiment), but overall, there were no clear patterns in the deployment of two or more discourse themes within single tweets that we could further explore. What we also found surprising was the lack of tweets explicitly questioning nurses' right to strike (Essex, Burns, et al, 2023).…”

Board talk: How members of executive hospital boards influence the positioning of nursing in crisis through talk

“…From that rationale, nurses also influence how board members talk. Nevertheless, we cannot deny the asymmetric power relations (Aspinall et al, 2022; Kee et al, 2021) and the gendered images (Essex et al, 2023; Langley et al, 2019) that exist of and between board members and nurses in crises. As Lopez‐Deflory et al (2023a) recently stated; “Nurses play an active role not, only in the reproduction of the institutional status quo which maintains their subordination, but also in the challenge of the complex network of power that constitutes its subordination (…).…”

“…This aligns with extant literature on talk and its influence on positioning (Greenhalgh et al, 2023; Oldenhof et al, 2016). However, this literature states that the influence of talk is dependent on hierarchical positioning (Essex et al, 2023). However, this is too limited as organizational interaction is more complex than just organizational hierarchy.…”

Contract doctors’ strike in Malaysia: A content analysis of the perception of medical fraternity and stakeholders on Facebook

“…Among HCWs, the determinants of strikes can be diverse. In the past, HCW strikes mostly stemmed from dissatisfaction over salaries, working hours, and other administrative factors [ 13 ]. While it is necessary to understand the underlying factors that provoke the call for strike by the organiser (i.e.…”

“…In general, our findings revealed that almost all HIGs and prominent MPs supported the strike in solidarity with the contract doctors. In other countries, HCWs’ support toward strike action was divisive and frequently fragmented [ 13 ]. For example, it was widely supported in Israel [ 23 ] and Croatia [ 24 ] while frowned upon in Nigeria [ 25 ].…”