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

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.

[1]  Ryan Essex,et al.  The justification for strike action in healthcare: A systematic critical interpretive synthesis , 2022, Nursing ethics.

[2]  G. Williams,et al.  The impact of strike action on patient morbidity: A systematic literature review , 2022, The International journal of health planning and management.

[3]  Ryan Essex Resistance in health and healthcare. , 2021, Bioethics.

[4]  Mani Shutzberg Doctors that “doctor” sickness certificates: cunning intelligence as an ability and possibly a virtue among Swedish GPs , 2020, Medicine, health care, and philosophy.

[5]  A. Catlin Nursing strike, America, 2019: Concept analysis to guide practice. , 2020, Nursing outlook.

[6]  P. Bejon,et al.  Prolonged health worker strikes in Kenya- perspectives and experiences of frontline health managers and local communities in Kilifi County , 2020, International Journal for Equity in Health.

[7]  S. Taylor-Robinson,et al.  Healthcare workers’ industrial action in Nigeria: a cross-sectional survey of Nigerian physicians , 2018, Human Resources for Health.

[8]  H. Butt,et al.  Educating Future Physicians for Ontario and the physicians’ strike of 1986: the roots of Canadian competency-based medical education , 2018, Canadian Medical Association Journal.

[9]  S. Taylor-Robinson,et al.  Industrial action by healthcare workers in Nigeria in 2013–2015: an inquiry into causes, consequences and control—a cross-sectional descriptive study , 2016, Human Resources for Health.

[10]  M. Mckee,et al.  Recent physician strike in Israel: a health system under stress? , 2013, Israel Journal of Health Policy Research.

[11]  P. Januszewicz,et al.  The opinions of Polish nurses and patients on nursing protests. , 2013, Collegium antropologicum.

[12]  O. Atilola,et al.  Nigerian resident doctors on strike: insights from and policy implications of job satisfaction among resident doctors in a Nigerian teaching hospital. , 2013, The International journal of health planning and management.

[13]  Linda Briskin Resistance, mobilization and militancy: nurses on strike. , 2012, Nursing inquiry.

[14]  S. Oliver,et al.  Enhancing transparency in reporting the synthesis of qualitative research: ENTREQ , 2012, BMC Medical Research Methodology.

[15]  M. McKeown Alliances in action: Opportunities and threats to solidarity between workers and service users in health and social care disputes , 2009 .

[16]  K. Janus,et al.  German physicians "on strike"--shedding light on the roots of physician dissatisfaction. , 2007, Health policy.

[17]  Catherine Law,et al.  Worked examples of alternative methods for the synthesis of qualitative and quantitative research in systematic reviews , 2007, BMC medical research methodology.

[18]  Jesse Lachter,et al.  Attitudes of medical students to a physicians’ strike , 2007, Medical teacher.

[19]  A. Greaney,et al.  The 1999 Irish nurses' strike: nursing versions of the strike and self-identity in a general hospital. , 2006, Journal of advanced nursing.

[20]  P. Dzendrowskyj,et al.  Effects of nursing industrial action on relatives of Intensive Care Unit patients: a 16-month follow-up. , 2004, The New Zealand medical journal.

[21]  D. Hren,et al.  Medical students' opinions on physicians' strike: cross sectional questionnaire study. , 2004, Croatian medical journal.

[22]  M. Muller Strike action by nurses in South Africa: a value clarification. , 2001, Curationis.

[23]  M. Muller,et al.  Strike action by nurses/midwives in a nursing service , 2000 .

[24]  P. J. Kunene,et al.  Strikes by nursing personnel: a challenge for nurse managers in KwaZulu-Natal Province. , 1996, Curationis.

[25]  R. Kravitz,et al.  Nurses' Views of a Public Hospital Nurses' Strikei , 1992, Western journal of nursing research.

[26]  R. Kravitz,et al.  Conditions that justify strikes as perceived by housestaff at a public hospital , 1992, Academic medicine : journal of the Association of American Medical Colleges.

[27]  J. Norris,et al.  Strike by nurses: perceptions of colleagues coping with the fallout. , 1991, The Canadian journal of nursing research = Revue canadienne de recherche en sciences infirmieres.

[28]  R. Kravitz,et al.  To strike or not to strike? House-staff attitudes and behaviors during a hospital work action. , 1990, The Western journal of medicine.

[29]  E. Meslin The moral costs of the Ontario physicians' strike. , 1987, The Hastings Center report.

[30]  S. Barnoon,et al.  Perceived health damages during a physicians' strike in Israel. , 1987, Health services research.

[31]  R. Linn Moral Reasoning and Behavior of Striking Physicians in Israel , 1987, Psychological reports.

[32]  L. Forfa Strike: more than two sides. , 1987, The American journal of nursing.

[33]  D. Pilpel,et al.  Coping With Health Services Disruption: Perceiving Need and Utilizing Available Services During a Doctors' Strike , 1985, Medical care.

[34]  B. Siegel,et al.  Physicians' changing attitudes about striking. , 1979, Medical care.

[35]  G. Hogben,et al.  Patient and staff reactions to a strike by essential hospital employees. , 1976, The American journal of psychiatry.