The findings of Paquet et al. (2000) seem to imply that nurse CBUs should study the outcomes desired in terms of whether there are mutual gains to be realized or whether the changes sought are solely union gains. For instance, a shared governance structure is associated with organizational autonomy (Hinshaw, 2002), but also has been shown to lead to improved patient outcomes (O’May & Buchan, 1999), which is desired by both the CBU and management.