This study concerns the general question, "What has been the impact of collective bargaining representation elections on nonprofit hospitals in Texas?" The means of answering this question involved a study of wages and attitudes of nonprofessional employees in both hospitals where such elections occurred and hospitals where no such elections had occurred in the State of Texas. An overview of the development of hospitals and the union movement in hospitals are presented as background information for this study. Further, a brief discourse on attitude development and attitude measurement is provided as theoretical foundational material. A researcher-constructed questionnaire was devised, tested, and administered to employees of the subject hospitals. There were 176 useable returns from employees where no union representation election occurred and 176 useable returns from employees where union representation elections occurred.