The president of a major nurses union detailed Wednesday how having volunteer leaders has helped avoid the problem of becoming disconnected from membership.

National Nurses United (NNU) is unique from other national unions in that everyone in a leadership position is a volunteer that works in the medical industry. The unions leaders say they know what their members need because they work alongside them and face the same problems. Labor unions elsewhere often become disconnected from the needs of their members, they say.

“It is a structure where the elected leadership are working nurses,” NNU President Deborah Burger told InsideSources. “The reason long ago we developed that structure is that we felt it was important to stay close to what our members needs and wants are, what their concerns are and what they think the agenda should be.”

National labor leaders elsewhere usually work full time for the union while collecting salaries much larger than rank and file members. They may hold the position for years or even decades in some cases. The Center for Union Facts found in its own analysis that the top 153 union presidents made more than the average CEO in gross annual salary.

“The elected nurse leadership, that’s the policy direction,” Burger also noted. “Then the executive director with the staff carry out the direction of the board.”

NNU still has paid staffers that carry out business activities and policy advocacy, but those decisions ultimately come for leadership. Burger notes her union is not the only way to properly represent workers. She adds the disconnect problem mainly occurs when union leaders don’t honestly seek input from members.

“Where the disconnect happens, I think, is when you become an elected official and you don’t take your membership’s values, concerns and issues to heart,” Burger continued. “There are many different structures in various unions, and they’re setup to represent the membership. Where you go astray is when you make deals regardless of what your membership feels.”

Labor unions also risk losing disenfranchised members who feel neglected by leadership. Many workers are forced to pay union dues if their workplace is unionized, but policy changes and right-to-work laws have made it easier for workers to choose than in the past. Union membership rates have been in sharp decline over the decades.

“You can get feedback from your members in quite a few ways that don’t have as many filters that go through it if you really wanted to,” Burger added. “There are some unions that do that well and there are some unions that don’t.

The Democratic primaries put the issue at the forefront for many workers. Democratic nominee Hillary Clinton won support from most national unions but many workers were behind her primary rival Sen. Bernie Sanders. NNU was one of the few national unions to endorse Sanders.

“Even when we made our endorsement we knew if we didn’t pick someone our members wanted then our endorsement didn’t really mean anything,” Burger concluded. “We wouldn’t get nurses working on the campaign, donating their time to do canvassing and those kind of things.”

Burger adds her union is likely going to look into changing their endorsement now that the primaries are over. As before, the goal will be to reflect the true will of membership. She doubts, based on general sentiment, that Republican nominee Donald Trump will win their endorsement.