More than 100 years of RN power

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Large group of nurses marching through streets holding banner "Globarl Nurses Solidarity"

Nurses in 1906


California Nurses Association (CNA) founded: One of the first professional RN organizations in the U.S.


CNA-sponsored legislation results in the first RN licensure law.


CNA first in the nation to represent nurses in collective bargaining agreements, negotiating contracts at five Bay Area hospitals that establish the 40-hour work week, vacation and sick leave, health benefits, shift differentials, 15 percent salary increase.

Newspaper headline "We Quit"


2,000 CNA RNs stage mass resignation protest and win major gains, including 40 percent pay increase, eight paid holidays, and time-and-a-half for holidays worked.


CNA contract language requires hospital staffing systems based on patient acuity and nursing care with staff RNs participating in staffing assessments.


CNA-sponsored regulation establishes mandated RN-to-patient ratios in intensive care units in all California hospitals.


Staff RN majority elected to CNA Board of Directors for the first time in CNA history on a platform promoting patient advocacy and challenging unsafe hospital restructuring.

Nurses at convention with hands raised


CNA Convention votes by 92 percent to end ties with the American Nurses Association (ANA). Adopts a program to reallocate resources to organize RNs, strengthen contracts, confront hospital industry attack on RN jobs and enact legislative and workplace protections.


CNA wins important changes in state law (Title 22) that licenses and certifies hospitals, strengthening RNs’ ability to advocate for patients. Provisions include staff RN participation on committee to review patient classification systems, floating protections, and requirement that every patient be assessed by an RN at least once a shift.

Nurses picketing outside Calfornia State Capitol Building


7,500 CNA Kaiser Permanente RNs wage epic battle with HMO giant to reverse unsafe hospital restructuring and RN layoffs, and to secure crucial patient safety protections.


California enacts first-in-the-nation law, sponsored by CNA, mandating minimum RN-to-patient ratios for all hospital units. CNA wins other major legislation, including whistle-blower protection for healthcare employees.

Group of nurses holding CNA banner with raised fists


CNA negotiates contracts with salaries up to $100,000 per year for thousands of RNs.


RN Safe Staffing Ratios implemented in all California acute-care hospitals.

CNA organizes nurse-to- nurse relief assistance with Sri Lanka’s Public Services United Nurses Union to assist with tsunami relief efforts.

Nurses celebrating organizing victory


CNA goes national in response to an overwhelming demand by direct-care nurses across the U.S. for a national vehicle to address the crisis faced by RNs. 1,800 Cook County, Illinois RNs vote to join the National Nurses Organizing Committee, a new national affiliate of CNA.

CNA embarks on an epic campaign to save RN-to-patient ratios after Gov. Arnold Schwarzenegger attempts to roll back the law. Schwarzenegger withdraws his challenge after tens of thousands of nurses hold 107 protests over one year.

CNA organizes Katrina relief effort, sending more than 300 RN volunteers to staff 25 healthcare facilities in Texas, Mississippi, and Louisiana, including a contingent of 50 RNs to Houston Astrodome.

Group of five nurses by harbor


Maine State Nurses Association (MSNA) votes to join CNA/NNOC.


Saint Mary’s RNs in Reno, Nevada vote to join CNA/NNOC, making it the largest RN organization in Catholic hospitals across the U.S. representing direct-care nurses.

Large group of people celebrating


RNs at Cypress Fairbanks Medical Center in Houston vote for CNA/NNOC representation in a dramatic breakthrough, becoming the first nurses in a private-sector hospital in Texas to win union collective bargaining rights.

Eight nurses stand in front of banner "Nevada Nurses Uniting for Patient Care"


1,300 RNs at three St. Rose Dominican hospitals in Las Vegas, Nev. vote by 76 percent to join CNA/NNOC.

CNA/NNOC joins forces with United American Nurses and the Massachusetts Nurses Association, and sets in motion a process for building an RN “super union.” The 155,000 RN organization, National Nurses United (NNU), became the largest union and professional association of RNs in U.S. history with contracts covering nurses in 24 states and individual members in all 50 states.

7,000 Veterans Affairs RNs in 22 VA hospitals in 11 states affiliate with National Nurses United.

Two nurses tending to patient


RNRN sends nurses to work on board the USNS Comfort and to Sacre Coeur Hospital in Haiti in response to the devastating earthquake.

8,000 HCA and Tenet RNs in Nevada, Texas, Missouri, and Florida vote to join NNOC/NNU.

1,300 RNs at the University of Chicago Medical Center vote to join NNU, followed by 1,600 RNs at Washington, D.C.’s largest hospital, Washington Hospital Center.

Nurses standing in front of convention podium with hands raised in celebration.


NNU begins “Nurses Campaign to Heal America”, calling for health care, good jobs, education, a clean environment, and retirement security for all, with revenue through a Robin Hood Tax on Wall Street speculation.

RNs in Massachusetts, Illinois, and Florida continue NNOC/NNU’s successful organizing streak.

CNA wins passage of bill requiring all California hospitals have a safe patient handling policy,
including “lift teams” trained to lift patients using proper equipment. Chicago landslide —
Jackson Park Hospital RNs vote by 85 percent to join NNU, bringing the total of NNU RNs in Chicago to 4,200.

Nurse holds sign "Provide charity care or pay"


CNA issues a major report calling for nonprofit hospitals to be held accountable for providing charity care.

NNU RNs lead 6,000 activists in Chicago rally on the eve of the G-8 and NATO summits.

Medicare for All California bus tour visits 18 cities with free health screenings and town hall meetings reaching thousands.


CNA/NNU joins nurses and health care workers’ unions in the Americas, Africa, Asia, Australia, New Zealand, and Europe to create Global Nurses United to fight austerity measures and work collectively to win universal health care as a human right for all.

RNRN sends volunteer RNs to the Philippines to help in the aftermath of Typhoon Haiyan/Super Typhoon Yolanda.

Two nurses holding signs for Ebola preparation


NNU launches “Insist on an RN” multimedia campaign to raise public awareness that health care technology cannot supplant the knowledge and experience of direct-care nurses.

NNU sounds alarm on hospitals’ lack of Ebola preparation, and CNA wins nation’s toughest safety standards to protect patients and health care workers through Cal/OSHA guidelines.

CNA sponsors and wins S.B. 1299, the nation’s strongest workplace violence prevention legislation despite staunch opposition from the hospital industry.

1,200 RNs at Kaiser’s flagship Southern California hospital, Los Angeles Medical Center, vote to join CNA.

Large group of nurses celebrating outside with hands raised


Nurses step up political activism, opposing the Trans-Pacific Partnership agreement and celebrating Medicare’s 50th anniversary in cities across the country.

NNU is first national union to endorse Sen. Bernie Sanders for president.

RNRN participates in a medical mission providing basic medical support to 11 countries in Central and South America, and the Caribbean.

Nurse stand outside building holding signs "Workplace violence effects everyone"



Nurses seize historic opportunity to support a presidential candidate whose platform aligns perfectly with nurses’ values, Sen. Bernie Sanders.

NNU hosts the People’s Summit in Chicago, gathering more than 3,000 nurses and progressive allies to discuss and plan how to grow the movement for social justice.

Cal/OSHA votes to adopt the nation’s strongest health care workplace violence prevention regulations, thanking CNA for its advocacy and leadership on this issue. NNU successfully petitions the federal government to adopt the same standards.

CNA/NNU launches the Nurses Health and Safety campaign, a national network of nurses and allies committed to collectively advocating for nurse and patient health and safety through direct action, and in the legislative and regulatory arenas.

RNRN sends volunteer nurses to the Standing Rock Sioux reservation to provide basic medical support for Dakota Access Pipeline (DAPL) protesters protecting the Missouri River watershed.

Panel sits in front of large banner "The People's Summit"



RNs at Emanuel Medical Center in Turlock, Calif. and RNs at Hi-Desert Medical Center RNs in Joshua Tree, Calif., both Tenet facilities, vote to join CNA.

Nurses support efforts around the country at passing state-based single-payer legislation, including the CNA/NNOC-sponsored SB 562 in California, the Minnesota Health Plan, and a single-payer initiative in Maryland.

As the new presidential administration quickly moved to ban refugees and travelers from certain countries, impose massive deregulation, and fill federal court seats with conservative judges, nurses and other progressive activists gather to strategize at the second People’s Summit under the rallying theme, “Beyond Resistance.”

RNRN sends nurses to help in the wake of Hurricanes Harvey, Irma, and Maria in Texas and Puerto Rico.

Nurses outside hold banner "Patient Safety Comes from Union Strength"



Nurses join with labor unions across the country to protest the Janus v. AFSCME U.S. Supreme Court decision, which turns all public-sector bargaining units into “right to work” environments where workers can refuse to pay dues but still be represented by the union.

Founding executive director of modern-day CNA/NNOC, RoseAnn DeMoro, retires after 32 years leading the organization. Bonnie Castillo, RN, a nurse leader who has served in numerous capacities within CNA/NNOC, steps in as the new executive director.

CNA/NNOC succeeds in initiating creation of Cal/OSHA standards to protect health care workers from noxious surgical plumes.

Nurses outside of UCSF hospital hold signs calling for nurse retention


Around 14,000 University of California registered nurses and nurse practitioners stage a two-day walkout as part of a historic sympathy strike with AFSCME and UPTE colleagues.

More than 19,000 RNs and NPs at 21 Kaiser Permanente medical centers, clinics, and office buildings in Northern California ratify five-year contract that protects existing standards and adds 500 patient care coordinators and new patient care protections for Kaiser enrollees.

Nurses holding signs in support of care for veterans

Veterans Health Administration nurses rally against major administration attacks on their union rights by eliminating “official time” for VA nurses who represent coworkers and leaving their negotiated contract in limbo.

RNRN deploys teams of nurses to assist in the wake of the eruption of Volcan de Fuego in Guatemala, Hurricane Michael in Florida, and the devastating Camp Fire in Paradise, Calif.

RNs at Stanford Health Care – ValleyCare in the Tri-Valley Area of California vote to join CNA. With this vote, the Livermore and Dublin campus RNs join RNs at the Pleasanton campus who voted to affiliate with CNA earlier in the year.

Large group of nurses outside hospital celebrating with raised fists

1,000 RNs at Carondelet St. Mary’s Hospital and St. Joseph’s Hospital, Tenet facilities in Tucson, Arizona, voted to join NNOC, making these the first unionized RNs in the state of Arizona.

RNs at Methodist Hospital of Southern California in Arcadia, Calif. vote overwhelmingly to join CNA. This vote represents the largest number of nonunion nurses in Southern California to join a union in at least five years.

Five nurses outside U.S. Capitol buidling holding signs "Safe Staffing Saves Lives"


A federal ratios bill, sponsored by NNU and based on California’s mandatory nurse-to-patient ratios law, is reintroduced by Sen. Sherrod Brown in the Senate and Rep. Jan Schakowsky in the House. The Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act addresses an epidemic of deliberate understaffing in our nation’s hospitals that puts patients and the public at risk.

Group of six nurses giving thumbs up.

In a historic victory, RNs at Chinese Hospital in San Francisco vote to join CNA/NNU. This vote represents one of the last remaining nonunion hospitals in San Francisco.

RNRN sends nurses to provide basic humanitarian aid to immigrants at a shelter in Tucson, Ariz., and to provide relief to victims of Hurricane Dorian in the Bahamas.

Nurses marching holding banner "Global Nurses Solidarity"

CNA/NNOC hosts Global Nurses Solidarity Assembly in San Francisco, Calif., a three-day gathering of 1,500 nurses, labor leaders, and representatives from more than 25 countries to address a range of topics including global health, environmental and racial justice, and the fight against inhumane immigration policy.

Grassroots momentum for Medicare for All, led by nurses, results in the U.S. House of Representatives holding its first-ever hearing on NNU-endorsed Medicare for All legislation, and the bill’s cosponsors grow to 118 members.

Nurses outside U.S. Capitol building with raised fists, signs that say "Workplace Violence Effects Everyone"

In a widely bipartisan vote, the U.S. House passes the groundbreaking H.R. 1309, the Workplace Violence Prevention for Health Care and Social Service Workers Act, a bill strongly endorsed by NNU. The legislation holds employers accountable, through federal OSHA, for having a prevention plan in place to stop workplace violence before it occurs.

Continuing the organizing wins at Tenet facilities in California and Arizona, 500 RNs at The Hospitals of Providence East in El Paso, Texas vote to join NNOC.

Masked nurses holds sign "Protect Nurses, Protect Patients, Protect Public Health from Covid-19"


NNU begins monitoring the Covid-19 virus in January and over the following weeks, writes to almost every global and federal health and workplace safety agency and leader to adopt the highest standards and protections against the virus.

Technical and nonprofessional health care workers at Methodist Hospital of Southern California in Arcadia joined Caregivers Healthcare Employees Union (CHEU), CNA’s affiliated union, achieving a wall-to-wall union hospital.

Group of nurses outside, arms around each other, giving thumbs up

RNs at Research Psychiatric Center, HCA, in Kansas City, Mo. vote to join NNOC.

NNU sends hospital facilities requests for information to ensure their preparation for Covid-19, and creates a SARS-CoV-2 fact sheet to keep members informed.

CNA/NNU teams up with the Asian American Studies Department at U.C. Davis to launch the Bulosan Center for Filipino Studies, and a new collaboration focused on Asian-American nurses. The launch premiered a short film commissioned by CNA/NNU about Filipino nurse activists, “The Strength of Many.”

NNOC wins workers’ compensation presumptive eligibility for Illinois nurses and other essential workers who contract Covid-19.

NNU conducts the first of several national surveys of RNs during the Covid-19 pandemic, documenting serious deficiencies in PPE and other protections for frontline health workers, and a general disregard for nurses and patient safety.

Group of nurses stand outside The White House surrounded by empty white shoes

For Nurses Week, NNU nurses speak out for Covid-19 protections at events all across the country, including the #ProtectNurses online art show, a 1,000-person online vigil in honor of fallen nurses, and a protest at the White House, placing one pair of shoes for every nurse who has died of Covid.

CNA sponsors and wins A.B. 2537, a bill that requires California hospitals to create and maintain a three-month stockpile of new, unexpired N95 respirators, gowns, and PPE to protect employees and patients.

CNA sponsors and wins A.B. 2037, a bill requiring hospitals to provide increased public noticing of hospital and service closures so that communities have time to save their local hospital services.

Large group of nurses outside with raised fists, holding various signs that start with "Save Lives"

On Aug. 5, thousands of RNs hold more than 200 actions in 16 states and the District of Columbia demanding that hospital employers, elected leaders, and the government take immediate steps to save lives during the Covid-19 pandemic and beyond.

TIME Magazine names NNU Executive Director Bonnie Castillo, RN to the 2020 TIME 100, its annual list of the most influential people in the world.

Group of nurses outside hold signs "Asheville Community Support Mission Nurses"

Mission Hospital RNs in Asheville, N.C. vote by a landslide to join NNOC/NNU, defeating a heavily funded anti-union campaign by hospital chain behemoth, HCA. This was the first private-sector hospital union election win ever in North Carolina, and the largest at any nonunion hospital in the South since 1975.

Nurses score a tremendous victory for the type of infection control measures they have been demanding since the start of the pandemic when the California Department of Public Health (CDPH) directs all general acute-care hospitals to begin Covid-19 weekly testing of all health care workers and all patient admissions.

Four nurses inside hospital hold signs "No Dignity, No Ratios"

In dozens of actions throughout California, RNs protest the California Department of Public Health’s use of Covid-19 as a pretext to allow hospitals to violate the state’s landmark RN-to-patient safe staffing law by issuing “expedited waivers.”

RNs at Sutter Center for Psychiatry in Sacramento vote overwhelmingly to affiliate with CNA, joining 8,000 RNs at 13 other CNA-represented Sutter hospitals.

NNU issues the report, “Deadly Shame: Redressing the Devaluation of Registered Nurses’ Labor Through Pandemic Equity,” an in-depth analysis of how nurses’ care work is devalued, the resulting inequities, their experiences on the pandemic’s front lines, and ways to redress these issues through collective action.

Three nurses inside hospital standing next to each other


RNs at Sutter Coast Hospital in Crescent City, Calif. vote by a wide margin to join CNA/NNU, bringing union representation to the state’s northwest coast.

Newly elected President Biden advances NNU’s demands by activating the Defense Production Act, and calls for a federal OSHA emergency temporary standard on infectious diseases.

In response to RNs’ intensive organizing, the California Dept. of Public Health (CDPH) announces it will no longer approve “expedited waivers” allowing hospitals to violate the state’s ratio laws during the Covid pandemic, and will end all existing waivers.

RNs at John Muir Behavioral Health Center, a psychiatric hospital in Concord, Calif., vote to join CNA/NNU.

Person in car in front of large CalCare banner, speaking into microphone at car rally.

CNA sponsors the introduction of CalCare/A.B. 1400 (Kalra), a bill to implement single-payer in California and guarantee comprehensive, high-quality health care to all California residents as a human right.

Nurses applaud the introduction of the Medicare for All Act of 2021, H.R. 1976, introduced by Rep. Pramila Jayapal (D-WA) and Rep. Debbie Dingell (D-MI), and cosponsored by more than half of the House Democratic Caucus including 14 committee chairs and key leadership members.

Nurse wearing faceshield administiring vaccine

RNRN deploys nurses to assist with Covid-19 vaccine administration to underserved communities in Los Angeles, Calif. and Corpus Christi, Texas.

The nurses’ fight for protection from workplace violence gains support with reintroduction of the Workplace Violence Prevention for Health Care and Social Service Workers Act (Rep. Joe Courtney, CT-2).

NNU issues a new nationwide survey of 9,200 RNs revealing that a year into the Covid-19 pandemic, employers are still failing to provide safe staffing, optimal PPE, and testing.

In April, all California hospitals must comply with A.B. 2537, requiring a three-month stockpile of PPE to protect employees and patients.

Group of eight nurses inside hospital posing for picture

2,000 RNs at Maine Medical Center, Portland, Maine, the state’s largest hospital, vote to join the Maine State Nurses Association/NNU.

A federal ratios bill, sponsored by NNU and based on California’s mandatory nurse-to-patient ratios law, is reintroduced by Sen. Sherrod Brown in the Senate and Rep. Jan Schakowsky in the House.

The Medical Debt Protection Act, a Maryland bill spearheaded by NNU with a broad coalition of Maryland activists, became law at the end of May.

In July, RNs at more than 24 facilities hold actions across the country to demand that employers address problems highlighted by the Covid-19 pandemic and prioritize patient safety and workplace protections.

Large group of nurses inside hospital holding long list or bragaining demands

Some 10,000 RNs at 18 HCA hospitals in six states ratified new contracts that included landmark health and safety language and many other improvements. RNs at HCA’s Mission Hospital ratified their first-ever union contract.

NNU nurses fought for and won the landmark U.S. Occupational Safety and Health Administration (OSHA) Covid-19 Health Care Emergency Temporary Standard (ETS), the first enforceable national Covid-19 standard to protect their union and nonunion colleagues and patients across the country.

Seven arms and fists put together in circle

More than 14,000 RNs in California and Nevada ratify a four-year contract with Dignity Health that features stronger infectious disease prevention measures for nurses and patients.

NNU’s sixth nationwide survey of more than 5,000 registered nurses reveals that employers must do more to be fully compliant with the OSHA Covid-19 Health Care ETS and to implement optimal standards to protect nurses and other health care workers from Covid-19.

CNA/NNU sponsors and wins A.B. 1407, landmark legislation to require implicit bias education and training for nursing students and new graduates in California, an important step in addressing persistent racial disparities in health care.

Nurses picketing outside building. Text "Equity is Health, Injustice is Not" displays on side of building.

21,000 RNs at 21 Kaiser facilities in Northern California hold a one-day sympathy strike in solidarity with IUOE Stationary Engineers, Local 39.

RNs at Doctors Hospital of Manteca in Manteca, Calif. vote by 94 percent to affiliate with CNA/NNU, joining more than 5,300 nurses at 13 Tenet facilities in Arizona and California.