National Nurses United is the largest union of registered nurses in the United States. It was formed in 2009, when the California Nurses Association and its national organising committee brought several state nurses associations together into a single national union, and it reports more than 225,000 members.
It is a union first. Unlike a professional association, it negotiates contracts with named employers, can call a strike, and represents members in disputes. See nurse strikes and bargaining for how those stoppages work, including the ten days' written notice federal law requires before striking a health care institution.
What it campaigns for
Legislated staffing ratios. Its signature position is that minimum nurse-to-patient ratios should be fixed in law, on the California model, rather than left to hospital discretion or to acuity systems. This is the clearest policy split in American nursing: the American Nurses Association favours flexible staffing adjusted for acuity, while this union argues that a number a nurse can verify at the bedside is the only enforceable protection. See nurse staffing and patient outcomes and patient acuity and staffing systems.
Workplace violence protections. Prevention programmes, security response and support for prosecution. See workplace violence in nursing.
Health and safety standards, particularly on infectious disease, where it campaigned hard during the pandemic on respiratory protection and isolation practice.
Universal health coverage, which it frames as a nursing issue rather than a general political one.
It also runs a disaster relief network, formed in 2005, that deploys volunteer nurses to emergencies in the United States and abroad.
Where it fits
Nursing representation in the United States is fragmented. Some nurses are represented by this union, some by state nurses associations that act as unions in their own right, some by general unions that include health care workers, and most by nobody. A nurse's own bargaining unit is a local fact, and the national organisation is not automatically the one at their hospital.
Its influence extends past its membership all the same. When a large system settles, the terms become the reference point for every employer in that labour market, whether or not their nurses are organised. That is visible in the 2026 settlements, where raises of 21.5 percent over four years and more than 12 percent over three years reset local expectations, and in the first contract clauses limiting how staffing algorithms may be used.
Related
- Nursing organizations
- Nurse strikes and bargaining
- Nurse staffing and patient outcomes
- Patient acuity and staffing systems
- Workplace violence in nursing
Sources
- About National Nurses United. National Nurses United, for the 2009 formation, membership and campaign priorities. Accessed September 9, 2026.
- 46,000 walked out in six weeks: what the 2026 nurse strikes actually won. NurseRecruiter, 3 March 2026. Accessed September 9, 2026.
- 29 U.S. Code section 158. Legal Information Institute, for the ten-day notice requirement. Accessed September 9, 2026.
- Principles for nurse staffing. American Nurses Association, for the contrasting position on ratios. Accessed September 9, 2026.