Quest for a Voice

Material presented to Massachusetts Nurses Association annual convention, October 1, 2008.
Addenda: Documents pertaining to founding of National Nurses United, 2009.

In the Beginning was the ANA

  • Origins of Collective Bargaining for Nurses
  • Tensions Mount
  • Dispersal (SNAs shed collective bargaining)
  • Connecticut - 1984
  • New Jersey - 1985
  • Maryland - 1990
  • Pennsylvania - 1991
  • Kentucky - 2008

Industrial Changes

  • Job Reengineering (deskilling, substitution, layoffs)
  • Privatization (public mission undermined)
  • Deregulation (marketplace medicine)
  • Managed Care Penetration (more management, less care)
  • Merger Mania (fewer beds, speedup, fewer EDs, diversion)
  • For-Profit Incursions (lower standards, more fierce competition for market share)

Political Changes

  • Anti-Labor Elected & Appointed Officials
  • NLRB & Courts: increasingly unfriendly to Labor
  • Breaking PATCO, passing NAFTA, redefining bargaining unit boundaries, health insurance boondoggles

Struggle for Power within ANA

  • Institute of Constituent Member Collective Bargaining Programs
  • Staff Nurse Caucus - each June at ANA HOD
  • SNA Viability Retreats - 1993 & 1994
  • National Nurses March for patient Safety (DC) - March 1995
  • International Unity Conference (San Francisco) - August 1995
  • CNA Disaffiliation - October 1, 1995
  • Staff Nurse Summits

         Minneapolis - 1996
         Boston - 1997
         Cleveland - 1998
         Albany - 1999

  • SNA Labor Coalition (1997- 1999)
  • UAN established - 1999
  • UAN receives charter from AFL-CIO - May 2001
  • UAN evolution toward democracy, funding; disaffiliation & split

Some International Comparisons: Australia, Canada, United Kingdom

AARN History (in development)

  • Philadelphia - May 2000: PASNAP formed, strategic alliance promised
  • Oakland - September 2000: International School of Nurse Activism
  • Baltimore - May 2001: Six principles adopted
  • San Diego - February 2002: AARN name chosen
  • Philadelphia - September 2002: conflict over SEIU’s presence
  • Tucson - February 2003: staffing legislation; logo, web site; lobbyist question
  • New Orleans - May 2003: Tulane nurses contemplate organizing
  • Honolulu - October 2003: UAN expansion blocked, disaffiliation planned; AARN web site & logo
  • DC - February 2004: bylaws; lobbying
  • Boston - July 2004: Rally in the Alley at DNC
  • ? Las Vegas
  • New York - October 2004: AARN bylaws discussed (approved by all except CNA)
  • Oakland - December 2004: NNOC unveiled
  • Santa Barbara - February 2005: NNOC discussion
  • Brewster - June 2005: AARN bylaws finalized; CNA announces 2:1 victory at Cook County
  • Kennebunkport - October 2005: MNA & NYPNU walk out

AARN Participants

  • CNA
  • MNA
  • MSNA (joined NNOC in 2005)
  • PASNAP (joined NNOC in 2007)
  • Saint Louis Area Nurses Coalition (amalgamated into CNA)
  • Southern Arizona Nurses Coalition (amalgamated into CNA)
  • ? Nurses United (DC)

Some Statements of Principles

CNA/MNA fundamental beliefs discussed with UAN, June 2000

  • Nurses should represent nurses.
  • New organizing efforts should be done by RNs and these efforts should put nurses into a national organization of nurses.
  • Direct-care nurses must control nursing practice through all venues, including legislation, regulation, collective bargaining, and do that without interference by statutory supervisors.
  • Nurses must organize against all industry attempts to undermine nurses’ ability to control their practice, protect their patients, and retain their primary role as patient advocates, and consistent with this is that unorganized nurses must be helped to achieve an effective and protective voice in their work settings.
  • National nurses organizations should, consistent with the individual role of nurses, promote and control a healthcare agenda that transforms the current unsuccessful market-driven healthcare model to one that provides universal access and coverage.

School for Nurse Activists agenda, September 2000

  • Resist corporate dominance of health care.
  • Connect with union nurse’s struggles for patient rights.
  • Implement safe staffing ratios (AB394) in California & achieve safe staffing elsewhere.
  • Integrate current campaign successes with your particular experience including learning how nurses are beating back corporate take over of the healthcare industry throughout the US and Canada.
  • Build viable coalitions with nurses nationally and internationally in order to have the necessary power to create universal access to health care.
  • Build a national and international movement led by nurses.

Rationale for MNA disaffiliation, November 2000

  • Protect and promote the profession of nursing.
  • Enhance the knowledge and promote the education of nurses fostering clinical expertise and activism on behalf of their patients and practice.
  • Accept and embrace the nurse’s role as patient advocate.
  • Promote the access to quality healthcare for all.
  • Protect the health and safety of nurses in all work settings.
  • Enhance and promote the economic, health and general welfare of nurses.
  • Provide and respect workplace democracy for all eligible nurses who desire to exercise this right.
  • Work toward solidarity with any and all nurses who share these core values for the survival of nursing.

AARN goals, May 2001

  • Establishing a progressive national voice of nurses.
  • Protecting, preserving and promoting RN practice, such as requiring safe staffing and opposition to deskilling and intrusion on RN scope of practice.
  • Autonomy and independence of the individual member organizations.
  • Support for universal health care, with establishment of a single-payer style national healthcare program.
  • Unionization of any RNs throughout the US who desire representation.
  • Solidarity with international nurses organizations that share similar goals and values.


AARN        American Association of Registered Nurses
AFGE        American Federation of Government Employees
AFL-CIO    American Federation of Labor-Congress of Industrial Organizations
AFSCME    American Federation of State, County & Municipal Employees
AFT          American Federation of Teachers
ANA         American Nurses Association
ANF         Australian Nursing Federation
CFNU       Canadian Federation of Nurses Unions
CNA         California Nurses Association
CRONA     Committee for Recognition of Nursing Achievement (Stanford University Medical Center nurses)
CtW         Change to Win
CWA-IUE  Communications Workers of America- International Union of Electrical Workers
HOD        ANA’s annual House of Delegates
IBT          International Brotherhood of Teamsters
ICN          International Council of Nurses
IUOE        International Union of Operating Engineers
JNESO      RN division of IUOE, having left NJNA in 1985
LIUNA      Laborers International Union of North America
MNA        Massachusetts (or Michigan, Minnesota, etc) Nurses Association
MSNA      Maine State Nurses Association
NEA         National Education Association
NENA       New England Nurses Association
NFN         National Federation of Nurses
NLRA        National Labor Relations Act (1935 - amended several times)
NLRB        National Labor Relations Board
NNOC       National Nurses Organizing Committee
NYPNU      New York Professional Nurses Union
NYSNA     New York State Nurses Association
ONA         Ohio (or Oregon, etc) Nurses Association
PASNAP    Pennsylvania Association of Staff Nurses & Allied Professionals
PE&GW     Professional, Economic and General Welfare (original title of MNA’s Labor Cabinet)
PSEA        Pennsylvania State Education Association
RCN          Royal College of Nurses (UK)
RWDSU     Retail, Wholesale & Department Store Workers Union
SNA          State Nurses Association
SEIU         Service Employees International Union
SLANC      Saint Louis Area Nurses Coalition
SNALC      State Nurses Association Labor Coalition
UAN          United American Nurses
UAW         United Auto Workers
UBC          United Brotherhood of Carpenters & Joiners
UFCW       United Food & Commercial Workers Union
UFW         United Farm Workers of America
UNAP        United Nurses & Allied Professionals
USW         United Steelworkers
WSNA       Washington State Nurses Association

Important Dates

1896          Nurses Associated Alumnae of the US & Canada founded, without any RNs
1903          MNA founded as the Massachusetts State Nurses Association; incorporated two years later
1911          American Nurses Association name adopted
1935          National Labor Relations Act passed, excluding healthcare & agricultural workers
1948          First nurses unions organized by ANA affiliates, starting in California
1955          American Federation of Labor and Congress of Industrial Organizations merged
1964          African-American workers at Jewish Memorial Hospital in Roxbury strike for union recognition
                 Massachusetts law establishing collective bargaining rights for healthcare workers enacted
1966-1967  MNA recognized as bargaining agent for RNs in Hale Hospital (Haverhill) & Quincy City Hospital
1969          RWDSU Local 1199 invited to Massachusetts to organize Boston hospitals
1971          First 1199 drive to organize New England Baptist Hospital killed by spies
1972          Massachusetts Rehabilitation Hospital strike broken by Kevin White’s police dogs
1975          Second 1199 drive to organize New England Baptist Hospital killed by racism
                 National Labor Relations Act amended to include healthcare & agricultural workers
1980-1986 RN strike wave in Massachusetts - impact ignored by other Massachusetts unions
1984          US Supreme Court rules professional associations not insulated from management domination
                 First of two-and-a-half raid attempts on Unit 7 by 1199
1985          MNA amends bylaws to insulate labor program, establish PE&GW (later Labor Relations) Cabinet
1987          Direct pass-through of bedside labor costs ends cyclical nursing shortage; 20% raise at Faulkner
1988          Unlicensed Assistive Personnel program developed at University Hospital & Quincy City Hospital
1989          Massive layoff at QCH, with 50-50 ratio of RNs/UAPs on medical-surgical units
                 State privatization begins
1991         Hospital finance deregulated in Massachusetts with enactment of Chapter 495
                Massive privatization drive launched in Massachusetts: state, county & municipal facilities
1993         Staff nurses seize power in CNA, intensify efforts to pass RN-to-patient ratio legislation
                MNA organizes first State House rally for patient safety, with RNs, LPNs and students
                Single-payer preference defeated by two votes in MNA’s annual business meeting
1994         MNA launches Statewide Campaign for Safe Care, begins to explore legislative agenda
                MNA adopts single-payer goal by overwhelming vote of members at business meeting
1995         National Nurses March for Patient Safety: 35,000 nurses from every state & union in DC
                Labor programs in Maine & Massachusetts establish New England Nurses Association
                CNA convenes International Unity Conference: emphasis on action against corporatization
                CNA House of Delegates votes overwhelmingly on October 1st to disaffiliate from ANA
1996        Minnesota convenes first Staff Nurse Summit in response to CNA disaffiliation
               Emphasis on electing staff nurses to state & national ANA bodies
1997        Massachusetts convenes second Staff Nurse Summit: emphasis on advocacy in hostile industry
               NYSNA convenes SNA Labor Coalition: nine largest labor SNAs work to influence ANA
1998        Ohio convenes third Staff Nurse Summit: emphasis on how to get along with the boss
1999        New York convenes fourth Staff Nurse Summit: emphasis on labor history and other RN unions
               Weak UAN founded by ANA over MNA/MSNA objections, without Hawai’i, MSNA or MNA
2000        PASNAP formed from PSEA, with help from CNA & MNA
               MNA Labor Cabinet pledges strategic alliances with like-minded nurses unions
               MNA & allies defeat Tenet Corporation in Worcester at Saint Vincent Hospital over MOT
               CNA convenes International School of Nurse Activism
               Cosponsored by CFNU, MNA, Minnesota NA et al
               First attempt by MNA to disaffiliate from ANA; staff nurses take power on December 1st
2001       Disaffiliation completed; seven-month struggle over District 5 and its resources
              Pledge to establish progressive national voice for nurses
              CNA, MNA, MSNA, PASNAP & SLANC meet in Baltimore, adopt six principles
              UAN given AFL-CIO charter on the day after AARN principles adopted
              Brockton Hospital nurses strike for 104 days, extracting pledge to staff safely
              California Governor Davis signs RN-to-patient ratio legislation, which survived Schwarzenegger
2002       American Association of Registered Nurses (AARN) name adopted
2003        AARN logo, web site established; Revolution magazine projected as official organ
               MNA, MSNA & CNA work with Hawai’i staff nurses to block UAN expansion, foster disaffiliation
2004        AARN bylaws developed, primarily by MNA board members; Rally in the Alley at Boston DNC
               NNOC founded; MSNA affiliates with NNOC, splitting NENA
2005        CtW (IBT, LIUNA, SEIU, UBC, UFCW, UFW) formed in split from AFL-CIO
               AARN ceases functioning over differences of structure, power, finances
2006        Massachusetts Patient Safety legislation passes House, dies in Senate
2007        NNOC given AFL-CIO charter; PASNAP affiliates with NNOC
               SiCKO premier in Sacramento: RNs from Alberta to NE
               Kentucky & West Virginia NAs strike Appalachian Regional Health system for 87 days
               Kentucky NA goes bankrupt
               UAN split as NYSNA, Ohio, Oregon & Washington leave UAN/AFL-CIO, forming NFN
2008        Michigan disaffiliates from ANA, walking out of ANA HOD; MNA continues to talk with all
               Massachusetts Patient Safety legislation passes House, killed in Senate
               CNA/NNOC & NYSNA hold staff nurse summits, with MNA observers present
               Hawai’i & Minnesota disaffiliate from ANA

Today’s Balance (2008): Where Are Organized Nurses?

(MSNA & PASNAP included in NNOC)

AFL-CIO                    (233,620)
    AFGE                    10,000
    AFSCME                40,000
    AFT                       30,000
    CNA-NNOC             80,000+
    CWA-IUE                10,000
    IUOE (JNESO)          5,000
    UAN                      54,120
    UAW                      2,500
    UMW                     ?
    USW                      2,000
ANA (NFN)                 (63,700)

    NYSNA                33,000
    Ohio NA                6,700
    Oregon NA           10,000
    WSNA                  14,000

CRONA                     2,000

CtW                        (87,000)

    IBT                    2,000
    LIUNA                5,000
    SEIU                 80,000
    UFCW                    ?

MNA                        23,000

Nurses United (DC)   1,500
NYPNU                     1,250

Small Independents  5,925

UNAP                       4,500

Total # RNs in US organized for collective bargaining (per UAN) 422,495 (14.6%)
Total # RNs in US (per ANA)                                                 2,900,000

Outline of Presentation (October 1, 2008)

Questions to Audience:

  • Anyone present who was on strike: 1980-1986?
  • Anyone present who demonstrated at State House in June 1993?
  • Anyone present who went to Washington on March 30, 1995?
  • Anyone present who attended the Boston Staff Nurse Summit, April 1997?


  • Preface: Why a national voice?
  • ANA: Rise & Fall
  • Industrial & Political Changes: Restructuring & Rightward Swing
  • Attempts to Reform ANA: Institute, Staff Nurse Summits, SNA Labor Coalition
  • Breakout & Beyond: UAN, AARN, NNOC ...


  • Commonwealth of Toil (1996): any mention of MNA omitted
  • BCH: Ann Hargreaves & Marie Snyder - failure to represent: decertification
  • Maryland NA fights “fascism”, drops collective bargaining
  • 1995 March on Washington: revelation of diversity of nurses’ unions
  • Minnesota Summit: Stephanie Stevens, campaign manager
  • 9/11 & Kathleen Connors: solidarity message sent to ANA
  • Steve Lynch’s Staff Puzzlement: UAN versus ANA

Our Story Told (so far):

  • Saint Vincent Strike in PeaceWorks (2000)
  • Disaffiliation in Labor Notes (2000-2001)
  • Hawai’i Experiences on Seachange Bulletin (2003)
  • Hundredth Anniversary Video (2003)

Motion Passed by MNA Voting Body (October 2, 2008)

“In these challenging times for patients and nurses, the voice of organized nurses cannot remain fractured. We the MNA members charge and authorize the MNA Board of Directors to participate as architects of an independent, national nurses union run by and for nurses, which would represent a majority of the nation’s unionized nurses, and to bring back that opportunity for a vote by the MNA membership.”

MNA Web Site History Summary

History: 1903-2003: 100 Years of Caring for the Commonwealth

Fact Sheet and Historical Timeline


The Massachusetts State Nurses Association is founded during meeting of 300 graduate nurses at Faneuil Hall on February 26 – one of the first of its kind in the nation. Its purpose is first, to secure legislation for the protection of the nursing profession for the benefit of the public, the physician and the nurse by creating a law requiring the registration of nurses; second, to formulate a code of ethics for the nurse of the state; and third, to work for higher standards of nursing practice and a uniform curriculum in nurses’ education.


Act to Regulate the Practice of Professional Nursing of the Sick is filed with the Massachusetts State Legislature.


MNA succeeds in passing legislation creating Massachusetts Board of Registration in Nursing (BORN). The law calls for a mixed board of nurses, physicians and hospital administrators. On Nov. 15th of that year, MNA President Mary Riddle is issued a license as Massachusetts Registered Nurse #1, the first RN in Massachusetts, and the first chairperson of the Mass. BORN.


The vast majority of graduate nurses worked as “private duty nurses,” working in private homes. Hospital nursing was performed by student nurses in the hospital-based training programs, where they were little more than indentured servants. To assist private duty nurses in finding work the MNA established a Central Directory for private duty nurses to help them find work. In the following two decades, the registry grew from 250 to 2400 nurses, the largest non-profit registry in the nation.


MNA members participate in World War I and assist in mobilizing nurses to assist in responding to the Influenza pandemic in 1918. More than 400 MNA members, 30 percent of its total membership would serve in the war.


The Massachusetts Nurse Practice Act is amended to provide for the registration of only graduates of nurse training programs and for a standardized curriculum for the nurse training schools in the state.


The 19th Amendment grants women the right to vote.


The Goldmark Report, the study of Nursing and Nursing Education in the United States , is published. Gertrude Peabody of Boston’s Visiting Nurses Association and a member of MNA is instrumental in persuading the Rockefeller Foundation to fund the study.


MNA drafts and publishes a code of ethics for nurses in Massachusetts and the organization establishes its first headquarters at 420 Boylston Street.


MNA supports the eight hour work day for nurses.


MNA helps pass legislation calling for compulsory registration for graduates of attendant schools of nurses, (later known as LPNs).


World War II. MNA takes a leadership role in working with state and federal officials to develop nursing contingency plans for the war effort.


Margaret L. Slanger, a native of Roxbury and MNA member is the first Army Nurse killed in action shortly after the D-Day invasion. Her death makes national headlines and draws significant attention to the contributions of nurses to the war effort. In all, more than 3,500 MNA members will serve in the war, representing more than a third of the membership.


Nurses returning from war are reluctant to work under the conditions that exist in peacetime hospitals. A labor survey shows that the average wage for a staff nurse is 78 cents an hour, compared to 95 cents per hour for women working in manufacturing. This year, the American Nurses Association will endorse collective bargaining as a means for nurses to achieve better pay and working conditions. MNA will establish a professional placement and career counseling service to assist nurses in finding work in the peacetime economy.


First bachelor’s degree program in nursing is established at Boston University.


MNA nurses recruited for service in Korea .


The MNA membership votes to establish an Economic Security program, authorizing the use of collective bargaining for nurses. The same year, the MNA will be called upon to recruit nurses to help the state address the growing polio epidemic. MNA District 5 responds to an outbreak in the city of Boston by recruiting more than 300 nurses. In recognition of their effort, City Council passed a resolution acknowledging their contributions to the public health and safety.


The nurses at Hale Hospital form a union and organize a mass resignation to force the city of Haverhill to grant them a contract and pay increase. The MNA is called in to assist them in their efforts, marking MNA’s first successful effort to use collective bargaining on behalf of nurses.


MNA wins one of the most important amendments to the Nurse Practice act, making it mandatory that anyone practicing nursing in the Commonwealth must be registered to do so through the BORN. Before that time, nursing registration was only concerned with defining who could call themselves a registered nurse. Now, only a registered nurse or a licensed practical nurse could practice nursing – period.


MNA drafts and wins passage of legislation (Chapter 150 A) authorizing nurses employed in the private sector to engage in collective bargaining activities. Before this, nurses could organize a union, but employers were not required to recognize and/or bargain with the union.


MNA begins collective bargaining efforts. Quincy Hospital became the first MNA bargaining unit under the new law, casting an historic 189 to 15 vote in favor of forming a union. Whidden Memorial Hospital would win its vote a few months later. Within four years, MNA organized more than 76 bargaining units throughout the state.

Associate degree programs in nursing flourished in the Commonwealth, increasing from 6 to 19 between 1968-1978.


Thousands of nurses rally at the State House and at Faneuil Hall to help defeat Governor Francis Sargeant’s attempt to abolish the Board of Registration in Nursing.


MNA drafts and passes legislation authorizing Nurses to Practice in the Expanded Role, which opens the door to nurses with advanced education to provide a variety of specialized services, such as the delivery of primary care by nurse practitioners and assistance with birth by certified nurse midwives.


MNA drafts and helps pass legislation mandating completion of continuing education credits as requirement for nursing licensure renewal passed. Massachusetts legislature passes statute allowing Massachusetts nurse midwives to deliver babies.

After 75 years, the MNA finally wins passage of legislation mandating an “all nurse” Board of Registration in Nursing. The struggle for nurses to have complete autonomy over their practice is finally achieved.


Cost containment and health care restructuring by the state and federal government, along with cost cutting by health care employers creates deplorable working conditions and low salary levels for nurses that set the stage for more militant approaches at the negotiating table. Nurses at Cape Cod Hospital and Berkshire Medical Center take strike votes for the first time in MNA history. This time they settle without a strike.


The MNA supports and helps win passage of the state’s first Patients Bill of Rights, making Massachusetts only the third state to grant such rights to its hospitalized patients. It gives patients the right to know who is caring for them, to inspect their medical records and the right to prompt life-saving treatment without discrimination.


On May 28, 450 nurses at Newton Wellesley Hospital go out on strike to force the hospital to recognize their union. This is the first nurses’ strike in Massachusetts and the nation’s first nurse's’ strike for union recognition.

Later that year, the nurses at the Visiting Nurses Association of Boston will conduct a strike to win a “first contract,” which is the first “economic” strike in MNA history. Over the next three years, MNA bargaining units would wage strikes at Berkshire Medical Center (1981, 69 days), Cape Cod Hospital (1981, 17 days) Burbank Hospital in Fitchburg (1982, at six months, the longest strike in MNA history), and at Lynn Hospital (1983, 42 days).


MNA succeeds in passing the first bill authorizing Nurse Practitioners to write prescriptions in long-term care facilities and for certain patients at home. This is the first time registered nurses are allowed to write prescriptions. Limited prescription writing authority is granted to nurse midwives.


Bill passed to mandate third-party reimbursement for services of psychiatric nurse mental health clinical specialists and nurse midwives.


As hospitals continue to cut costs, nurses find themselves working with fewer ancillary support staff and being forced to perform extensive custodial, non-nursing duties. The nurses at Carney Hospital respond by waging a highly successful 36-day strike, winning language prohibiting them from being assigned non-nursing tasks.


Throughout the late 1980’s and early 90’s the health care industry attempts to deal with a shortage of nurses by replacing nurses with unlicensed technicians and aides. Nurses at Quincy Hospital and Boston Medical Center are the first to confront these schemes. Nurses at Carney Hospital fight back with an aggressive campaign to prevent this plan from being implemented, winning national recognition for their efforts.


Bill passed to allow nurse midwives to write prescriptions.


Special Commission on Nursing established by the Massachusetts Legislature.


Bill passed to allow nurse practitioners and psychiatric nurse mental health clinical specialists to write prescriptions.

Brigham & Women’s Hospital nurses ratify a contract which includes a landmark, first-in-the-nation provision guaranteeing disability insurance for those infected with HIV from a work-related exposure.


With the deregulation of the health care industry and the introduction of managed care in Massachusetts, the health care industry responds by slashing its nursing staff, laying off thousands of nurses and employing plans to replace nurses with unlicensed personnel. Nurses’ patient assignments double and the care they deliver begins to deteriorate.

The staff nurses at MNA bargaining units respond by appealing to the MNA Board of Directors for the MNA must take a stand and go public with their concerns. The MNA Cabinet for Labor Relations and the Board of Directors call a joint meeting in Randolph attended by more than 250 nurses from across the state. The nurses pass a resolution declaring that the quality of patient care in Massachusetts hospitals is being jeopardized and that the MNA should wage a campaign to improve patient’s access to safe nursing care. The MNA membership later will pass a resolution launching the MNA Statewide Campaign for Safe Care, an organization-wide public awareness and legislative campaign to improve the quality of patient care by increasing patient’s access to quality nursing care. This is the first time MNA members will agree to publicly and uniformly criticize the intent and practices of the health care industry in their delivery of health care.

Nurses at Brigham & Women’s Hospital will begin a campaign to draw media and public attention to the issue of poor indoor air quality workplace hazards on the health of nurses in their facility. More than 300 B&W registered nurses will suffer from illnesses related to the problem. group of affected nurses will mobilize a campaign to draw attention to the issue, first within in the MNA, and later throughout the national nursing community. Their efforts will make occupational health and safety a focus of MNA activity for years to come, establishing MNA as a leading voice for improvements in workplace safety to deal with the issues of indoor air quality, latex allergy, ergonomics/back injury prevention and workplace violence.


A Blue Ribbon Commission of nursing experts called together by the Safe Care Campaign drafts a legislative agenda to improve patient care. The package includes a bill mandating the identification of health care workers, legislation mandating the collection of patient outcome data compared to nurse staffing levels, and a bill regulating RN staffing levels and providing whistle blower protection to all health care providers.

The MNA wins passage of its legislation requiring all health care providers to wear name badges identifying their licensure status. This bill, part of the Safe Care Campaign, was designed to combat efforts by hospitals to pawn off unlicensed workers as nurses. Now patients would be able to know who is there nurse and who is not.


Nurses at Brigham & Women’s Hospital take a 90 percent vote in favor of a strike in their effort to prevent their employer from implementing contract provisions allowing the hospital to replace registered nurses with unlicensed personnel. The strike vote draws extensive state and national publicity to the dangers of such practices, leading the hospital to capitulate and preventing the need for a strike. Following this, 8 other MNA bargaining units will take strike votes winning similar protections.


The MNA wins passage of Whistle Blower Protection legislation, preventing health care employers from firing or reprimanding nurses and other providers from reporting unsafe conditions.


The MNA, through the work of its newly established Congress on Occupational Health & Safety, wins passage of legislation to protect health care workers from needlestick injuries and to mandate utilization of safe needles and sharps instruments. The initiative was sparked by by a tragic event, when then President Karen Daley, a nurse at Brigham & Women’s Hospital went public with her story of contracting HIV and Hepatitis C from a preventable needlestick caused by a poorly designed needle dispensing system.


On March 31st, 615 RNs at St. Vincent Hospital go out on strike over the issues of inadequate staffing and mandatory overtime. The first nurses’ strike in 14 years, the strike against for-profit Tenet Health Care will last 49 days, drawing significant local, state, national and international media coverage to the issue of mandatory overtime. It will end dramatically with a settlement negotiated in the Washington, DC offices of Senator Edward Kennedy. The settlement reached will serve as the foundation for contract language to be subsequently negotiated into a number of MNA contracts , and in nurses’ union contracts across the nation.

The MNA membership, led by the a number of leadership groups within the organization, begins to campaign for a vote for the MNA to disaffiliate from the American Nurses Association. The MNA, which for years had struggled to make the ANA more responsive and aggressive in addressing the needs of front-line nurses, had determined it needed to seek independence from the national federation and pursue new alliances with more like-minded and progressive state nurses’ associations.


On March 24th, at the more than 2,400 MNA members, the largest single gathering of nurses in one place in the state’s history, gather at Mechanics Hall in Worcester to cast their vote (82 percent) in favor of disaffiliation from the American Nurses Association.

The MNA, along with the California Nurses Association, the Maine State Nurses Association and the Pennsylvania Association of Staff Nurses and Allied Health Professionals announce the founding of the American Association of Registered Nurses, a new progressive national organization of nurses dedicated to protecting and advocating for nurses on the front-lines of health care.

Nurses at Brockton Hospital wage a 103-day strike over issues of unsafe staffing and mandatory overtime, once again drawing significant media coverage and community support. This time, Senator Kerry would step in to broker a settlement to the strike.

A special Legislative Commission on Nursing and Nursing Practice holds hearings across the state for nurses to testify about the crisis in nursing. In June, a report is issued calling for legislation, proposed by the MNA, to regulate RN to patient ratios and to prohibit mandatory overtime. The report validates what the MNA had contended for years through its safe care campaign.


The MNA, in support of its legislation to regulate RN to patient ratios in health care settings, conducts a survey of the public showing that more than 70 percent support legislation to regulate RN to patient ratios. In May, nurses from throughout the state circulate petitions calling for the passage of safe staffing legislation in their communities for eight days. On May 6, ambulances driven by nurses pick up the petitions and deliver 80,000 signatures to the front steps of the state house in an emergency call for legislative action.

On December 3, the MNA once again files Quality Patient Care/Safe RN Staffing legislation to regulate RN to patient ratios in Massachusetts Hospitals. The measure is essential to protecting patients and to ending a shortage of nurses caused by poor staffing conditions. To date, 100 legislators have signed on as sponsors of the bill.


MNA Members Speak on National Nurses Union
In a video presentation MNA members and officers speak out on the importance of having a national voice for bedside nurses and why now if the time to form The National Nurses United. Massachusetts Nurses Association, September 30, 2009

MNA Membership Votes In Favor of Dues Proposal to Support Affiliation with National Nurses United - the New “RN Super Union”
Massachusetts Nurses Association, November 10, 2009

Canton – The Massachusetts Nurses Association membership has voted today in favor of a dues increase to support the organization’s affiliation with the new national nurses union. The dues vote followed an overwhelming vote by the membership on October 1, 2009 to endorse the MNA’s affiliation with National Nurses United, what will be the largest nurses union in US history.

As dictated by MNA bylaws, the vote for the dues change was conducted by a supplemental mail ballot, which followed an in-person vote held at the MNA convention on October 1, 2009. The secret mail ballot was conducted over a 30-day period following the MNA convention. The counting of the ballots was overseen by Labor Connections, a firm that specializes in the monitoring and certifying union voting procedures.

National Nurses United (NNU), unifying the 23,000-member MNA with the 86,000-member California Nurses Association/National Nurses Organizing Committee (CNA/NNOC) and the 45,000 member United American Nurses, is scheduled to hold its founding convention December 7 and 8 in Phoenix, AZ. The new union of will comprise more than 150,000 front-line direct care nurses working in 22 states.

“With the formation of National Nurses United, we have a historic opportunity to create a the largest union and most influential collective voice of registered nurses at a time when that voice is sorely needed,” said MNA president Donna Kelly-Williams. “The MNA is proud to be a founding member of this new national movement of direct care RNs. We understand that this is a unique moment for nurses, a once in a lifetime opportunity to dramatically improve the lives of all nurses and patients and to transform the face of health care.

The goals of the new national union include a commitment to:

  • Win national RN staffing standards and an end to mandatory overtime nationally.
  • Obtain organized power and influence for our profession, like teachers, firefighters and police have done.
  • Build a national retirement pension for nurses.
  • Create one national progressive voice for healthcare reform, protection and advancement of safe nursing practice.
  • Strengthen contract standards nationally for nurses that already have union contracts.
  • Reach out to organize the millions of nurses in America who have been waiting for the opportunity to be part of a union.
  • Take back our profession so that every RN can advocate for patients without fear of retribution.

At its annual meeting the MNA membership voted by more than a three to one margin in favor of the affiliation with the NNU, and passed all related motions supporting the organization’s participation in the new union. The CNA/NNOC voted unanimously in September to endorse affiliation, and the UAN is expected to complete its vote by November 30th.

Copyright © 2009, Massachusetts Nurses Association

About National Nurses United

National Nurses United, with close to 185,000 members in every state, is the largest union and professional association of registered nurses in US history.

NNU was founded in 2009 unifying three of the most active, progressive organizations in the US - and the major voices of unionized nurses - in the California Nurses Association/National Nurses Organizing Committee, United American Nurses, and Massachusetts Nurses Association.

Combining the unparalleled record of accomplishments for nurses and patients embodied in the proud history of those nurses associations, which for some span more than 100 years, the establishment of NNU brought to life the dream of a powerful, national movement of direct care RNs.

At its founding convention in December, 2009, NNU adopted a call for action premised on the principles intended to counter the national assault by the healthcare industry on patient care conditions and standards for nurses, and to promote a unified vision of collective action for nurses with campaigns to:

  • Advance the interests of direct care nurses and patients across the US.
  • Organize all direct care RNs "into a single organization capable of exercising influence over the healthcare industry, governments, and employers."
  • Promote effective collective bargaining representation to all NNU affiliates to promote the economic and professional interests of all direct care RNs.
  • Expand the voice of direct care RNs and patients in public policy, including the enactment of safe nurse to patient ratios and patient advocacy rights in Congress and every state.
  • Win "healthcare justice, accessible, quality healthcare for all, as a human right."

In its first year, NNU made some spectacular achievements, including:

  • Organizing 6,500 RNs into NNU in Florida, Illinois, Iowa, Nevada, and Texas.
  • Sharing collective bargaining resources and experiences to support major collective bargaining campaigns in Massachusetts, Michigan, Minnesota, Washington DC, and other sites.
  • Sponsoring major national legislation to promote comprehensive reform for patient safety and professional nursing practice, including RN-to-patient ratios modeled on the successful California law sponsored by NNU affiliate CNA.
  • Strengthening the voice of RNs in the national healthcare reform debate, and in electoral campaigns from coast to coast.
  • Most notably, CNA/NNOC sponsored the nation’s foremost RN patient safety law, in California, requiring minimum RN-to-patient ratios, the most effective solution in the U.S. for stemming the erosion of care standards in hospitals.

NNU affiliate members are renown as leading advocates of guaranteed healthcare by expanding and updating Medicare to cover all Americans, for negotiating many of the best collective bargaining contracts for RNs in the nation, and for sponsorship of innovative legislation and regulatory protections for patients and nurses.

© 2010 - 2014 National Nurses United

Brand-New Nurses Union Aims to Ramp Up Organizing, Push for Single-Payer
David Moberg, In These Times, December 8, 2009

In a move that could ramp up healthcare worker organizing, three nurses’ unions joined together to form the new National Nurses United (NNU) at a convention in Phoenix on Monday and Tuesday. As we reported earlier today, the new 150,000-member union – bringing together the California Nurses Association/National Nurses Organizing Committee (CNA), the United American Nurses (UAN), and the Massachusetts Nurses Association – will be the largest union of nurses in the country.

But only 20 percent of roughly 2.5 million registered nurses (RNs) in America are organized, and they’re scattered across many unions – Service Employees (SEIU), AFSCME (public employees), Teachers (AFT), and many more, including the National Federation of Nurses.

National Nurses United hopes to unite all RNs and become the leading advocate nationally for nurses. “We hope to have all nurses united under one banner,” says former UAN secretary Jean Ross. All the NNU constituents broke away at different times from the American Nurses Association, which they saw as dominated by management interests.

As a united effort, NNU hopes that its combined resources and greater geographic coverage – about 23 states with at least one collective bargaining contract - will make it possible to better organize nurses at the workplace and in politics.

“What we believe it will accomplish is to provide strength in numbers, and with unification of state nurses associations to speak with one voice on patient advocacy, healthcare reform, workplace advocacy, the nursing profession, and how we move this country forward,” says Deborah Burger, the former CNA president who will be one of three NNU co-presidents. “Working together we’ll be out there nationally,” continuing CNA’s strong support for a single-payer healthcare system.

“We see every single day insurance companies trying to default on their responsibilities,” Burger says. “We will push for what will save lives and money and be the right thing in the end.” That will include, in addition to single-payer insurance reform, federal legislation mandating a minimum ratio of nurses to patients, similar to a law CNA got passed in California.

And, Ross adds, “we want to move forward on organizing faster than we are.” NNU plans to organize in states where it does not have a base, as well as where it has members and contracts. It will encourage associate memberships as well as try to organize RNs in hospitals.

Earlier this year, CNA and SEIU signed an agreement that CNA – and now NNU – will organize nurses whenever SEIU is organizing the rest of hospital workers. It was a victory for CNA and NNU’s strategy of craft unionism over the industrial union approach of organizing all hospital workers in one union.

Three co-presidents, one from each affiliating union, will lead the new union and serve as part of an executive committee of vice-presidents weighted to reflect the membership.

Copyright © 2009 In These Times

Michigan nurses celebrate creation of a national nurses union this week
Liz Shaw, Flint Journal, December 9, 2009

Okemos – A press release this morning from the Michigan Nurses Association has announced the founding of the National Nurses United (NNU), a new national nursing union with over 150,000 registered nurses as members.

The new organization will be the largest nurses’ union in the country and be a powerful voice for addressing nursing issues, according to the press release. The NNU was created by a unanimous vote on Monday, December 7 at the founding convention in Phoenix, AZ.

Here's the rest of the MNA announcement:

“This has been an incredible day for all of us at the Convention,” said John Karebian, MNA Executive Director, who was present at the voting. We are witness to the birth of a strong vibrant organization that will address the injustice in the health care system and restore a balance of power in our hospitals.”

The NNU joins three strong nurses’ unions that were already in existence: the California Nurses Association/National Nurses Organizing Committee (CNA/NNOC), the Massachusetts Nurses Association, and the United American Nurses (UAN). The Michigan Nurses Association (MNA), through its affiliation with UAN, will become part of the NNU.

“What a day Monday was! Nurses across the country joined together at the founding convention of the National Nurses United to be a powerful force in the movement for health care reform,” said Diane Goddeeris, RN, NNU Vice President and MNA Board member. “Taking to the streets on Tuesday, nurses used their voice to assist the nurses in Arizona as they fight for the right to join a union and work on safe patient care and safe working conditions. To be part of the NNU - 150,000 nurses strong - is only the beginning. We are one and will fight with solidarity so that the front line voice of nurses is heard across the country and every individual in this country will benefit from their advocacy. I've always been proud to be a nurse and today was a great day when we spoke together with one voice.”

In adopting a constitution and electing national officers, the NNU plans to quickly move forward on an active campaign to:

  • Advance the interests of direct care nurses and patients across the US.
  • Organize all direct care RNs "into a single organization capable of exercising influence over the healthcare industry, governments, and employers."
  • Promote effective collective bargaining representation to all NNU affiliates to promote the economic and professional interests of all direct care RNs.
  • Expand the voice of direct care RNs and patients in public policy, including the enactment of safe nurse-to-patient ratios and patient advocacy rights in Congress and every state.
  • Win "healthcare justice, accessible, quality healthcare for all, as a human right."

“We have before us an incredible opportunity to grab a hold of the future with NNU,” stated Jeff Breslin, RN, MNA President, “The strength of 150,000 nurses working together has never been seen before. The benefits of belonging to NNU for MNA are outstanding.”

© 2009 All rights reserved.

Nurses from 10 (sic) States Embrace National Union
Sandy Eaton, RN, Labor Notes, December 9, 2009

Registered nurses from across the US, with guests from as far away as Canada and South Africa, gathered this week for the founding convention of the National Nurses United, destined to be the largest RN union in the country's history.

Among the states represented were California, Massachusetts, Minnesota, Maine, Michigan, Pennsylvania, Illinois, Kentucky, Texas, Nevada and the District of Columbia.

Of prime significance was the presence of a delegation from the Veterans Affairs system represented by the United American Nurses. This national VA bargaining unit holds nurses from 13 additional states, and many thought they would decline to join the NNU. The UAN has been consumed by a contentious, litigation-filled atmosphere in recent months.

All warmly embraced, and many nurses, leaders and rank and filers together, took the mike. Mike D'Intinosanto from Massachusetts and Trande Phillips from California approached the mike together to call for vigorous support for a national legislative agenda, including safe RN-to-patient ratios, the Employee Free Choice Act, and real health care reform—single payer.

A delegate from Kentucky recalled that two years ago, while on strike against the Appalachian Health System, CNA and the UAN together brought real support. Having been dumped by the Kentucky Nurses Association at the end of the strike, those nurses have reconstituted themselves as the Southern United Nurses, and are now working to let the “SUN shine” on organizing all other front-line nurses. A repeated theme throughout these spontaneous remarks was how long overdue this formation of a national voice for frontline nurses is.

Delegates moved quickly to adopt unanimously the draft NNU constitution. The slate of officers proposed by the three merging nurses' unions, including three presidents and eleven vice presidents, was elected unanimously. Martha Kuhl, CNA-NNOC treasurer, was nominated for NNU secretary-treasurer from the floor and unanimously elected. The proposed dues policy was duly approved.

The essential business before this body was clear and everyone present knew why they were there. Unanimous votes followed in swift succession.

The conclusion of this business meeting unleashed a torrent of joy. John Karebian from Michigan and I shared a comradely embrace. After sharing in the fights to democratize the management-dominated American Nurses Association in the ‘90s and after the separation caused by disaffiliation, our states were united again, but on a much higher level.

Nurses young and old discussed their experiences in three panels Monday afternoon, followed by a panel composed of the three newly elected co-presidents, Karen Higgins of Massachusetts, Jean Ross of Minnesota, and Deborah Burger of California.

Jeff Breslin from Michigan moderated the panel on today's challenges. Phillips described how recent technological changes are often designed to make nurses "responsive to the machine." She held up a new "Technology Despite Objection" form. She suggested that every nurse's contract needs language that technology will not be used to supersede the nurse's professional judgment.

Donna Kelly-Williams from Massachusetts outlined the plight of those falling victim to mounting insecurity and joblessness as mental health and substance abuse programs are slashed. She described how the injustices built into the Massachusetts health plan created in 2005 and the cutbacks introduced to bail it out have undermined the ability of safety net facilities to cope with this economic crisis.

The national health care reform fight was on everyone’s lips.

“Who was at the debate?” asked Karen Higgins of Massachusetts. “Insurance, hospitals, PhARMA (the pharmaceutical lobby). Where were we? The few times we were supposed to be there, ANA was standing there. How can you have this discussion without our presence?”

Lorna Grundeman from California described the experience of forging a master agreement for the Catholic Healthcare West chain in California and Nevada, with the demand for occupational safety in the face of the spread of the H1N1 virus. A 97 percent strike vote followed a period of intense internal organizing.

The presidential panel examined what it took to get us here and what we need to do now. Jean Ross greeted the UAN's VA Council, which overcame the lies regarding the proposed NNU that had been foisted upon them. She thanked the legal team that beat back the divisive assault.

Higgins recalled the March 24, 2001 meeting in Worcester, Massachusetts, the largest gathering of nurses in the history of the state. The first vote was to disaffiliate from ANA. The second vote, following swiftly, was to form a national nurses union. "Nine years later we accomplished that."

Two thoughts immediately arose, she said: "What took us so long?" and "Don't screw it up!"

Higgins pointed out that, with 23,000 members, Massachusetts has done well on issues affecting our practice. "But we don't live on an island," she said, observing that New Hampshire has passed legislation to allow unlicensed personnel to give out medications in hospitals. Connecticut has passed a weak "safe staffing" bill that has harmed our attempt to push forward in Massachusetts. How do we stop it? "Organizing: we need to organize every nurse," Higgins concluded.

Tuesday morning opened with presentations on collective bargaining strategy and tactics. Samples of model contract language were circulated by Californians, while Massachusetts stressed leadership development as concretized in its Labor School. The idea was raised of organizing a national labor school.

There followed a demonstration outside the offices of the Arizona Hospital Association. Nurses in Flagstaff and Phoenix have been trying to organize, and they have been viciously thwarted thus far by professional union busters paid $900 an hour. Chants and freedom songs punctuated the rally, and the Communications Workers, Service Workers, and other unions were represented at the rally as well. The convention's final session heard the charge from Rose Ann DeMoro, NNU's newly chosen executive director, to pool resources in order to organize on a scale never before seen and to supplant the voices of the tea baggers. Delegates began their trek home to take up the challenge.

Sandy Eaton is a Massachusetts nurse and NNU delegate.