Yes, there are several nurses unions in the United States, and the largest is National Nurses United (NNU), which represents more than 225,000 registered nurses across all 50 states. Nurses also organize through state-level unions like the New York State Nurses Association and through broader healthcare worker unions. Whether you can join one depends on your state, your employer, and whether your workplace has already organized.
The Largest Nursing Unions
National Nurses United is the primary national union for registered nurses. It formed in 2009 through a merger of three major nursing organizations and has grown steadily since. NNU focuses not just on wages but on staffing ratios, workplace safety, and patient care standards.
Beyond NNU, many nurses belong to state-specific unions. The New York State Nurses Association (NYSNA), for example, represents over 20,000 nurses across a dozen private-sector hospitals in New York alone. Other nurses join broader labor organizations like SEIU Healthcare or the American Federation of Teachers’ healthcare divisions, which represent a mix of healthcare workers including nurses, nursing assistants, and support staff.
What Unions Actually Win for Nurses
The pay difference between union and non-union nurses is real but modest compared to some other professions. Bureau of Labor Statistics data from 2025 shows that healthcare practitioners who belong to unions earn median weekly pay of $1,605, compared to $1,521 for non-union workers. That gap of roughly $84 per week adds up to about $4,400 a year.
For lower-paid healthcare support workers like nursing assistants, the union advantage is proportionally larger: $884 per week compared to $777 for non-union workers, a difference of over $5,500 annually.
But wages are only part of the picture, and research suggests nurses often prioritize non-wage issues when they organize. Recent contract wins illustrate this well. In early 2026, NYSNA nurses at NewYork-Presbyterian ratified a three-year contract after a 41-day strike that secured salary increases of more than 12% over three years, enforceable staffing standards requiring hospitals to hire more nurses, protection of existing health benefits that the hospitals had tried to cut, new workplace violence protections, and the first-ever contract language safeguarding nurses against the unchecked use of artificial intelligence. These non-wage provisions, particularly around staffing and safety, are increasingly what drives nurses to organize in the first place.
Your Legal Right to Organize
Federal law protects your right to form or join a union. Section 7 of the National Labor Relations Act guarantees employees the right to organize, join labor organizations, and bargain collectively. It also protects your right not to join a union if you choose.
The law makes it illegal for your employer to interfere with organizing efforts, retaliate against you for supporting a union, fire or discipline you for filing complaints, or refuse to negotiate with a union that your coworkers have voted in. These protections apply to most private-sector nurses. Public-sector nurses (those working for government hospitals or agencies) are covered by separate state laws, which vary.
How Nurses Form a Union
If your workplace isn’t already unionized, there are two paths to getting there. Both start the same way: you contact an existing union’s organizers or begin organizing independently among your coworkers.
The faster route is voluntary recognition. If a majority of nurses in your unit sign authorization cards indicating they want union representation, you can ask your employer to voluntarily recognize the union. If the employer agrees, bargaining can begin immediately.
The more common route goes through the National Labor Relations Board. You need at least 30% of your coworkers to sign authorization cards, then file a petition with the NLRB for a formal election. If the union wins more than 50% of the votes cast, your employer is legally required to bargain in good faith over working conditions, pay, and benefits. The election process typically takes several weeks from petition to vote, though employer challenges can extend the timeline.
Why Union Coverage Varies by State
Nursing union membership is concentrated in certain regions, particularly the Northeast, the West Coast, and parts of the Midwest. In states with right-to-work laws, which exist in about half the country, workers in a unionized workplace cannot be required to pay union dues as a condition of employment. This doesn’t prevent unions from forming, but it does make them harder to sustain financially, since some workers benefit from union-negotiated contracts without contributing dues.
The practical result is that nurses in states like California, New York, and Massachusetts are far more likely to be covered by a union contract than nurses in Texas, Florida, or Georgia. If you’re job hunting and union representation matters to you, the state and the specific hospital system are both worth researching. Large urban hospitals and academic medical centers are more likely to be unionized than small rural facilities or for-profit chains.
What Unions Don’t Cover
Supervisory nurses, including many nurse managers and directors of nursing, are excluded from NLRA protections and generally cannot join the same bargaining unit as staff nurses. Independent contractors and certain advanced practice nurses in supervisory roles may also fall outside union eligibility. Travel nurses, because they work for staffing agencies rather than the hospital itself, typically aren’t part of a hospital’s bargaining unit either, though some staffing agencies have their own labor agreements.
If you’re a staff RN, LPN, or nursing assistant at a private-sector hospital or clinic, you almost certainly have the legal right to organize. The question is whether your coworkers share the interest and whether an existing union is willing to support the effort. Most major nursing unions have organizers you can contact confidentially through their websites to explore what the process would look like at your facility.