California Nurses Association/National Nurses Organizing Committee

Under RoseAnn DeMoro's leadership, CNA gained attention for its sponsorship of legislative and regulatory reforms, including the nation's only legislatively mandated nurse-to-patient ratios in California.[2][3] The ratio law, which requires hospitals to maintain a minimum number of nurses in all hospital units at all times, was signed in 1999 by then-California Gov. Gray Davis. The ratios were implemented in 2004. When California Gov. Arnold Schwarzenegger sought to roll back key portions of the law in late 2004 at the request of the California hospital industry, CNA led a successful year-long campaign to challenge Schwarzegger and protect the law.

A subsequent study evaluated the effect on outcomes for nurses and patients by comparing outcomes in California in the subsequent two years with those of New Jersey and Pennsylvania — two similar states without such mandates.[3] There was substantial compliance with the mandate in California, with over 80% compliance rates reported across several different units of surveyed hospitals; equivalent levels of non-mandated compliance in the comparator states were considerably lower, at 19%, 52%, and 63% compliance in medical/surgical, pediatric, and intensive care units (ICUs) in New Jersey and 33%, 66%, and 71% in Pennsylvania.[3] After extensive adjustment for patient and hospital characteristics, the study revealed statistically significant relationships between the nurse-to-patient ratio and 30-day mortality and failure to rescue (FTR — that is, failure to prevent a clinically-important deterioration, such as death or permanent disability, from a complication of an underlying illness or of medical care) in all three states.[3] In particular, for every additional patient added to a nurse's workload, the odds of patient death increased by in 13% California, 10% in New Jersey, and by a factor of 6% in Pennsylvania after adjusting for these factors. Across all three states, facilities with nurse-to-patient ratios consistent with those mandated in California were associated with lower rates of nursing burnout, and nurses reported consistently better quality of care.[3]

A California Field Poll in April 2008 found that CNA has the highest favorable rating among all groups, politicians, and institutions involved in public policy debates over health care reform in the state.[4]

On May 9, 2008, the Public Broadcasting Service television show with Bill Moyers featured a segment on CNA/NNOC describing a campaign conducted by the organization saying all Americans should be entitled to the same level of care available to Vice President Dick Cheney and members of Congress.

The growing achievements of CNA and NNU received much national attention in 2010. A profile of CNA and DeMoro in Business Week, July 22, 2010, noted, "Under DeMoro, the union threw itself into the broader fight for patients' rights in the face of consolidation in hospital chains and insurers. The NNU simply takes that fight national, says DeMoro." The Washington Post, November 20, 2010 described "an aggressive strategy by a national nurses union, experts say: Its members are growing in numbers, and they have not been afraid to walk picket lines." The San Francisco Chronicle, in an article headlined, "Nurses union becomes potent political force," November 24, 2010, wrote, "The Oakland-based California Nurses Association has made its mark by delivering some powerful political punches with a combination of entertaining theater and savvy strategizing."

On February 18, 2009, CNA/NNOC announced that it is joining with two other nurses unions, the Massachusetts Nurses Association and the United American Nurses, to create a 150,000-member union. The organization is called National Nurses United[8] and is affiliated with the AFL-CIO. Deborah Burger, co-president of CNA/NNOC said that the new group is intended to give registered nurses a national voice and more organizing strength.[9]

On January 3, 2013, the CNA joined forces with the National Union Of Healthcare Workers (NUHW) to form a new union, NUHW-CNA. Part of the motivation regarding the affiliation was the 2013 election for 43.000 Kaiser service and tech workers represented at the time by CNA rival, SEIU-UHW. Despite CNA support, SEIU-UHW won the election and the partnership between CNA and NUHW eventually ended.[10]