Registered nurses at CommonSpirit Memorial Hospital in Chattanooga, Tennessee, will vote next month on whether to form a union with National Nurses United (NNU), after the US National Labor Relations Board (NLRB) set the dates for a secret-ballot election.
According to the Chattanooga Times Free Press, which reported the decision on 28 October 2026, about 700 registered nurses are eligible to vote. Voting will take place on 17 and 18 November 2026 in a boardroom at the hospital on Desales Avenue, with ballots counted after the final voting session.
What nurses are asking for
A union flier described in the report lists the priorities nurses want to bargain over:
- Adequate staffing support.
- Protections against technology replacing nurses, a concern that has featured in a growing number of US nurse contracts as hospitals adopt AI tools.
- A fair and competitive wage scale.
- Protection of benefits.
Nurses filed for union representation in early October. NNU has publicly accused the hospital of putting “money over patients”, a charge typical of union organising campaigns. Hospital management positions on unionisation are usually set out to staff during such campaigns; the report did not include a detailed response from CommonSpirit.
Who is National Nurses United?
NNU, based in California, is the largest union and professional association of registered nurses in the United States. It says it has more than 225,000 members, including more than 17,000 registered nurses at 32 hospitals in the CommonSpirit Health system, one of the largest nonprofit hospital chains in the country.
How an NLRB union election works
For nurses outside the US, the process may be unfamiliar:
- Workers sign cards or a petition showing support for a union, and the union files a petition with the NLRB (at least 30% support is required to trigger an election).
- The NLRB determines who is in the “bargaining unit” (here, registered nurses) and schedules a secret-ballot election.
- If a majority of votes cast are in favour, the NLRB certifies the union.
- The employer is then legally required to bargain in good faith with the union over pay, hours and working conditions. Reaching a first contract can take months or longer.
Part of a wider trend
2026 has been an active year for US nurse labour relations, with strikes, new contracts and organising drives across the country. Recent examples on our site include Allegheny General nurses winning a contract with AI protections, Brigham and Women’s nurses rejecting a “final” offer, and strikes in California. Tennessee is a “right-to-work” state, where union membership has historically been lower, making a successful vote in Chattanooga notable.
What it means for international nurses
Many internationally educated nurses work in US hospitals on green cards. In a unionised hospital, you would typically be covered by the collective agreement, including pay scales, seniority rules and staffing provisions, and you have the same right as US-born colleagues to vote in union elections. Your immigration status does not remove your rights under US labour law. If you’re considering a US job, it’s worth asking whether the hospital is unionised and reading the contract.
We’ll report the result after the vote.
Related: Brigham nurses reject “best and final” offer · Santa Rosa strike and Allegheny contract · US licensure for international nurses
Source: Chattanooga Times Free Press (28 October 2026); NLRB election procedures.