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J U LY | A U G U S T | S E P T E M B E R 2 0 2 6 W W W . N A T I O N A L N U R S E S U N I T E D . O R G N A T I O N A L N U R S E 19 WRAP-UP REPORT California statewide—on june 1, California nurses celebrated the historic implementation of long-awaited safe nurse-to-patient staffing ratios in the state's acute psychiatric hospitals (APH) that should dramatically improve the care behavioral health patients receive and that RNs can provide. The state only established these emergency regulations after California Nurses Association (CNA) pressured the gov- ernor and the California Department of Public Health (CDPH) to do so. Though mandatory minimum safe regis- tered nurse-to-patient staffing ratios for acute psychiatric hospitals were mandated by the seminal safe staffing legislation Cali- fornia Nurses Association sponsored and fought to pass in 1999, A.B. 394 (Kuehl), the state failed for over two decades to follow up with regulations for acute psychiatric hospi- tals after they rolled out ratios for general acute-care hospitals in 2004. After a San Francisco Chronicle investigation exposed staffing problems at acute psychiatric hospi- tals last year, CNA demanded that the state establish these long-promised regulations for such facilities. In the face of intense lobbying by the profit-driven corporate hospital industry to adopt weak regulations, the current emer- gency regulations represent a significant correction upon earlier versions. Due to nurses' strong advocacy through public comments, testimony, and direct action, CDPH closed up major loopholes that would have not only let acute psychiatric hospitals evade meaningful staffing ratios, but also have undermined the existing RN- to-patient standards in general acute-care hospitals. Contra Costa County—Registered nurses with Contra Costa County Health Services voted 95 percent in August to ratify a new con- tract, winning protections to improve patient safety and nurse retention, announced Cali- fornia Nurses Association (CNA). Highlights of the contract include: improved union nurses' ability to combat vio- lence, harassment, and retaliation in the workplace; job and hour stability as H.R. 1 cuts to Medi-Cal impact the health system; prevention of the elimination of the health plan of more than 400 nurses and many more retired county nurses; and no takeaways. The new pact covers the period from September 2026 to November 2029. CNA represents more than 1,300 nurses at Con- tra Costa County Health Services. St. Helena—In a landslide vote, about 250 registered nurses at Adventist Health St. Helena in St. Helena, Calif. voted in July to join California Nurses Association (CNA). Nurses at the 150-bed facility say they voted to join the union because it is critical that nurses have a say in making decisions to help recruit and retain experienced nurses, which leads to improved patient care. CNA repre- sents more than 1,880 nurses at Adventist facilities in California including 700 RNs at Adventist Health Rideout in Marysville; 400 RNs at Adventist Health Lodi Memorial in Lodi; 300 RNs at Adventist Health Sierra Vista in San Luis Obispo; and 230 RNs at Adventist Health Twin Cities in Templeton. Maine registered nurses at Houlton Regional Hospital (HRH) in Houlton, Maine, held a four-day strike starting May 26, to protest management's refusal to address their deep concerns about emergency department (ED) staffing and its impact on patient care, announced Maine State Nurses Associa- tion/National Nurses Organizing Committee (MSNA/NNOC). After the closure of labor and delivery services on May 2, 2025, HRH nurses had reached an agreement with the hospital to increase RN staffing to three nurses at all times in the emergency department in antic- ipation of pregnant patients showing up with urgent cases there. However, new man- agement took over at the end of May 2025 and is not honoring the agreement to ensure patient safety. Currently, only two nurses are scheduled from 11 p.m. to 9 a.m. daily. HRH nurses have been negotiating for over a year and a half for a new contract. The previous contract expired on Nov. 30, 2024. Missouri registered nurses at Research Medical Center (RMC) in Kansas City, Mo., held a rally on June 4 to demand immediate action to address what nurses describe as danger- ous patient care conditions impacting emergency and surgical services following the Sept. 8, 2025 closure of units that pro- vide labor and delivery, neonatal intensive care, and obstetrics emergency care services. Several pregnant patients arrive at RMC every month, unaware that these perinatal services have been shut down. The nurses, who are represented by NNOC/NNU, report ongoing concerns about inadequate staffing, lack of special- ized training to care for pregnant patients, insufficient fetal monitoring capabilities, inadequate obstetric and pediatric emer- gency resources, lack of consistent OB/GYN provider coverage, and inadequate prepara- tion for obstetric emergencies occurring in the emergency department (ED) and oper- ating room (OR). At a minimum, nurses' demands include obstetric, trauma-trained RN coverage on all shifts, including nights and weekends; immediate review of emergency obstetric response readiness in the ED and OR; read- ily accessible fetal monitoring equipment; appropriate neonatal emergency equip- ment, medications, code resources in the ED and OR; and clear patient-facing notifica- tion regarding the closure of obstetric services at RMC. —Staff report Clockwise from top left: California nurses rally for acute psychiatric hospital RN staffing ratios; Houl- ton RNs in Maine protest ripple effects to ED after closure of L&D services; Kansas City nurses also protest shutdown of perinatal care.