Nurses from one end of the United States to another have formed the largest nurses union to date to give them a greater voice in the health care debate and expand their ranks. The new National Nurses United will represent about 150,000 nurses following the joining of the California Nurses Association (83,000), the United American Nurses (45,000) and the Massachusetts Nurses Union (23,000). The unions will continue to operate separately, while also combining their forces under the National Nurses United to lobby Washington, DC. The nurses favor the single-payer model in the healthcare reform debate, and they want the country to adopt California’s mandatory nurse-to-patient ratio law. Despite its size, the new union represents only ten percent of all nurses working in hospitals or clinics (1.5 million).