Registered nurses at HCA HealthONE Swedish Medical Center in Englewood, Colorado voted on July 1 and 2, 2026 to join the National Nurses Organizing Committee/National Nurses United (NNOC/NNU), adding nearly 800 nurses at a 504-bed Level I trauma center to NNU's growing HCA footprint. The election was overshadowed by allegations of employer interference — one nurse described management attempts to undermine the campaign as "illegal" — but the vote carried regardless.
The result makes HCA HealthONE Swedish NNU's 20th HCA-affiliated facility win. NNOC/NNU now represents more than 10,000 nurses at 19 HCA facilities spanning seven states, from California to Florida. Each additional NNU win inside HCA's portfolio strengthens the union's position in eventual system-level bargaining and gives nurses at non-unionized HCA facilities tangible evidence that organization is achievable even at a company with a well-documented history of aggressive anti-union activity.
Why It Happened at Swedish
HCA HealthONE Swedish is one of the flagship hospitals in Denver's south suburban healthcare corridor — a Level I trauma center serving a large catchment area that includes some of the most complex cases in the region. Nurses at Swedish face the staffing, workload, and recognition issues common across HCA's national system: HCA is the largest for-profit hospital operator in the US, with a culture that prioritizes margin targets, and nurses have consistently cited staffing ratios and management practices as primary organizing drivers at HCA facilities across the country.
Christina Michas, RN in the general rehabilitation unit at Swedish, said in NNU's announcement: "This is a huge victory for the nurses at our hospital and across the HCA system nationwide — even when they try to illegally interfere with our elections, nurses will hold them accountable." The allegation of interference is significant; NLRB case filings at HCA facilities have documented management tactics including mandatory anti-union meetings, targeted one-on-one conversations with nurses, and distribution of materials alleging union dues would eliminate take-home pay gains. Whether the Swedish campaign involved specific NLRB charges has not yet been confirmed in public filings.
What This Means for HCA Nurses Nationwide
Each NNU election win inside HCA creates a data point that nurses at other HCA facilities can use: the company will run an anti-union campaign, the campaign will include pressure and information designed to discourage a yes vote, and the vote will still happen if nurses are organized. The Swedish result continues a pattern that has seen NNU win elections at HCA facilities despite significant institutional headwinds.
NNU is systematically working through HCA's footprint. 19 facilities, 10,000+ nurses, seven states. That's not a wave — that's a campaign. The leverage that comes from representing nurses at a significant fraction of the largest for-profit hospital system in the country is different in kind from single-facility wins. If NNU gets to 25-30 facilities covering 20,000+ nurses, they'll have a viable mechanism to bargain on a coordinated HCA-system basis, which changes the math for every HCA RN in the country.
HCA, Staffing, and What Comes Next
HCA Healthcare reported $67.9 billion in revenue in 2025 and is among the most profitable hospital operators in the country. That financial backdrop matters to nurses negotiating first contracts at facilities like Swedish: the argument that there is no money for staffing improvements or competitive wages is harder to make credibly when the parent company posts record margins. NNU has used HCA's own financial disclosures as a bargaining tool at multiple facilities, highlighting the gap between executive compensation and bedside nurse wages.
Colorado has no state-level nurse-to-patient ratio law, meaning staffing at HCA HealthONE Swedish has been entirely at management discretion. Union contract language establishing minimum staffing ratios or mandating nurse input on staffing decisions would represent a substantive operational change — and is almost certainly among first-contract priorities NNU will bring to the table. Nurses at Swedish will now begin negotiating that first contract, a process that typically takes 12–18 months at facilities with contentious management-labor histories.
Sources
- National Nurses United — Nurses at HCA Swedish Medical Center join nation's largest nurses union — nationalnursesunited.org
- NLRB — HCA-HealthONE LLC, d/b/a Swedish Medical Center — Case 27-RC-346403 — nlrb.gov