Registered nurses at Ascension Saint Agnes in Baltimore voted overwhelmingly to ratify a three-year collective bargaining agreement, the hospital’s first union contract for private-sector nurses. The ratification was announced in a press release dated September 19, 2026, from the National Nurses Organizing Committee/National Nurses United (NNOC/NNU).
The new pact covers the period from September 2026 through September 2029 and applies to more than 600 nurses represented by NNOC at Saint Agnes. According to NNU, the agreement delivers a mix of patient-safety, workplace-protection, and economic provisions that nurses had prioritized during four years of organizing and bargaining.
Contract highlights, as described by NNOC/NNU, address multiple issues nurses said were undermining patient care and retention:
Safe staffing changes: The agreement calls for an end to floating nurses to units outside their clinical competency. It establishes a Professional Practice Committee and a Staffing Issues Committee and ends mandatory overtime. These measures are intended to strengthen nurse assignment practices and reduce staff movement between unrelated units.
Workplace violence prevention: New language requires security be available to immediately assist nurses and includes protections against discipline when nurses raise safety concerns.
Fair process and representation: Nurses won a formal grievance procedure that includes the right to arbitration, just-cause and progressive-discipline standards, and the right to union representation during disciplinary proceedings.
Economic improvements: The contract includes a 5–6% pay increase over three years. NNU also reported that since unionizing in 2023, full-time and part-time Saint Agnes nurses have seen cumulative raises of up to 34% as a result of union advocacy.
No mass layoffs of per diem nurses: The agreement prevents the mass layoffs of per diem nurses that were reportedly proposed by Ascension earlier in negotiations.
Successorship protections: Language in the contract protects the agreement’s terms in the event of a change in hospital ownership.
Nurses who organized and bargained for the contract framed the agreement as the product of a multiyear effort. Robin Buckner, RN in intravenous therapy, said the contract provides protections against unsafe floating, unfair discipline, and workplace violence, and that nurses now have a voice to advocate for safe staffing so patients get better care. Melissa LaRue, RN in the intensive care unit, noted that the organizing campaign won equipment and staffing improvements as well as raises, and said nurses are prepared to hold Ascension accountable to the contract while continuing to press for a hospital that prioritizes patients over profits.
NNOC represents the bargaining unit at Saint Agnes, which unionized in 2023. The union describes itself as the largest and fastest-growing organization of registered nurses in the United States, with more than 225,000 members nationwide and several state affiliates. The Saint Agnes agreement is presented by NNU as a watershed moment for nurses across Baltimore, marking the first private-sector hospital contract for RNs in the city.
From the nurses’ perspective, ending mandatory overtime and limiting floating to areas within a nurse’s clinical competency are practical changes intended to reduce fatigue, improve continuity of care, and lower the risk of assignment-related errors. The establishment of committees for professional practice and staffing issues creates formal venues where front-line nurses can participate in staffing decisions and clinical policy discussions. Workplace-violence protections are meant to provide immediate security support and to ensure staff can report safety concerns without fear of retaliation.
Economically, the negotiated pay increases aim to help retain and recruit experienced nurses amid competitive labor markets and staffing shortages. NNU’s report that cumulative raises since 2023 reached up to 34% for some nurses suggests substantial wage changes over the unionization period, although the press release does not provide a breakdown of how those cumulative increases were distributed across roles or time.
Union leaders said they will hold Ascension accountable to the contract’s terms. The press release states the contract empowers nurses to enforce provisions through grievance procedures and arbitration rights. Specifics on implementation timetables, committee membership, or how the hospital will operationalize security provisions and staffing committees were not reported in the source.
NNOC framed the ratification as a significant advance for Baltimore nurses and an example of what sustained organizing can produce at a local hospital. The agreement’s combination of staffing, safety, process, and pay elements reflects priorities that many nurses nationally have cited as central to improving hospital working conditions and patient outcomes.
The source does not report detailed timelines for when each contractual change will take effect, metrics the parties will use to measure staffing improvements, or the hospital’s public response to the ratification. Those implementation details and any follow-up statements from Ascension Health were not included in the press release.
Observers and nurses are likely to track whether the new committees and grievance processes produce measurable changes in staffing assignments and safety incidents, and how the hospital responds to enforcement actions under the contract. NNOC said the agreement runs through September 2029; any long-term effects on retention, patient care quality, and labor relations in Baltimore will become clearer over the life of the contract.
National Nurses United describes itself as a large nurses’ union and professional association with over 225,000 members nationwide and multiple state affiliates. In Baltimore, NNOC represents more than 600 nurses at Ascension Saint Agnes and led the organizing and bargaining that produced the three-year contract announced in September 2026.
For further details about the contract’s operational plans or Ascension’s response, the source press release did not provide additional information or timelines.
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