National Nurses United may be proof that unions are not all on their way out: Some are very much alive, although they may look a little bit different than they used to.

“Nurses United is among the most innovative and bold of U.S. unions,” said Harley Shaiken, a labor expert at Berkeley. “They’ve emerged as a powerful voice in defense of people who receive health care treatment.”

Last year, 14.5 million workers were members of unions, that's about 11.3 percent of wage and salary workers, according to the Bureau of Labor Statistics. In 1983, by comparison, there were 17.7 million union workers, or about 20.1 percent of workers.

Yet the nurses have organized 20,000 new nurses in 50 new hospitals since 2009. Some of those new nurses are in right-to-work states such as Texas, where just 4.8 percent of workers are represented by unions. In California, 16.4 percent of workers are unionized.

“We are organizing Texas—and we'll organize all of the United States,” DeMoro told me. “There’s no question in my mind, that's a given. I say that with absolute certainty.”

NNU was formally created in 2009, but its origins go back further than that, to 1995, when the California Nursing Association, led by DeMoro, broke off from American Nursing Association. It wanted to more aggressively fight hospital management for better working conditions for nurses. The new union soon became a force in California politics, battling Arnold Schwarzenegger when he tried to block a law that would increase the numbers of nurses in hospitals, an effort he eventually dropped. The nurses outed former gubernatorial candidate Meg Whitman for hiring an undocumented maid, who contacted NNU for help after being fired. The union advocated for stimulus dollars and against Wall Street in the debt talks of 2010.

The California Nurses Association joined two other groups to form National Nurses United in 2009. DeMoro still leads the group from a building in downtown Oakland, right next to the regional headquarters of Kaiser Permanente, which the nurses have taken on with particular vitriol. Thousands of Kaiser nurses are planning to strike on November 12th to protest insufficient Ebola protection; Kaiser and NNU are in the middle of bitter contract negotiations.

On the day I visited DeMoro, we could hear faint chants of women’s voices outside in the sunny Oakland morning, coming from the direction of the Kaiser building.

“Did someone forget to tell me we were protesting?” DeMoro asks one of her staffers, who explains that the nurses, here for a press conference later in the day, just decided to wander over to Kaiser and march around for a bit.

It is perhaps not surprising that the nurses have done so well—after all, healthcare is a growing field. The recent Ebola epidemic has helped them gain even more traction: Nurses at Texas Presbyterian, who are not unionized, contacted NNU out of frustration with the lack of advanced preparations for Ebola patients.