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Despite the challenges of the Covid-19 pandemic, as well as a campaign by union busters to delay the election, nurses in North Carolina, the second least unionized state in the country, have been able to file a petition to form a union with National Nurses United (NNU). Approximately 1,600 nurses will be eligible to vote. The nurses had to contend with HCA Healthcare, the nation's largest hospital corporation, in their union drive efforts. HCA Healthcare has owned seven nonprofit hospitals in western North Carolina since 2019, and nurses say that since that acquisition, patient care and working conditions have deteriorated. HCA has attempted to delay the election by using the pandemic as a reason as well as hiring staff at $400 per hour to talk to workers to convince them to not join the union. North Carolina's labor history has been predominantly anti-union.