Labor unions have historically played an essential role in the fight for democracy and workers’ rights. Yet they have largely retreated during Donald Trump’s second presidency in the face of his administration’s vicious attacks on organized labor.

In 2025, the number of strikes in the United States declined by 36 percent from their uptick in 2023, the year of the United Auto Workers’ “stand-up strike” against the Big Three automakers and of a number of other major strikes across the country. Although union density increased by 1 percentage point last year, and unionized workers engaged in important efforts from launching rank-and-file caucuses to organizing against Immigration and Customs Enforcement (ICE), unions increasingly neglected one of their most powerful tools: withholding their labor.

Health care unions are an important outlier in this national story of union retreat, however. Public and private sector health care unions drove 29.4 percent of all strikes and twelve out of the thirty-one major strikes (those involving more than one thousand workers) in 2025. Much of this activity was led by nurses. Thanks to their leverage in a growing health care industry in need of their skilled labor — and their willingness to take collective action — many nurses won impressive improvements to patient care through safe staffing as well as workplace safety measures, income increases, and other gains.