Frequently asked questions about districts

What are districts?

District nurses associations in Washington state first formed as "county graduate nurses associations" as far back as the late 1890s, and they exist to this day. Read the full history of districts in Washington state below.

Am I a member of a district?

All WSNA members are a member of the district for the county in which they live. See the full list of district nurses associations below.

How are districts different from local units?

A local unit is specific to the facility where a nurse works, and local units are an important part of the collective bargaining program. If you are a WSNA union member, you are a member of the local unit for the WSNA-represented facility where you work.

Districts are not involved in collective bargaining (union) activities. All WSNA members are members of a district, whether they are a union member or not.

The move to Regional Nurses Associations

In 2018, the WSNA Board of Directors approved a plan to create Regional Nurses Association, combining multiple existing WSNA Districts to better meet the needs of members.

District Nurses Associations have been a part of WSNA from the beginning. Districts are unrelated to Local Units and are not involved in collective bargaining (union) activities. All members of WSNA are also members of their District or Regional Nurses Association. They are supported by a portion of membership dues and are intended to provide educational offerings, scholarship fundraising and networking on a local level. While larger Districts have successfully fulfilled that mission, most of the county-based districts are too small to effectively manage a program of local offerings.

The combined resources of Regional Nurses Associations will offer members more opportunities and, we trust, result in more vibrant organizations. Two regional associations have been formed, with more on the way in 2019:

Northwest Region Nurses Association

In late January 2018, members of three WSNA districts voted to join together as the Northwest Region Nurses Association. The new region encompasses WSNA members in Skagit, Island, San Juan, Snohomish and Whatcom counties.

Expanded Pierce County Nurses Association

In December 2018, boundaries for PCNA were expanded to form a regional association that spans seven counties: Pierce, Thurston, Kitsap, Mason, Grays Harbor, Jefferson and Clallam. PCNA, which has served members for 100 years, will now support 3,187 nurses across the Olympic Peninsula.


Beginnings of WSNA

District nurses associations in Washington state first formed as county graduate nurses associations as early as the late 1890s. This was the beginning of WSNA.

Nine graduate nurses in Spokane set the precedent for other local efforts when they first met on October 10, 1898 and organized the Spokane County Nurses Protective Association. Membership dues were one dollar per year. In 1909, the Association was incorporated and the name changed to the Spokane County Graduate Nurses Association.

On November 17, 1902, the Association for Graduate Nurses of King County was formed. In 1908, the King County Nurses Association had the distinction of being the first county association to be accepted by the Nurses Associated Alumnae of the United States and Canada.

Tacoma was the next scene of activity, although the actual date of organizing is not known. From existing records, it is believed that the formal organization took place in the winter months of 1904-1905. The Whatcom County Graduate Nurses Association was organized January 20, 1906, and in 1907 the Graduate Nurses Association of Walla Walla County was organized.

After three meetings of representatives from the five original county organizations – Spokane, King, Tacoma, Whatcom and Walla Walla – the formal organization of the Washington State Graduate Nurses Association was created in 1908.

Rapid growth

In 1925, the state of Washington was divided into districts and nurses could organize by District instead of by counties. Preliminary efforts to form district nurses associations continued; however, it was not until 1935 that any new local groups joined the Washington State Graduate Nurses Association. From 1935-1941 there was a mushrooming of local activity and the following districts became part of the statewide association:


  • District 11, Clark and Skamania Counties
  • District 12, Clallam and Jefferson Counties
  • District 17, Bremerton


  • District 13, Olympia


  • District 19, Chehalis


  • District 14, Colfax
  • District 15, Pasco
  • District 16, Mt. Vernon


  • District 18, Ellensburg


  • District 20, Okanogan County


  • District 21, Colville
  • District 22, Mason County
  • District 23, Jefferson County

In the second half of the twentieth century, the number of district nurses organizations increased to 28. The districts varied in the size of geographic area they each covered, their membership numbers and the numbers of nurses living in or employed within the district. The district nurses associations served as a training ground for state leadership.

The district nurses associations developed local plans for supporting ANA and WSNA programs in nursing practice, nursing education, and health care for the citizens and legislative activities. Many of the districts also worked with local cities and counties on issues important to nurses and the health care of citizens. In an age without cell phones and the Internet, the role of providing social and networking opportunities for district members was an important part of the district nurses association activities.

Support for nursing careers and nursing students engaged many districts in fundraising for scholarships. The districts were part of the tri-level organization with similar membership in the districts, state and national levels. In 1962, when ANA changed to a federation model, the individual nurse membership was in the district and state.

District Nurses Associations were once the source of delegates elected to ANA and WSNA House of Delegates until 1985 when WSNA changed it’s House of Delegates to a General Assembly.

Recent times and creation of local units

The growth and development of the Economic and General Welfare Program at the state level saw the creation of “Local Units” at each employment site. Although there is overlapping membership, the district nurses associations are not involved with the local unit activities or the specifics of the collective bargaining program.

In more recent years, with more opportunities for nurses to network in other settings, less time for meetings and the increasing local unit activities, some district associations have struggled to stay active. Others have refocused their activities on:

  • Provision of nursing scholarships and recruitment of nursing students.
  • Networking of nurses within the district on special issues, health promotion projects and community outreach.
  • Support of WSNA's legislative program and responses to proposed local legislation.
  • Support for local candidates.
  • Support of the WSNF nursing scholarship program.
  • Programs of continuing education on health issues and nursing practice issues.
Although there is overlapping membership, district nurses associations are not involved with local unit activities or the specifics of collective bargaining