In 1979, registered nurses at newly built Palisades General Hospital in North Bergen, New Jersey, formed a union and joined HPAE.

But on September 25, 1979, the union struck Pascack Valley Hospital over wages and floating of nurses to units where they had no experience or training.

In 1985, the union changed its name to the Health Professionals and Allied Employees to represent its shift away from purely hospital organizing.

The union wanted across-the-board wage raises of 5 percent and pay increases for senior nurses.

HPAE continued to marshall significant financial and political resources from its parent union and the AFL-CIO.

With the support of her executive council, the union altered its spending and staffing priorities to focus on a comprehensive, interlocking program of external organizing, enhanced political influence and legislative accomplishments.

The union's organizing program ran the breadth and length of New Jersey, extending into the Camden-Philadelphia market in 1996.

In 1997, HPAE won amendments to NJ's whistleblower law, providing specific protections for healthcare professionals who report unsafe patient care conditions.

And in 2005, the union won passage of a law requiring public disclosure of nurse-to-patient staffing levels in hospitals and nursing homes.

Twomey's image appeared on the cover of the first issue of the AFL-CIO's new America@Work publication in November 1996.

HPAE also led efforts to require transparency and accountability in NJ hospitals, particularly in the for-profit takeovers.

HPAE leaders and members are focusing on addressing the challenges from hospital system mergers and re-focusing their efforts to win safe staffing legislation.