Union is known for its tactics, which some question will be enough to boost Sanders in June.

As Bernie Sanders prepares for the California presidential primary, he has a local ground force that he leans on as “one of the sponsors of my campaign”: nurses.

They typically focus on healthcare policy. But when they weigh in on more purely political pursuits, they have gained a reputation as the mischief-makers of California politics. They have thrown all their might — and that of their affiliated super PAC — behind the Vermont senator’s uphill presidential bid, despite Sanders’ expressed disdain for such outside spending groups.

They are not as big or as wealthy as the political action committees or California unions backing Democratic front-runner Hillary Clinton, but the nurses have proven adept at putting better-funded rivals on the defense.

Instantly recognizable in their pastel scrubs, they stalked then-Gov. Arnold Schwarzenegger around the nation in 2005 to protest his effort to increase the patient-to-nurse ratios in state hospitals and emergency rooms. In 2010, they introduced the public to Meg Whitman’s housekeeper, an immigrant in the U.S. illegally. The billionaire abruptly fired her before running for governor as a staunch critic of employers who hire immigrants in the country illegally.

Now, the California Nurses Assn. is campaigning for Sanders as the presidential race heads toward the state’s June 7 primary.

Even as Sanders’ ability to win the nomination has grown increasingly unlikely, he has pledged to continue his campaign through California and is expected in the state this week.

The critical question is what kind of effect the nurses will have — and what tactics will they use — as they try to boost Sanders over Clinton on their home turf.

Labor observers say Sanders benefits from being associated with the nurses, the first national group to endorse him in August, and a profession that is viewed warmly by the public.

“When Bernie comes to California, the fact that the nurses support him legitimizes his candidacy. Here’s a union that’s powerful and important in California,” said Nelson Lichtenstein, a labor historian at UC Santa Barbara.

But others are skeptical, notably because of the decades-long long relationship that Clinton and her husband, former President Bill Clinton, have with Californians. They also question how effective the nurses’ tactics will be in a Democratic primary.

“They are successful at being disrupters — protesting, crashing town halls, interrupting rallies,” said GOP consultant Rob Stutzman, a former top advisor to Schwarzenegger and Whitman. “It’s hard for me to imagine them going out and antagonizing Hillary Clinton, somehow it’s going to hurt her in California.”

Political consultants in California note that unlike the Republicans that the nurses have targeted in the past, Clinton is backed by more powerful unions. The nurses have 90,000 members in California, compared with 700,000 for the Service Employees International Union.

“They are definitely a factor in California, although there are other unions that are stronger politically,” said Roger Salazar, who coordinated labor efforts to boost Gov. Jerry Brown’s 2010 bid over Whitman and a Clinton supporter. “They have become very expert at being visible thorns in people’s sides. That’s a compliment by the way, not an insult.”

There is perhaps no better example than their efforts against Whitman.

They dogged Whitman throughout her 2010 campaign, dressing an actress as “Queen Meg,” in a red velvet fur-trimmed cape, gloves and a sash. She followed the billionaire around the state proclaiming, “Healthcare for the rich, education for the few, prisons for all.”

More significantly, the nurses doomed Whitman’s already faltering campaign when they connected Nicky Diaz, the immigrant the former eBay chief employed as a housekeeper, with celebrity attorney Gloria Allred.

The resulting images — of a tearful Diaz describing how she cleaned Whitman’s Atherton mansion and shuttled her children to school for years before she was dismissed “like a piece of garbage” — reinforced public perception of Whitman as a heartless corporate chieftain. Brown beat Whitman by 13 points.

RoseAnn DeMoro, the executive director of the California Nurses’ Assn. and the National Nurses United, which the California group co-founded in 2009, said Sanders is a natural fit.

“For all of our signature issues, he’s been an advocate his entire life,” DeMoro said, pointing to his support for universal single-payer healthcare. “This is organic for us.”

She said many were shocked when the union backed Sanders.

“Sanders for the nurses is almost the ideal candidate. It’s too bad he isn’t a woman,” DeMoro said with a chuckle. Sanders is a “game-changer,” she said, whereas Clinton represents “the status quo, at best.”

Two thousand California nurses have traveled the country stumping for Sanders, registering students to vote in Wisconsin, monitoring caucuses in Nevada and trailing the candidate in a crimson “Bernie bus,” emblazoned with the slogan: “The Most Trusted Profession TRUSTS BERNIE.”

They have started organizing in California, running phone banks, hosting rallies and erecting more than two dozen billboards. The bus arrived in Berkeley on Thursday.

The National Nurses United’s super PAC has spent more than $2.4 million to back Sanders.

Despite the support from the nurses’ political action committee, Sanders often proclaims falsely that he is the sole presidential candidate “who doesn’t have a super PAC.”

There is a difference between the nurses’ super PAC and the one for Clinton: The nurses’ committee is funded by union dues, whereas the pro-Clinton super PAC accepts donations from individuals who can write seven-figure checks.

A Clinton-allied group has filed a complaint with the Federal Election Commission alleging illegal coordination between Sanders’ campaign and the nurses’ super PAC — a charge that the Sanders’ campaign called “frivolous.”

The nurses dismiss talk that their tactics will not be effective in the race.

“They always underestimate us because we’re women,” DeMoro said before turning her sights to the California primary. “We’re going to have a lot of fun.”

NESTOR VILLATORO, a union organizer, hangs signs at the center. “Sanders for the nurses is almost the ideal candidate,” union head RoseAnn DeMoro says. Photo by Rick Loomis LA Times.

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