National Nurses United

10 N A T I O N A L N U R S E W W W . N A T I O N A L N U R S E S U N I T E D . O R G J U LY | A U G U S T | S E P T E M B E R 2 0 1 6 F or decades, neoliberal orthodoxy has viewed regula- tions—public protections—as a huge obstacle to profiteer- ing and domination of economic policy by wealthy corporate interests. Though politicians from both major parties have promoted this agenda—see the deregulation of banking and communica- tion signed by President Bill Clinton—early indications from the incoming Trump administration make it clear that regulatory standards and protections will be high on the chopping block. Everything we hold sacred is up for grabs, including a safe environment for our families and the future of our planet. Safeguards nurses count on for their professional and workplace standards and patient protections, and their right to have a collective voice through their union, are at stake. In a deregulated environment, no nurse, worker, or patient in our communi- ties is secure. Ratios, RN standards, workplace protections a long-term target one obvious target is nurse-to-patient ratios, both where they exist, in California law and individual RN contracts, as well as efforts to win federal or other statewide ratios. As the California law has amply demonstrated, ratios are the most effective means to secure safer staffing in hospitals, but are public enemy number one for the hospital industry and their many lobbyists who view them as an implacable impedi- ment to greater hospital profits and control over the workplace. Gains RNs have made are also at risk in a deregulatory push. Those include new regu- lations on workplace violence prevention, safe patient handling, rules requiring that hospital patients receive continual RN assessment, and the general role of RNs as patient advocates independent of the economic demands of their employer. RN licensure and professional nursing boards have already been subjected to anti- regulatory initiatives that would put nursing standards, including scope of practice protections, in jeopardy. Nurse practice acts commonly hold implied or explicit language regarding accountability for the provision of nursing care, a direct barrier to healthcare industry policies that do not provide any guarantees to ensure patients optimal levels of compe- tent care. One result of deregulation would be to make it far easier for individual nurses, not their employers, to be blamed for harm- ful errors or system failures. Elimination of regulatory standards would substantially undermine the ability of nurses to advocate for patients, which is at the heart of nurses' social contract with patients and credibility with the public, the legacy of more than a century of nurse advo- cacy and activism. Further, we can expect a major attack on unions inspired by rightwing assaults on collective bargaining in states like Wisconsin, Michigan, and Indiana and in cases brought before the U.S. Supreme Court. Strong unions are essential for the ability of nurses to act collectively to protect themselves and advocate for patients. Prodded by corporate funded anti-union policy groups, like the American Legislative Exchange Council, Republicans have placed a national "right-to-work" law high on their agenda. Research has demonstrat- ed that in right-to-work states, the rates of workplace injuries and fatalities are higher, and wages, working conditions, and living standards are lower than in non right-to- work states. Major threat to clean air, water, anti-pollution protections nurses, their families, and communi- ties are, of course, also threatened by the broader assault on regulatory protections. Initial indications, from personnel appoint- ed to the Trump administration transition team and several high level posts, illustrate there is ample cause for alarm. By 1970, nearly a third of drinking water sampled by a federal agency exceeded the public health safety limits. The Bureau of Sport Fisheries found DDT in 584 of 590 fish samples, with levels up to nine times the Food and Drug Administration limit. Bacte- ria levels in New York's Hudson River were 170 times the "safe" limit. Through much of the first half of the last century, many cities were choked by pollut- ed air. The industrial town Donora, Pa. became a symbol of the problem in October 1948 when a cloud of smog as yellow smoke poured out of a zinc smelter that left 20 people dead and half the town's residents sickened. Consumer advocates like Ralph Nader and unions won reforms to protect public safety with a series of state, local, and federal regulations that culminated in 1970 with passage of the federal Clean Water Act and Clean Air Act. While the clean up job is far from complete, significant improvements have been made. For example, the six most common airborne pollutants have been cut in half, air toxics from industrial plants is down 70 percent, and new cars are 90 percent cleaner. But progress is on shaky ground. Gutting the Environmental Protection Agency, which oversees the Clean Water and Clean RoseAnn DeMoro Executive Director, National Nurses United Attack Mode The assault on regulatory public protections accelerates Elimination of regulatory standards would substantially undermine the ability of nurses to advocate for patients, which is at the heart of nurses' social contract with pa tients and credibility with the public, the legacy of more than a century of nurse advocacy and activism.

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