NNU Urges Passage of S.4182 (Health Care Violence Prevention Bill) in Wake of Tulsa Shooting

NNU Urges Passage of S.4182 (Health Care Violence Prevention Bill) in Wake of Tulsa Shooting

National Nurses United has released a statement concerning the mass shootings that closed the month of May (as there have been so many mass shootings: NNU is addressing the one that left a surgeon, receptionist, and visitor dead in a Tulsa hospital).

Yet another tragic mass shooting demonstrates the importance of legislation currently in the U.S. Senate that would provide substantial safety protection for our nation’s health care workers, patients, and their families, noted National Nurses United.

S. 4182, the Workplace Violence Prevention for Health Care and Social Service Workers Act currently supported by 27 Senators, would mandate that the Occupational Safety and Health Administration (OSHA) create a federal standard requiring health care and social service employers to develop and implement a comprehensive workplace violence prevention plan. S. 4182 is a companion to H.R. 1195, which passed the House of Representatives in a strong bipartisan vote in April 2021.

This legislation is especially important given that health care and social service workers face extremely high rates of workplace violence, noted NNU.

“Tulsa’s terror on Wednesday should remind us all of both the accelerating incidents of violence in health care settings and the urgency of legislative action to safeguard our caregivers, other health care staff, and every patient or family member in those facilities,” said NNU President Jean Ross, RN.

Reports now confirm that the Tulsa gunman was a former patient who, according to The Washington Post, murdered two doctors, a receptionist, and another patient in an orthopedic clinic at the St. Francis Hospital Natalie Building. He was also reportedly armed with an AR-15-style weapon he bought on the same day as the attack, a reminder also of the need for a national ban on assault weapons, added Ross.

“If the caregivers who save our lives and who provide therapeutic healing when we are at our most vulnerable cannot be safe, we are all in danger,” said Ross. “Protecting public safety must be a top national priority. As the past few weeks have grimly proven, we have a horrifying national crisis of public safety, whether it is in our schools, supermarkets, houses of worship, or hospitals.”

“With S. 4182, there is legislation ready to be enacted to address a vital part of the national solution for this emergency,” Ross added. “We urge the Senate to act.”

S. 4182 was introduced in the Senate in May by Sen. Tammy Baldwin, D-Wis., at a press conference that also included Rep. Joe Courtney, D-Conn., chief sponsor of H.R. 1195, as well as NNU President Ross and representatives of the AFL-CIO, American Federation of Teachers, United Steelworkers, and American Federation of State, County and Municipal Employees.

“We need the Workplace Violence Prevention for Health Care and Social Service Workers Act to help protect us on the job, so we can continue to care for you, your loved ones, and our communities,” Ross said then. “We strongly urge the Senate to take up this bill with the urgency it deserves, pass it, and send it to the president’s desk for his signature.”

recent NNU national survey of more than 2,500 hospital nurses found that nearly half of RNs (48 percent) reported a small or significant increase in workplace violence, up from 30.6 percent in September 2021 and 21.9 percent in a March 2021 survey. This is a nearly 57 percent increase from September 2021 and a 119 percent increase from March 2021.

Between 2011 and 2016, as reported in the U.S. Bureau of Labor Statistics Census of Fatal Occupational Injuries, at least 58 hospital workers died as a result of violence in their workplaces. In 2016, the Government Accountability Office found that health care workers at inpatient facilities were five to 12 times more likely to experience nonfatal workplace violence than workers overall.

National Nurses United is the largest and fastest-growing union and professional association of registered nurses in the United States with more than 175,000 members nationwide.

Nurses Reflect on Workplace Stress, Safety Concerns in Latest NNU Pandemic Survey

Nurses Reflect on Workplace Stress, Safety Concerns in Latest NNU Pandemic Survey

National Nurses United’s (NNU) new nationwide survey of more than 2,500 registered nurses reveals significant increases in staffing issues, workplace violence, and moral distress compared to NNU’s previous survey results released on Sept. 27, 2021. Hospital RNs also reported that their hospitals are still not adequately prepared for a Covid-19 surge.

This survey is the seventh national survey of nurses during the pandemic by NNU, the nation’s largest and fastest-growing union of registered nurses.

Zenei Cortez, RN, National Nurses United.

Zenei Cortez, RN, President of National Nurses United.

“We are now more than three years into the pandemic and not only is staffing worse, but workplace violence is increasing,” said Zenei Triunfo-Cortez, RN and a president of National Nurses United. “Nurses are experiencing alarming levels of moral distress and moral injury due to the unsafe working conditions. Since our last survey in September 2021, even more nurses have reported feeling more stress and anxiety as well as feeling traumatized by their experiences caring for patients.

“In addition, many nurses reported that their hospitals do not have surge plans or enough personal protective equipment in stock to protect staff during a surge,” said Triunfo-Cortez.

“It is unconscionable that some RNs are still reusing single-use PPE and putting their health and well-being at risk.

“Despite these challenges, nurses have continued to fight for safe working conditions and patient safety and they are organizing,” said Triunfo-Cortez. “During the pandemic, nurses at Mission Hospital in Asheville, North Carolina, Maine Medical Center in Portland, Maine, and Longmont United Hospital in Longmont, Colorado, organized and voted to join affiliates of National Nurses United. We have also been strongly advocating for federal RN-to-patient ratios legislation and for the Occupational Safety and Health Administration to issue a permanent standard to protect nurses and other health care workers from Covid-19 in the workplace.”

Here are the responses from 2,575 nurses, gathered from both NNU union nurses and nonunion nurses in all 50 states plus Washington, D.C. The results cover the period Feb. 2, 2022 to March 20, 2022.

Staffing Issues

Hospital RNs reported that staffing is worse: 69 percent reported that staffing has gotten slightly or much worse recently, a 20.2 percent increase from NNU’s September 2021 survey and a 47.8 percent increase from our March 2021 survey.

More than a quarter of nurses (26.5 percent) reported being “floated” or reassigned to care for patients in a clinical care area that required new skills or was outside of their competency, up from 17.8 percent reported in September 2021. Meanwhile, 46 percent of hospital RNs reported that they did not receive any education or preparation before being floated to units outside of their expertise, up from 44.3 percent reported in Sept. 2021.

Excessive overtime and use of travel nurses:

  • 64.5 percent of hospital nurses reported that their facilities are using excessive overtime to staff units, up from 49.3 percent, a significant increase from our September survey.
  • 72.3 percent hospital RNs reported an increase in the use of travel nurses in the prior month.

Workplace violence on the rise

Nearly half of hospital nurses (48 percent) reported a small or significant increase in workplace violence, up from 30.6 percent in September 2021 and 21.9 percent in our March 2021 survey. This is a nearly 57 percent increase from September 2021 and a 119 percent increase from March 2021.

Alarming evidence of moral distress and mental health

Covid-19 is still having a deep impact on the mental health of hospital nurses, who continue to face moral distress and moral injury at work. There are significant increases in all of the mental health impacts reported in our September 2021 survey.

  • 66.8 percent of hospital RNs fear they will contract Covid, a 59.4 percent increase from September.
  • Nearly three-quarters (74.6 percent) are afraid they will infect a family member, a 47.4 percent increase from September.
  • Nearly 60 percent (58.4 percent) are having more difficulty sleeping, a 66.4 percent increase from September.
  • 83.5 percent feel stressed more often than before the pandemic, a 56.1 percent increase.
  • 77.2 percent feel anxious more often than they did before the pandemic, a 53.2 percent increase from September.
  • 68.7 percent feel sad or depressed more often than they did before the pandemic, a 64.6 percent increase from September.
  • More than half (56 percent) feel traumatized by their experiences caring for patients, a 65.7 percent increase from September.
  • 23 percent sought treatment for a mental health condition related to caring for patients during the pandemic, a whopping 87 percent increase from September.

Personal protective equipment

  • Only 71.8 percent of hospital RNs reported wearing a respirator for every Covid-positive patient encounter, up from 60.8 percent in our September 2021 survey. Meanwhile, 62 percent of hospital RNs reported having to reuse single-use PPE, an unsafe practice.
  • Only 32 percent of hospital nurses report that their employer has sufficient PPE stock to protect staff from a rapid Covid surge. (For more on surge plans, see “Surge preparedness” section below.)

Exposure, testing, and screening

  • Nearly a quarter (24 percent) of hospital RNs reported that their employer notifies them of Covid exposures in a timely manner. Meanwhile, 29 percent of hospital RNs reported that nurses are informed of exposures but not in a timely fashion. Prompt notification is essential for infection control.
  • Access to testing is still an issue at some hospitals: 17.8 percent of RNs report that access to testing has declined since the beginning of the pandemic.
  • Only 56.8 percent of hospital RNs report that every patient is screened for recent exposure history to covid, down from 61.7 percent in our September survey. Screening of visitors has also gone down since our last survey: 48.6 percent of hospital nurses reported that all visitors are screened for Covid signs and symptoms at their facility, down from 52.7 percent in our September survey.
  • Only 23.8 percent of hospital RNs report that every visitor is screened for recent Covid exposure history at their facility, down from 38.5 percent in our September survey.

Woefully inadequate surge preparedness

Only 24 percent of hospital RNs reported that their employer has an overflow plan to place additional, trained staff to safely care for Covid patients on isolation. This is a decrease from our first Covid survey in March 2020 when 29 percent reported that there was a plan in place to isolate patients with possible novel coronavirus infection.

Previous surveys

In 2020, NNU’s four surveys covered hospitals’ lack of preparedness for Covid-19 (March); government and employers’ disregard for nurse and patient safety (May); the devastating impact of reopening too soon (July); and hospitals’ and health care employers’ lack of preparation for the fall/winter surge, despite more knowledge about the dangers of the virus and effective measures to prevent spread (November). In 2021, NNU’s March 2021 survey highlighted the continuing disregard of hospitals and health care employers for the safety of nurses and health care workers. The September 2021 survey revealed that employers must do more to be fully compliant with the Occupational Safety and Health Administration emergency temporary standard to protect nurses and other health care workers.

Ukraine Hospital Bombing Prompts Nurses’ Union to Call for Ceasefire

Ukraine Hospital Bombing Prompts Nurses’ Union to Call for Ceasefire

National Nurses United (NNU) joined with health care leaders around the world in expressing horror and outrage at Russia’s bombing of a maternity and children’s hospital in Mariupol, Ukraine, and other health facilities, and urged an immediate cease-fire to end the bloodshed.

At least three people, including a child, were killed in the hospital attack. The World Health Organization (WHO) has so far reported at least 18 attacks on hospitals, ambulances, and other health care facilities since the invasion began, with multiple deaths and injuries among patients and staff.

“Nurses across the United States stand in solidarity with the embattled nurses and other medical professionals who are bravely working to save lives and protect their patients from this unwarranted war on the people of Ukraine,” said NNU President Zenei Triunfo-Cortez, RN. “Bombing hospitals is also a war crime and a violation of international law.”

“As nurses, we know that war, and all the suffering it produces, is a human calamity that is not justifiable and must end,” Triunfo-Cortez said. “In the meantime, as our Global Nurses United colleagues in the Irish Nurses and Midwives Organisation said today, ‘The safety of access to healthcare and delivery of humanitarian assistance must be a priority.’”

NNU is also alarmed at reports that the escalation of the violence has led to shortages of vital medical supplies in Ukraine, as well as a mounting crisis for people in desperation seeking refuge from the attacks.

“In addition to the daily assaults, the crisis of the war creates a breeding ground for the spread of infectious diseases at a time when we continue to face a persistent global pandemic,” Triunfo-Cortez noted.

“Crowded conditions and the massive refugee migration are also laboratories for other physical and mental health illnesses, a clear reminder of the cruelty of any war,” said Triunfo-Cortez. “Whether it is in Ukraine, Yemen, or any other war zone, any war threatens to lead to an incalculable loss of lives and other long-term health consequences for the people of that nation and region.”

NNU, said Triunfo-Cortez, concurs with WHO Director-General Tedros Adhanom that the “only real solution to the situation is peace.”

NNU: Lack of “Good, Permanent” Nursing Jobs and Industry Greed are Driving Staffing Crisis

NNU: Lack of “Good, Permanent” Nursing Jobs and Industry Greed are Driving Staffing Crisis

“Understaffing is not the result of the nursing shortage, but the cause of it,” Zenei Triunfo-Cortez, RN, president of National Nurses United (NNU), told Congressional leaders this week.

Triunfo-Cortez and frontline RNs from across the country explained the understaffing crisis at a Congressional briefing, which accompanied the launch of a new NNU report on the issue.

The RNs described first hand to members of Congress the many ways that the hospital industry, in pursuit of profits, has intentionally created the intolerable working conditions under which many nurses are unwilling to practice and has led to current crisis levels of unsafe staffing. The briefing was co-hosted by Rep. Jan Schakowsky, sponsor of H.R. 3165, the Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act.

 U.S. Rep Janice Schakowsky, from Illinois's 9th congressional district.

U.S. Rep Janice Schakowsky, from Illinois’s 9th congressional district.

“Right now, there are no federal mandates regulating the number of patients that a registered nurse can care for at one time in U.S. hospitals. This is dangerous – for nurses, for patients, for all Americans. This is why I introduced the Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act (H.R. 3165), to require hospitals to develop annual safe staffing plans with the input of direct care nurses,” said Rep. Jan Schakowsky.

Schakowsky continued: “Even before the pandemic, registered nurses have consistently been required to care for more patients than is safe. Nurses have been pleading with hospitals to give them the staff that they need. Yet hospitals say they cannot find enough nurses and cannot afford to pay permanent nurses more in wages. This comprehensive report shows that is incorrect. There is no shortage of registered nurses. There IS a shortage of good, permanent nursing jobs where registered nurses are fully valued for their work. We celebrate nurses. We call them heroes. If we truly value their work and their sacrifices, we must give them the support that they are asking for.”

Nurses from across the country, from California to Washington, D.C., and Michigan to Florida, shared their stories. View the nurses’ testimony here.

This manufactured staffing crisis is detailed in NNU’s new report, “Protecting Our Front Line: Ending the Shortage of Good Nursing Jobs and the Industry-Created Short Staffing Crisis.” The report explains the methods the hospital industry has used for decades before the pandemic that have driven nurses away from the bedside and states that hospitals have been:

  • Adopting policies of not supplying enough RN staff to safely care for patients
  • Cutting corners at work that endanger nurses’ health and safety, including refusal to provide necessary PPE to RNs during the pandemic until they were forced to do so
  • Disrespecting nurse judgment and autonomy by fragmenting, deskilling, and replacing aspects of their profession
  • Resisting hiring RNs from associate degree programs—an elitist practice that exacerbates the staffing crisis and undermines the nursing workforce’s racial and ethnic diversity

The report explains how these hospital industry practices played out during the Covid-19 pandemic and caused irreparable harm to registered nurses by creating unsafe workplaces that led to their mental health distress, moral injury, and hundreds of RN deaths.

On the matter of workforce diversity, the report notes,

“Although there is no general nursing shortage, the lack of racial, ethnic, cultural, linguistic, and socioeconomic diversity within the current nursing workforce reflects the need for increasing the numbers of and support for socioeconomically diverse registered nurses from BIPOC communities and other underserved communities. Racial and socioeconomic diversity within the nursing workforce is crucial for both improving our nation’s health and achieving health equity.”

Finally, the report proposes a number of immediate and long-term legislative and regulatory solutions that Congress and the executive branch could take to retain and grow the nursing workforce. Key recommendations include:

  • Pass federal safe staffing ratios legislation
  • Make the meeting of minimum safe staffing requirements a condition of getting Medicare reimbursements
  • Protect RNs’ health and safety at work
  • Strengthen union protections
  • Expand free, public community college nursing programs
  • Reform and expand the Nurse Corps Loan Repayment Program
  • Beef up financial assistance for nursing programs that improve workforce diversity

“These patients can go south in an instant; you need to watch them like hawks,” said June Browne, RN, who works in the multi-system intensive care unit at Osceola Regional Medical Center in Kissimmee, Fla. and explained that ICU nurses who should typically be assigned only one or a maximum of two patients at her hospital were routinely assigned three and up to four patients on one shift. “These patients cannot be left alone. But now I hear an alarm ringing in another room, letting me know something is wrong with another patient. What am I to do? Who do I help? I am being asked to make an impossible decision with someone’s life hanging in the balance.”

Zenei Cortez, RN, National Nurses United.

Zenei Trifuno Cortez, RN, President of National Nurses United.

The story is frighteningly similar around the country. Leah Rasch, RN, who works at Sparrow Hospital in Lansing, Mich., said her community is dealing with a massive surge of Covid patients but that management has provided “horrendous” staffing levels. “I simply cannot do my job well when I’m responsible for caring for eight Covid patients at one time,” said Rasch. “We are just trying to keep them breathing and keep them alive long enough to pass them off to the nurse on the next shift. One of the most heartbreaking things is that when a patient is passing away, I often don’t have time to even sit with them because I am trying to keep someone else alive. It is heartbreaking to know that anyone is dying alone. I can’t tell you how brutal that is and how brutal it feels.”

All the nurses encouraged lawmakers to help pass NNU-endorsed current pending federal safe staffing bills, S. 1567 and H.R. 3165, as well as support the many recommendations outlined in NNU’s report.

“Nurses need the backing of a union to be able to speak up safely at work, and patients, no matter where they get sick in the country, deserve safe, quality patient care that we believe, in the face of hospital industry greed, can only be achieved through RN-to-patient minimum staffing ratios,” said Triunfo-Cortez. “That’s why it’s so critical for Congress to pass the PRO Act, the safe staffing legislation we have proposed, and all the rest of the commonsense recommendations we lay out in this report.”

National Nurses United is the country’s largest and fastest-growing union and professional association of registered nurses, with more than 175,000 members nationwide.

NNU Urges OSHA: Make Covid Emergency Protection Standards Permanent

NNU Urges OSHA: Make Covid Emergency Protection Standards Permanent

National Nurses United (NNU) October 4th urged the U.S. Occupational Safety and Health Administration (OSHA) to adopt a permanent OSHA standard on Covid-19 in health care workplaces, building on the emergency temporary standard adopted last June. According to nurses, the Covid-19 health care ETS has been an important step forward in ensuring safe working conditions for frontline health care workers by mandating optimal PPE and other protections. But it has also been a stopgap, and nurses say they are calling for ongoing protections.

“The Covid-19 health care ETS has saved lives during the ongoing crisis, but this pandemic will not be over by December. Nurses urge that OSHA adopt a permanent standard on Covid-19 without delay,” said NNU President Deborah Burger, RN.

Read NNU’s letter to OSHA here.

The Covid-19 health care ETS has meant mandatory requirements for employers, with penalties for those who violate those requirements, on infection control protections in health care settings. Registered nurses noted that this has been the first OSHA emergency temporary standard since 1983, and it was promulgated thanks to unrelenting union nurse advocacy over the extensive opposition of the hospital industry and other corporate interests. Letting it expire without adopting a permanent standard would mean more transmission of the virus, more hospitalizations, and more deaths from Covid-19.

“Nurses and other health care workers haven’t had one day’s rest for this entire pandemic. We stood up on the front lines of Covid to save lives when we were needed most, including in the days when our employers, with no repercussions, told us that we could wear bandanas as PPE. It was a major step forward when OSHA issued the Covid-19 health care ETS in June, and it is imperative that OSHA maintain these lifesaving protections by issuing a permanent Covid-19 standard to ensure nurses and other health care workers can protect our patients,” said Burger. “Nurses call on OSHA to do the right thing for patients, health care workers, and communities across the country by issuing a permanent standard as soon as possible and ensuring that there is no lapse in the enforcement of the temporary standard before the permanent standard is issued.”

Nurses say the adoption of a permanent OSHA standard on Covid-19 in health care workplaces should be built on current ETS requirements, the precautionary principle, and updated scientific knowledge of the virus. Such a standard should include:

  • All health care employers must have written infection control safety and implementation plans, developed in consultation with non-management employees and their representatives.
  • All nurses and other frontline health care workers exposed to Covid-19 must be provided optimal personal protective equipment against aerosol transmission of the virus, including respiratory protection, eye protection, protective clothing, and gloves.
  • Protective requirements on notification of health care employees exposed to Covid-19 in the workplace, and provision of pay and benefits for those who must take time off as a result of exposure or infection.
  • Mandates on screening and testing of patients and visitors, mask wearing, physical distancing, and ventilation in the workplace.

“This is still a dangerous and deadly pandemic. People in the United States continue to be infected and die. And nurses and other frontline caregivers remain in danger. It is essential that OSHA’s emergency temporary standard be made permanent so that nurses and other health care workers are protected,” said Burger. “We can’t let our guard down now.”

As of this week, 458 RNs have died of Covid-19, among 4,547 health care worker deaths overall, according to NNU tracking data. Since the data has not been collected in many places, a full accounting may never be known. At least 1,037,083 health care workers have been infected.

National Nurses United is the nation’s largest and fastest-growing union and professional association of registered nurses, with more than 175,000 members nationwide.

Listen to the Chapter Podcasts for Jonas and Kovner's Health Care Delivery in the United States


Gain a better understanding of the current state of the US health care system and how it might impact your work and life.

You have Successfully Subscribed!