Congressional and Judicial Actions Addressing Border Conditions


By Brooke Trainum and Janet Haebler

As we celebrate America’s birthday and the freedoms we enjoy, recent headlines remind us that others’ have not been as fortunate. The July 4th holiday comes right after a federal judge’s order to US Customs and Border Protection (CBP) addressing concerns in detention facilities holding refugees. On June 28th, a federal judge in Texas ruled that “CBP must permit health experts into detention facilities holding migrant children to ensure they’re ‘safe and sanitary’ and assess the children’s medical needs.” This order is only applicable in the El Paso and Rio Grande Valley regions, due to the subject of the lawsuit. Judge Dolly Gee gave the Trump administration a deadline of July 12th to report what they have done to correct the conditions. This ruling is on the heels of Secretary of Health and Human Services Alex Azar stating in an interview shared by Politico that “the centers run by CBP were not good conditions for kids to be in.”

The situation at the border is complex in nature and for many that can lead to a feeling of helplessness and despair. ANA has repeatedly expressed concerns with the Department of Health and Human Services (HHS), the Department of Homeland Security (DHS) and Congress, most recently via a June 2019 letter sent to DHS. Additionally, Congress recently passed emergency supplemental funding to help alleviate this situation. Given the complexities of this issue there was even disagreement within the political parties on how to address this crisis.

The reports coming from these detention facilities are unfathomable. There are two main government agencies that oversee refugee shelters, with both DHS and HHS each carrying a different mission. The Office of Refugee Resettlement (ORR) within HHS is specifically responsible for unaccompanied minor children; however, it has been the facilities overseen by DHS and CBP that has made the news most recently as having unsafe, unsanitary, and inhumane conditions.

What many do not realize is the unacceptable conditions of border detention facilities is not new. Greater media attention has highlighted the situation. Accommodations erected decades ago were intended for single males, not families. The situation has been exacerbated by a backlog in the immigration court system. Under standard procedures, detention is intended to be for a short duration, not exceeding 72 hours, while claims for asylum are received and processed. Yet, it has been reported that in mid-2019, the average length of detention exceeded one week. In May and June 2019, between 14,000 and 18,000 people were held by CBP each night. And yet another confounding factor is that several of the detention facilities housing refugees are operated by private corporations who have contracts with Immigration and Customs Enforcement (ICE).

While many agree that immigration laws need to be reviewed and modernized, this is an issue where many Americans are split on the solution. Due to this divide, ANA has focused on the immediate issue of a humanitarian crisis affecting the health and well-being of those impacted at the border. As nurses, we have a duty through the Code of Ethics for Nurses to speak out and advocate for the human rights and health care needs of all, particularly the most vulnerable.

Preventing Workplace Violence – Is It Time to Call OSHA?


A behavioral health facility in Colorado was recently fined nearly $12,000 and given 15 days to make the premises safe from workplace violence (WPV). The citation came from the Occupational Safety and Health Administration (OSHA), which found workplace hazards that exposed staff to physical threats and assaults by patients. The hazards were so great that nurses and other direct-care staff were experiencing concussions, broken skin, bruising, scratches, sprains and strains, and head injuries.

In the citation notice, OSHA ordered the employer to remove these hazards. Specific steps included implementing a comprehensive WPV prevention program, remodeling nurse stations, equipping staff with devices to call for help, continuously monitoring security cameras, and setting up procedures to notify affected staff of incidents and risks of WPV.

OSHA citations are somewhat rare for WPV issues that affect nurses, despite the fact that health care workers experience workplace violence at a rate 5-12 times higher than other workers. Nurse advocates would like to see stronger federal actions, which would reduce WPV hazards while driving employers voluntarily to adopt meaningful prevention programs.  ANA is supporting a bill in Congress that would require OSHA to develop enforceable standards specifically for WPV in health care. To tell your federal lawmakers why it’s so important they support this legislation, please click here.

As the citation in Colorado shows, however, OSHA is willing to use its general enforcement power when inspectors hear about egregious cases that risk workers’ lives and physical safety.

Does it have to go that far before something is done? No, certainly not.

Nurses are engaged everyday with co-workers and employers in efforts to prevent WPV. It is, after all, a nurse’s ethical duty to help foster an overall culture of safety and civility for everyone in a care setting. ANA has created a treasure trove of resources to support nurses who want to take a more active role in making their workplace safer.

Yet when a true culture of safety is not achieved, federal oversight may be necessary to prevent WPV. Nurses have a right to complain to OSHA about WPV incidents stemming from unsafe situations, as well other hazards. It’s best for complaints to be specific about existing hazards and name the workplace injuries or health impacts that have occurred. If you are thinking about filing an OSHA complaint, this brief Fact Sheet from ANA will tell you more about the process and link you to important information.

To learn more about what ANA is doing to #EndNurseAbuse, contact Policy and Government Affairs at

The Power of Hill Day


Every membership group has an iteration of “Hill Day,” “Legislative Conference,” or “Fly-in” where its members come to Washington, DC, to speak directly to their members of Congress on issues of importance to the association. Hundreds of members of the American Nurses Association (ANA) will be on Capitol Hill on June 20 for our annual Hill Day. This is a powerful experience and, in many ways, the most basic form of the democratic process. These constituents have the ability to schedule a meeting with their elected representatives or their staffs to discuss issues of importance to them and the association.

Members of Congress will always feel the weight of an issue when the constituent is able to make a personal connection and being able to draw upon those stories is quite effective. For nurses, this might be an instance where you have encountered workplace violence or a lack of resources to effectively perform your job for example.

With the 116th Congress a quarter of the way into its session, it has already been bombarded with special interest groups seeking to meet with members of Congress and their office staffs. These groups have been introducing themselves to freshman members of Congress while solidifying previous relationships with the more experienced lawmakers.

It is truly an incredible experience for nurses and nurse advocates to head up to Capitol Hill for the first time – as well as for those more experienced participants. When a constituent advocates on behalf of a cause they believe in and are passionate about, it empowers them to become more engaged politically and professionally. It enables a person to tangibly connect with their history, with the policies they are fighting for, and allows them to fulfill their civic duty of participating in democracy. Advocating for a cause on Capitol Hill provides citizens the platform to provide critical feedback to a lawmaker and serves as a check on the legislative branch by those it represents.

It is an especially important time for nurses and nurse advocates to take their experience and insights to Capitol Hill. There are many pieces of legislation impacting nurses and their patients gaining momentum in Congress. The Workplace Violence Prevention for Health Care and Social Service Workers Act (H.R. 1309), the Home Health Care Planning Improvement Act of 2019 (H.R. 2150), and the Title VIII Nursing Workforce Reauthorization Act of 2019 (H.R. 728) are all being discussed by over 400 nurses making their way to Capitol Hill this week. To read more on these pieces of legislation, please visit RNAction. Nurses and nurse advocates must speak in a clear, united voice because when nurses speak, Washington listens. And regardless of the issue our members are advocating for, or whether it is called a fly-in or Hill Day, when you are advocating on behalf of your profession on an issue you care about, it is a powerful feeling. This communication makes a real impact on members and their staffs. We are excited for ANA’s upcoming Hill Day and look forward to the feedback our members will share about their experiences.