No Pride in the Status of Health Care Rights for the Transgender Community 


As we close out Pride month, it is important to reflect on the state of access to quality compassionate health care for LGBTQ+ communities. As LGBTQ+ Liberation makes a step forward, there is always a backlash right on its heels. Transgender individuals specifically face immense danger for living authentically, which includes having access to gender-affirming health care. They are more than four times more likely to experience violence, including sexual assault, than cisgender people. Instead of offering more support and services to this community, anti-trans legislation has grown exponentially. Before 2021 there were no gender-affirming care bans in law. Today 16 states ban this essential health care for young people. There are over 350 active anti-trans laws attacking access to care, instituting criminal charges for providers, child-abuse charges for supportive parents of transgender children, and much more. 

The risks of violence and legislative bans have undeniable implications for high-quality, equitable health care delivery. In fact, such tactics are antithetical to nursing practice. The Code of Ethics for Nurses states that “the nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person.” Nurses are not only advocates for their patients and the right for everyone to receive the health care they need – nurses practice evidence-based care. Research continues to prove that gender-affirming care improves the overall wellness of gender diverse young people. Laws banning this care are passed under the guise that they are protecting children and parents. In reality, these laws “are not grounded in reputable science” and instead promote misinformation endangering the lives of transgender people across the country.  

Nurses continue to be voted the most ethical professionals and hold a unique and enduring level of trust with their patients. From schools to primary care and emergency rooms, we need to be increasing access to comprehensive and compassionate nursing care for the entire LGBTQ+ community. Nurses can ensure they are LGBTQ+ compassionate by following best practices and talking to their colleagues about barriers they witness in their workplaces. Even though June is over, the work to ensure the right of equitable health care for this community must continue year-round. 


OSHA Slowly Moves Forward on Workplace Violence Prevention 


Workplace violence continues to be a profound concern for nurses across the country. 

  • 1 in 4 nurses are assaulted at work.  
  • Health care and social assistance workers face nearly six times the risk of workplace violence (WPV) than other industries.  
  • We hear often that the COVID-19 pandemic has only exacerbated this risk. In a 2022 ANA survey of nurses, 29 percent reported experiencing a violent incident at work in the previous year.

ANA has advocated for decades that the Occupational Safety and Health Administration (OSHA) strengthen WPV protections for health care workers. OSHA is a sub-agency in the U.S. Department of Labor and OSHA’s standards are regulations that require employers to have safety protections in place for their employees. In 1996 OSHA published voluntary guidance for health care employers to help them create effective WPV prevention programs. As research evolved, OSHA updated this guidance, with the most recent edition released in 2016. From the statistics, it does not appear that voluntary guidance has had a significant impact protecting nurses from violence on the job.  

There has never been a federal regulation requiring these prevention programs and clarifying the legal responsibilities of health care employers. When there is no specific standard on a workplace safety issue, OSHA can still hold an employer accountable if inspectors find the employer violated the “general duty clause”. This clause is the basis of the Occupational Safety and Health Act of 1970 which created OSHA. The general duty clause states that employers must maintain “a place of employment which [is] free from recognized hazards that are causing or are likely to cause death or serious physical harm to…employees.” OSHA has held employers accountable for failure to protect workers from WPV under the general duty clause, but WPV prevention has been very hard to enforce without a specific standard. 

OSHA finally moved forward in creating a WPV prevention standard early this year. The first step was to gather feedback on a proposed standard from a Small Business Advocacy Review (SBAR). The Small Business Regulatory Enforcement Fairness Act of 1996 installed this first step in OSHA and other federal agencies’ rulemaking process. Small business employers apply to be on SBAR panels that review and give feedback on the proposed standard to OSHA and the Small Business Administration. The panels are open to the public to listen in, and public comments on the feedback are allowed. This review was completed at the end of March 2023. ANA staff listened to the proceedings and then submitted comments reinforcing the need for this prevention standard so that employers can be held accountable for building an organization specific prevention program. 

OSHA released a report about the SBAR review on May 1, 2023. ANA was disappointed to see that the report gives no timeline on next steps for the rulemaking, but rather recommends further research on many pieces of the proposed standard. OSHA also reopened public comments on the proposed standard and the report until July 3, 2023.

You can visit and submit your own comments. Let OSHA know: Why is this standard necessary? What are the biggest WPV risks you have experienced? What prevention strategies have you seen to be effective in your workplace? 

OSHA’s rulemaking process is driven by research and finding the best evidence-based solutions. This means creating a new rule can take OSHA decades. The Government Accountability Office (GAO) estimates it could take OSHA at least 7 years to create a WPV prevention standard. Rep. Joe Courtney has been a champion against health care WPV. He has led the Workplace Violence Prevention for Health Care and Social Service Workers Act in the House of Representatives for many years. This bill was reintroduced in the 118th Congress on April 18, 2023 with Sen. Tammy Baldwin leading in the Senate. It requires OSHA to release an interim final standard for WPV prevention within a year of passage and a final standard within three and a half years. OSHA already has decades of research to utilize including recent evidence gathered during the SBAR. Nurses and all health care workers cannot continue to wait for this life-saving standard. Visit RNAction today to tell your legislators to cosponsor the bill that will make sure nurses get the protection they need now. 

To learn more about ANA’s surround-sound advocacy approach on WPV prevention, visit the recording of the 2023 Nurses Month Webinar. 


New Mexico Nurses Association Focuses On Climate and Health


Eric T. Riebsomer, DNP, RN – Guest Author
New Mexico Nurses Association

According to the World Health Organization (WHO), climate change is the biggest health threat facing humanity (WHO, 2023).  As we have witnessed recently, extreme weather events directly impact both social and environmental determinants of health (e.g., clean air, water, our food, and where we live).  The WHO estimates that between 2030 and 2050, these changes will result in approximately 250,000 additional deaths per year. According to the Centers for Disease Control (CDC), health impacts in the southwest will be related to higher temperatures (increased death associated with heat), poor air quality (from wildfires and dust storms), vector-borne diseases, and water-related illness (CDC, 2023).  A recent example of this occurred during the 2022 New Mexico wildfire season, where approximately one million acres were burned due to wildfires.  These wildfires impacted the respiratory and cardiovascular health of families while they were burning, impacted water quality after the fire because of massive flood and debris flow events, and displaced thousands of people from their homes in fragile communities in New Mexico.  

New Mexico Nurses for Climate and Health is a recently formed special interest group within the New Mexico Nurses Association (NMNA).  The aim of this group is to bring together passionate, New Mexico nurse leaders to advocate for building resilience against changes in our climate that directly impact our health.  In the 2021 New Mexico Climate Strategy report published by the climate change task force, building adaptation and resilience in public health was one of the highlighted sections where New Mexico was focusing time and resources. The New Mexico Department of Health (NMDOH) was using the CDC’s Building Resilience Against Climate Effects (BRACE) Framework to help New Mexico communities prepare for the impacts of climate change.  The other areas focused on building resilience were, natural and working lands, emergency management and infrastructure, and water and natural resources.

During the 2022 legislative session, New Mexico lawmakers brought forth legislation to create a public health and climate resiliency program within the Department of Health (DOH). The purpose of the legislation was to create a fund, which would be disbursed to local and tribal government entities for the purpose of adapting to climate change through grants. The purpose of the grants would be to help the recipients to prepare for or respond to health threats related to extreme weather and other climate change effects. The legislation passed both the House and Senate committees, though it was not signed. As New Mexico continues to address climate and health issues, the New Mexico Nurses Association needs to be a part of these initiatives, offering a nurse’s perspective on how climate impacts the health of our patients, when it comes to combining primary prevention strategies with building resiliency in our communities.   

While NMNA has created a special interest group to bring nurses together for this purpose, the role of nurses can be expanded outside of this, in all states.  As health care experts, a nurse’s voice during legislative sessions can be very powerful.  Nurses should get to know their legislators, talk to them about the effects climate change has on their patients.  Community and public health nurses in particular play a vital role in communicating this.  Another way nurses can get involved is by being on planning committees where they work, in their communities, or at their child’s school.  This allows them to have a voice in preventing or modifying activities that may cause harm to the environment, which may ultimately harm people.  Also, getting involved with the disaster preparedness team at their facility, this will offer nurses an opportunity to assist in developing primary prevention strategies to reduce the impact of environmental disasters, thereby building a more resilient community. In the end, anywhere a nurse can be involved in communicating how the health of their patients is impacted by environmental and climate changes, the better we are, and the more resilient our communities will become.


Centers for Disease Control (CDC); (Accessed, April 2023)

New Mexico Climate Change Annual Report (2021);

World Health Organization (WHO); (Accessed, April 2023)