At press time, congress was still weeks away from passing a Patients' Bill of Rights. But AFT Healthcare has won a significant victory: strong whistleblower protections for RNs and LPNs in both the House and Senate versions of the legislation.

"In both the Senate and House bills we won in identical form strong language protecting nurses from retaliation when they report threats to quality care," said Bill Cunningham, an assistant director in the AFT's legislative department. "If enacted, the Patients' Bill of Rights will be one of the first federal laws to provide this crucial protection."

The proposed legislation now goes into the "conference" stage, in which the Senate and House will attempt to compromise on a final, single bill to put to a congressional vote. Currently, both the Senate and House bills include most of the strong patient protections that the union fought for, including: ensuring emergency care without prior authorization; authorizing direct patient access to pediatricians and OB/GYNs; providing continuity of care when there is a change of health plan or a change of provider network; and providing for an independent appeals process. The House bill, however, is far more lenient with HMOs and health plans than the Senate bill. The House bill would make it more difficult for patients to sue HMOs and health plans in state courts. It also limits the amount of damages patients can win.

"We're pleased with the whistleblower language that made it into both pieces of legislation," says Cunningham. "Now we'll be working for a federal law that will include that language and that won't preempt stronger patients' rights laws that have been passed in some states over the years."