The law is necessary but never sufficient
When the sorry state of patient care in this country is being discussed, legal regulation is brought up as a possible solution far more often than strong unions. But one look at the political quagmire surrounding health-care reform dumps a big bucket of cold water on all that. The most workable solution is the most obviously local: patient care issues can be solved on the spot by a strong union that sees these problems as shop floor issues. If the organization of workers in a hospital is weak, nurses will go on working to exhaustion, and patients will go on lying in pain, pressing call buttons that no one answers because one worker is frantically tending to three other call buttons. Even if we could pass laws regulating this sort of thing, the only appropriate enforcers would be the workers in the hospital. This is a problem that has plagued all kinds of efforts at social change, from labor to civil rights to the environment and more: we fight so hard to get the right policy or law, then forget that the only way to enforce it is through ongoing organizing and mobilizing at the base. The only way to stop unfair and dangerous hospital practices is for nurses and hospital workers to build strong organizations.
–Jane McAlevey, Raising Expectations (and Raising Hell): My Decade Fighting for the Labor Movement (Verso, 2012)