The World War II veteran had no family by his side as he lay dying a few months ago, so Ella Wilverding and her union co-workers stepped into the role.

They took turns sitting vigil with the man, talking to him, holding his hand, and making him as comfortable as possible during his final days.

“We have a policy,” explained Wilverding, a certified nursing assistant (CNA) at the Oregon Veterans’ Home in Lebanon, Ore., and the president of United Steelworkers (USW) Local 9559. “No one dies alone.”

This is the kind of compassionate, top-quality care that ensues when responsible staffing levels empower nurses, CNAs and other nursing home workers to provide the time and attention that residents need.

Right now, states set their own staffing requirements, and some have none at all. Fortunately, the U.S. Centers for Medicare & Medicaid Services (CMS) recently took the first step in fixing this broken system of care by proposing minimum mandatory staffing requirements for nursing homes across the country.

CMS will take public comments for about two months before issuing a final rule—a window that enables advocates like Wilverding to shine a light on the incredible difference that robust staffing makes and to fight for standards strong enough to revolutionize an essential part of the health care system.

“I wish every facility could be like this,” Wilverding said of the Lebanon location, where she works with seven veterans on an average day shift.

Under Oregon law, each resident there receives at least 2.16 hours of CNA care every day, plus assistance and services from other staff members. Oregon’s staffing standards now rank among the strongest in the nation, but Wilverding champions further improvements, knowing that they would enable workers to provide ever-better care.

The Lebanon site consists of a dozen houses, with as many as 14 residents in each, spread among four neighborhoods on a manicured campus.

CNAs like Wilverding prepare meals, wash the dishes and handle laundry in addition to helping veterans with bathing, dressing and other tasks. If residents’ needs increase—such as when the staff mobilizes to provide around-the-clock end-of-life care, for example—the facility schedules additional workers for support.

She only wanted a few hours at her dying mother’s bedside.

But the woman’s bosses at Twin Rivers Paper in Madawaska, Maine, lacked all decency and forced her to the mill on overtime even though it was her day off.

About an hour and a half into the mandatory shift, the woman’s mother died. She left the mill heartbroken, exploited by an industry that continues to spurn workers’ basic need for work-life balance.

Now, workers are battling harder than ever to end this appalling mistreatment. They’re fighting back—at the bargaining table and at the state capitol—against inhumane mandatory overtime requirements that strain families to the breaking point and put lives at risk.

“It’s definitely caused a lot of heartache at the mill,” said David Hebert, financial officer and former president of United Steelworkers (USW) Local 291, one of three USW locals collectively representing about 360 workers at Twin Rivers.

USW members long warned paper companies about the need to increase hiring and training to keep facilities operating safely and efficiently. Yet some employers preferred to keep working people to the bone.

Workers at Twin Rivers, for example, work a base shift of 12 hours. On top of that, to fill in the schedule, each can be drafted for an additional 12-hour shift every month regardless of whether they want the extra hours.

But it gets much worse.

Hebert and his co-workers also face the possibility of having a 12-hour shift extended with six hours of mandatory overtime, without warning or advance notice, virtually any day bosses choose.

And they’re often forced to pull multiple 18-hour days in a week, especially when winter cold and flu season exacerbates the company’s intentional understaffing. Many of these union members commute 45 minutes or more each way, meaning they get only a few hours of sleep at a time.

James Golden knew the crowbar wasn’t the right tool for the job, but it’s what the bosses provided when he needed to perform work on a piece of equipment at the Kumho tire plant in Macon, Ga.

The crowbar slipped from Golden’s hand and smacked him in the head. Bleeding, yet unable to find adequate help on the sparsely staffed night shift, Golden drove himself to the hospital while a supervisor agonized over whether to fill out paperwork about the injury or try to get the machine operating once more.

While the memory of that night still infuriates him, Golden takes comfort knowing that he and his 325 co-workers now have the power to protect themselves, look out for one another and hold management accountable.

Along with wage increases, better work-life balance and other wins, the workers gained a real voice on the job two weeks ago when they ratified their first contract with Kumho as members of the United Steelworkers (USW).

The contract establishes a labor-management workplace improvement committee, affording Golden and others on the front lines the means to address issues like turnover, efficiency and quality.

The agreement also mandates a joint health and safety committee, giving workers not only a say in how to properly operate and maintain equipment but a role in developing emergency plans and input into other aspects of plant safety.

“It’s a new day,” Golden said, referring to the power of a first contract to level the playing field and afford workers a seat at the table. “This is the law of the land.”

Workers who want to band together for better futures often face prolonged and brutal anti-union campaigns from employers hellbent on holding them down.

Kumho, for example, committed such egregious violations of workers’ rights that an administrative law judge at one point ordered company representatives to call a plant-wide meeting and read a statement acknowledging their illegal conduct.

“Solidarity means everything,” said Golden, recalling how workers met at bars and cookouts to build the union drive and support one another during management’s attacks.

The grief hits Scott Campbell like a ton of bricks every time he walks into the union hall and sees the memorial to the fallen workers.

Seven members of the United Steelworkers (USW) union reported for their shifts at the former Tesoro refinery in Anacortes, Wash., on April 2, 2010, and never drove back out. They perished when a decades-old, structurally deficient piece of equipment called a heat exchanger exploded and caught fire in one of the worst industrial incidents in state history.

Campbell and other members of USW Local 12-591 pay tribute to the seven with a laser focus on safety at the refinery, currently owned by Marathon.

But now they’re seizing the chance to go even further and spare workers at other refineries the kind of loss that weighs so heavily on them. Campbell, president of Local 12-591, is helping to lead the union’s push for stronger rules aimed at revolutionizing the safety culture at all five refineries in the state.

The proposed improvements, modeled on the industry-leading advances that the USW pushed California to enact in 2017, represent the first comprehensive, statewide enhancements to “process safety management” (PSM) at Washington’s refineries in nearly 30 years. PSM refers to how workers and management use planning, training and equipment to reduce risk and respond to incidents.

“Improving process safety is something that we always want to keep working on,” explained Campbell, who will testify during upcoming public hearings on the proposed rules overhaul. “It’s not something we ever think is finished. We’re always learning, and technology is always changing.”

“We don’t want to go backward. We don’t want to get complacent,” emphasized Campbell, noting that oil companies increasingly attempt to “exploit the loopholes” in the current, outdated rules despite the deadly warnings provided by the Tesoro incident and other tragedies.

For example, Campbell said, refineries sometimes have one management representative resolve a safety concern when the safer, prudent course would be to assemble a team of experts from engineering, production and other disciplines to work through the issue.

The new PSM rules—also championed by community residents and other advocates fighting alongside the USW—would force employers to toe the line and hold management accountable. Among many other provisions, they’d require refineries to ensure the structural and mechanical integrity of equipment, make prompt repairs and give workers the authority to suspend operations when they identify hazards.