“When nurses are exposed to tuberculosis, the hospital notifies us. When nurses are exposed to head lice, the hospital notifies us. Why then are we not told when we are exposed to H1N1? Staff need to know if they have been exposed in order to keep our patients from further unnecessary exposure,” said Carol Koelle, an RN at St. Bernardine Medical Center in San Bernardino, Calif.
“We can’t get enough masks, patients are not being properly isolated, and nurses are not informed of the latest guidelines. Last time I worked it took me more than four hours to get masks when we ran out. If we don’t put the proper precautions in place now before flu season peaks we will be in serious trouble,” said Kathy Dennis, a registered nurse at Mercy General Hospital in Sacramento.
These concerns, voiced by nurses this week, follow months of warnings by the nation’s RNs about inadequate swine flu hospital safeguards. In California alone, more than 3,000 people have been hospitalized and over 200 have died, including a nurse infected on the job.
Some 16,000 registered nurses from three large Catholic hospital chains in California and Nevada will do more than just continue their warnings this weekend when they stage a one day strike and picket Oct. 30 to dramatize the lack of readiness by hospitals to confront the swine flu pandemic.
The strike will affect hospitals throughout California from San Bernardino and Long Beach in the south to Eureka and Redding in the north, and include major facilities in Los Angeles, Sacramento, San Francisco, San Jose, Bakersfield, Stockton and the Central Coast. Nurses will also picket major facilities in Las Vegas and Reno, Nev.
Nurses at almost all the hospitals involved agree with Koelle and Dennis that hospitals are doing a poor job at isolating patients with swine flu symptoms and are not taking other steps necessary to limit contagion, including provision of masks and safety gear for workers and patients.
As late as last week the Centers for Disease Control confirmed that it had re-issued guidelines for isolation and safety equipment and had urged hospitals to stop encouraging employees to work when sick, another problem cited by many nurses.
The Occupational Safety and Health Administration confirmed, also last week, that it plans to issue a compliance directive to ensure uniform procedures “to identify and minimize or eliminate high to very high risk occupational exposures” to H1N1.
The California Nurses Association/National Nurses Organizing Committee issued a statement Oct. 19 urging incorporation of all CDC and OSHA guidelines into its existing contracts with hospitals.
In August CNA/NNOC released the findings of a survey of 190 hospitals in the U.S. where nurses cited major problems with poor segregation of patients, lack of sufficient masks, numerous cases where nurses were infected, inadequate training and punitive sick leave policies. The union says that substantial problems remain all over the country.
Making the swine flu issue even more serious, many nurses say, is the failure of hospitals to assure proper staffing.
“Our hospitals are not adhering to the safe staffing ratios law,” said Allen Fitzpatrick, a nurse who works at St. Mary’s Medical Center in San Francisco. “Nurses are being harassed by supervisors to accept unsafe assignments and not to take any breaks. Bedside nurses are busy enough trying to provide care to our patients. We need someone to stand up for safe RN-to-patient staffing.”
“We have a comprehensive staffing proposal on the table because no matter how much care a patient requires our hospital won’t add nurses and has eliminated our aides,” said Susan Johnson, an Obstetrics RN at St. Joseph Hospital in Eureka. “We work 12 hour shifts, often without a break, and are assigned to work outside our area of expertise. We have proposed a break relief nurse on every unit and a safe “floating” policy, all essential patient care protections.”
Additionally, the RN’s are insisting that hospitals stop their efforts to reduce healthcare benefits by shifting more costs to nurses and reducing coverage options. In some cases, hospitals are also demanding a wage freeze.
“As nurses, we see the consequences when employers reduce coverage, it’s disgraceful to see our hospitals taking the same step,” said Debra Amour, a registered nurse at Seton Medical Center in Daly City.