As President Obama declares swine flu a national emergency and California flu related hospitalizations and deaths increase, several California hospitals, including St. Mary Medical Center in Long Beach, are facing the prospects of a nursing strike. The 435 registered nurses at St. Mary Medical Center plan a 24 hour strike this Friday, October 30 in conjunction with a labor negotiations impasse.
. St. Mary is one of the 30 Catholic Healthcare West, CHW, hospitals in California which will go on strike from 7:00 am Friday until 7:00am Saturday.
According to a release from The California Nurses Association/National Nurses Organizing Committee (CNA/NNOC), the nurses are striking because they believe the hospital chain has not implemented adequate preparations for the swine flu pandemic.
“Central to the walkout is concern over the failure of the hospital chains to assure adequate safety precautions for patients, their families, nurses, and other healthcare employees for the escalating H1N1 ‘swine flu’ pandemic” the CNA/NNOC said in a statement.
According to St. Mary registered nurse and union bargaining representative Sandy Shukla, swine flu training and the implementation of specific swine flu protocols is a major part of the issue. “There’s no education for all the people that work at the hospital. There are no guidelines for all the people that work at the hospital. I, as a registered nurse, don’t have guidelines to say when a person calls, this is our protocol.”
However, according to Jerry Pennington, RN, St. Mary’s Director of Infection Prevention and Employee Health, the hospital does have H1N1 protocols and all employees have been trained. “All nurses have been trained in isolation protocol and also, they do a yearly learning module.”
We asked to get a copy of the protocols but Pennington deferred to CHW, the corporate office. We contacted them and asked for the protocols and an interview, but received neither.
Another aspect of a hospital’s defense against spreading flu virus is the proper handling of protective masks and other gear for hospital workers. According to nurse Shukla, when in the room of patients with flu like symptoms, hospital workers are supposed to wear fitted disposable respirator masks and other protective gear. The protective clothing is supposed to be stored and disposed of inside the patient room so the germs will not spread.
The masks, which are different from the loose fitting general purpose surgical masks, must be closely fitted to prevent virus spreading through coughing and sneezing. Shukla said “We haven’t even gotten them {the masks} in all of the departments. The training hasn’t even started in half the departments at St. Mary. Not all of us have been trained in the use of the disposable mask because we all have to be fitted and that has not occurred as yet.”
St. Mary’s Pennington rebutted those assertions and had a very different take on the approved procedures. He indicated that the new Cal-OSHA protocols permit reuse of the masks, if done properly. He also said storing the protective gear outside the rooms was ok and that all nurses had been fitted and trained on use of at least one of the masks.
Pennington indicated that masks from different manufacturers fit differently, so as their supply of masks comes from different vendors, the hospital must re-test the fit of each mask. He said it is more like an ongoing process, rather than something that is completed at a point in time.
Union spokesperson Shum Preston said ”We want CHW {Catholic Healthcare West} to put the Cal-OSHA guidelines, which are the highest level of standards to prevent the transmission of influenza within settings like hospitals--we want them to put those directly into the contract.” Regarding implementing the guidelines outside of a contract stipulation requiring it, nurse Shukla said “No, they’re not doing it and putting it in the contract would mean that we would hold them accountable for doing it. No, they’re not doing it even half way adequately right now.”
Shukla said the union gave the chain a 15 day notice on October 15 indicating they would walk out on 10/30, the day after the end of the current temporary contract. The contract expired on June 30, but has been extended until 10/29 to give time for more negotiations.
According to Shukla, “This is very serious—H1N1 is very serious. A lot of lives could be lost this winter because the hospitals are not prepared.”
Pennington, who is in management and not in the union, said the hospital, will be ready for the strike. “We have nurses coming in. I know that all the nurses will be covered by a competent nurse because we have to provide for the care and safety of patients.”
Late last week, Dr. Mark Horton, director of California Department of Public Health, CDPH, reported that California hospitalizations for flu like illnesses are increasing and have reached over 3,500 since the pandemic began in the spring. During the same period, deaths in California have totaled 233. He said “We continue to see a significant increase in the percentage of patients seen in doctors’ offices that are presenting with influenza like illnesses. We’re seeing that nearing 6% of the patients have influenza like illness. This is typically what we see at the peak of the influenza season. We are continuing to characterize ourselves as having widespread disease. We continue to see significant activity throughout the state.”
Given the seriousness of the disease and the widespread shortages of H1N1 vaccine, Dr. Horton indicated procedures to prevent the spread of infection are now even more important. In fact, hospital spokesperson Pennington said none of St Mary’s employees have received the H1N1 vaccination because they do not yet have it available. Thus, implementing the Cal-OSHA guidelines becomes that much more critical. Pennington said they expect the H1N1 vaccinations for the hospital staff to be done in mid November.
Dr. Horton outlined 4 major steps California is taking to help offset the shortage of vaccination. In addition to releasing 25 million of the state’s stockpile of 50 million N-95 respirator masks, he said California Occupational Safety and Health Administration, Cal-OSHA, “is reissuing guidance on how those respirators are to be used to clarify what individual healthcare workers need to do to ensure that they are being worn properly to protect themselves and how to use them in the way that’s most efficient.”
These Cal-OSHA mask guidelines are part of the very same H1N1 infection control guidelines which, according to Pennington, St. Mary follows, and the nurses union wants incorporated into their contract. Union spokesperson Preston said “The wage issue is not the sticking point in this strike and if that was the only issue, there would not be a strike. This is not an economic issue strike. The main thing that would need to be resolved for this strike to be settled is for Catholic Healthcare West to write these industry leading patient safety standards {Cal-OSHA and Centers for Disease Control guidelines} into the contract so that nurses can rest assured that we won’t skip on patient care ever again.”
In our attempt to deliver balanced reporting to our readers, we made several calls to CHW. We were told that Jill Dryer, Director of Marketing and Communication, in their Sacramento office, was the person authorized to respond to the media for the chain. In addition to requesting an interview and the H1N1 protocols, we asked for a statement on the strike. What we received was a statement which said nothing about H1N1 preparations and referred only to disputes about salary. Dryer did not return our phone calls.
