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Press Release: California Nurses’ Union says latest CDC reversal is last straw; puts out its own pandemic safety guidelines.

September 22, 2020

For Immediate Release:

Monday, September 21, 2020

CONTACT: Terry Carter, (805) 312-0024

Los Angeles, CA–The Registered Nurses of SEIU Local 121RN put forward their own pandemic safety guidelines today (outlined below) in response to the CDC’s recent move to acknowledge airborne transmission of COVID-19…and then quickly reverse itself.

“Nurses and other healthcare workers around the nation are dying, while the CDC refuses to affirm what scientific research and healthcare professionals know will protect them. Our governing healthcare agencies have failed us. Nurses have known since the beginning of this outbreak that this disease is airborne,” said SEIU Local 121RN President Dr. Nina Wells, DNP, MSN-NE, RN, PHN. “That’s why we insisted on wearing Respirator N95 masks, face shields, and protective eyewear throughout the hospital, even when our employers threatened to discipline us. We were relieved at the reports over the weekend of the Center’s acknowledgement of airborne transmission. This retraction has left us frustrated, angry and, quite frankly, betrayed.”

“Due to hospitals’ obvious lack of appropriate preparedness during this pandemic, we are tackling this in a multi-faceted manner. This includes contract negotiations when our members have the best opportunities to make workplace improvements in health and safety for healthcare providers and their patients. We must be more prepared for future health emergencies,” said SEIU Local 121RN Executive Director, Rosanna Mendez.

In response, Union members introduced their safety recommendations today. They plan to use all tools at their disposal to implement this platform—their bargaining tables, grievance processes, Labor-Management and other joint committees, passage of new state and federal laws and regulations, the enforcement of existing laws through agency complaints, public actions like this summer’s 10-day Safe Staffing strike at Riverside Community Hospital, and Union Stewards—to continue to take the lead on making hospitals and our healthcare system safer for patients and staff.

“Instead of taking extra precautions during this pandemic, our hospitals continue to cut dangerous corners and take risks with Nurses’ lives and the lives of our patients,” said SEIU Local 121RN Vice President Sydnie Boylan, RN. “This Pandemic Safety Platform is part of a long arc of Union Nurses leading the way (over decades) to ensure patient and Nurse safety. Union Nurses have fought on the front lines for everything from AIDS treatment to needle safety to workplace violence prevention to safe staffing levels. We will continue to take the lead.”

As a result of confusing CDC positions, our communities have been placed at risk—especially our most vulnerable. Hospital administrators adhere to the CDC’s most extreme emergency recommendations instead of Cal/OSHA advisories, which have been steadily improving to better protect workers and better enforce California’s unique aerosol transitable disease standard, the strongest in the nation. Cal/OSHA appears to understand that a droplet is a form of airborne and the CDC’s hairsplitting is only costing more lives.

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SEIU Local 121RN represents registered nurses and other healthcare professionals in California. This member-led organization is committed to supporting optimum working conditions that allow nurses to provide quality patient care and safety.

Union Nurses and healthcare professionals are in a unique position to provide valuable insight and precise guidance. For decades, we have been at the forefront, pushing hard for every major safety advancement in our professions. We led the way (often fighting hospital administrators) on:

The COVID-19 pandemic is no different. Those of us on the front line continue to see clearly what is needed. We propose our Pandemic Safety step-by-step plan for our hospitals, which includes:

Pandemic Safety Platform

The coronavirus global pandemic has uncovered severe deficiencies in our hospitals, including—but not limited to—dangerous lack of staffing and supplies, inadequate patient care, reckless COVID-19 transmission, and needless staff burnout.

For some of what we outline below, it’s as simple as better adherence to the things we’ve already established. The Cal/OSHA Aerosol Transmissible Disease Standard, for example, was specifically created for a time like this. And yet in hospital after hospital, it wasn’t effectively followed, leading to illness and unnecessary transmission. Our Title 22 safe staffing regulations should have guided our hospitals as they shifted resources to treat COVID-19 patients. In other cases, this once-in-a-century crisis has made us aware of weaknesses in our systems that we haven’t yet addressed.

Here’s what our hospitals need in order to improve safety during a pandemic:

New, optimal PPE

Early in the pandemic, the public learned a new acronym: PPE—personal protective equipment. They learned that our hospitals, our local public health departments, California and our nation were caught woefully under-supplied.

Our Union urged California legislators to ensure that this lack of PPE won’t happen again. SB 275—The Healthcare and Essential Workers Protection Act—was introduced by State Senators Leyva and Pan to create a reliable supply of PPE to ensure healthcare workers, essential workers, and the public at large are protected during the next health emergency. SEIU members from all over the state pushed for its passage. It currently sits on Governor Newsom’s desk after being passed by the state legislature. We have every hope that it will soon be signed into law.

SEIU Local 121RN members point out that having a stockpile of PPE is a first critical step in the right direction. It must go hand-in-hand with other necessary remedies. Nurses need more than a supply closet full of N95s. We need access to them. We need to be able to wear them the way we were trained to wear them—for a single use when visiting an infected patient, to prevent the spread of disease to other patients and to staff.

All hospital staff must have access to adequate PPE. There are no “clean” areas, as several deaths in our hospitals have proven. We don’t know who’s infected. Both patients and staff go untested when they don’t show symptoms, potentially spreading the disease to both. Test results are often delayed or even inaccurate.

NIOSH approved and tested N95s or PAPRs must be available for all staff facing possible exposure—especially, but not limited to, those caring for COVID-19 patients or those suspected of having COVID-19. PPE must not be reused from patient to patient. All staff must be properly fitted and thoroughly trained in safe donning and doffing. Staff members must have the right to replace any PPE they consider unsafe (for any reason). Any recycling, reuse or sterilization programs must be used only as the very last resort in a true emergency situation when all supplies have actually been depleted, including the supplies of all vendors and sources of PPE. Hospitals must not allow shortages simply because supplies became more expensive.

Bottom line: we know that our colleagues have died as a direct result of inadequate PPE. We know that we have likely infected patients who came into our hospitals without COVID-19. L.A. County now reports more than 5,300 Nurses have fallen ill in the county and 37 have died.

Immediate notification of exposure

Hospitals must notify staff of all possible exposure as soon they are aware, including exposure to suspected COVID-19. This notification must happen immediately, but no longer than 24 hours after the exposure incident. Hospitals must provide immediate testing of all exposed staff.

Regular testing

Hospitals must establish a regular schedule for testing of all frontline workers to ensure patients are safe and not unnecessarily exposed to COVID-19 from those providing care. Staff members must also have access to free, on-demand testing whenever they consider it necessary.

Quarantine that’s safe and affordable

Hospital staff must have access to paid quarantine as needed for the full recommended duration or until they test negative. Contraction must be assumed to be job related. Hospitals must provide additional PTO for the care and quarantine of family members.

Safe staffing levels

Hospitals also must have enough staff on their floors every shift to safely care for patients. California’s nurse-to-patient ratio regulations should have guided our hospitals as they shifted resources to treat COVID-19 patients. Instead, many hospitals use the pandemic as an excuse to slash their staffing levels. Having enough Nurses and other healthcare personnel on duty is critical. A New York Times investigative journalist discovered that the death rate in hospitals without sufficient staff and equipment was as much as three times higher than properly staffed/equipped hospitals.  Our hospitals have the available staff, but they’ve chosen to reduce hours or remove them from the schedule. Nurses leave their shifts near tears because they aren’t able to spend time with their frightened, isolated COVID-19 patients.

There must also be minimum staffing levels for support and specialty staff, including Respiratory Therapists, Phlebotomists, Nurse Assistants, Environmental Services and Unit Secretaries.

COVID-19 patients, due to the risk of rapid and unpredictable decline, are akin to ICU patients. The maximum number of COVID-19 patients per RN should be two. There must be a dedicated Charge Nurse who is not put into this ratio. There must also be minimums established for support and specialty staff, including Respiratory Therapists, Phlebotomists, Nurse Assistants, Environmental Services and Unit Secretaries.

Dedicated Labor/Management Pandemic Safety Committee

Those of us on the front lines of patient care must have a voice in safety policies and procedures. We knew from the outset that there were airborne risks with COVID-19. That’s why we desperately scrambled for PPE that our hospitals weren’t supplying. That’s why we risked being disciplined when we insisted on wearing our own. We know from decades of safety fights that official guidelines are sometimes off the mark. We moved OSHA to establish the Aerosol Transmissible Disease standard, not the other way around. We demanded needle safety, not the other way around. We must be at the table on pandemic safety issues.

Union Nurses and healthcare professionals will continue to risk our health and safety to care for our communities during this pandemic. At the same time, we will continue our long tradition of fighting for the establishment of improved professional standards. In addition to urging our hospitals to join us in these efforts as outlined here, we will also continue to push for better enforcement of the standards we have and will establish.