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As many as 16,000 registered nurses from three large Catholic hospital chains in California and Nevada will join a one-day strike and picket on Oct. 30, as RNs step up the protest over poor readiness by many hospitals to confront the H1N1 swine flu pandemic, the California Nurses Association/National Nurses Organizing Committee (CNA/NNOC) announced today.
The strike will affect hospitals across 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. Additionally, nurses will picket major facilities in Las Vegas and Reno, Nev.
Central to the nurses' walkout is ongoing concern over the failure of the hospital chains to assure adequate safety precautions for patients, their families, nurses, and other healthcare employees in the wake of the escalating H1N1 influenza pandemic. In particular, the RNs say, many hospitals continue to do a poor job at isolating patients with H1N1 symptoms and other steps to limit contagion, or provide sufficient fit-tested N95 respirators and other protective gear for healthcare workers and patients.
Updated Centers for Disease Control and Prevention (CDC) recommendations released last week re-affirmed guidelines for isolation and safety equipment, and urged hospitals to avoid policies that encourage employees to work when sick, another problem in many hospitals.
The Occupational Safety and Health Administration said 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.
CNA/NNOC wants hospitals to formally adopt all CDC and Cal-OSHA guidelines to make them enforceable by CNA/NNOC contract provisions assuring the highest safety measures are met, are uniform, and consistently applied throughout the systems.
For months, RNs have repeatedly voiced alarm at inadequate H1N1 hospital safeguards. In August, CNA/NNOC released the findings of a survey of 190 U.S. hospitals where RNs cited widespread problems with poor segregation of patients, lack of sufficient N95 masks, numerous hospitals where nurses have been infected, inadequate training for hospital staff, and punitive sick leave policies.
But substantial problems remain. In California alone, more than 3,000 people have been hospitalized, and over 200 have died, including an RN infected on the job at one of the hospitals where RNs will strike.
“Our hospital isn’t being proactive in preparing for the expected onslaught of H1N1 infected patients,” said Kathy Dennis, RN, of Mercy General Hospital in Sacramento. “We can’t get enough N95 masks, patients are not being properly isolated, and RNs are not being kept informed of the latest guidelines. Last time I worked, it took me more than four hours to get masks when we ran out. We must put the proper precautions in place now before flu seasons peaks or we will all be in serious trouble.”
"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? All staff have the right to know if they have been exposed in order to keep our patients from further unnecessary exposure," said Carol Koelle, RN, of St. Bernardine Medical Center in San Bernardino.
Complicating swine flu preparedness, RNs say many hospitals fall far short in assuring proper RN staffing as required under a California law requiring minimum, safe RN-to-patient staffing ratios. CNA/NNOC proposes RN monitors to assure compliance with the law in all hospital units.
“Our hospitals are not adhering to the safe staffing ratios law,” said Allen Fitzpatrick, RN ,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 that already exists in most hospitals throughout the state.”
RNs also want to stop the practice of some of the hospitals that mandate RNs to "float" – work in clinical areas outside their expertise, training, and orientation – which puts patients at risk. Additionally, the RNs are insisting that hospitals withdraw efforts to reduce healthcare benefits by shifting more costs to nurses and reducing coverage options. In several areas, 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, RN, at Seton Medical Center in Daly City. "Such demands, would also sharply undermine the ability of the hospitals to keep nurses at the bedside and recruit new RNs."
RNs will be participating in the strike or picketing at the following facilities:
Catholic Healthcare West
Arroyo Grande Community Hospital
Bakersfield Memorial Hospital
Bruceville Terrace - Sacramento
California Hospital Medical Center - Los Angeles
Community Hospital of San Bernardino
Dominican Hospital - Santa Cruz
French Hospital Medical Center - San Luis Obispo
Glendale Memorial Hospital and Health Center
Marian Medical Center - Santa Maria
Mercy General Hospital - Sacramento
Mercy Hospital - Bakersfield
Mercy Hospital of Folsom
Mercy Medical Center - Merced
Mercy Medical Center Redding
Mercy Medical Center - Mt. Shasta
Mercy San Juan Medical Center - Carmichael
Mercy Southwest Hospital - Bakersfield
Methodist Hospital - Sacramento
Sacramento Foundation Clinics
Saint Francis Memorial Hospital - San Francisco
St. Bernardine Medical Center - San Bernardino
St. Joseph's Behavioral Health Center - Stockton
St. Joseph’s Medical Center - Stockton
St. Mary Medical Center - Long Beach
St. Mary's Medical Center - San Francisco
Sequoia Hospital - Redwood City
Sierra Nevada Memorial Hospital - Grass Valley
Saint Mary's Regional Medical Center - Reno
St. Rose Dominican Hospital, Rose de Lima - Henderson
St. Rose Dominican Hospital, Siena - Henderson
St. Rose Dominican Hospital, San Martin - Las Vegas
Daughters of Charity Health System
O'Connor Hospital - San Jose
Saint Louise Regional Hospital - Gilroy
Seton Medical Center - Daly City
St. Vincent Medical Center - Los Angeles
St. Joseph Health System
Petaluma Valley Hospital
St. Joseph Hospital - Eureka
St. Mary Medical Center - Apple Valley