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The Editors of Effect Measure are senior public health scientists and practitioners. Paul Revere was a member of the first local Board of Health in the United States (Boston, 1799). The Editors sign their posts "Revere" to recognize the public service of a professional forerunner better known for other things.

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« Playing Grandmaster chess with swine flu | Main | Ron Paul nuttiness on swine flu »

Swine flu produces a good settlement for hospitals and workers

Category: HospitalsInfectious diseaseInfluenza treatmentOccupational healthPandemic preparednessProgressive public healthPublic health preparednessSwine flu
Posted on: November 4, 2009 7:00 AM, by revere

It's being described as a "dramatic settlement" that will set a pattern for the nation. Let's hope so, because the agreement reached yesterday by the California Nurses Association/National Nurses Organizing Committee (CNA/NNOC) and hospital player Catholic Healthcare West (CHW) sounds like just what the doctor ordered. It covers 32 CHW facilities in California and Nevada, where CNA/NNOC represents 13,000 registered nurses.

Some details:

A centerpiece of the agreement is the creation of a new system-wide emergency task force, comprised of CNA/NNOC RNs and hospital representatives following the declaration of pandemic emergencies.

The task force will monitor system-wide preparedness and set uniform standards on full implementation of federal, state and local guidelines, availability of the property safety protective equipment, communication and training policies for all hospital personnel, and other needed steps, such as consideration of off-site emergency triage and treatment.

At each facility, CNA/NNOC nurse committees, in cooperation with facility infection control teams, will implement the system-wide policies and procedures.

In addition, the new CNA/NNOC contract covering CHW facilities will include:

  • Employer agreement at each facility to comply with all federal, state, and local laws and regulations, such as those set by the Centers for Disease Control and California Occupational Safety and Health Administration, to limit the spread of communicable diseases, like proper isolation of patients with H1N1 symptoms. Including the guidelines in the CNA/NNOC contracts gives them the added force of contract law.
  • Assurance that RNs "shall be provided" appropriate equipment and attire to stem contagion, such as single-use, N95 respirator masks when available.
  • Guarantee that the employer will provide information and training for nurses on communicable diseases to which they may have been exposed.(Medical News Today)

CHW used good sense in reaching this win-win agreement with labor. It wasn't a concession in the substantive sense because it just contractually commits the hospitals to do what they are either legally or medically required to do, anyway. Of course it isn't always the case that rationality and commonsense prevail. Many hospitals have blithely looked the other way when it came to protecting their workers and patients from infectious disease, either on the grounds that you never give in to labor demands, no matter how warranted or rational, or because it would be too expensive to do what is needed for the sake of their workers and patients.

It's good to see labor and management working toward a common purpose. It would be even better to see more of it.

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Comments

1

Don't suppose you've run into this group yet, have you?

http://www.medicalvoices.org/

...For each voice of reason lifted, it seems like the morons develop a larger advertising budget.

Posted by: Luna_the_cat | November 4, 2009 7:13 AM

2
Assurance that RNs "shall be provided" appropriate equipment and attire to stem contagion, such as single-use, N95 respirator masks when available.

Interesting, given the recent article in JAMA by Loeb et al http://jama.ama-assn.org/cgi/content/full/2009.1466 and the retraction of the Austrailian study referenced by the IOM as justifying their recommendation for N-95 masks over surgical masks.

It now appears that N-95's are no more effective, cost more, are more difficult to wear, and must be fit tested to be compliant with OHSA regs. I'm not sure mandating them is really a step in the right direction.

Posted by: MoM | November 4, 2009 2:19 PM

3

MoM: notice it says "when available."

Posted by: revere Author Profile Page | November 4, 2009 2:42 PM

4

Great to hear this. CNA has been in the forefront on healthcare reform, inc single-payer, too.

Posted by: Paula | November 4, 2009 4:43 PM

5

The Australian study by MacIntyre has not been retracted and the media reports stating this have been in error.

Posted by: Epifreak | November 4, 2009 8:15 PM

6

For MoM re Ontario study. This study is very limited. Were I reviewing it for a journal, I would have demanded substantial changes. Anyway,even if you bought the methods, about 20% of both groups seroconverted during the study (from memory), showing that neither regimen protected.N95 group had way less ILI compared to surgical masks.

Posted by: Frank Mirer | November 5, 2009 9:19 AM

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