In a development that might be attractive to other hospitals and bargaining units, the California Nurses Association (CNA) has worked pandemic flu preparation into its new labor agreement with Catholic Healthcare West (CHW).
While the agreement doesn't delve into vaccinations—mandatory or otherwise—it covers personal protective equipment and promotes communication between union rank-and-file members and hospital management via a joint task force charged with limiting the spread of seasonal and H1N1 swine flu.
The settlement involves 13,000 registered nurses in 32 CHW facilities in California and Nevada who are represented by CNA and its affiliate, the National Nurses Organizing Committee.
The top three issues the pact aimed to resolve are probably endemic to many hospital's response plans. Sacramento nurse Richard Sandness, RN, one of the CNA members who sat at the bargaining table, pointed to the following pain points the union and health system will be working together to eliminate:
- N95 respirator inventories. When a patient with confirmed or suspected H1N1 presents to the hospital, caregivers need to have N95s available per the latest recommendations from the Centers for Disease Control and Prevention. The pact between the CNA and CHW addresses how staff members who need N95s can get them right away.
- Exposure notification. Nurses need to know if they're potentially facing H1N1 exposures.
- Patient screening and tracking. Patients coming down with—or getting over—H1N1 may show up at the hospital for treatment of other medical issues. Uncovering these cases and tracking them through the hospital is key to controlling flu's spread.
Not just for H1N1 response
The upside of making a union-friendly plan—which can cover other diseases beyond the flu—is that it gets staff members involved more deeply in emergency preparation and response. While management can put together a plan, the union can poll the nurses to make sure they understand it and can execute it.
"It's management's responsibility to provide the proper safety equipment, but on the other end, are we getting it when it runs out in the department? Does everyone know where the proper safety equipment is?" Sandman said. "We're working on it on both sides."
The agreement codifies guidelines CHW had been following, said Jill Dryer, a spokesperson for the health system.
"The agreement covers measures that CHW already has in place, including information and training for direct caregivers as well as the provision of personal protective equipment, including N95 respirator masks and clothing," Dryer said. "We are pleased to now have the CNA's full collaboration in furthering our efforts."
Scott Wallask is senior managing editor for the Hospital Safety Center. He can be reached at swallask@hcpro.com.