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November 17, 2009
Dear WSNA member,
As you are well aware, the H1N1 flu pandemic is hitting communities all across
the country, including Washington State, very hard right now. As a Registered
Nurse, you are on the frontlines each day and play a critical role in the battle
to slow the spread of H1N1 and to diagnose and treat its victims.
I’m writing today to briefly update you on just a few of the activities that The
Washington State Nurses Association (WSNA) has been engaged in to help support you
– the registered nurse -- as you care for your patients with suspected or diagnosed
H1N1 and to direct you to some important documents that may be of additional help
to you.
WSNA is strongly committed to protecting and advocating for the health and safety
of registered nurses and the patients we serve. This is an unprecedented time for
everyone in health care, with new information, multiple rumors, and differing recommendations
about H1N1 coming out almost daily. WSNA and ANA strongly supports and urges everyone
to follow the Center for Disease Control and Prevention (CDC) guidelines on Infection
Control Measures rather than take a hospital-by-hospital approach to setting H1N1
policy. You can find two of these important CDC documents at the links below and
I urge you to read them carefully:
CDC Interim Guidance on Infection Control Measures for 2009 H1N1 Influenza in Healthcare
Settings, Including Protection of Healthcare Personnel http://www.cdc.gov/h1n1flu/guidelines_infection_control.htm#A
Questions and Answers about CDC’s Interim Guidance on Infection Control Measures
for 2009 H1N1 Influenza in Healthcare Settings, Including Protection of Healthcare
Personnel http://www.cdc.gov/h1n1flu/guidance/control_measures_qa.htm
Over the past few weeks and months, WSNA members and staff have worked intensely
and tirelessly in a coordinated team effort to ensure a comprehensive approach to
the H1N1 crisis that includes education, sound public policy, advocacy, and union
representation to protect both patients and nurses. WSNA has been actively engaged
in working with many stakeholders, governmental agencies and the public to collaborate
and support these efforts.
In addition to our ongoing work with stakeholders and governmental agencies on emergency
and pandemic preparedness, our recent efforts on H1N1 include:
Educating the public and nurses on flu prevention:
- Partnered with the Washington State Department of Health, Washington State Medical
Association, Washington State Hospital Association, and Washington Health Foundation
on statewide television ads in English and Spanish on H1N1 and seasonal flu prevention.
- Focused eight pages of the Fall issue of the Washington Nurse on H1N1 and
Seasonal Flu.
- Development of an entire section on the flu on the WSNA website –
www.wsna.org/flu
Ensuring patient and nurse safety:
- WSNA staff are participating in briefings and continuously monitoring the CDC and
OSHA websites for the latest standards and recommendations on infection control
measures for H1N1, including the recommendations for nurses’ use of personal protective
equipment (PPEs), such as N95 respirators, in caring for patients with suspected
or diagnosed cases of H1N1.
- WSNA filed formal complaints with both the WA Department of Health (DOH) and Labor
and Industry Division of Occupational Safety and Health, when notified by our members
that Sacred Heart Medical Center was not following CDC guidelines and not providing
N95 respirators to nurses directly caring for suspected or diagnosed H1N1 patients.
- WSNA has lobbied state agencies for enforcement of state regulations to ensure that
hospitals are following CDC infection control guidelines for H1N1 and that hospitals
are held accountable for providing a safe workplace for their employees.
- WSNA worked with the Washington State Hospital Association on a joint letter to
the Department of Health urging DOH to develop guidance to hospitals and to re-emphasize
the importance of implementing the hierarchy of controls recommended by the CDC.
- WSNA has worked closely with the Department of Health in establishing a standardized
procedure and checklist to ensure that all health care facilities are following
the CDC recommended action steps, including the hierarchy of controls, and documenting
their efforts to secure N95 respirators from commercial suppliers prior to receiving
N95 respirators from the Washington State allocation from the strategic national
stockpile.
Protecting nurses’ rights:
- WSNA filed an injunction against MultiCare Health System for violating the collective
bargaining contract by unilaterally implementing a flu policy requiring all nurses
to be vaccinated against H1N1 or wear a surgical mask at all times without first
negotiating with WSNA. While the judge did not grant the temporary restraining order,
the hospital did agree to negotiate the policy.
We have renewed negotiations with MultiCare and successfully achieved significant
changes to the flu policy.
- WSNA has opposed use of vaccination declination forms that require the nurse to
disclose personal health information.
- WSNA is advocating for nurses who are disciplined or discharged for calling in sick.
Supporting sound public policy for flu vaccination for nurses:
- ANA and WSNA continue to strongly recommend that nurses and all other health care
providers who provide direct patient care be vaccinated against the seasonal influenza
and H1N1 viruses.
- We do not believe that a hospital-by-hospital policy concerning mandatory vaccination
is good public policy. It lacks consistency and adequate protection for the patients
and workers. Absent of a Center for Disease Control (CDC) or Department of Health
requirement for mandatory annual influenza vaccination of all health care workers,
WSNA supports aggressive and comprehensive voluntary efforts.
- WSNA believes that any mandatory vaccination policy should be comprehensive and
only be enacted as a federal or statewide public health regulation. The policy must
include the following core components:
- Employers must ensure that appropriate protection and safety measures are in place
to provide a safe workplace environment for nurses and health care workers.
- Employers must ensure that influenza vaccines are available and offered to every
health care worker annually.
- The policy must cover all health care settings and health care workers. This includes
all settings such as hospitals, long-term care facilities, adult boarding homes,
outpatient clinics, etc. Health care workers must include those licensed and unlicensed
who work in close proximity to patients, e.g. nurses, emergency responders, physicians,
housekeeping personnel, health care secretarial staff, etc.
- If a declination form is required, the nurse must be able to sign the form confidentially;
that is, the nurse must not be required to divulge personal health information or
declare the reason(s) for refusal of a vaccine. The employer must not discriminate
against or discipline a nurse for opting out.
- The employer must not discriminate against or discipline nurses for the appropriate
use of sick time.
- CDC Guidelines must be used for prevention, protection, and safety of nurses and
patients.
WSNA firmly believes that registered nurses must have input into flu prevention
strategies and that nurses need to be involved in the decisions that affect their
health and the health of their patients. This position is supported by the
CDC guidelines, which states: “Strong sustained management commitment and active
worker participation in a comprehensive, coordinated prevention program are extremely
important in promoting implementation of, and adherence to, prevention recommendations.”
(Excerpted from CDC’s Interim Guidance on Infection Control Measurers for 2009 H1N1
Influenza in Healthcare Settings, Including Protection of Healthcare Personnel:
October 14, 2009)
Unfortunately there is no single answer to keeping our patients and health care
providers healthy this flu season, WSNA is committed to a variety of approaches
to accomplish this goal. Combating H1N1 will require coordination and collaboration
among many stakeholders and WSNA will continue to actively lead and engage in these
efforts. You can also help us with these efforts by filling out a short online survey
about the availability and use of N95 respirators in your workplace - Go to
http://www.wsna.org/flu/ to complete the survey.
Attached please see a list of useful links to additional online resources as well
as the H1N1 Frequently Asked Questions developed by WSNA. Don’t forget
to check the WSNA website frequently for updated information of H1N1.
Thank you for the opportunity to share this information with you. I appreciate all
that you do each and every day on behalf of safe and quality patient care. Please
feel free to contact WSNA at wsna@wsna.org or
206-575-7979 with any questions.
Sincerely,
Judith A. Huntington, MN, RN
WSNA Executive Director
