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October 14, 2014 01:00 AM

More Ebola preparedness needed, healthcare workers urge

Adam Rubenfire
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    Hospitals' ability to protect their employees is weighing on the minds of American healthcare workers as a nurse in Texas fights for her life against the deadly Ebola virus she contracted while caring for a patient there.

    Some healthcare worker groups and leaders are calling for increased protection for healthcare workers, while others are focusing on efforts to educate members.

    National Nurses United, a union and trade association for registered nurses, has said its members do not feel that hospitals are adequately prepared to treat Ebola patients. The union is calling for hospitals to increase training, ensure that personal protective equipment is in adequate supply, and plan adequately for isolation of potential Ebola patients and proper disposal of their waste.

    Nearly 80% of members told NNU in a recent survey that their hospital has not communicated isolation policies to them, while 85% said their hospital has not provided education in a setting that allows nurses to interact and ask questions. One-third of respondents said their hospital doesn't have an adequate personal protective equipment supply. Roughly 1,400 RNs at more than 250 hospitals in 31 states responded to the poll as of Monday morning, NNU said.

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    The union is expected to hold a conference call for members Wednesday to discuss hospital preparedness.

    Deborah Burger, one of three co-presidents of the union, said the Centers for Disease Control and Prevention needs to mandate a specific level of protection for workers, rather than leaving it up to hospitals to decide based on guidelines.

    “We're saying we need to have a strict protocol to have optimal protection that is not optional,” Burger said.

    The case of Nina Pham, the nurse in Dallas who contracted the disease, shows negligence on behalf of healthcare companies and the CDC, Burger said.

    “What it tells me is that employers have very little regard for their employees,” she said. “We need to make sure we hold our elected officials accountable and our employers accountable.”

    Personal protection equipment isn't high cost and hospitals generally maintain a stockpile, said Adam Higman, vice president at Soyring Consulting, a healthcare consulting firm. Depending on what level of protection a hospital wishes to provide, it could pay as little as $8 and as much as $12 for each disposable personal protective equipment suit, which would include CDC-recommended protection items such as double gloves, a resistant or impermeable gown, leg coverings and a full face shield, all of which are generally sold separately.

    In this situation, education and training represents hospitals' biggest cost, he said, though actual expenses would vary widely based on the cost of labor and whether the instruction is done during working hours.

    If healthcare providers don't invest in adequate equipment and education, Burger said, some nurses could choose not to come to work out of concern that they are at too high of a risk for being infected with the virus. Members don't want to risk harming their families, she said.

    A wide array of healthcare workers, not just physicians and nurses, could come into contact with Ebola patients or waste from their treatment. A spokesman for the Service Employees International Union, which represents housekeepers, technicians and other hospital employees, said some of its healthcare members will be engaged in training to prepare for the virus. So far, the organization has not issued a call for action akin to the demands of National Nurses United.

    At many facilities, hospital security officers are the first point of contact individuals have at a hospital, and they're also often responsible for guarding quarantine areas.

    Marilyn Hollier, president of the International Association for Healthcare Security and Safety, an industry trade association, said hospital security officers may have some anxiety over the virus, but emphasized that they're prepared because of the lessons their departments have learned after dealing with other infectious diseases such as SARS and varieties of influenza. Many hospitals include security personnel in preparedness drills and tabletop exercises, she said.

    “As of today, I think that fear could be our worst problem. We don't want panic and we train our security officers to always use universal (hygiene) precautions,” said Hollier, who is director of security and entrance services at the University of Michigan Hospitals and Health Centers, Ann Arbor.

    In Liberia, nurses and other nonphysician health workers threatened to strike this week if they didn't receive increased hazard pay from the government, the Associated Press reported. Many workers ignored the call for a strike and came into work Monday. U.S. Marines traveling to the region to assist are earning up to $400 extra per month for working in the epicenter of the virus, Army Times reported.

    Ed Hannibal, global leader of the mobility practice at human resources consulting firm Mercer, said he hasn't heard any discussions regarding the possibility of offering hardship pay to workers in the U.S.

    “In my experience, I have never seen true hardship pay in a domestic situation like this,” Hannibal said, adding that organizations will need to continue to evaluate their obligations as the situation evolves.

    Officials at Texas Health Presbyterian Hospital Dallas convened their staff Monday at a town hall meeting to thank them for their efforts in treating Pham and Thomas Eric Duncan, who died of Ebola Oct. 8 at the hospital. Hospital leaders assured employees that they are doing everything they can to keep them safe.

    The American Medical Association said it regularly evaluates physician morale through an ongoing study and is monitoring the progress of the Ebola virus in the U.S.

    While nurses and others worry about their safety in dealing with Ebola, some nurses are lining up to help treat potential Ebola patients at the Nebraska Medical Center, one of only four hospitals around the country with a top-level bio-containment unit.

    Six to seven employees have volunteered to be trained to work in the unit, which has a maximum of 40 staff members, said Taylor Wilson, spokesman for Nebraska Medicine, the Omaha-based system that owns the facility.

    “We're not trying to fill any more positions right now but there's a lot of internal interest,” Wilson said. “I think there's something about folks who live in Nebraska wanting to help, and I think the nurses by nature have that in them.”

    Follow Adam Rubenfire on Twitter: @arubenfire

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