In what may be the first such agreement in the U.S., the University of Michigan Health System has signed a memorandum of understanding with the state's nurses union that sets guidelines for staffing, benefits, training and working conditions in the event that the system's Ann Arbor hospital receives a potential Ebola patient.
Specific training that registered nurses who treat an Ebola patient must undergo is detailed, as is the appropriate personal protection equipment that the system must provide in tandem with evolving federal requirements. It also requires that there be three nurses assigned to an Ebola patient at all times—one directly caring for the patient in a negative-pressure room, another in the anteroom outside the patient's room and a third at the nursing desk.
Nurses treating an Ebola patient will work 12-hour shifts, rotating between roles in four-hour increments, the agreement states. An additional fourth RN should be available to the Ebola care team if needed.
Texas Health Presbyterian Hospital Dallas, the facility at which the first Ebola case diagnosed in the U.S. turned up in late September, began allowing nurses to stay at the hospital overnight after Amber Vinson became the second nurse there infected after treating Thomas Eric Duncan before his death in October.
The University of Michigan Health System agreement requires that the system must provide any RN caring for an Ebola patient with no-cost accommodations if they desire to limit their exposure to others or are required to do so by law.
Bellevue Hospital Center in New York City did not respond to a request for comment earlier this month when asked whether it would provide accommodations for nurses who were treating Dr. Craig Spencer, the Ebola patient there who has since been released.
In the event that a nurse contracts Ebola in the workplace, the Michigan agreement states that his or her pay will not be affected during the treatment or post-recovery periods and that the employee won't be required to use benefits to make up for the time he or she missed work for up to 12 months. Similar rules apply for a nurse who must miss shifts due to a suspected exposure to Ebola because he or she is in quarantine. The University of Michigan Health System is required by the agreement to pay for all necessary treatment in the event a nurse becomes infected.
The memorandum also establishes a Nursing Ebola Preparedness Task Force, made up of union and administration officials, which will now meet twice a week. The task force will meet more frequently if an Ebola patient is admitted.
Katie Oppenheim, president of the University of Michigan Professional Nurse Council and a labor and delivery nurse at the University of Michigan Health System, said although nurses felt safe at the hospital before the agreement was drafted, it was important to get certain terms of employment in writing.
“We believe that anything that involves the working conditions of our members is something that must be negotiated,” Oppenheim said. “You can't possibly plan for everything, so we felt that in order to protect our members we needed to have some very clear language that spoke to this potential situation with Ebola.”
Though some priorities needed to be negotiated, the hospital was receptive to the nurses' request, Oppenheim said. The union hopes that the agreement will become the standard for all Michigan hospitals.
Marge Calarco, the health system's senior associate director of patient care and chief nursing officer, said in a statement that the system was “pleased that our process of working closely with our union partners on this issue of great importance to nurses has resulted in a solution that is satisfactory to all sides.”
Kevin Troutman, an employment attorney for Fisher & Phillips, said he doesn't find such an agreement unusual in a union or non-union setting, because it's a demand from workers that is relatively easy to negotiate based on existing protocols.
Although Troutman, who worked for 17 years as a healthcare executive before becoming an attorney, doesn't think hospitals need to seek out such agreements to protect themselves, they may be an important step to stay competitive.
“If you have information that tells you that this is something that the market is going to require, then you should do it,” he said.
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