October 16, 2014

Unions help lead Ebola effort throughout state's health care system

Author: By Liza Frenette and Darryl McGrath 
Source: NYSUT Communications

Health care workers continue to clamor for information and protection since the recent arrival of the Ebola virus into the United States, and its infection of two nurses treating an Ebola patient.

The spotlight is primarily on hospitals, as questions and concerns surface from frustrated health care workers about the proper health and safety protocol within these facilities. Unions are in the forefront of responding by working with health and safety specialists to get precise, timely information to health care professionals and the public. 

NYSUT represents nurses at hospitals throughout the state and the State University of New York has three teaching hospitals: Stony Brook in Long Island, Upstate in Syracuse and Downstate in Brooklyn, where members of United University Professions, a NYSUT affiliate, work. 

Nurses from the country's largest nurses union rallied in California this week to demand clearer safety guidelines for hospitals. Fear has been rising since two Texas hospital nurses became infected with Ebola after caring for a patient with the disease, including one who traveled by airplane before being diagnosed. Congress is holding a hearing today on the nation's response to Ebola. 

Unions are responding with training and with newly developed fact sheets for members, created with the assistance of health and safety specialists. The sheets provide protocol for safety as well as information on the disease itself. Directed at nurses, laboratory personnel and other health care workers, these new reports include specifics on how to dress for patient care, what kind of gloves to wear, how to remove clothing and what hospital protocols should be in place, including environmental cleaning and disinfection. 

The AFT Nurses and Health Professionals group has prepared a leader alert and a range of documents to support health care professionals and the facilities where they work. Visit http://www.aft.org/healthcare/ebola-virus-disease-global-health-and-domestic-preparedness.

The AFT's array of fact sheets also includes pertinent information on preparing schools and protecting staff and students. 

"Keeping our workers safe is a fundamental union issues," said NYSUT President Karen McGee. "We will be steadfast in our advocacy and monitoring of the situation." 

The New York Committee for Occupational Safety and Health released its fact sheets today after holding conference calls with groups of union health and safety specialists, including NYSUT's Wendy Hord, and professionals from other unions and nurses associations. NYSUT immediately sent those fact sheets out to members of its Health Care Professionals Council to distribute to union health care workers across the state. 

Ebola fact sheets report the virus is spread through contact with infectious blood or bodily fluids, contaminated environmental surfaces or an infected individual or animal. According to the Center for Disease Control and Prevention, "in some instances, exposure may be due to aerosolized viral particles." Quarantine, which is at the discretion of public health officials, usually lasts through the disease's 2-to-21-day incubation period. 

Attention has been focused on contact, but "respiratory protection is still important," Hord said.  "We have to make sure isolation precautions are totally in place and followed to the letter." 

Separation and protection of isolation rooms also includes having separate ventilation under negative pressure, she said. 

The protocols affect thousands of New York City-area hospital and visiting nurses represented by the NYSUT affiliate UFT, along with thousands of NYSUT's higher education members working in SUNY hospitals and other settings where there could be risk for exposure to the Ebola virus.  

Many of these members are participating in training and also helping to disseminate information and protocols about the outbreak to keep patients, students, their colleagues and themselves safe.  

"It's definitely on everybody's radar," said Rowena Blackman-Stroud, UUP chapter president at SUNY Downstate Medical Center. "The general population tends to think it is insulated from the health care needs of the world. This is a lesson for all of us that what happens in one country could happen here."  

The U.S. Department of Homeland Security has identified Ebola as a high-priority threat, according to CDC. 

The New York City Department of Health and Mental Hygiene, which has been working with hospitals, clinicians, community groups and city, state and federal agencies, reports that, as of early this month it had received inquiries from health care providers about 88 patients. Some had not been in an affected area; some met travel criteria but not clinical criteria. Others did not have any high-risk or low-risk exposure factors. Some had malaria or typhoid fever. 

"Some patients had potential delays in diagnosis because of hesitancy by health care providers to examine patients or laboratory workers to handle specimens," the CDC reports.

There are different routes upon which Ebola can arrive, particularly from people who are not yet aware they are sick, or have a fever and believe it is the flu, and come to the U.S. from parts of Africa where Ebola is widespread. 

Two students from Africa were set to enroll in a junior high school in Queens last week, but concerns about what region of Africa they were from prompted a call to the office of United Federation of Teachers for union support on how to proceed. Junior Linton, the UFT's health and safety program coordinator, said the district reps were advised to check with the New York City Department of Health and the Office of School Health of the Department of Education to make sure the students' health privacy was protected and to ensure that the proper questions were asked by the school nurse reviewing their cases, in order to protect the larger school population. 

"We've had ongoing calls, especially in light of new developments with Ebola," Linton said, adding that vigilance is of the essence. 

Responses are being formed after researching information from "a cadre of people throughout the state, connected mostly to unions," said Hord. She has been NYSUT's point person on health care scares that union members have been confronted with in the field: H1N1, pandemic flu and MRSA. Advocacy and information about safety are the number one tasks. 

The AFT fact sheets on preparing schools includes basic protocols of hand washing, equipping all school staff with gloves, barriers to prevent exposure to blood and body fluids, and having a strict protocol for cleanups. Disinfectants and sanitizers should be used judiciously to clean up blood and body spills. AFT advocates for every school to have a new protocol for early identification of children with high fevers. They should not be allowed to stay in the school population. It is a strategy that may also help protect students and staff from unnecessary influenza exposure during flu season. 

The 2014 Ebola epidemic is the largest in history, affecting multiple countries in West Africa, CDC reports. Although the risk of an Ebola outbreak in the United States is very low, according to the CDC, the organization is taking precautions to prevent this from happening.( Cases of Ebola Diagnosed in the United States.) 

At Downstate, Ebola protocol information sheets from CDC have been prominently posted in the emergency department. Staff have attended mandatory training sessions in every hospital department, said Edison Bond Jr., SUNY Downstate UUP chapter vice president for professionals and the hospital's director of patient and guest relations.    

Downstate President Dr. John Williams also sent a message to the staff assuring employees that the hospital is well prepared to deal with an infectious disease outbreak, and that "we are performing choreographed and detailed training drills to review our preparedness for Ebola patients that may present in the emergency department and our clinics." 

SUNY Upstate Medical University issued a 13-page document on protocols including how to recognize possible cases, what to do if a suspected Ebola patient walks into an outpatient clinic, and how to properly disposal of possibly contaminated trash.  

On Long Island, SUNY Stony Brook University Hospital is the region's only tertiary care center – a  hospital that takes difficult cases on referral- as well as the only Level 1 trauma center on the island. Dr. Reuven Pasternak, the chief executive officer, sent a recent memorandum to the hospital's medical board and department heads, detailing the hospital's extensive preparations for treating a patient with Ebola. Pasternak wrote that he has spoken with the Suffolk County health commissioner to determine how prepared other hospitals in the region are, on the expectation that smaller hospitals might turn to Stony Brook for assistance. 

"Thus far, while there has been guidance from the state with regard to clinical treatment, there has not been a comprehensive regional plan," Pasternak wrote. He added that major county agencies planned to meet soon to start forming such a plan.  

Pasternak told staff that "we will be maintaining the balance of high vigilance and preparedness as well as reassurance during a time of heightened public anxiety."  

Carol Gizzi, UUP's chapter president at Stony Brook Health Sciences Center, said that "staff questions and concerns are being addressed ... it appears that hospital leadership is taking this very seriously and working to protect our patients, the public and our staff."  

NYSUT's Professional Staff Congress members at the City University of New York have access to health information and forums on Ebola sponsored by CUNY. Among those options: a page on the CUNY website with information and resources, at http://www.cuny.edu/about/administration/offices/ehsrm/healthmanagement/ebola.html, with a link to New York City's guidelines for colleges, at http://www.nyc.gov/html/doh/downloads/pdf/cd/ebola-students-staff-guide.pdf. ( http://www.nyc.gov/html/doh/downloads/pdf/cd/ebola-students-staff-guide.pdf. )   

The epidemic has raised questions about the world's response and those concerns were the topic of a recent forum at the Roosevelt House Public Policy Institute at CUNY's Hunter College, entitled "Ebola: The Imperative of Immediate Action, Here and Abroad," which examined "the human rights standards applicable to the epidemic." The free forum was open to CUNY employees and members of the public.

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