National Nurses United

17 National Nurses United fomites, and detailed investigations when infections are discovered to identify—and correct—conditions that caused the infection. When hospitals, in their quest for profit, limit resources and staff, they prevent vital infec- tion prevention protocols from being implemented for every patient, jeopardizing the health and lives of their patients. Despite the alarming evidence about the scope of infectious diseases and impacts on patients and nurses, there has not been much movement from employers or regulatory agencies on comprehensive infection preven- tion programs. Nurses are at the forefront of health care and are in a position to recognize new and re-emerging infectious diseases. Nurses are also often the first to be exposed to infectious diseases. Often during an ongoing epidemic, not much is known about the disease, how it is transmitted, or what kinds of protections health care workers need. In these situations, it is vital—literally— that hospitals and other health care employers adhere to the precautionary principle—even in the face of scientific uncertainty, protective measures should still be taken. Nurses, as patient advocates, are in a unique position to identify issues, develop solutions, and advocate for changes. For example, one hospital changed gloves to a cheaper version even though there were no issues with the original type. The new, cheaper gloves constantly ripped and broke and irritated some nurses' hands causing the skin to peel. Nurses organized to start doc- umenting every time an issue was encountered, every time their employer was not providing effective PPE and protections to prevent exposures to potentially infectious bodily fluids. With the threat of nurses organizing around an OSHA complaint, the employer quickly switched back to the original gloves. Nurses across the U.S. organized and advocated for effec- tive PPE, safe protocols, and hands-on training during the 2014-15 Ebola epidemic. When a traveler returned to Texas from a trip to a country with an active Ebola out- break, he unknowingly brought Ebola to the US. In the course of providing care, two nurses were infected with Ebola because their hospital was not sufficient prepared. Based on reports from nurses across the US to National Nurses United around the time events were unfolding in Texas, this could have happened at virtually any hospital in the United States. Even after the two nurses became infected while provid- ing care to this traveler, the CDC did not change its weak protocols readily. In fact, the first response from the head of the CDC was that these nurses must have failed to follow the infectious disease guidance it had issued. The next day, nurses with their union, National Nurses United, took to the streets with the message "Stop Blam- ing Nurses" and a demand for hazmat suits, powered air-purifying respirators, training, and optimal protocols. With Ebola raging in West Africa it was only a matter of time before an Ebola patient arrived at a US hospital. National Nurses United began its escalating campaign of direct action just one day before Thomas Eric Duncan first showed up at the Texas hospital emergency depart- ment—NNU held a die-in of 1,000 nurses in Las Vegas to draw attention to the threat of Ebola. NNU continued to demand that the CDC issue clear, uniform guidance on the training, education, and PPE needed to protect workers caring for Ebola patients. Although the CDC has no means to enforce its guidance, it generally is taken seriously regarding policy. Unfortunately, corporate health care organizations exert a powerful influence over the CDC and other public health agencies. In November of 2014, nurses from Global Nurses United member unions raised their voices internationally by joining in Global Ebola Awareness Day actions. Leaders from National Nurses United and other health care worker unions joined with local nurses at a meeting of G20 leaders in Australia to press for a heightened response on Ebola and other global health concerns such as AIDS. In the US, actions included 20,000 striking RNs, a White House vigil, and rallies and pickets across 16 States. Nurses across the country won protections in their workplaces through continued protest at the national, state, and local levels and through collective bargaining. Immediately following the day of action for Global Ebola Awareness Day, California issued enforceable guidance that met nurses' demands for full-body protective suits that are impervious to blood and viruses, powered air-purifying respirators, detailed infection protocols, and an effective training program. Every shift, when nurses are organizing and advocating for better staffing, they are improving infectious disease protections for their patients and themselves. Empirical evidence is mounting and unmistakably validating what nurses have known all along—that occupational health and patient safety in health care settings are inseparable. In addition, much of this research has specifically found the strongest positive measures of associations are seen between nurse staffing and the physical working envi- ronment and safety of both patients and nurses. This CE program discussed some of the available evidence that shows the statistical connection between better nurse staffing and lower rates of health care-acquired infections in patients. In addition to improving safety, these actions can build power and solidarity and the workplace that can bolster nurses' advocacy around other issues, such as inadequate PPE, inappropriate procedures, and other issues related to infection prevention. Nurses can join with other nurses and with National Nurses United to fight for policy changes to improve protections and enforcement. Sometimes these changes are made through legislative and regulatory processes. In these situations, nurses' testimony and expertise about incidents that have happened in the workplace and how prevention should happen are important. Other times these changes are made through communication and advocacy with agencies that establish guidelines, such as

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