National Nurses United

W hen a resident doctor wearing an N95 respirator came to check on the patient, registered nurse Elizabeth Lalasz was worried. She and her colleagues in the medi- cal-surgical telemetry unit at Chicago's John H. Stroger Hospital had spent hours caring for that patient with nothing but loose-fitting surgical masks. Why was the doctor wearing an N95 and calling in the infectious disease team, when no one was telling the nurses that they may have been exposed? "You can be told you're being paranoid, but as a nurse, you have an instinct," said Lalasz, who had a nagging feeling that the patient, who was sent home without testing and just instructions to self- monitor his symptoms, had COVID-19. "I told my manager I may have had a possible exposure, but my manager said the patient's team assures me the patient is low risk." A few days later, on Mar. 23, Lalasz cared for the patient's room- mate, who now had a terrible cough. That evening, Lalasz also started to cough, and just three days later, she tested positive for COVID-19. "We always knew the health care system was not working, but this really reveals it," said Lalasz. "The fact that no one felt it was necessary to follow up with me shows that there is no plan, and that's devastating." According to National Nurses United's data tracking, more than 63,000 health care workers have contracted COVID-19, although the number is surely higher, given that workers have often been denied testing. And the total will only continue to grow unless employers not only give nurses and health care workers the personal protective equipment (PPE) they need, but also the information they need. Lalasz was not alone in being left in the dark. Why? Employers can shirk their responsibility to provide nurses with optimal PPE if they fail to ever tell the nurses they have been caring for COVID-19 patients. And employers can refuse to pay for nurses' precautionary leave or their workers' compensation if they deny COVID-19 expo- sure happened in the hospital. In our profit-based health care system, failing to communicate that nurses are in danger saves employers money. Nurses know this goes against basic morality. It also shows a lack of enforcement and underlines the need for the federal Occupa- tional Health and Safety Administration (OSHA) to pass an emergency temporary standard on infectious diseases. The agency requires employers to give employees access to exposure records, including exposure to biological agents such as SARS-CoV-2, the virus causing COVID-19, if the employer creates them. But here's the loophole: There is currently no direct and explicit requirement that employers must create such documentation. In California, Cal/OSHA has an aerosol transmissible diseases (ATD) standard, which requires the employer to notify an employee of an exposure within a certain time frame. But California nurses know that's not happening. "The hospital never notified me I was exposed. I found out from a coworker," said Jennifer Rodas, a registered nurse in the telemetry unit at Good Samaritan hospital in San Jose, Calif. Rodas was off work when management announced that there had been a positive patient on her unit in the previous days. A col- league sent Rodas a photo of a list that management had collected of nurses who had potentially been exposed, and Rodas' name was on it. She reached out to management, employee health, and the chief nurse officer, all with no response. "I am still very frustrated," said Rodas, a mother of five, who had only used gloves and no mask with the patient in question. "I was scared. I didn't know what to do." Her fear was compounded by the fact that when she found out she had been exposed a few days earlier, she already felt sick with a cough, sore throat, and fever. She fought for and finally got a test. After weeks went by with no result, she was told the lab had lost her sample. A second test came back negative, but her symptoms had already cleared by then. Rodas is still unsure today whether or not she was ever sick with COVID-19. "We don't want to hurt our patients; we are there to help them get better," said Rodas, who used up all of her paid time off self- quarantining, trying to protect her patients and her family until she could find out whether she was positive. "[Management] is ignoring us. How can we be advocate for our patients if we don't know any- thing?" Allesha Jeffries, a registered nurse in the neonatal intensive care unit at Kaiser Permanente Los Angeles Medical Center, was exposed to a positive health care worker but never informed by the hospital. 34 N A T I O N A L N U R S E W W W . N A T I O N A L N U R S E S U N I T E D . O R G A P R I L | M AY | J U N E 2 0 2 0 Silence Kills During COVID-19, employers have withheld information about exposure risks from nurses to avoid accountability. BY KA R I J O N E S

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