National Nurses United

respirators, the version with replaceable dual insert filters. "It was a victory for the COVID unit," said Cuazo. "We raised the bar for other [Florida] hospitals." University of California nurses at uc san francisco Medical Center sounded the alarm about COVID-19 preparedness in early February because they received some of the Bay Area's earliest COVID patients. UCSF nurses zeroed in on the importance of educating RNs about optimal PPE for COVID, donning and doffing PPE, and communicating with staff about COVID patients. "We initiated the meeting with management," said Jamille "Jam" Lee Cabacungan, RN in the med- surg unit and chair of the professional practice committee. "Nurses didn't know how to don and doff. We needed to practice. Meanwhile, just weeks after UCSF nurses were raising concerns about preparedness, dozens of nurses at UC Davis Medical Center in Sacramento had been quarantined because they had been exposed to a COVID patient. Clearly, they needed plans in place to isolate suspected and positive COVID patients and proper PPE. "In the beginning, we had contact, droplet, and airborne precautions in place," said Cabacungan, whose med-surg unit was converted into an acute respiratory isolation unit in mid-March. However, after the CDC downgraded its COVID-19 guidance from airborne to droplet precautions on March 10, the University of California made the decision systemwide to follow suit. This meant that all UC campuses–UCSF, UC Davis, UC Irvine, UC Los Angeles, and UC San Diego–were violating the state's Cal/OSHA aerosol transmissible disease (ATD) standard. The ATD standard requires airborne and contact precautions. Nurses across all campuses were immediately spurred into a flurry of activity for the next two weeks to fight for airborne precautions and more. For example, at UCLA, nurses called the CEO and CNO to demand access to PPE with airborne protections and immediate hands-on training for all nurses expected to care for suspected or positive COVID patients. "We also sent out flyers to nurses about knowing your rights for protection at work and the Cal/OSHA ATD standard," said Marcia Santini, an RN in UCLA's emergency depart ment. "We had a petition to protect and train UCLA nurses. We filed complaints to Cal/OSHA. We were really busy." By the end of March, the UCLA nurses in the ED had a better process for screening incoming patients, N95 respirators, and hospital-provided scrubs. Nurses at each UC campus organized and escalated their demands of UC management at the unit, facility, and statewide levels, leading countless workplace actions, including press conferences, candlelight vigils, petitions, filing assignment despite objection forms, grievances, and Cal/OSHA complaints. "We held a honk-a-thon on April 16, with dozens of supporters circling the hospital in their cars," said Santini. The event was to protest the lack of PPE and the unsafe practice of decontaminating N95 respirators, and to demand safe staffing and full employment. Through their persistence and constant pressure, the UC nurses won 128 hours of administrative leave for employees who are unable to work due to COVID-19 related issues, increased access to, and training on N95s for EDs and ICUs, permissive use of N95s in ED, ICU, and COVID-19 units for UCSD, UCSF, UCLA, and UCI, universal masking, free parking, all 40 hours of CEU's online, off- site housing, and a commitment from UC Regents President Janet Napolitano to no lay-offs through June 30, 2020, among many other hard-fought victories. Kaiser Permanente in march, nurses at various Kaiser hospitals were told that if they wore their own N95 respirators, they could be disciplined and even fired "on the spot" for insubordination. Gina Macalino, an RN at Kaiser's Vacaville Medical Center, was harassed for wearing her own N95 to work. Her facility was one of the first to admit patients from a COVID-contaminated cruise ship because they were located close to Travis Air Force Base, where the cruise ship patients had been quarantined. "Right away, management took N95s off the shelves and said it would be given to us as we needed them," said Macalino, who works in the interventional radiology unit. "But we had to go through many, many layers." So Macalino brought her own PPE to work. "I was the first person wearing an N95 mask to work in my facility," said Macalino. "I was wearing it out of concern for myself, patients, and colleagues." Then three different levels of management harassed her about wearing an N95, including her manager who told her to take off her N95, saying she did not need it and to wear a surgical mask instead. Macalino refused to take it off and demanded that her manager put her request in writing so she could inform her union and lawyer. She also emailed management demanding that they tell her why they objected to her wearing an N95 but she never got an answer. Nurses and the public called upon Kaiser to demand that it fully protect nurses, stop harassing them for taking precautionary measures, and stop threatening to fire nurses for diligently doing their jobs. Nurses at several facilities were galvanized into action, holding protests for the right to wear their own PPE. As a result of their collective action, Kaiser backed down. The CEO said nurses could bring their own PPE without fear of discipline. "We are raising awareness and giving people a voice," said Macalino. "Nurses who aren't unionized are seeing the media coverage and what we put on social media. It validates their concerns and that what their management is saying is wrong." Chuleenan Svetvilas is a communications specialist with National Nurses United. A P R I L | M AY | J U N E 2 0 2 0 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 N A T I O N A L N U R S E 33 OPPOSITE: RN at Kaiser Permanente, Oakland ABOVE: Nurses at Regional Medical Center of San Jose

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