National Nurses United

Occupational Safety and Health Administration on Oct. 21, nurses in California lobbied for the state to lead the way for the nation in requiring such equipment and training from hospitals. On Oct. 24, NNU Co-President Deborah Burger, RN, testified before a Congressional committee about the equipment, training, and staffing that registered nurses need to safely treat Ebola patients and prevent spread of the disease. Knowing that they cannot just count on government officials, NNU nurses also began to take direct action. The 18,000 registered nurses and nurse practitioners of Kaiser Permanente, one of the country's largest healthcare chains and the most extensive in California, are currently in contract negotiations with their employer and decided to put all other discussions on hold until they hammered out Ebola safety standards that provided nurses what they need. Kaiser has been recalcitrant on the issue. "My 6-year-old son says, 'Mommy, why don't you practice [for handling Ebola]?'" said RN Amy Glass. "Wow, a 6-year-old gets it, so why doesn't Kaiser?" Around the nation, nurses have been holding protests and drawing media attention to their employers' lack of readiness. In Chicago, nurses held a press conference Oct. 21 to call on Obama and Congress to enforce the highest standards. In Texas, nurses crashed Gov. Rick Perry's Ebola task force hearing to give state- ments to the media. In California, nurses at St. Joseph Hospital in Orange publicly called on management to immediately procure the equipment, provide the training, ensure proper staffing, and other protections for workers dealing with Ebola. Across California, nurses working for University of California medical centers—many of which have been designated by the state as "priority hospitals" for treating Ebola patients—protested and held speak-outs for nurses in late October to expose the poor level of preparedness at their facilities. "We are not prepared, not equipped, not staffed for even one Ebola patient," said Erin Carrera, a pre-op RN at Univer- sity of California San Francisco Medical Center. Carrera is the one who went hunting for the "Ebola cart" that did not exist. "We need protocols that follow the precautionary principle, not the profit principle. We need help because we can't depend on our hospitals to do the right thing." As of press time, nurses were preparing to escalate their demands through their Nov. 12 Day of Action on Ebola. "It will be the largest action by nurses in the history of the United States for health and safety," said DeMoro. "The hospitals make tremendous profits and I don't want to hear any more lies from them. The current situation with Ebola is just an example of what goes on every day with your patients. We won't allow one more person to be infected. We will never stop." S E P T E M B E R | O C T O B E R 2 0 1 4 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 15 come in contact with patients exposed to Ebola, including updated training and edu- cation for all RNs that are responsive to the changing nature of the disease. It means multiple hours of hands-on training, in teams, with practice of donning and doffing the proper PPEs because train- ing with PPEs that are not fully impervious to the virus are the same as no training at all. It means training for everyone in the hospital, not just a select few chosen by the hospital administrators. For weeks, NNU has made proper PPEs and training the centerpiece of demands to hospital employers. We have also insisted that there must be at least two RNs caring for each Ebola patient with additional RNs added as needed based on direct-care RN professional judgment, and that the RNs will not be given additional patient assignments. We have insisted that all RNs should have the right to refuse to care for an Ebola patient if, in the RN's judgment, the conditions are unsafe. And, for those many hospitals that will not adopt these optimal standards and are guided by their bottom lines and the profit principle, not the precautionary principle, we have called on the White House, Congress, and state governments to mandate they follow these standards—with the attached stick of a loss of public funding if they fail to act. As we have also emphasized, it is Ebola today, but it will be another epidemic tomor- row. In a world in which deadly diseases are becoming more common due to a constella- tion of reasons, including climate change, ill- nesses becoming resistant to antibiotics, and mutating viruses, the precautionary principle is needed to gird all our health centers as pro- tective and healing havens for any disease threat, not as carriers of contagion. Under the precautionary principle, the burden of proof must be on actions to avoid or diminish harm, not to find ways to hide from that responsibility, for action, not inac- tion. In short, the precautionary principle is a moral imperative, another term for patient advocacy writ large. RoseAnn DeMoro is executive director of National Nurses United. (Continued from page 11) THE PRECAUTIONARY PRINCIPLE RICK REINHARD

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