At 7 a.m. this morning, the Northern California Kaiser nurses strike involving 18,000 nurses came to an end at some 86 Kaiser Permanente hospitals and clinics. They have been on strike since Monday, according to a California Nurse Association (CNA) released statement due to the U.S. hospitals’ inadequate Ebola safeguards.
According to the CNA, lowered care standards for Ebola patients, nurses and other healthcare workers are among the reasons for the strike.
“Our call for a strike speaks loudly and clearly that we want management to stop their stalling in bargaining our first contract, stop the unfair labor practices and provide the safeguards and resources needed to deliver safe patient care. It’s high time to listen to the nurses,” said Sutter Tracy RN Dotty Nygard in a statement released by the CNA.
Kaiser Permanente said in a statement that they have met the criteria the nurses have asked for when it comes to provisions for treating Ebola. The statement says that Kaiser has tried to work with the National Nurses Union on creating the best strategy for dealing with Ebola, but they have refused.
“The union leaders at National Nurses United/California Nurses Association are letting all of us down on this critical issue of public health. This is not the time for conflict-based tactics that will put America’s health at risk. They should be working with all of us as the nation faces this important fight against Ebola, not calling on nurses to step away from their patients’ bedsides,” the statement said.
The statement goes on to say that this strike is fueling fear of Ebola, and that the timing of the strike coinciding with flu season is irresponsible.
As of today, there have been four documented cases of Ebola in the United States, one of which, who was treated at Texas Health Presbyterian, proved fatal. Of the three remaining patients, all of which are healthcare professionals, two have since recovered and one is still in treatment. The two recovered patients were the nurses that treated the since-deceased patient in Dallas, Texas. The remaining patient was proclaimed Ebola free on Nov. 10. He underwent treatment in New York, as he had contracted Ebola while working in Guinea with the non-profit Doctors Without Borders. As of now, there are no known Ebola cases in the United States.
Due to the threat of the spread of Ebola the California State Health Officer Dr. Ron Chapman issued a risk-based quarantine order on Oct. 29 holding individual counties responsible for administering quarantines to individuals susceptible to contracting or spreading the disease.
This order applies to those entering California from an Ebola-affected area and has had confirmed contact with a person infected with Ebola. According to the order such persons would be subject to quarantine for 21 days.
“This order will protect the health and safety of Californians and support the state’s local health officers’ existing authority to develop protections against disease spread,” Chapman said.
National Nurses Union is calling for appropriate protective gear as well as interactive training because the health care workers that are on the front lines of this epidemic do not have the proper materials to protect themselves.
“You just can’t have [the protective equipment] there and not try to put it on, take it off, and know how to properly use it otherwise you think you have personal protection but you don’t. You end up contaminating yourself from not using the equipment properly,” said Deborah Burger, the president of the California Nurses Association (CNA).
She added that the equipment and training are not wasted once this epidemic of Ebola is over; the equipment and the knowledge of proper protocol can be used for other communicable diseases that healthcare professionals may come across in the future.
Having correct protocol and standardized hospital training is essential, according to Burger, in order to make certain that patients and nurses know how to respond.
“Any one of our hospitals could have been Texas Health Presbyterian,” Burger said.
In California alone there have been three near-misses of Ebola cases, one of which was in South Sacramento at a Kaiser facility where according to Burger, the nurses did not know what to do. The patient was in the emergency waiting room for over an hour where the disease could have easily spread, had he contracted Ebola.
“Some of the facilities are not doing the right thing, they are having the patient stand outside on a green matt until they get the team together. How is that going to work in the rainy season?” Burger said.
The only real way to prevent transmission of the disease is to have the equipment in order to prevent infection. According to Burger, it is more likely than not a healthcare worker will contract the disease.
Burger also said that the CNA is encouraging pressure on the federal government to send resources to West Africa to stop the spread of Ebola. She said she believes the countries with the most resources should be helping Liberia, Guinea and Sierra Leone because they simply don’t have the resources and infrastructure to control the Ebola outbreak.
While the strike ensues in Northern California, across the country in Atlanta the CDC is holding a training for healthcare workers planning to deploy to West Africa with various non-governmental organizations (NGO).
According to CDC spokesperson Jason McDonald, the training includes the donning and doffing — meaning the putting on and taking off — of the Ebola gear as well as using the gear in practical situations so that healthcare workers can practice donning and doffing the gear in the most realistic way possible.
“There’s always a chance that there will be cases [in the United States], but thankfully because of our sophisticated medical facilities and sophisticated healthcare systems, we probably won’t see an outbreak [here] like we see there,” McDonald said.
Will Heegaard, an emergency medical technician from Minnesota is currently enrolled in the CDC course and plans to deploy to West Africa with a non-governmental organization (NGO) as soon as he is called upon.
Heegaard believes that the U.S. health care workers planning to treat Ebola in West Africa as well as those who may treat the disease domestically should be trained sufficiently. The infected West African nations, however, are struggling to maintain supplies.
“It is hard to keep the supply chains flowing with the proper equipment partially because hospitals in rich countries are buying it all up and storing it,” Heegaard said.
Additionally, NGOs attempting to treat Ebola in the most infected nations are having to outbid wealthy governments to get the protective gear they need.
Heegaard said he thinks that proper training and having protocols in place of who to call and how to transport a patient to designated facilities would take significantly fewer resources and go farther than just providing equipment to hospitals in the U.S.
While still on U.S. soil Heegaard said he has no fear of contracting Ebola.
“It is unfortunate that the fear has crippled the response. I am more scared that people are so scared [of Ebola] that [they] quarantine every healthcare worker that goes [to West Africa],” Heegard said. “The longer we wait to get [the disease] under control in West Africa, the more likely it is to spread, ” Heegard said.
Graphic by Courtesy