July 24, 2009
Nurses need the best protection from H1N1 You are within your rights to refuse work and ask to be reassigned if adequate protection is not in place
UNA has learned that some health managers are telling nurses they only need a surgical mask when working with H1N1 patients or suspect cases, "Influenza Like Illness" patients.
Best protection is still provided by a fit-tested N95 respirator, however. UNA's position continues to be the precautionary one. Nurses should insist on the best protection.
Nurses can refuse to enter a patient room unless they are supplied with personal protection, including eye protection and the N95.
Under the Occupational Health and Safety Code every worker has the right to refuse unsafe work without any fear of discipline or repercussions. The OH&S regulation is the one exception to the general "obey now, grieve later" rule.
If you have not been fit-tested and do not have access to an adequate supply of fit-tested N95 respirators you should request to be reassigned. If you experience any problems with your supervisor and/or manager regarding this request please contact your Local representative or your LRO as soon as possible.
No indication of a change in guidance
UNA has also heard reports of managers saying there was a change in the safety guidance from the Public Health Agency of Canada. But the Agency's website continues to indicate that if there is any risk of uncontrolled coughing or aersolizing procedures, the N95 is indicated. And Alberta Health Services H1N1 website www.albertahealthservices.ca/13060.htm also continues with the previous protocols.
In fact, CEO Stephen Duckett seems to imply a surgical mask is quite adequate on his blog: "In the absence of an N95 mask, if in doubt surgical masks can also be used. Eye protection is important and so on. Taking these precautions is something that can be done today whether or not you have been fit tested for the N95 mask."
It is clear, however, that a surgical mask provides less protection from infection than an N95 respirator.
The U.S. Centre for Disease Control guidance for healthworkers is very clear: "All healthcare personnel who enter the rooms of patients in isolation with confirmed, suspected, or probable novel H1N1 influenza should wear a fit-tested disposable N95 respirator or better. Respiratory protection should be donned when entering a patient's room. Note that this recommendation differs from current infection control guidance for seasonal influenza, which recommends that healthcare personnel wear surgical masks for patient care."
Nurses need to be vigilant in protecting themselves and their family from infection. Insist on having the appropriate personal protective equipment (N95 respirator mask, gloves, gown & eye protection) available for use when providing care to patients, residents and clients with suspected or confirmed H1N1 virus infections.
What You Need to Know:
Get Fit Tested! - The Multi-Employer/UNA Joint Committee has reached an agreement regarding N95 Respirator Provision and Fit Testing, which requires the employer to provide N95 respirator fit-testing to all employees covered by the Multi-Employer/UNA Collective Agreement. Fit-Testing is mandatory as per Article 35.02 (a)
Ensure you have enough N95 respirators - The Joint Committee agreement obligates the Employer to ensure that an appropriate supply of N95 respirators is available.
You may be temporarily transferred - In the event of an emergency Article 44: Mobility (44.05 (e)) allows the Employer to reassign Employees from any site to perform work at any other site in emergency circumstances. An emergency is defined as “an unforeseen combination of circumstances or the resulting state that calls for immediate action”. Contact you Local representative or Labour Relations Office for additional information regarding emergency transfers.
Do not report to work if you are sick - Nurses should not be reporting to work if they have influenza like illness (fever and respiratory symptoms). Nurses who do report to work are putting patients and their co-workers at risk of infection and illness. The Alberta Government is asking that individuals with flu like symptoms stay home from work and avoid public places when ill.
You do not have to put your health at risk - The agreement between the parties states that employees who have not been fit-tested for an N95 respirator or are unable to achieve an effective facial seal shall not be expected to enter or provide services in an area where a suspected or confirmed case of swine influenza A has been identified. These Employees may be deployed to another area.
You need to assess whether you believe that you need to provided with N95 respirators (fit-tested), gown and eye protection. If your employer refuses then ask to be reassigned.
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