May 7 , 2009
Alberta Health reported 4 new confirmed cases of Influenza A H1N1 in the province, which increases the total to 30 cases. According to the World Health Organization there are now 1516 confirmed cases in 22 countries.
On May 5, 2009 Alberta Health Services (AHS) issued a new update to all employees maintaining their position on requirements for respiratory protection when providing care to suspected and confirmed cases of influenza A H1N1. The AHS statement suggests surgical masks are sufficient when a patient is not forcibly coughing and no aerosol producing procedures are in progress. Given the uncertainty about transmission of the new virus, this position fails to meet the precautionary principle, which demands higher safety standards, N95 masks, when it is not certain the lower standard is safe.
After the SARS outbreak in Toronto, the Public Inquiry of Justice Campbell recommended the precautionary principle be applied to best protect health workers.
In response to this recent AHS staff update, David Harrigan, Director of Labour Relations, advised AHS that when there are health and safety concerns, employees may choose to refuse to work in unsafe conditions. This is a circumstance where the "work now grieve later" rule does NOT apply. In addition, Harrigan suggested that managers would be wise to consider that with H1NI cases, nurses will not work unless provided with an N95 respirator, regardless of the employer's policy. It would be wise for managers to make appropriate contingency plans.
Alberta Health Services in violation of the Collective Agreement
On May 1, 2009 UNA filed a province-wide policy grievance alleging that the employer (AHS) is creating unsafe working conditions and that they are failing to adhere to the Centre for Disease Control (CDC) guidance regarding precautions of health care workers dealing with suspected or confirmed cases of Influenza A H1N1.
Article 34.01 in the collective agreement between United Nurses of Alberta and HBA Services states that the employer shall be responsible for providing safe and healthy working conditions. The guidance documents distributed by AHS clearly place our members' health and safety at risk.
Recommended precautions for health workers remain
It is the position of United Nurses of Alberta that until such time as there is scientific certainty regarding the mode of transmission of Swine Influenza A (H1N1) all Employees covered by the Multi-Employer/UNA Collective Agreement that are required to provide patient care for suspected or confirmed swine influenza A cases must be provided with an appropriate supply of fit-tested N95 respirators and mandatory education regarding the care of procedures for donning and doffing N95 respirators.
Along with respiratory protection until the manner of causation is known, in addition to routine practices, infection control measures for suspected and confirmed cases of the swine influenza should include contact precautions, respiratory hygiene, accommodation, eye protection, surveillance and reporting.
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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