2007 Resolution - Number 7-07

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SUBJECT: All Hazard Preparedness Resolution

Introduced by: The Economic and General Welfare Commission of the Minnesota Nurses Association

Action: Passed 3/22/07

SUBJECT: All Hazard Preparedness Resolution
All hazards and nursing-specific emergency preparedness to achieve the solutions necessary to ensure:

• members’ healthcare data remains private and unavailable to the employer;
• timely and appropriate education about the necessary information needed to make an informed decision related to a given illness and/or vaccination and/or treatment;
• free, easily available voluntary vaccinations with the availability of non-benefit compensation in those cases where there is a reaction to the vaccination or treatment;  
• free and accessible personal protective equipment (PPE) that is properly fitted and field tested as the safest product currently available for the specific situation. It must be wearable and preferably recyclable and reusable;
• that nurses’ rights are protected preceding, during, and after an event;
• immediate and free education for all nurses related to All Hazard Preparedness.

RELEVANT CORE ISSUE:

Association advocacy for employee safety; public safety; education; healthcare privacy; due process; collective bargaining agreements; and legislative action.

WHEREAS, Registered Nurses, over 2.7 million in the U.S., make up the single largest group of healthcare workers, and there are over 15 million healthcare workers at various points of care susceptible to the hazards relative to disasters of the last decade.

WHEREAS, including and frequently providing nursing–specific disaster management, knowledge, response planning, strategies, practices, and evaluations have been shown to be equally important for nurses as other education (Rebmann, 2006).

WHEREAS, the ANA has lobbied for worker protection issues and proposed funding for training of healthcare workers in pandemic preparedness (ANA statement).

WHEREAS, the “All-Hazards” Preparedness approach to training for disaster management has been adopted by multiple states, the ANA, AMA, and CDC (Basic and Advanced Disaster Life Support) as the current best approach to prepare for all disasters. 

WHEREAS, healthcare facilities are predominantly corporate entities designed for efficiency and profit, they are not designed for massive demand fluctuations that would result from any disaster. 

WHEREAS, business communities see their involvement in pandemic planning as a “means to gain customers at the expense of unprepared competitors.”

WHEREAS, Registered Nurses are essential responders and caregivers during any and all hazards event (ANA, 2006).

WHEREAS, nurses, as employees, have the same right to make informed healthcare decisions for themselves and their families as any other person. Neither the employer nor government agencies should become nurses’ healthcare decision makers (Slattengren, 2006).

WHEREAS, the AFL-CIO, AFSCME, AFT, CWA, UAN, and USW have petitioned the Department of Labor to issue an emergency temporary OSHA standard in the event of a pandemic influenza outbreak that would address the lack of protection inherent in the current DHHS planning (article).

KEY FACTS REGARDING THE CURRENT ENVIRONMENT:

WHEREAS, education for disaster management that is nursing specific for all Registered Nurses is not funded or available to the nursing community.

WHEREAS, it is estimated that more than 20-30% of the total workforce will be unable to go to work in the event of a pandemic, and governmental agencies are recommending ramping up on personal preparations such as food, water, and medical supplies to last two to six weeks duration.

WHEREAS, there has been an uncoordinated and ineffective approach at the local, state, and national level related to oversight, training, and funding. An all hazard approach to preparedness is a means to a consistent, valuable, and functional plan to encompass every potential disaster, not just a pandemic influenza. 
 
WHEREAS, since the ‘90s, the healthcare system has become predominantly a business enterprise motivated by bottom line profits.  The focus for “all hazard preparedness” does not bring profits to their doorstep and there is inadequate funding from the government to support essential elements required for training and resources.

WHEREAS, regardless of experts’ opinions and best guesses, there is still no single source of best practice information for communities and individuals to rely on.employers continue to pick and choose preparedness plans based on corporate decisions irrespective of frontline workers.

WHEREAS, JCAHO has established an infection control standard to be put into effect January 2007. While this could potentially support worker concerns, it also includes a requirement that potentially violates ADA by requiring the worker to provide reasons for non-participation in the organization’s immunization programs (Hill, 2006).

KEY FACTS REGARDING ETHICAL AND POLITICAL CONSIDERATIONS:

WHEREAS, the ANA Code of Ethics supports the care of self, nurses must be attentive to surveying situations and weighing risks to themselves versus blindly following potentially unrealistic employer expectations.

WHEREAS, workers within healthcare and workers in general must be protected from the threat of all hazard consequences, not limited to influenza.

WHEREAS, workers must be protected from misuse of information and actions by employer/government agencies that result in mandating vaccination and health information surveillance. These practices have a potentially negative impact on the employee rights.

WHEREAS, subjecting healthcare workers to employer surveillance of their private health information puts them at risk and potentially breaches their rights under ADA (vaccination declination forms and sick call logs).

WHEREAS, the concept of mandatory vaccination as a condition of employment violates healthcare workers’ right to make an informed decision; (e.g., smallpox vaccination).

WHEREAS, unions support free, accessible, voluntary influenza vaccination for HCW, following appropriate health information screening and education.

WHEREAS, “Just in time” education has been proposed by employers to meet the needs of healthcare workers at the point of care. Nursing believes this standard is unacceptable in creating an environment of bona fide readiness, and the basic foundation for training of all healthcare workers must include elements of rapid reverse triage, the “all-hazards” approach, and incident command systems.

WHEREAS, legislation is currently being drafted in multiple states that may impact nurses’ rights.

THEREFORE BE IT RESOLVED THAT THE UAN AFFIRMS AND SUPPORTS:

• the AFL-CIO petition regarding OSHA standards revision requiring mandatory provisions of guidance with relationship to respiratory protection, a comprehensive national exposure control plan, and substantial funding for these revisions, as well as appropriate funding to secure permanent solutions within the public health system.
• ANA’s call for:
  1. free, convenient access to voluntary vaccines for healthcare workers;
  2. free and confidential pre-screening for workers receiving vaccine;
  3. government-funded education for healthcare workers.

BE IT FURTHER RESOLVED THAT THE UAN:

• will actively pursue collaborations, lobbying activities, or other efforts that will lead to ongoing comprehensive preparedness education relevant to nurses, their families, and their patients.
• will demand non-benefit compensation time for lost work and expenses related to illness or injury in the event of a disaster.

THEREFORE BE IT ALSO RESOLVED THAT UAN WILL:

• draft legislation for the rights of the healthcare workers that includes, but is not limited to, protection from:
  a. the threat of all hazards consequences in addition to influenza;
  b. actions by the employer or government agencies that result in mandating vaccination or treatment;
  c. infringement upon healthcare worker data privacy;
  d. infringement on workers’ collective bargaining rights;
  e. employer-only mandated decisions related to safety of the worker;
  f. any real or potential impact on workers’ collective bargaining and/or human rights prior, during, or after an event;
  g. economic loss connected to injury and/or illness for all exposures in the workplace and with vaccinations or treatments obtained relative to disaster events by assuring non-benefit compensation.

REFERENCES

Basic Disaster Life Support Provider Manual, Version 2.5. (2004, American Medical Association, Washington, D.C.).

Bodely, A. (2006, Amicus brief in support of the Washington State Nurses Association, Medical News Today, retrieved from http://www.medicalnewstoday.com/printerfriendlynews.php?newsid=42900, June 2006).

Business Pandemic Preparedness and Recovery Planning for Small to Medium-Sized Businesses. (2006, Minnesota Chamber of Commerce, St. Paul, MN, retrieved from http://www.mnchamber.com, June 2006).

Daly, B., Connelly, E., Drought, T., Fowler, M. (2001, Code of Ethics for Nurses with Interpretive Statements, American Nurses Association, Washington D.C.).

Hill, C., D. (2006, Joint Commission Establishes Infection Control Standard, News Releases, Joint Commission on Accreditation of Healthcare Organizations, retrieved from http://www.jointcommission.org/NewsRoom/NewsReleases/nr-06-13-06.htm, June 2006). 

McEntee, G. (2006, Petition for OSHA Emergency Temporary Standard for Pandemic Influenza Preparedness, American Federation of State, County, and Municipal Employees, Washington, D.C.).

Slattengren, L., (2006, JCAHO’s Proposed Standards for Immunization of Staff, Students, Volunteers, and Licensed Independent Practitioners, Minnesota Nurses Association, St. Paul, MN).