Nurses File Cal-OSHA Complaint After Hospital Refuses to Supply Swine Flu Masks for Units With Infected Patients

RNs from the California Nurses Association/National Nurses Organizing Committee (CNA/NNOC) have filed an urgent plea with the state of California to step in and force Sutter Solano Hospital to provide nurses with proper safety equipment when they care for patients infected with the H1N1 "swine flu" virus. The nurses fear that the unsafe procedures at the hospital create a danger of infection for every patient at the facility, as well as for the surrounding community.

The plea comes as nurses are actively caring for hospital patients infected with the virus, and with up to 10 RNs from the facility experiencing severe respiratory illness in recent weeks that their physicians have called "probably" the swine flu, leaving them physically unable to work.

The nurses requested assistance from the California Division of Occupational Health and Safety just days after the World Health Organization re-classified H1N1 as an "unstoppable" Level 6 pandemic, with the number of confirmed cases worldwide approaching 100,000, and 170 confirmed deaths in the United States alone.

Sutter Solano has purchased so few of the proper N95 masks that most nurses working with patients are unable to procure an adequate supply of disposable masks. Last week, the union raised their concerns with management. On Friday, the hospital supplied new masks that did not properly fit, making them useless for stopping the virus. Management responded by ordering the nurses to wear a contact mask on top of the ill-fitting N95 masks but the nurses raised concerns because doing so can increase carbon dioxide retention in the mask wearer. Earlier that week, management had given nurses a single mask in a plastic bag, with instructions to re-use it repeatedly, rendering the mask useless for infection control purposes. Compounding these problems, some rooms with infected patients lack appropriate HEPA filters, and proper isolation protocol is not being followed, with visitors moving in and out of contact with infected patients.

"Nurses will be on the front line of the fight against the H1N1 virus. However, if hospitals refuse to take basic safety steps to protect them from exposure, then infected RNs will be physically unable to continue working and may well become a vector for further infection. We nurses are shocked that hospital management is exposing us to this risk. It endangers every other person we come into contact with - our patients, our family, even management. This is not a time for finger-pointing, this is the time for Sutter Solano management to do their job and provide nurses with basic safety protections," said Sherry Ramsey, a RN at Sutter Solano.

Hospital management has claimed that there is a national shortage of the appropriate masks, a charge not verifiable in any way: neither the Centers for Disease Control nor the mask's manufacturers have reported any shortage, and other hospitals are able to provide their nurses with this safety protection.

"Sutter Health is an outlier with their refusal to protect nurses against the H1N1 virus. They must immediately move to safeguard these nurses, because we have a very busy and deadly flu season coming up, and hospitals must meet safety standards," said Deborah Burger, RN, a diabetes case management nurse and co-President of CNA/NNOC.

A study published in October 2009 by the Journal of Occupational and Environmental Hygiene found that face-seal leakage, such as that caused by the use of ill-fitting masks, is a key reason for mask failure, and allowing the penetration of viral particles. The article, "Performance of an N95 Filtering Facepiece Particulate Respirator and a Surgical Mask During Human Breathing: Two Pathways for Particle Penetration," by Sergey A. Grinshpun et. al., reports that, "The number of particles penetrating through the faceseal leakage of the tested respirator/mask far exceeded the number of those penetrating through the filter medium."