Editorial: Nurses, Please, Please Roll Up Your Sleeves

Editorial: Nurses, Please, Please Roll Up Your Sleeves

The miasma of mistrust and paranoia around Covid vaccinations and other vaccines is profoundly ironic in a nation that places more trust in nurses and doctors than just about any other profession.  

For weary nurses and other health workers caring for victims of the latest surges , this year’s unnecessary loss of life is heartbreaking. And the latest death tolls can in large part be charged to the accounts of unprincipled politicians, who—instead of using their influence to guide the public responsibly—have severed all contact with reality. Tennessee even fired their top vaccine official (a highly respected pediatrician) for sharing 100% accurate, legal information regarding parental permission laws.  

Some of the mistrust is understandable, given Americans’ suspicion of authorities and resentful sense that the people In Charge are trying to modify our behaviors through public health laws, rules, and mutable “guidelines.” No matter that rules and guidelines help humans to survive together and perhaps even flourish, or that communities and polities have depended on public health measures for millennia to protect populations from disease and death.  

Nurses and other HCWs know better (or should know better)

However, we expect health care workers to be more mindful than the general public. APRNs, RNs, CNAs, and orderlies know all too well how high the stakes are, and during every shift, they see the consequences of ignoring basic health guidelines.

The Wild One | film by Benedek [1953] | Britannica
Marlon Brando in The Wild One. His iconic headgear set a dangerous trend.

HCWs did not need a pandemic to remind them that people die all the time because they refuse to follow simple, obvious medical advice based on empirical evidence. Cigarette smokers persistently ignore the facts and die slowly from cancer or suddenly from heart attacks. Motorcyclists die young when they leave their helmets behind to cultivate a Wild One rebel-biker mode.

Seniors succumb to annual flu viruses because the vaccine once made them ill for a day. Or, more recently, 30-something men and women never make it to 40 because surgical masks are uncomfortable and alienating . . . Or because a photogenic politician told them that Covid vaccinations are really a ploy to implant nanochips that will give shadowy Elites control over every man, woman, and child in the country. 

Naturally, in a nation that celebrates maverick behavior and hates to be bossed around, we can expect to find plenty of contrarians even among our 22 million health care workers (enough people to populate Sweden twice over). But it is deeply distressing that 100 nurses tried to sue Houston Methodist Hospital for firing them over noncompliance with its mandatory Covid vaccination policy. A story in Becker’s even referred to the case as “the nurses’ lawsuit.” 

Why even an “anti-vax” nurse has an obligation to get vaccinated

Now, like every American, nurses have the right to believe whatever they like. However, as a vital part of the healthcare system, you have a professional obligation to take all necessary precautions to protect the health of your patients. If you have cavils with medical science, you are probably in the wrong profession (Christian Science nursing might be a better fit). 

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What about nurses and other HCWs who cannot be vaccinated for medical reasons? Hospitals with mandatory vaccination policies for other highly contagious diseases such as flu or Hepatitis B have been able to accommodate such nurses in the past by requiring them to wear masks; some even offered a choice: get your shots or you can wear a mask.

Over the past year, scientists all over the globe have been intently studying the prophylactic benefits of surgical masks as well as the well-beloved N95, but we have long known that wearing masks significantly reduces the risk of infecting others. So, hopefully, hospitals will allow masking as an alternative when they deploy vaccination mandates. Seeing immunocompromised nurses wearing surgical masks could also help patients and their families to understand that masks are not part of an insidious plot, but in fact really do protect them from infection. 

Again: you have the right to believe anything about mRNA vaccines, childhood shots and autism, abortion, evolution—anything—and should not be ridiculed or castigated for sincerely held beliefs.  However, as a nurse, when you put on your scrubs it is your professional duty to doff any personal, non-evidence-based beliefs that contradict your scientific training. If you are in a caring profession, respect your training enough to roll up that sleeve or mask up! 

Thanks to 21st-century science—and to the nurses who worked overtime to administer Covid vaccines—an additional 279,000 people in the US would be filling morgue trucks around the US. You cannot destroy ignorance entirely, but by taking a stand against it, you can save lives. 

NNU Welcomes New OSHA Standards: “Important Step Forward for Safer Health Care Settings”

NNU Welcomes New OSHA Standards: “Important Step Forward for Safer Health Care Settings”

On June 10, National Nurses United welcomed the new Occupational Safety and Health Administration (OSHA) Emergency Temporary Standard (ETS) on Emerging Infectious Diseases to ensure safe workplaces for nurses and other frontline health care workers as “an important step forward that will contribute to safer health care settings for workers, patients, and communities.”

“After more than a year of the Trump administration’s refusal to require employers to provide enhanced infection control protections in health care settings in the face of the worst pandemic in a century, this is a monumental message that they will be held to account,” said NNU President Zenei Triunfo-Cortez, RN. “The ETS means new, mandatory requirements for employers, with penalties for those who violate those requirements,” she noted.

Upon preliminary review of the lengthy new temporary standard, NNU said there are significant requirements that will protect nurses and other health care workers and patients, and some areas that can still be strengthened as OSHA conducts updates.

Concurrently, NNU joined with other labor and health care activists in encouraging additional protections in other settings. “All workers, everyone, deserve to be safe — on the job, in their homes, and in their communities,” said NNU Executive Director Bonnie Castillo, RN.

In the health care arena, especially in acute-care hospitals, “this standard is testimony to the advocacy of registered nurses and our allies across the country who have fought with employers to demand safer workplaces, from optimal personal protective equipment, to stronger infection control measures, to corporate accountability from employers,” said Castillo.

“We now have an additional legal sanction for employers who continue to put their profits and budget goals over worker and patient safety. And we know that the test of the standard is dependent on our ability to enforce it to make sure our employers comply,” Castillo said.

Castillo noted that this is the first OSHA emergency temporary standard since 1983, was promulgated over the extensive opposition of and lobbying by the hospital industry and other corporate interests, and lays the groundwork for adoption of broad, permanent OSHA standards on infectious diseases for future epidemics. “We appreciate the strong support of Labor Secretary Marty Walsh, and many supporters in Congress, especially Rep. Bobby Scott, chair of the House Committee on Education and Labor,” she added.

Among the important new requirements included in the ETS:

  • All health care employers must have written infection control safety and implementation plans, developed in consultation with non-management employees and their representatives.
  • A major step forward in requirements for lifesaving respiratory protection against aerosol transmission of the virus for nurses and other frontline health care workers caring for suspected and confirmed Covid-19 patients.
  • New requirements on notification of health care employees exposed to confirmed Covid-19 patients in the workplace, and to provide pay and benefits for those who must take time off as a result of infection.
  • Mandates on screening, mask wearing, physical distancing, and barriers in the workplace.

NNU will continue to review the full ETS and encourage measures to strengthen its provisions, added Triunfo-Cortez.

Examples of areas for improvement include:

  • Moving away from reliance on screening through self-response from patients and employees as to whether they are experiencing Covid-19 symptoms, rather than on testing, for a disease in which more than half of transmissions are known to be caused by people who are asymptomatic.
  • Stronger provisions on aerosolized transmission and the risk of infection, and on ventilation requirements within health care facilities.
  • Provisions for full isolation of Covid-19 patients from non-Covid-19 patients, such as establishing dedicated Covid units.
  • Ensuring a multiple-measures approach where vaccines are one important measure in addition to mask wearing, physical distancing, ventilation, PPE, and other measures to protect nurses, other health care workers, and their patients.

“Still, this ETS is a major victory for those who have worked so hard to achieve this recognition of the terrible toll on nurses and other health care workers, against the malfeasance and resistance of employers and many elected officials,” said Castillo.

“This is still a dangerous and deadly pandemic. People in the United States continue to be infected and die. And nurses and other frontline caregivers remain in danger, especially with the pullback in safety measures across the country that will likely only increase the number of infections, hospitalizations, and deaths,” said Triunfo-Cortez.

As of this week, 405 RNs have died of Covid-19, among 3,908 health care worker deaths overall, according to NNU tracking data. Since the data has not been collected in many places, a full accounting may never be known. Nearly 900,000 health care workers have been infected, an increase of more than 3,000 from the week before.

National Nurses United is the nation’s largest and fastest-growing union and professional association of registered nurses, with more than 175,000 members nationwide.