The Associated Press

Posted: 07/14/2009 10:56:23 AM PDT

VALLEJO, Calif.--Nurses at a northern California hospital say inadequate masks and air-filters have resulted in medical staffers becoming ill while caring for three swine flu patients. ...

http://www.mercurynews.com/breakingnews/ci_12834125

This is just starting. We are going to find a lot of instances where there is lack of equipment and especially help.

A Few Words from the Ontario Nurses Assoc - June 2009

http://www.ona.org/node/1325

We have received reports that large hospitals and small facilities around the province are claiming they have run out of respirators and have been unable to acquire more, and some are claiming to be unable to fit test workers.

The Ministry of Health and Long-Term Care (MOHLTC) recently confirmed to ONA that:

The H1N1 outbreak created initial N95 supply issues, in which 3M and other companies responded by ramping up production. Because of the sustained demand, some supply issues continue.

3M did discontinue a couple of popular N95 models used by health care workers. As a result, many institutions need to re-fit test those workers fitted to the deleted models.

Despite the challenges, hospitals and significant health care facilities still have access to a continued supply of N95s. Early on, the MOHLTC urged that if an individual facility has an access issue to contact its Emergency Operations Centre (EOC), which will assist in locating suppliers that can meet their needs.

Despite an increased need for re-fit testing, there are many service providers that are still available. If a facility says they can't get fit testing, it is not likely a completely forthright assertion.

3. Confusing directives and distortion of directives were real problems that contributed to the SARS disaster. To its credit, since the beginning of the H1N1 outbreak, the MOHLTC has been issuing guidance documents for health care professionals and wants wide distribution and transparent public access to these documents. ONA has assisted in publicizing the Important Health Notices (IHN) "in order to ensure cascading messages are received across the Ontario health care sector" (see links below).

It is, therefore, with great disappointment and frustration that we have learned that at least one hospital issued an internal bulletin about the IHNs and omitted important health and safety information and the need for respiratory protection for at-risk workers. And, a public health unit recently refused to distribute the IHNs to their workers.

IHNs are not state secrets, but are intended to be open and widely communicated, especially to clinical and other health care professionals who may be directly affected and who also provide advice to those in the community who may be affected.

4. We have also received reports of public health units that are resisting establishing respiratory protection programs for at risk workers. Medical Officers of Health have been charged with coordinating community pandemic planning and response, and should be leading by example and applying occupational health and safety principles and law to their own staff.

It is sadly ironic that we need to say this, but it is completely unacceptable for an employer, especially a health unit charged with overseeing public and worker health and safety in an outbreak, to create information bottlenecks and resist protecting workers.

In consulation with your Joint Health and Safety Committee (JHSC), your employer should have planned for an influenza pandemic. This planning should have included stocking of at least four weeks supply of N95 respirators and updated fit testing of workers at risk of exposure.

Health care facilities that typically lack N95's would include nursing homes, assisted living facilities, and doctor's offices. Will they see cases of swine flu? Not as many as hospitals, but yes they will.

Nurses File Cal-OSHA Complaint

http://www.calnurses.org/media-center/press-releases/2009/july/nurses-file-cal-osha-complaint-after-hospital-refuses-to-supply-swine-flu-masks-for-units-with-infected-patients.html

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 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...

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.

State Reviews Nurse Swine Flu Threat

http://www.mercurynews.com/breakingnews/ci_12836945

Moral of story, make sure you get tested if you get sick at work, have it documented that in your clinicians's judgement, you are diagnosed as probable case of swine flu. Remember the rapid test has frequent false negatives.

If a clinician decided to put them on Tamiflu because of the s/s, then that should be good enough proof, imo.

I wonder if the nurses are protected as whistle blowers.

The complaint was filed with the state Division of Occupational Safety and Health. By law, the state investigation must be completed within six months.

Since exposure was likely, the nurses were presumed to have swine flu and were being treated for it while staying at home to recuperate, California Nurses Association President Deborah Burger said.

Sutter Solano's Chief Nursing Executive Kim Trumbull said only one employee tested positive for swine flu and others were only known to have respiratory illness.

"If we had 10 confirmed cases then we would probably be taking it a little more seriously," Trumbull said.

The complaint claimed the hospital failed to provide nurses with individually fitted, duck bill-shaped masks used while treating patients who have an airborne illness.

It said the nurses had been provided with a brand of mask they hadn't been fitted for.

Trumbull said the hospital has more than 400 masks and provided nurses with fittings to ensure proper use.

(hat tip PFI/monotreme)