IRI Intelligence Briefing

News and Developments Affecting the Workplace

Volume Number & Date: 
Vol. 6 No. 2 - November 2014

Managing Ebola from an Employee Relations Perspective

As U.S. healthcare officials and hospital leaders work to ensure proper healthcare system preparedness and quell Americans’ anxiety about Ebola, National Nurses United (NNU) and its state affiliates have been exploiting the issue. The union is using Ebola to attract media attention, advance its organizing strategy and position itself as the nurses’ protector against what it portrays as bottom- line-oriented healthcare leaders and inept government healthcare bureaucrats.

With 24-hour news coverage where networks work to break news before bloggers scoop the latest detail, facts can get distorted quickly and incorrect information is reported. It is exactly this media frenzy that NNU has been manipulating. While the White House, the Centers for Disease Control (CDC) and healthcare providers are trying to address the situation, NNU has sought to grab headlines. RoseAnn DeMoro, the executive director of NNU who is not a registered nurse herself, said in one interview, “if the nurses controlled the resources, there wouldn’t be an Ebola crisis in this country.”

During its annual convention in September, NNU staged an Ebola “die- in” along the Las Vegas Strip that garnered international news coverage. Shortly thereafter, DeMoro sent a letter to President Obama calling on him to use presidential powers to mandate national Ebola protocols for every hospital to follow. The former organizer for the International Brotherhood of Teamsters claimed shewas speaking on behalf of all U.S. nurses and healthcare workers – but her union represents only 185,000 registered nurses across the country. NNU also created an online petition urging President Obama to “Protect Nurses,” a tactic that allows the union to build its database with names, addresses and email addresses.

At hospitals from California to Florida that the union is attempting to organize, union organizers marched on administrative offices to deliver letters outlining a list of Ebola preparedness demands. NNU also distributed paper-based surveys and launched an online survey to solicit information about hospitals’ Ebola preparedness. Of course, the survey also asked nurse participants to provide the type of personal contact information that union organizers collect during union card-signing drives.

Additionally, the union took its campaign to Capitol Hill. On October 24, NNU co-president, Deborah Burger, testified before the House Committee on Oversight and Government Reform. Burger used this platform to say the union conducted a survey where “85% of RNs say they have not been adequately trained and the level of preparedness for Ebola in our facilities is woefully insufficient.” Burger also noted, “our long experience with U.S. hospitals is that they will not act on their own to secure the highest standards of protection without a specific directive from our federal authorities.”

Despite Burger’s testimony, unions have no independent authority to change any standards or policies involving infection control. It is management’s right and responsibility, and hospitals’ professional teams are addressing Ebola and taking crucial steps to support and protect their entire staff as well as all of their patients and visitors.

NNU even has proposed Ebola-related demands in negotiations with hospitals across the country, using negotiations at the healthcare giant Kaiser Permanente as one platform for the union’s Ebola campaign. The union seeks to add contract language requiring additional training, full-body hazardous material suits and the provision of additional life insurance for nurses who risk contracting the virus. In one case, the Michigan Nurses Association, an NNU affiliate, negotiated contract language with the University of Michigan Health System (UMHS) that outlines specific regulations for safety training for Ebola protection and personal protective equipment for all of UMHS’ 5,000 nurses. It provides that nurses will receive paid time-off (not sick time or vacation days) during quarantine after treating Ebola patients. Nurses also will be permitted to return to their same position after being deemed free of the virus. NNU’s demand is a sharp detour for a union that has opposed other protective measures for healthcare workers, including mandatory immunization and requiring nurses to wear surgical masks in some care environments.

Nationally, NNU has proposed that nurses and other caregivers who interact with Ebola patients are provided with “optimal personal protective equipment (PPE), including full hazmat suits that are body fluid, blood and virus impervious.” This would include providing:

  • Equipment that meets American Society for Testing and Materials F1670 standard for blood penetration;
  • Equipment that meets F1671 standard for viral penetration;
  • National Institute for Occupational Safety and Health-approved powered air purifying respirators with an assigned protection factor of at least 50, with full hood;
  • PPE that leaves no skin exposed or unprotected; and
  • Hands-on interactive training on proper donning and doffing of hazmat suits.

DeMoro commented, “We know from years of experience that these hospitals will meet the cheapest standards, not the most effective precautions. And now we are done talking and [are] ready to act.”

With that, NNU announced an RN Ebola Strike and National Day of Action for November 12. According to the union, “hospitals across the country refuse to set proper safety protocols and training with optimal personal protective equipment.” There were strikes at Providence Hospital in Washington, D.C., and 66 Kaiser Permanente hospitals as well as picketing at a handful of other facilities around the country. The union claims Ebola and patient safety are the reasons for the strike, but the true catalyst is contract negotiations.

The union’s rhetoric and actions are clearly opportunistic and antagonistic when compared with that of the American Nurses Association (ANA), the professional organization that represents the interests of the nation’s 3.1 million registered nurses. ANA offered a more collaborative approach. “We urge all hospitals and health care workers to engage in comprehensive education and preparedness activities in order to ensure the safety of the public and health care professionals. We have the utmost confidence that health care providers are eager to take part in learning protocols that will protect health care workers and keep patients safe.”

Other nursing associations and unions have not followed the NNU’s radicalized approach. Betsy Snook, an RN and CEO of the Pennsylvania State Nurses Association (not to be confused with the Pennsylvania Association of Staff Nurses and Allied Professionals, the NNU affiliate in that state), dismissed the call of some NNU activists for nurses to strike over their Ebola concerns. “The situation doesn’t currently call for a nurses’ strike because of all the preparation efforts being done, Snook said. “The nurses are clearly voicing their concerns, and I believe their hospitals are listening to them, and state agencies and the federal government are listening to them and preparing nurses in the ways they are able to at this time.”

While hospitals’ infection control specialists and related subject-matter experts are working to stay a step ahead of evolving CDC guidelines and train staff most likely to interact with suspected and confirmed Ebola cases, human resources and communications leaders should consider other actions, including:

  1. Communicating to internal stakeholders the latest information from the Centers for Disease Control and Prevention and the World Health Organization, both of which continue to revise their policies and protocols.
  2. Educating your employees, volunteers and other stakeholders through multiple channels (e.g. meetings, email, web postings, video, newsletters) about how your organization is preparing and staying prepared and answering their questions.
  3. Ensuring your crisis communications plan is current by, in part, identifying staff and including contact information.
  4. Considering opening your doors to reporters to demonstrate how your facility is prepared, and providing them with access to spokespeople who are well-versed in the issue and trained to speak effectively with the media.
  5. Understanding employee relations implications, including state and federal Occupational Safety and Health Administration requirements as well as how management decisions may ripple to Department of Labor regulations and employment laws such as the worker’s compensation claims.
  6. Understanding that Family and Medical Leave Act time must be granted for personal and family health issues. Similarly, there must be reasonable accommodation analysis for disabled employees according to the American Disabilities Act.
  7. Being aware of protected concerted activity concerns from Section 502 of the National Labor Relations Act. Employees can band together to protest unsafe working conditions and no union involvement is necessary. However, employees must have an objective good faith basis for refusing to work.
  8. Being careful about disciplining any employee who raises concerns about their personal safety and/or refusing to work.
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