The Employer and CNA/NNOC/NNU agree to the following:
Standards, Training and Equipment
The employer shall provide optimal protocols and personal protective equipment for Ebola including, but not limited to, the following:
1. Full-body hazmat suits that leave no skin exposed or unprotected and have integrated undersocks or underboots
2. National Institute for Occupational Safety and Health [NIOSH] -approved powered air purifying respirators with HEPA filters, a full cowl or hood with an integrated full face shield that covers all areas of the face, head, neck, and upper torso, and an assigned protection factor of at least 50
3. Impermeable boots or coverings for the feet and lower legs must be used and must not create a slipping hazard
4. Single-use (disposable) apron as needed based on the independent professional judgment of the direct care RN assigned to the patient
5. All personal protective equipment including, but not limited to, those identified above must meet or exceed the American Society for Testing and Materials (ASTM) F1670 standard for blood penetration, the ASTM F1671 standard for viral penetration. ASTM F1670 and F1671 standards apply to all seams, zippers, and other fastenings or closures (for example, seams are taped)
6. The employer shall provide all PPE, scrubs, undergarments, etc. No items worn when caring for a suspected or confirmed Ebola patient or potentially contaminated items may leave the premises until they are decontaminated
7. The above PPE shall be donned upon identification of a suspected case of Ebola and for all confirmed Ebola patients
- There will be continuous interactive training with the RNs who are exposed to patients or their body fluids. There will also be continuous updated training and education for all RNs that is responsive to the changing nature of disease. This would entail continuous interactive training and expertise from facilities where state of the art disease containment is occurring.
- The employer shall adhere to precautions and protections based on the precautionary principle.
- An RN has the right to refuse to care for an Ebola patient if, in the RN’s judgment, the conditions are unsafe.
- There shall be at least two RNs caring for each Ebola patient with additional RNs added as needed based on direct-care RN judgment and they shall not have other patient assignments.
- If the employer, state or federal OSHA, CDC, state or local health department, or other agency has standards that exceed those stated herein, the highest standard shall be used.
Infectious Disease Task Force
- The Employer and the Union shall create an infectious disease task force (IDTF) comprised of (3) representatives appointed by the Union and three (3) representatives appointed by the Chief Nursing Officer. The IDTF shall meet at least twice per year.
- In the event of an infectious disease outbreak, epidemic, or pandemic that impacts the facility, the IDTF shall meet within twenty-four (24) hours. Thereafter, the IDTF shall meet daily/weekly as needed.
- Time spent by Union representatives in IDTF meetings shall be paid at each RN’s regular rate of pay, including shift differential and shall also constitute hours worked for the purposes of calculating overtime. Participating RNs shall not suffer any loss of seniority, PTO accrual or other benefits.
- The IDTF is hereby charged with monitoring system-wide preparedness and response to an infectious disease outbreak, epidemic, or pandemic, including but not limited to the availability of Personal Protective Equipment (PPE), evaluation of the Infectious Disease Plan (IDP), implementation of the IDP prevention standards, procedures, and protocols; the need for off-site emergency triage, immunization, and treatment services; isolation accommodations, and effective communication and/or training to direct care providers and other frontline staff.
- IDTF recommendations regarding communication and/or training shall be forwarded to the facility Professional Practice Committee (PPC) for local discussion and implementation in collaboration with the facility’s infection control team. The facility PPC shall be the forum for facility discussion consistent with the terms of the CNA/NNOC/NNU contract. Minutes of meetings will be taken by administration, approved by the committee members with approval by at least two of the Union-appointed representatives, and posted on the nursing intranet.
Medical Services for Employees
The Employer shall provide a medical services program at no cost to the employees that includes testing for any employee who requests it who believes he/she may have been exposed to Ebola at the hospital. The program shall maintain medical confidentiality. The employer shall provide all vaccinations, prophlyaxis, and medical surveillance recommended by the strictest standards among the CDC, the state health department, the local health officer, or other government agency. The medical services program shall include, at a minimum:
(A) Initial medical evaluation to be provided prior to first entrance into a restricted area or area of potential exposure.
(B) Surveillance for signs and symptoms of infection. Employees exhibiting signs or symptoms of infection including fever and employees requesting referral shall be referred immediately for follow-up evaluation.
(C) Surveillance for signs and symptoms of over-exposures to hazardous substances used for disinfection and decontamination as appropriate for substances present in the work operation. Employees exhibiting these signs or symptoms shall be referred immediately for follow-up evaluation, and the employer shall further investigate the source of the potential over-exposure and take corrective measures, as needed.
(D) All treatment and follow-up medical evaluations necessary to support full recovery.
RN PTO/Sick Time
- RNs who are required to miss scheduled shifts as a result of exposure to an infectious disease shall be placed on administrative leave without loss of pay or PTO. The presumption shall be that exposure occurred at the work place.
- RNs who are required to miss scheduled shifts as a result of exposure to an infectious disease shall not be penalized or disciplined in any way. Hospital policies that call for discipline after employee use of sick leave or leaves of absence related to illness will be amended to eliminate the use of discipline in the event of a documented illness or exposure to an infectious disease. Occurrences of absence that are for a documented illness or exposure to an infectious disease will not count toward “point” totals that may lead to discipline.
- Supplemental Insurance for Ebola.