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MNA Calls for Directive Requiring Daily N95 Masks, Expanded COVID-19 Testing, Presumption of Work-Related Virus Exposure and Halting of All Service and Staff Reductions in April 21 Letter to Gov. Baker

04.21.2020

The MNA is advocating for a consistent approach to COVID-19 utilizing the expertise of frontline nurses and healthcare workers

CANTON, Mass. – In a new letter to Gov. Charlie Baker, nurses and healthcare professionals on the front lines of the COVID-19 pandemic represented by the Massachusetts Nurses Association are calling for strong and immediate steps to be taken by state officials and healthcare facilities.

“COVID-19 is surging across Massachusetts and yet nurses and healthcare professionals on the front lines are still being denied the proper protection and support they need to save lives and slow the spread of this virus,” said RN and MNA President Donna Kelly-Williams. “State officials and healthcare facilities must take immediate action to keep caregivers and their families safe.”

  • The MNA is requesting Gov. Baker issue a directive such as the one issued by Gov. Andrew Cuomo in New York that would require all healthcare to provide all direct caregivers a new N95 mask at least once a day. The Massachusetts directive would expand on the New York order by requiring daily N95 masks at ALL healthcare facilities because MA is experiencing high rates of infection in non-acute facilities as well.
  • Even as the MNA has consistently called for adherence to best practice standards of one-time use N95 masks for healthcare workers caring for any patients, healthcare facilities have forced nurses to re-use masks for multiple shifts, even multiple weeks, and have refused to provide N95 masks even to nurses who are caring for symptomatic patients awaiting test results.
  • The MNA has also expressed concern about the unproven “decontamination” procedures for masks. The use of any of these experimental methods must involve the consent of the healthcare worker.
  • Healthcare facilities must publicly disclose their PPE stockpiles so the state and caregivers can best make decisions about the supply chain.
  • Testing of caregivers must be ramped up. If testing is not available at a facility, there should be remote healthcare worker-only testing sites available that quickly and without hurdles test and report back results.
  • All healthcare workers who have tested positive for COVID-19 since the beginning of this crisis must be presumed to have acquired the virus at their healthcare facility. Employers who say their workers must have been infected in the community ignore their own facility’s failure to provide proper PPE, adequately isolate infected patients, provide timely testing and implement other critical measures.
  • Facility and service closures, and staff layoffs and cancellations must be halted while we are in the midst of a pandemic and hospitals are receiving more than $800 million in additional state and federal funding. Asked about the furloughs of nurses at St. Vincent Hospital during a press conference April 16, Gov. Baker said the state has provided almost $1 billion to the health care industry to ensure financial stability.

In its seventh letter to Gov. Charlie Baker, Secretary of Health and Human Services Marylou Sudders and the Massachusetts Legislature, the MNA, representing more than 23,000 frontline nurses and healthcare professionals in 85 healthcare facilities and the vast majority of RNs in hospitals statewide, calls on state officials and healthcare employers to immediately apply the experience and expertise of nurses and healthcare workers on the front lines of the COVID-19 pandemic. The MNA previously sent letters on March 14, March 19, March 24, March 31, April 7, and April 14. The April 21 letter can be found at www.massnurses.org/COVID-19.

Highlighted Updates in April 21 Letter:

  • Daily N95 Mask Directive. Gov. Baker has instructed healthcare facilities to distribute PPE rather than stockpile it for “the future,” but we reiterate that not all facilities are following this directive as too many frontline healthcare personnel are still reusing non-reusable N95 masks. Therefore, the MNA is requesting Gov. Baker issue a directive such as the one issued by Gov. Andrea Cuomo in New York that would require all healthcare to provide all direct caregivers a new N95 mask at least once a day

From the MNA April 21 letter:

In light of this inconsistent distribution and usage of PPE across healthcare facilities, we ask you to immediately issue a directive that when a direct care giver in a healthcare facility asks for a new N95 mask they will receive one at least once a day. This follows a similar directive issued last week in New York, but also expands upon it to include all healthcare facilities given the level of exposure of COVID-19 positive patients and staff that Massachusetts is experiencing in non-acute healthcare facility settings.”

  • Consent for Unproven Decontamination.

From the MNA April 21 letter:

“Though we have seen various ‘decontamination’ methods touted as mitigating the PPE shortage problem, we remain concerned with the employment of these unproven methodologies. Any re-use of masks through various mechanisms including, H202 and UV lighting are experimental and as such, should require consent from the worker which is not being obtained.”

  • Disclose PPE Supply.

From the MNA April 21 letter:

“We also reiterate our call for full transparency regarding the distribution of PPE. Every hospital should be mandated to report its full stockpile of PPE, so caregivers and the state have an accurate assessment of need as we attempt to maximize allocation of resources from the supply chain.”

  • Expand Healthcare Worker Testing.

From the MNA April 21 letter:

“It is imperative that we prioritize the testing of healthcare personnel and that we standardize the criteria for testing staff. If a patient is positive, staff should be notified and tested. If staff becomes symptomatic, even absent a fever, testing should occur. To accomplish this, all healthcare workers should have access to on-site testing at the healthcare facility where they work. Though there has been an increase in testing sites across the state for the general public, if all healthcare workers tried to utilize these sites it would clog up these test sites. We propose that if testing on-site at the workplace cannot be made available, there should be designated times at public testing sites just for healthcare personnel where the individual could just present with a healthcare facility ID, get tested without having to preregister and receive results within fifteen minutes. Additionally, testing of all patients and staff should be occurring at every inpatient behavioral health and public health facility, nursing home, assisted living facility, state hospital, group home and prison in order to stem the spread of the virus within these facilities. We are alarmed at the rise in cases in our state operated facilities, and the resistance to authorize testing of all staff in these facilities and programs despite requests to do so.”

  • Presumption of Occupational Exposure.

From the MNA April 21 letter:

“We continue to be baffled by the insistence on the part of multiple healthcare facilities that workers who test positive for COVID-19 acquired the virus in the community rather than at work. This default assumption follows weeks of concerns regarding the co-mingling of patients, failure to triage and segregate patients, lack of appropriate PPE, failure to provide timely testing to healthcare workers and a delay in providing onsite facility parking to employees, forcing healthcare workers to cram into crowded shuttle buses to get to their work. We again call for immediate action to presume occupational acquisition of COVID-19 for all workers in healthcare facilities who become positive and who have tested positive since the beginning of the crisis.”

Asked about the furloughs of nurses at St. Vincent Hospital during a press conference April 16, Gov. Baker said the state has provided almost $1 billion to the health care industry to ensure financial stability.

From the MNA April 21 letter:

We remain outraged that amidst a pandemic where we have heard for weeks about the need to increase capacity and avoid overcrowding emergency departments, hospitals are not only proceeding with planned closures but eliminating additional beds and units. We reiterate our call for the state to direct healthcare facilities to halt all planned bed, unit and facility closures for the duration of this crisis. This includes the absurd decision by Steward Healthcare to close ICU beds at Nashoba Valley Medical Center and Holy Family Hospital in Haverhill, the closure of mental health beds at Trinity Health-owned Providence Behavioral Health Hospital, the closure of Maternal Child Health Unit at Falmouth Hospital, the Somerville Hospital Emergency Department set to close on April 30, and the closure of the mental health unit at Heywood Hospital.” …

“Instead of retraining and utilizing staff to respond to the COVID-19 surge, hospitals are cancelling shifts, furloughing staff or laying them off all the while collecting additional money from the state and federal government which was meant to make up for the reduced, non-COVID-19 volume. There is no justification for staff reductions in light of this funding and the crisis at hand. We remain concerned that some hospitals are using this crisis as an excuse to shed staffing costs and improve the hospital’s bottom line. The latest and most shocking example is for-profit, Tenet-owned St. Vincent Hospital, which is reducing staff on a daily basis, and has announced plans to implement mandatory furloughs at the height of the surge. And this is happening just steps from where the state has opened a field hospital directly across the street at the DCU center. This decision by Tenet is part of a strategy they announced on April 2, to utilize furloughs and nearly $2 billion from the CARES Act stimulus package to ‘maximize our cash position.’”

Read the full April 21, 2020 MNA letter to Gov. Baker and more information at www.massnurses.org/COVID-19.

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Founded in 1903, the Massachusetts Nurses Association is the largest union of registered nurses in the Commonwealth of Massachusetts. Its 23,000 members advance the nursing profession by fostering high standards of nursing practice, promoting the economic and general welfare of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Legislature and regulatory agencies on health care issues affecting nurses and the public.

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