With cases of the novel coronavirus continuing to rise and no plateau in sight, nurses in Massachusetts have found themselves fighting more than just the virus to keep themselves and their patients safe and healthy. Between the ineptitude and inaction of the government and the barriers to care created by hospital administrators and shareholders, the nurses are exercising their collective power and using the resources of their union to take control of providing supplies, support, and guidance to healthcare workers. The nurses’ actions clearly demonstrate the timeliness and effectiveness of the demands for workers’ control and for opening the books.
In the midst of a pandemic, it’s almost unimaginable that hospital administrators would be more concerned with their bottom line than in pulling out all the stops to battle the virus. But that is exactly what they are doing. From covertly closing intensive care unit (ICU) beds in rural communities, to providing inadequate protection for behavioral health (BH) and obstetric (OB) units, hospital administrators have made myriad decisions aimed at protecting profits at a time when people are literally dying en masse. Their greed puts not only frontline workers but the entire working class at risk.
Despite the Centers for Disease Control and Prevention (CDC) having established personal protective equipment (PPE) standards for pandemics such as this, hospital administrations did not adequately protect healthcare workers at the beginning of the latest outbreak, and effectively decreased workplace safety by successfully pressuring the CDC to relax PPE standards that had been established after the SARS pandemic of 2003. These relaxed standards have led to countless COVID-19 exposures, infections, and deaths among frontline healthcare workers.
When administrators aren’t lying to workers and the public about providing adequate PPE, they are misleading furloughed workers when it comes to qualifying for unemployment insurance, not providing hazard pay to active-duty workers, firing workers who speak out about the lack of PPE, equipment, and services, and telling workers who test positive that they do not qualify for workers’ compensation.
Workers who have contracted the virus have reported that employers and representatives of the employers’ privately purchased workers’ comp insurance have been telling them that they do not qualify for benefits. The nurses of the Massachusetts Nurses Association (MNA) are fighting the misinformation of the bosses by demanding that any healthcare worker who tests positive for the virus should be presumed to have contracted it in the workplace. They have moved might and main to educate nurses about their rights, guiding nurses to apply for workers’ comp directly through the state, and introducing legislation to officially deem COVID-19 as workplace-acquired for essential workers.
Nurses have reported that the testing of workers has been inconsistent at best. There is no set method for determining how and who is being tested. Some workers report only being tested if symptomatic or having worked directly on a unit with COVID-19-positive patients. While some workers receive test results in as little as 15 minutes, others must wait as many as 10 days after the test is administered. Of the nurses surveyed, just 29% had been tested. 19% of those tested reported having to initiate their own testing after their employer created a barrier to them obtaining the test. Even when workers are able to take tests, there has been insufficient training for those administering the tests, resulting in many false-negative results.
Enough time has passed since the beginning of the pandemic to allow us to analyze the effectiveness of measures used to prevent the spread of the virus. Research shows that transmission within the hospital is lowest when every hospital worker in a facility has one mask per person per shift, and disposes of that mask at the end of the shift. In addition, every patient in every unit needs to be treated as positive in order to effectively combat this disease.
Hospital administrators claim that they have adequate inventory to provide everyone in each facility with masks. But the nurses on the ground report that this is patently untrue. Of the nurses surveyed, 84% report using the same mask for over a week. Of the remaining 16%, 41% reported using the same mask for one week, 23% for 4–7 days, and 36% for 2–4 days. Not a single one reported using one mask per nurse per shift.
In response to the challenges of acquiring sufficient masks, Massachusetts General Hospital, along with other hospitals in the area, are testing a variety of methods to decontaminate and reuse masks. The use of these sterilized masks was rolled out in the hospitals as a research study.
However, in an interview with the Boston Globe, Judith Pare, director of nursing education and practice at the nurses’ union, explained: “These masks have always been designed to be one-time use. They were never designed to be reused, because over time the materials these masks are made out of naturally break down.”
We may have adequate research to determine how frequently a nurse should change their mask when caring for COVID-19 patients, but research has not yet been conducted on the safety and efficacy of sterilizing and reusing masks. Nurses have agreed to wear the decontaminated masks but report that they have not given informed consent regarding the experimental nature of the decontamination process and their participation in a research study. This is in clear violation of the ethical principle of research which demands that individuals participate of their own volition and with full knowledge of the risks and benefits of participation.
Fighting on the frontline
Over 320 healthcare workers in the US died in the first 90 days of the virus. Patients in Massachusetts are currently at their sickest, with viral loads shedding at their highest rates. Now is not the time to test the effectiveness of decontaminated masks. The MNA released a position statement opposing the decontamination methods for N95 masks/respirators, informing the nurses of their right to grant informed consent and the right to refusal without retaliation, demanding that the mask decontamination experiment be halted at this time.
All of the above demonstrates that hospital administrators and profit-hungry shareholders cannot be trusted to manage and distribute the PPE to healthcare workers. In response, the nurses took control of the acquisition and distribution of PPE, and are pushing for full-transparency of inventory in each facility. In a statement recently published on Facebook, the union announced:
In the wake of dangerous delays in the provision of desperately needed PPE for nurses and healthcare professionals during the COVID-19 pandemic, and the lack of an adequate state and federal effort to provide needed protections, the MNA in conjunction with donors, contractors, and outside organizations, has successfully acquired and is now distributing a significant quantity of PPE and other supplies to its members statewide.
The MNA diverted funds normally used for face-to-face conferences and purchased thousands of N95 and KN95 masks for hospital workers. The nurses appealed to the broader working class and to other labor unions for donations. Thousands of masks were donated by individuals and thousands more were donated by the building-trade unions. The nurses have so far acquired and distributed thirty thousand masks and eleven thousand face shields.
Rather than distribute the PPE directly to the hospitals, the nurses furnished the inventory directly to union representatives within each facility. It is worth noting that the MNA did not solely distribute PPE to nurses or solely to unionized facilities. Rather, they have distributed PPE to all healthcare workers in both union and non-union facilities.
Essential workers continue to be forced to work in unsafe conditions with inadequate protections. Bosses have unequivocally proved that they will literally sacrifice the lives of workers and put the public at risk in the pursuit of profit. The capitalists’ response to COVID-19 has created conditions in which workers have no choice but to take matters into their own hands. The nurses and leadership of the MNA have set a clear example of what it looks like when labor leadership stands up to management, and workers begin to assert control over their workplaces.
In order to beat back the administrators and boards of directors in the healthcare industry, the MNA should appeal to all healthcare workers to form a united front—a Health Workers’ Alliance. Such a class-based alliance could help us win safe working conditions, better pay, and other needed improvements, and should include a campaign to organize the unorganized in the healthcare industry.
The IMT has developed a program of demands to fight COVID-19 and the economic crisis. Massachusetts nurses are demonstrating what these demands look like in action. Programs, slogans, and demands can sometimes seem abstract in periods of relative stability. But the nurses have shown that these demands are not all abstract, far-fetched, or unreasonable—they are exactly what we need.