Saturday, October 25, 2014

Editorial: Public Needs Facts, Nurses Need Union

Republicans and corporate media have sown fear with rampant misinformation on the Ebola threat. They blame federal authorities for failing to prepare local hospitals to deal with potential victims, but the debacle at Texas Health Presbyterian Hospital in Dallas points out the need for more oversight of healthcare providers as well as unions to protect doctors, nurses and other healthcare providers from administrators who are more concerned with bottom lines than quality control for patients and workers.

The biggest mistake the officials at the Centers for Disease Control and Prevention made in late September was in trusting Texas health authorities to deal with the Ebola victim, but Gov. Rick Perry has largely escaped criticism for the state’s failure of oversight.

Thomas Eric Duncan, who showed up at the Dallas emergency room on Sept. 25 with a fever, stomach pains and a piercing headache, reportedly told an ER worker that he had recently arrived from Africa and didn’t have insurance. He was sent home with antibiotics. When he returned three days later in an ambulance, he was left waiting with other patients for hours before he was admitted to the hospital’s isolation unit, nurses say.

“No one knew what the protocols were or were able to verify what kind of personal protective equipment should be worn and there was no training,” a nurse told National Nurses United, which has been warning for months that poor training and oversight is putting US healthcare workers at risk of contracting the virus. A nursing supervisor who demanded that Duncan be moved to an isolation unit faced resistance from other hospital authorities, the nurses said.

Luckily, none of the hospital’s patients or Duncan’s friends and family came down with Ebola as the 21-day incubation period expired on Oct. 20. But two nurses who treated Duncan were infected with the deadly virus, possibly because they were not trained in use of the limited protective gear they had, and more than 200 others with proximity to the stricken nurses were still being monitored.

As the hospital sought to defuse the criticism of its treatment of Duncan, it hired the global public relations firm Burson-Marsteller and started a more assertive defense, with employee pep rallies and complaints that the CDC didn’t help the hospital adequately prepare for an Ebola outbreak.

But some of the nurses at Presbyterian, who are not represented by a union, contacted the nurses union out of frustration with the lack of training and preparation. They spoke anonymously because they were warned not to speak to reporters and they fear retaliation from the hospital, NNU officials said.

Before Duncan showed up there was one optional lecture/seminar on Ebola and a link to the CDC website, but no mandate for nurses to attend the training sessions or protocols on what nurses had to do in the event of arrival of an Ebola patient.

“This is a very large hospital. To be effective, any classes would have to offered repeatedly, covering all times when nurses work; instead this was treated like the hundreds of other seminars that are routinely offered to staff,” the nurses said.

There was no advance hands-on training on the use of personal protective equipment for Ebola. No training on what symptoms to look for. No training on what questions to ask.

The problem is nationwide. NNU conducted a survey of 700 RNs at over 250 hospitals in 31 states and found that 80% said their hospital had not yet communicated any policy regarding potential admission of patients infected with Ebola; 87% said their hospital had not provided education on Ebola where nurses could interact and ask questions; and one-third said their hospital had insufficient supplies of eye protection and fluid-resistant gowns.

Also, while Texas Health Presbyterian Hospital operates as a non-profit organization, it booked an operating profit of $89 million for a 14.5% profit margin in 2012 and the Dallas Morning News reported Oct. 18 that Presbyterian’s ER actually is run by an independent contractor, Emergency Medicine Consultants Ltd., operating as Texas Medicine Resources L.L.P.

In such arrangements, which are common nationwide, companies typically assume many duties for the hospital, the News noted. So it is possible that the night the ER sent Duncan home with a wrong diagnosis of sinusitis, no Presbyterian employee was involved.

We agree with AFL-CIO President Richard Trumka, who called on President Obama to use his executive authority to put in place mandatory protections and other workplace standards for hospitals and other healthcare facilities.

“Existing protocols, standards and guidelines, and adherence to them, are deficient,” Trumka said. “The failures in the response have put dozens of additional health care workers at risk, and potentially exposed many other workers and members of the public. ... Immediate action is needed.”

The standards should include the “highest level of protective equipment,” including use of air purifying respirators and full body suits with hands-on training on the proper way to put on and take off the protective gear. Trumka also called for protection from retaliation against workers who report health and safety issues or who contract the Ebola virus or are restricted or placed under quarantine.

Congress also must stop partisan posturing and work with the administration to provide support that is needed to stop the threat here and the bigger threat in West Africa, restoring the budget cuts that House Republicans have demanded since 2011 and adopting legislation to see that these protections are put in place without delay.

Supreme Court OKs Voter Suppression

A federal judge in Texas ruled Oct. 9 that a Voter ID bill unconstitutionally imposes a tax on the right to vote but the Supreme Court Oct. 18 decided to let Texas go ahead with suppressing hundreds of thousands of Texas voters in this year’s general election while the appeal works its way through the courts.

The order was unsigned, but Justice Ruth Bader Ginsburg filed a six-page dissent joined by Justices Sonia Sotomayor and Elena Kagan. “The greatest threat to public confidence in elections in this case is the prospect of enforcing a purposefully discriminatory law, one that likely imposes an unconstitutional poll tax and risks denying the right to vote to hundreds of thousands of eligible voters,” Ginsburg wrote.

Republicans claim to be confident that they can keep control of Texas, but they don’t want to leave anything to chance, so they railroaded the voter ID bill through the Legislature in 2011. US District Judge Nelva Gonzalez Ramos of Corpus Christi ruled the bill was passed with a “discriminatory purpose” and could disenfranchise more than 600,000 citizens, disproportionately black and Hispanic, including students and seniors who don’t have cars so they don’t have drivers’ licenses, a military ID, a passport or a concealed weapons permit. Republicans claimed the law was needed to prevent voter fraud, but only two people were found to have impersonated others at Texas polls during a recent 10-year period.

The Supreme Court also upheld new restrictions on voting in North Carolina and Ohio that cut back early voting, but the high court stopped Wisconsin from implementing a voter ID bill for this election. At least 16 Republican-dominated states have acted to restrict voting in this election — and the suppression works. The US Government Accountability Office reported that strict photo ID laws in Kansas and Tennessee lowered voter participation in the 2012 elections by roughly 2 to 3 percentage points from 2008.

If Republicans were acting in good faith to prevent voter fraud, they would make state IDs easier to obtain for the roughly 10% of people who lack them. Many of those unlicensed don’t have the time or money to get the required documents, take a day off and find transportation to a license bureau, which are often in the suburbs, to get a state-approved voter ID. The GOP is unmoved.

Some day Republicans will be embarrassed by their role in suppressing the vote. But not this year. — JMC
From The Progressive Populist, November 15, 2014
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