Hundreds of nurses picketed outside Kapiolani Medical Center on Wednesday, demanding more access to personal protective equipment and an overhaul of coronavirus-related staff policies that they claim put both hospital workers and patients at risk. 

Nurses at the Makiki hospital for women and children have been trying to negotiate a new three-year contract for nearly 10 weeks. 

But the management team at Kapiolani, whose parent organization is Hawaii Pacific Health, has not offered feedback on the nurses’ proposals to address pandemic policies that they view as unsafe, said Daniel Ross, president of the Hawaii Nurses’ Association, OPEIU Local 50.

Nurse hold signs protesting at Punahou street near Kapiolani Womens and Childrens hospital.
Nurses and respiratory therapists at Kapiolani Medical Center say the hospital is taking health and safety risks by limiting their access to PPE. But the hospital’s CEO said efforts to preserve PPE are due to fears about the fragility of the global PPE supply chain. Cory Lum/Civil Beat/2020

The nurses’ previous contract expired on Nov. 30. 

Nurses, and the respiratory therapists who joined them, identified several main demands in their picketing, including the halt of a policy that requires hospital workers to reuse their N95 surgical masks five times before discarding them.

Paulette Vasu, a registered nurse at Kapiolani’s Family Birth Center, said after each wear the N95 mask is sanitized in a manner that causes it to lose its shape. Staff members have no way of knowing whether these distorted masks are continuing to protect them, she said.

“We’re told we can take a new mask, but we have to call down to the central supply and they ask your name,” Vasu explained. “And we don’t know if they’re keeping a tally of how many masks you get a week.”

Martha Smith, the hospital’s chief executive officer, said hospital management differs with the nurses union on this point: The hospital considers itself to be in a state of emergency, due to the virus and the fragile supply chain of PPE supplies.

The nurses union, on the other hand, does not. Ross said that’s because the hospital has maintained that it has enough PPE on hand at this time.

Hospital Worries About Protective Equipment Supplies

But Smith said she’s concerned about future PPE supply chain problems. That’s why the hospital is asking staff to reuse their N95 masks five times, following guidance from the Centers for Disease Control and Prevention for an emergency.

“If there was ever a concern from a staff member about the integrity of the mask or if the mask appears soiled, we tell our staff, ‘Throw it out and we’ll give you a new one,’” Smith said. “But we need to ensure, because we know we’re in this pandemic for the long term, that our staff are going to have the supplies they need going forward.”

“If we, in fact, gave our staff a new N95 every day, we would basically empty out our inventory within a month,” Smith added. “We don’t feel that’s the right thing to do.”

The union, which represents more than 700 nurses, also wants to halt a practice that has hospital workers providing care to coronavirus-infected patients at the same time that they’re caring for those who’ve tested negative. The nurses say these patient groups should receive care separately.

“You’ll have a positive patient and a patient who’s not positive and you’re going back and forth all day,” Vasu said. “We don’t think that’s appropriate. We just feel like we could be exposing our patients, and we don’t want to do that. We want to keep our patients safe and we want to stay safe.”

Smith said the hospital is fortunate to have a very low risk population for COVID-19, with only 48 patients testing positive since March. Nonetheless, the hospital, she said, requires staff to treat all patients as if they are infected with the virus out of an abundance of caution.

“It’s really a non-issue,” she said of the nurses’ complaint.

Nurse hold signs protesting fronting the Kapiolani Womens and Childrens hospital.
Nurses hold protest signs in front of the Kapiolani Medical Center for Women and Children. Cory Lum/Civil Beat/2020

Ross said he thinks the hospital management is trying to balance coronavirus-related revenue losses on the backs of nurses and other staff.

“They’re assuring us that they have adequate PPE supplies, but if they have adequate supplies then why are they having them wear their N95 for five days instead of one day?” Ross said. 

“Our position, which we’ve advocated for all along, is if you have new ones, you use the new ones,” he said. “A used one is better than none at all, but we should not be doing that unless there’s an emergency. They are made to be used once and then tossed, and that’s what should be happening.”

Nurses at other hospitals and health care facilities whose union contract terms and conditions are also negotiated with support from the Hawaii Nurses Association do not appear to be facing the same transparency problems, Ross said. 

“Picketing is a tactic to put some pressure on them by embarrassing them and showing the public how they’re treating the nurses,” he said. “We’ll see when we get back to the table if they actually start to move any.”

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