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President’s message 3 BCNU president Debra McPherson discusses why OH&S issues are a top priority and what our union and nurses are doing to keep members safe. Long Term Disability 4 Nurses forced to survive on Long Term Disability benefits since before 1998 are eagerly awaiting the additional money they will begin receiving this spring. Campaigning for change 8 BCNU will focus on OH&S issues in 2005 by using the proven power of member- driven campaigns to make our workplaces safer for nurses and patients. Know your rights 14 Keep yourself and your co-workers safe by learning about your right to refuse work in unsafe situations, and about your employer’s and union’s duty to accommodate. Working safely 16 Read about the results of BCNU’s recent polling of our members on health and safety issues, and the highlights of our union’s recent OH&S conference. INSIDE SPECIAL EDITION ON OH&S IN THIS SPECIAL EDITION, Update examines a wide range of OH&S issues including: musculoskeletal injuries, violence prevention, WCB cuts, the right to refuse unsafe work, improving LTD benefits, N95 masks and retractable needles. BCNU UPDATE is published six times each year by the BC Nurses’ Union, an independent Canadian union governed by a council elected by 25,000 working nurses from across the province. Signed articles do not necessarily represent official BCNU policies. EDITOR Dan Tatroff CONTRIBUTORS Lara Acheson, Juliet Chang, Gayle Duteil, Debra McPherson, Art Moses, Jim Parker, Tuula Sillantaus, Patricia Wejr PHOTOS Dan Tatroff PROVINCIAL COMMUNICATIONS COMMITTEE Alice Edge, Chair Cheryl Appleton, Mitzi Arthur, Shannon Chutskoff, Barb Connolly Elizabeth Chrusch, Rita Deverney, Susan Hotson, Kelly Pawlyszyn, Laura Napier, Sarah Johl, Susan St. John, Sharon Sharp, Susan Shyluk, Jacquie Thesen, Lorie Ward, Martin Wong CONTACT US BCNU Communications Department 4060 Regent Street, Burnaby, BC V5C 6P5 PHONE 604.433.2268 TOLL FREE 1.800.663.9991 FAX 604.433.7945 TOLL FREE FAX 1.888.284.2222 BCNU website www.bcnu.org EMAIL Update at [email protected] Publications Mail Agreement No. 40834030 Return Undeliverable Canadian addresses to BCNU, 4060 Regent Street, Burnaby, BC, V5C 6P5 BCNU is affiliated with the Canadian Federation of Nurses Unions. Design by Working Design. KEEPING NURSES SAFE
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Page 1: KEEPING NURSES SAFEold.bcnu.org/publications_forms/update_magazine/... · load, security, skill mix and the impacts of the ongo-ing nursing shortage, have left nurses exhausted, stressed,

President’s message 3BCNU president Debra McPherson discusses why OH&S issues are a top priority andwhat our union and nurses are doing to keep members safe.

Long Term Disability 4Nurses forced to survive on Long Term Disability benefits since before 1998 are

eagerly awaiting the additional money they will begin receiving this spring.

Campaigning for change 8BCNU will focus on OH&S issues in 2005 by using the proven power of member-driven campaigns to make our workplaces safer for nurses and patients.

Know your rights 14Keep yourself and your co-workers safe by learning about your right to refuse work in

unsafe situations, and about your employer’s and union’s duty to accommodate.

Working safely 16Read about the results of BCNU’s recent polling of our members on health and safetyissues, and the highlights of our union’s recent OH&S conference.

INSIDE SPECIAL EDITION ON OH&S

IN THIS SPECIAL EDITION, Update examines a widerange of OH&S issues including: musculoskeletalinjuries, violence prevention, WCB cuts, the rightto refuse unsafe work, improving LTD benefits,N95 masks and retractable needles.

BCNU UPDATE is published six times

each year by the BC Nurses’ Union, an

independent Canadian union governed

by a council elected by 25,000 working

nurses from across the province. Signed

articles do not necessarily represent

official BCNU policies.

EDITOR

Dan Tatroff

CONTRIBUTORS

Lara Acheson, Juliet Chang, Gayle Duteil,

Debra McPherson, Art Moses,

Jim Parker, Tuula Sillantaus, Patricia Wejr

PHOTOS

Dan Tatroff

PROVINCIAL COMMUNICATIONSCOMMITTEE

Alice Edge, Chair

Cheryl Appleton, Mitzi Arthur,

Shannon Chutskoff, Barb Connolly

Elizabeth Chrusch, Rita Deverney,

Susan Hotson, Kelly Pawlyszyn,

Laura Napier, Sarah Johl,

Susan St. John, Sharon Sharp,

Susan Shyluk, Jacquie Thesen,

Lorie Ward, Martin Wong

CONTACT US

BCNU Communications Department

4060 Regent Street, Burnaby, BC

V5C 6P5

PHONE 604.433.2268

TOLL FREE 1.800.663.9991

FAX 604.433.7945

TOLL FREE FAX 1.888.284.2222

BCNU website www.bcnu.org

EMAIL Update at [email protected]

Publications Mail Agreement No. 40834030Return Undeliverable Canadian addresses toBCNU, 4060 Regent Street,Burnaby, BC, V5C 6P5

BCNU is affiliated with the Canadian

Federation of Nurses Unions.

Design by Working Design.

KEEPING NURSES SAFE

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F E B R U A R Y / M A R C H 2 0 0 5 3

THE BCNU COUNCIL, at its annual planning ses-sion, renewed its commitment to the health and safe-ty of our members.

The continuous change and restructuring of thehealth care system in British Columbia, the manage-ment structure, increased patient acuity and work-load, security, skill mix and the impacts of the ongo-ing nursing shortage, have left nurses exhausted,stressed, feeling vulnerable and experiencing highlevels of illness and injury.

This issue of the magazine explores some of theeffects in terms of both sta-tistics and the human cost. Italso highlights how nursesare taking action, with sup-port from other BCNU mem-bers and staff, to fight back;to create safe and healthyworkplaces.

Both nurses and theiremployers have a jointresponsibility under the lawto ensure a safe workplace.

Yet sadly, the data fromthe employers, the Workers’Compensation Board of BCand our own polling of

BCNU members shows that at times none of us makeit our priority.

The BCNU polling shows that nurses continue torisk injury to themselves in order to ensure theirpatients get the care they need. Three-quarters of ourmembers indicated in the poll that they have put thehealth and safety of their patients ahead of their ownhealth and safety.

Employers continue to put nurses at risk by nottaking the necessary measures to prevent illness andinjury, such as providing sharps systems that are engi-neered to reduce risk of injury, ensuring sufficientsecurity on-site, implementing and enforcing “no tol-erance” policies and addressing unsafe staffing levelsand workloads.

In order to focus the organization on this issue, theBC Nurses’ Union Council had made the theme ofthis year’s convention “Building for a Safe andHealthy Future” and will feature speakers and displayson the issue.

As well, we have held a conference for our activistsand budgeted money for 16 workplace campaigns toresolve health and safety problems.

Through our bargaining, we argued for and suc-ceeded in securing ongoing funding for the BCOccupational Health and Safety Agency.

And finally, we undertook to support our disabledmembers most in need when the employer refused tocontinue their Long Term Disability supplementalmonthly benefits.

Taking care of our own, taking care of ourselves;that is the challenge before us.

One of the RNBABC Standards cites the need tomaintain our physical, psychological and emotionalfitness to practice. It is something we must fight for ashard as we fight for the ability to ensure patients getthe care they need.

Please think about this the next time you are aboutto risk your own health, or the next time you areexposed to a danger in your work environment. This isnot part of your job.

We need every nurse in this province to have a safeand healthy career. Let’s fight for it together. �

BCNU Council has renewed its

commitment to the health and safety

of our members

PRESIDENT’S REPORT Debra McPherson

Employers continueto put nurses at risk

by not taking thenecessary measures

to prevent illnessand injury, such as

providing sharpssystems that are

engineered to reducerisk of injury.

WORKINGSAFE

CHRIS CAMERON PHOTO

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4 B C N U U P D AT E

“This is extremely positive news,”says Fleming. “The extra money eachmonth will mean no longer having tolive hand-to-mouth and no longerbeing forced to choose between havinga roof over my head and food in mystomach.

“It gives me hope for the future. Ifeel a bit more alive, just being able topay my bills and have extra money forgroceries and the othernecessities of life. Thefirst thing I’ll do is getorthotics for the arthritisin my knee, which mydoctor has been wantingme to do for the past twoyears. Then I’ll replacemy glasses, which havechipped lenses and a broken frame.”

Fleming’s LTD experience datesback to 1986, when she suffered a dis-abling back injury while working as aregistered nurse. The problem waseventually diagnosed as acute arthritis.

Since then she has been forced toeke out a meager existence on the $977LTD payment she receives each month.Inflation, which was extremely high

during the eighties, continues to eataway at the buying power of hermonthly benefit.

Over the years, Fleming has beenforced to sell family heirlooms andother assets.

She had to leave Vancouver whereher children live and move into a tiny,but more affordable, rural cottage. Sheoften couldn’t afford the prescription

drugs she needed and was unable topay for the physio she requires. “Eachpassing year,” she says, “I feel a little bitcloser to being out on the street. It isfrightening.”

Her situation finally improved a lit-tle in 1999, when she began receivingan additional $241 per month – afterBCNU’s bargaining team negotiated

| LONG TERM DISABILITY |

“I just can’t believe the generosityof BCNU members. They have

really provided me with new hopefor the future.” — Janella Fleming

Nurses who have survived on Long Term Disability seagerly awaiting the additional money they will beg

Janella Fleming is looking forward to a brand new lease on

life in April. That’s when a new Supplementary Monthly

Benefit package kicks in for her and 400 other nurses who

began collecting Long Term Disability benefits before 1998.

Scraping By OInspections, penalties and enforce-ment have all been reduced at theBC Workers’ Compensation Boardsince the Gordon Campbell Liberalscame to power in 2001.

“The Workers’ CompensationBoard has become the Employers’Compensation Board,” says BCFederation of Labour president JimSinclair. “If no one enforces therules, then there are no rules.”

Approximately 1200 WCBemployees have been laid off –even though there has been a 30per cent increase in serious injuriesand 5700 people were seriouslyinjured on the job last year.

The Federation of Labourreports that “in an attempt todeliver $300 million in ‘savings’ toemployers, compensation forinjured workers was dramaticallycut in May 2002, when the BCLiberals passed Bill 49.

“The legislation reduces thebenefits paid to injured workersfrom 75 per cent of a worker’sgross income to 90 per cent of aworker’s net income.

“It also reduces the pensionspaid to workers with a permanentdisability and limits the payment ofstress-related claims to a traumaticevent.”

In 2002, the provincial govern-ment also introduced Bill 63. Itrestricts an injured worker’s right toappeal the denial of compensationcoverage by reducing the numberof levels of appeal from three totwo. The bill also eliminates thebeleaguered board’s medical reviewpanel.

The BC Liberals have also direct-ed the WCB to slash health andsafety regulations by one third.

BC LIBERALS ATTACK WCB

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Supplementary Monthly Benefits fromthe employer for her and other LongTerm Disability claimants duringBargaining ’98. BCNU negotiated anextension of the SMB in 2001.

But at the bargaining table last year,the provincial government and ouremployers refused to fund a renewal ofthe SMB when it expires on April 1,2005 (see page seven) because it wouldhave exceeded the Liberal’s compensa-tion guidelines mandating no increasesfor nurses and other public servants.

Rather than allow the LTD recipientsto fall further into poverty, BC Nurses’Union members voted last fall to fund anew and fairer SMB as part of a newProvincial Collective Agreement.

Until BCNU receives detailed finan-cial figures from the Healthcare BenefitTrust, which oversees LTD payments, itis unclear exactly howmuch additional moneyFleming and the 400other affected nurses willreceive. But BCNU esti-mates (see sidebar onpage six for full details)reveal that a nurseinjured in 1982 could receive an addi-tional $1,080 each month above her cur-rent $1,400 LTD payment. (All figuresare approximate.)

Fleming says she is extremely grate-ful to BCNU members and elected offi-cials for doing the right thing andimproving the lives of LTD recipients.

“I just can’t believe the generosity ofBCNU members,” she says. “It really ishumanity at its best. I can’t thank themenough. They have really provided mewith new hope for the future.”

BCNU LTD provincial rep DorothyLeslie says the rules needed to bechanged and “thankfully they finally

have been.” She points out that injurednurses like Fleming, who have been onLTD the longest, have suffered themost over the years because their LTDbenefit is based on 66.6 per cent of thewage they earned at the time of theirinjury.

“We have members,” adds Leslie,

“who have lost their homes, cars, fami-lies, are in abusive relationships, havehad to move in with family or friends,claimed bankruptcy as they are finan-cially powerless and make day-by-daydecisions on whether to buy food ormedication.”

“I could tell you many horror storiesof these vulnerable existing claimantsliving below the poverty line,” SouthIslands Pacific Rim LTD caucus chair-person Cheryl Jones wrote in a letter toBCNU in 2004, prior to the last round ofbargaining. “Many are too sick orembarrassed to come forward and telltheir stories.

“We already have had many lossesthat are out of our control due to varioushealth issues, but our financial burdensmake life more challenging than itneeds to be. Without our health, we areunable to pull ourselves out of povertyand need your support.”

Jones, who has been unable to nurse

F E B R U A R Y / M A R C H 2 0 0 5 5

POSITIVE NEWS “The extra money each month means no longer having to livehand-to-mouth and no longer being forced to choose between having a roofover my head and food in my stomach,” says Janella Fleming, who was injuredat work in 1986.

“We have members who have losttheir homes, cars and families.”

— Dorothy Leslie

since before 1998 areegin receiving this spring

On LTD

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6 B C N U U P D AT E

since the early-eighties, is forced to liveon just $1,175 before taxes. “Out of thatI have to pay $160 each month for med-ical and dental coverage. There is nocost of living allowance.”

Understandably, the LTD nursesfeel abandoned by HEABC and theprovincial government, which haveboth refused to extend the SMB or provide the LTD claimants with a live-able inflation-indexed income – unlikenurses who went on LTD after 1998.

“Their refusal to act on this says to me that they have no respect fornurses and the nursing profession,”says Fleming.

Sally Kimpson is also angry that thegovernment and her employer haveignored her since rheumatoid arthritisended her nursing career in 1982. “Ilost my home to the bank in the first

Current ProposedDate of LTD benefits Current SMB Current total LTD benefits New SMB New totalinjury (gross) per month per month (gross) per month per month

1982 $1,464 $270 $1,734 $1,464 $1,080 $2,544

1990 $2,026 $145 $2,171 $2,026 $580 $2,606

1992 $2,438 $71 $2,509 $2,438 $284 $2,722

1997 $3,041 $29 $3,070 $3,041 $116 $3,157

Average $2,173 $75 $2,248 $2,1731 $300 $2,473

* The above are selected examples of LTD nurses injured in various years prior to 1998. The figures on the left hand side ofthe table show what these nurses have been receiving as a result of the existing SMB arrangement, which is due to expireon April 1, 2005. The figures on the right hand side are projections of what these nurses would receive under the “new”SMB arrangement. The projected figures are approximations as the actual amounts of the new SMB might be affected byoffsets such as the indexing of CPP or the levels of other incomes, like those from rehabilitation.

Current and proposed LTD Supplementary Monthly Benefits*

five years I was on long term disability,”she says, adding that her financial situ-ation went downhill from there.

“I was never eligible for the SMBpayments that began in 1999 becauseI’m part of an approved rehab plan,”she explains.

Kimpson says the new SMB pay-ments “are going to make a substantialdifference for me, and I’m utterly grate-ful to the union and the members. Theadditional money will be a great help. Imight be able to begin saving a littlemoney for my retirement.”

Kimpson is still worried about thefuture, because the new SMB is only atwo-year deal. “We continue to face anunstable future and remain very, veryconcerned about what will happenwhen this comes up at the bargainingtable next year.

“But,” she adds, “I really appreciatewhat BCNU members have done to tryto help improve our lives.” �

| LONG TERM DISABILITY |

TOUGH CHOICES Many LTD recipientssay they are often forced to choosebetween buying costly prescriptiondrugs and eating properly.

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F E B R U A R Y / M A R C H 2 0 0 5 7

Manulife will be paid directly by BCNU. Unfortunately, funding for this

improvement was not possible withinthe provincial government’s mandate ofa zero, zero increase in total compensa-tion during Bargaining 2004. BCNUand the Nurses’ Bargaining Associationagreed to the zero and zero mandate inorder to achieve an agreement from thegovernment of no rollbacks in nurses’hourly wage rates, benefits and hours ofwork.

No savings could be identified with-in the provincial collective agreementthat would have been feasible or accept-able to fund the LTD improvement.

So BCNU agreed to self-fund theSMB for 2005-07 at a cost of about $2.2million. BCNU Council is recommend-ing to Convention that the funds betaken from our Defense Fund. An alter-native that delegates may considerwould be a levy for each member ofabout three to five cents an hour.

Eligible nurses will be required tosign a waiver to release their personalinformation to the union for purposesof calculating the benefit. TheHealthcare Benefit Trust will adminis-ter the new SMB on behalf of BCNU.

For the next round of provincial bar-gaining the provincial government hasdeclared it will provide money for com-pensation increases. BCNU will be ableto propose that the SMB become part ofan overall nurses’ compensation pack-age, funded by the government. �

Delegates to BCNU Convention2005 will decide how to fund thesignificant improvement in

Long Term Disability benefits achievedfor nurses who are in the greatest need.

That’s the group of about 400 nurs-es who went off on LTD before 1998. Asa result of the 1998 round of provincialbargaining, these nurses began receiv-ing a Supplementary Monthly Benefit.The SMB was developed to assist nurs-es ineligible for the improvements inLTD benefits that were negotiated in1998. That year LTD benefits wereincreased to 70 per cent of a nurse’swages at the time of dis-ability (up from 66.6 percent) and the benefitswere indexed to futureincreases in BC nurses’wages.

To assist the pre-1998group, who were receiv-ing LTD benefits basedon 66.6 per cent of theirwage levels from as far back as 1980,the SMB paid them 25 per cent of thedifference between their last wage ratebefore disability and the 1999 wagerate.

The SMB has had to be re-negotiat-ed with every provincial contract. It wasscheduled to expire on March 31, 2005.Without a renewal at the bargainingtable in 2004, the pre-1998 LTD nurseswould have gone back to receiving only66.6 of their pre-disability wage rate.

For the 2004 round, delegates to theProvincial Bargaining Conferenceheard from the pre-1998 LTD nursesand committed to not only renewingthe SMB but to improving it at the bar-gaining table.

The result is a new SupplementaryMonthly Benefit that will improve theireconomic status and make an impor-tant difference in the lives of thesenurses (see table at left for rough esti-mates of what the LTD membersshould receive).

The improved SMB will be calculat-ed based on 100 per cent of the differ-

ence between what the nurse earnedwhen she went off on LTD and the 1999wage rate (instead of 25 per cent).

And, unlike the former SMB, thenew supplementary benefit will be paidto all nurses receiving LTD through theHealthcare Benefit Trust, includingthose who are eligible for early retire-ment and those who earn rehabilitationincome.

BCNU members on LTD who arecovered by other plans such as

BCNU members have stepped in to help LTD nursesin the greatest need after they were abandoned byour employer and the provincial government

BCNU Council is recommendingto Convention delegates that

the money for the new SMB betaken from our Defense Fund.

A helping hand

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8 B C N U U P D AT E

O ccupational Health and Safetyissues have always played animportant role in BCNU work-

site campaigns. For example, improv-ing nurses’ health and safety was amajor reason ER nurses at NanaimoRegional General Hospital campaignedlong and hard to convince their employ-er to hire additional registered nursesfor their understaffed and overcrowdedemergency room. Their ongoing cam-paign recently led to NRGH announc-ing it would add eight full-time ERnursing positions.

Now BCNU wants to make OH&Sissues an even higher priority by usingthe proven power of member-drivencampaigns to make our workplacessafer for nurses and our patients.

WHAT BCNU IS DOINGTo better understand how nurses feelabout a wide range of OH&S issues,BCNU conducted extensive polling ofthe membership in late-2004.

The concerns our membersexpressed to the pollsters (see page 20)are now being reflected in the union’swork.

Last fall, BCNU held a two-dayOH&S conference, attended by 150members and students from all regionsof the province (see page 16).

Then, late last year, BCNU Councilapproved a budget that includes fundsto launch 16 campaigns around theprovince on OH&S issues. The cam-paigns will focus on preventing muscu-loskeletal injuries.

In an attempt to reduce injuries,BCNU is also working to convert over-time and casual hours to regular posi-tions through the nursing policy dis-

Safety FIRST

cussion process with government andhealth authority officials. BCNU is alsosupporting members who want toorganize worksite campaigns and usethe Professional Responsibility Formprocess to address workload and safetyconcerns, such as protecting nursesfrom violent prisoners.

BCNU OH&S STEWARDSEven before those new campaigns getoff the ground, OH&S stewards repre-senting nurses at acute care facilities,in the community and in long termcare homes are working hard to keeptheir members safe. They’re filinggrievances, using the ProfessionalResponsibility Form process, speakingout to the media, lobbying politiciansand talking to their employers. They’re

BCNU stewards across the province are workingto protect the health and safety of nurses

STOPPING VIOLENCE Victoria GeneralHospital steward Irma Verde is cam-paigning to protect nurses from vio-lent prisoners.

| CAMPAIGNING FOR CHANGE |

Here’s how to use ProfessionalResponsibility Forms to highlightOH&S issues

“PRFs provide nurses with an opportuni-ty to document their patient safety andworkload concerns,” says BCNU presi-dent Debra McPherson. “They’ve provento be a highly-effective tool in our fightto deliver improved working conditionsfor nurses and patients.”

The PRF process is part of theProvincial Collective Agreement. Article59 includes a detailed list of the stepsmembers should follow when they haveworkload, safety or nursing practice con-cerns. If you’re having trouble filling outthe form, ask a BCNU steward for help.

After completing a PRF forwardcopies to your unit manager, the chair ofyour facility’s PRF committee and thehead of nursing. Also, to ensure yourPRF isn’t misplaced by management, givea copy to your BCNU steward.

Our collective agreement states thePRF committee must hold a meetingwithin 14 days of receiving your PRF. Thejoint union-management PRF committee(there should be one in every facility)meets with you, your steward, managerand the unit’s excluded supervisor.

If the matter isn’t resolved withinseven days of the committee’s meeting,you should submit your concerns in writ-ing to your steward, administrator andhead of nursing. After meeting with you,management has seven days to respond.

If your concern is still not resolvedyou can make a written submission tothe members of your health authorityboard. The board must review your sub-mission at their next regularly-scheduledboard meeting and respond to you with-in 14 days. If you are not happy with theboard’s response, you can then make averbal presentation to the board.

TAKINGACTION

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F E B R U A R Y / M A R C H 2 0 0 5 9

also representing their co-workers onjoint OH&S committees and at healthauthority board meetings.

Like their counterparts around theprovince, stewards in BCNU’s NorthEast and South Islands regions havebeen keeping nurses safe by working ona wide variety of health and safetyissues.

For example, North East regionalOH&S chair Rosemary Gutteridge isworking on several projects, includingthe development of a MSI program;N95 respirator fit testing; the creation of

a WCB Safe Patient Handling initiativeat GR Baker in Quesnel; and the launchof “respect in the workplace” and “pre-vention of violence” training programs.

Gutteridge, who works on the rehabward at Prince George RegionalHospital, says OH&S issues are moreimportant for nurses now than everbefore. “With the aging population, weneed to protect all nurses.”

Gutteridge says the North Eastneeds more OH&S stewards and thatany member interested in becomingone can take advantage of a wide rangeof BCNU-sponsored educational oppor-tunities.

She’s pleased that BCNU is focusingmore attention on health and safetyissues. “It’s a really positive step. In theNorth East we plan to start incorporat-ing those issues into our regional meet-ings, starting with bringing a WCB offi-cer to discuss the safe handling of cyto-toxic drugs which is an issue at somesmaller facilities.”

At Victoria General Hospital,OH&S steward Margo Wilton has beenrepresenting nurses on the healthauthority’s Blood and Body Fluid JointSteering Committee. The BBF com-mittee has been examining ways ofreducing the number of injuriescaused by exposure to needlesticks andsharps (see page 23).

In 2004, it conducted a survey thatincluded 1037 staff and managementmembers at Vic General, Royal Jubilee,Saanich Peninsula, Port Hardy andPort McNeill hospitals (see sidebar on

next page). The BBF survey was

a joint effort betweenBCNU, HEU, HSA, BC’sOccupational Health andSafety Agency for Health-care and the VancouverIsland Health Authority.

Wilton, who has been an OH&Ssteward for five years, says VIHA isalready moving ahead with plans toreduce injuries. For instance, IVcatheters are now being used in mostVIHA facilities and specimens are usu-ally being collected in plastic instead ofglass vials. BBF exposure incidents arealso being tracked.

Wilton says VIHA has also commit-ted $350,000 annually for three yearsto purchase safety engineered productsand that “we expect the roll-out of safe-ty engineered needles and syringes to commence inthe very nearfuture.”

The busyOH&S stew-ard says that

another of her main projects continuesto be ensuring that all Vic General nurs-es are fit-tested for N95 masks. “Theyneed to be fitted and then retestedannually,” she says.

“Management has tried very hard toget masks for areas they determine to behigh risk. But we’re a long way fromhaving everyone fitted. And that is scary,because if we ever have an incident likeSARS again, we’re really not ready. Wemay have to launch a campaign to getthe protection nurses need.”

Carol Malmgren, another VicGeneral OH&S steward, has been keptbusy trying to get asbestos removedfrom the hospital’s flooring tiles. “Thetiles were starting to bubble and breakup at the nursing stations,” she says. “Igot involved and told maintenance thatit was an accident waiting to happen.But I didn’t realize we had an asbestosproblem until several months later.”

Malmgren says nurses were veryconcerned to learn about the asbestos-backed tiles and that she encouragedthem to fill out exposure forms, so “ifthey have any related health problems,they have the documentation to provethey were exposed to asbestos.”

Malmgren raised the nurses’ con-cerns to the joint OH&S committee,plant services, WCB and management.“WCB came in to investigate the problem,” she says, “and ended up

writing up ordersthat afternoon.”

There are still afew areas in thehospital which have

PROTECTING NURSES Victoria GeneralHospital BCNU OH&S stewards (from

left) Margo Wilton and Carol Malmgren.

“It is the right of nurses to be,and to feel, safe while caring for

any patient.” — Irma Verde

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10 B C N U U P D AT E

| CAMPAIGNING FOR CHANGE |

not had the tiles changed, she says,“but the nursing stations are all doneand I’m continuing to monitor the situ-ation. Eventually everything will bereplaced.”

Irma Verde, another dedicated VicGeneral steward, has spent the pastyear attempting to ensure that nursesare warned about the potential threat ofviolence they face when caring for pris-oners at the hospital. She becameinvolved in the issue last February,when nurses on 7B filed a PRF becausea prisoner was left unattended after hissentence ended at midnight.

“When the nurses came on nightshift,” she explains, “they learned thecorrections officer was leaving at mid-night. He said he couldn’t tell them ifthe inmate, who had been under con-stant guard at the hospital for a week,had a history of violence. What the cor-rectional officer did say to them was‘You should be alright.’”

The nurses weren’t satisfied withthat answer and called their patientcare coordinator and security for help.They also asked a doctor to issue ordersthat the patient required 1:1 security.

But, says Verde, they were told by man-agement the situation didn’t warrantadditional security.

“The nurses were extremely upset,”says Verde, “and rightfully so. Theirconcerns weren’t being taken seriouslyand they were left in the dark.”

The nurses’ PRF led to a manage-ment investigation and recommenda-tions that included the call to “workwith correctional facilities to develop arisk assessment (on patient chart) andthe associated policy/procedure to com-municate potential for violence/safetyrisks for prisoners when in hospital.”

After several months, with no riskassessment in place, Verde began work-ing with management and correctionsofficials to come up with a plan that willnot only protect a prisoner’s privacy,but also alert nurses to any potentialsafety risks.

“Everyone seems concerned aboutprivacy,” says a frustrated Verde, whohas worked at Vic General for 20 years.“But what about the security of nurses?We shouldn’t have to walk blindly into apotentially violent situation.”

“It is the right of nurses to be, and

to feel, safe while caring for anypatient,” Verde wrote in a letter to theregional director of provincial correc-tions last year. “Nurses are trained notto make assumptions but to makeassessments. To do this we needknowledge.”

Verde eventually learned that corrections officers, police officers,security guards and others already havea system that alerts them to aninmate’s risk factors, called VISEN MD(violence, infection, suicide, escaperisk, normal, mental disorder and drugdependency). “It’s a code they use toprotect themselves and provide thenecessary level of security,” says Verde.“This info is exactly what nurses need.”

She remains hopeful that an infor-mation-sharing agreement to commu-nicate VISEN MD code and other infor-mation about prisoners to Vic Generalsecurity officers will soon be in place.“Once that is implemented,” she says,“nurses here and around the healthauthority will be included in the sys-tem. After that, I believe the systemshould go province-wide to protect allnurses who care for inmates.” �

• Survey participants experi-enced a total of 1070 BBFexposures

• 1037 participants

• Of those exposures onlyabout 148 (14 per cent) wereformally reported

• Respondents reported experi-encing 1937 near-misses in themonth prior to surveying; if

Highlights of Vancouver Island

Health Authority’s Blood & Body

Fluid Exposure Surveywe divide this value by thetotal number of respondents,each person experiencedapproximately two near-misses in that month

• Devices most often associatedwith exposure are injectiondevices, glass vials and hol-low-bore needles

• Procedures most often associ-ated with exposure are giving

injections, suturing, cuttingand connecting intravenouslines

• Nurses and nursing studentsare at highest risk followed bylaboratory technicians.

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F E B R U A R Y / M A R C H 2 0 0 5 11

N urses are deeply concernedabout the provincial govern-ment’s drive to contract out

cleaning services to the lowest bidder,because it is hurting them and theirpatients.

An investigation into staff concernsabout deteriorating cleaning standardsat St. Paul’s Hospital in Vancouver lastyear paints a disturbing picture of dirtyconditions and the consequences thatcome with overworked, poorly-trainedworkers who no longer have a directworking relationship with hospital staffor the infection control department.

The concerns of the St. Paul’s staffabout privatized cleaning issues deliv-ered by the US-based multinationalAramark are highlighted in FallingStandards, Rising Risks, a researchreport jointly produced by BCNU, theHospital Employees’ Union and theHealth Sciences Association.

Hospital staff reported observingold feces on curtains for several days;bedsides and bedside tables sticky withjuice, again for days; no cleaning ofmonitor cables or IV poles; and inade-quate cleaning in TB rooms.

“The conditions reported by nursesand other frontline staff at St. Paul’s arealarming,” BCNU president DebraMcPherson told the media when thereport was released late last year. “We’rehearing these same concerns fromnurses around BC, and we’ve seen whatcan happen to patients as a result. It’stime for government and the healthauthorities to take these concerns veryseriously.”

Similar fears have been raised bynurses and other hospital staff aroundthe province, including at SurreyMemorial, Nanaimo Regional, EagleRidge and Burnaby General.

“There aren’t enough cleaners to dothe job properly,” says Simon Fraser co-chair and Burnaby Hospital nurseMelanie Leckovic. “The numbers mightbe appropriate for a hotel, where aroom is cleaned once a day, but whenyou’re dealing with a patient with diar-rhea or if someone is hemorrhaging,you might have to call for a cleanernumerous times in a shift and theycan’t cope. This means extra work fornurses and that takes us away from our patients.”

A recent report into an infectionoutbreak at Surrey Memorial last yearreveals an almost complete breakdownof infection control procedures as aresult of the restructuring forced on theFraser Health Authority by the provin-cial government.

The Campbell Liberals pushed thatagenda despite a mountain of evidencefrom around the world showing therisks. It has been reported that inBritain nine out of the 10 dirtiest hos-

A Dirty StoryContracting out of cleaning services places nurses and their patients at risk

pitals have contracted-out cleaningservices. And, after years of problems,the country’s health secretary recentlyannounced that “cut price” cleaning byprivate contractors will end as part of aseries of measures aimed at improvingcleanliness and reducing rates ofMRSA. “Cheapness,” he says, “cannever be a substitute for cleanliness.”

The UK’s Guardian newspaperrecently reported that “there is growingconcern about how a drop in hygienestandards has contributed to the rise ofMRSA, which was contracted by100,000 people last year in hospitalsand is the cause of about 5,000 deaths ayear.”

But here in BC our provincial gov-ernment continues to ignore the facts.That’s why BCNU and HEU aredemanding BC’s Auditor General carryout a thorough audit of housekeepingservices at St. Paul’s and other VCHAhospitals, as well as in VIHA, the IHAand FHA. �

Worker and patient safety• contamination from dirty sinks

or instruments

• contamination of floors and bedsides

• increased hospital stay from noso-comial infection

• increased risk of colonization of MRSA and VRSA

• potential for falls from uncleaned spills.

What to do about your concerns?

• contact the “call centre” to reporthousekeeping concerns

• notify your manager

• fill out a PRF and incident report

• tell your steward that you filled outa PRF

• if you have immediate safety con-cerns contact a steward and WCB

• leave a message on the BCNU hot-line (1-800-894-3311).

Here’s how privatized cleaning services hurt you and your patients

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12 B C N U U P D AT E

Statistics on violenceagainst nursesIt’s impossible to get accurate figures onthe current level of on-the-job violencenurses experience. In fact, the InternationalNursing Association estimates less than halfof on-the-job violence is reported.

But BC’s Workers’ Compensation Boardstatistics reveal just how big the reportedproblem is. Between 1998 and 2002 anaverage of 112 nurses a year were injureddue to violence in our province. In 2002,8300 days of employment were lost bynurses due to violence.

The board also states that violence is“the second most common reason for anurse to lose time from work” and thatnurses suffer approximately 10 times asmany claims for violence-related injuries asthe general workforce.

WCB statistics also reveal that nursesand other health care workers experiencemore violence than any other occupation,including police and jail guards.

Violence PreventionThe Violence in the Workplace sections ofthe WCB OH&S Regulation require theemployer to have written procedures andpolicies for violence protection.

They are also required to conduct riskassessments in any workplace where theremay be a risk of violence, to instruct work-ers, carry out investigations of violent inci-dents and provide information to and con-sult with the joint OH&S committee.

If a hospital’s OH&S steward is unawareof the existence of an official ViolencePrevention Program, as is the case in far too many worksites around BC, thenthe employer is likely in violation of theregulation.

Part of the problem is that the WCBhas been unable to adequately enforce theregulation that is currently in place.

The board may be taking steps forproper enforcement in some worksitesaround the province.

For example, on January 30, 2005, theywrote six orders against Kelowna GeneralHospital and the Interior Health Authorityfor failing to properly investigate, assess,control, have procedures and provide infor-mation to the joint OH&S committee onviolent incidents in the emergency and psy-chiatric units.

RNs have had enough of beingon the receiving end of violent attacks.That’s why nurses across BC are stand-ing up and speaking out to ensure thatthey and their co-workers are no longerput at risk while caring for theirpatients.

For example, Nanaimo RegionalGeneral Hospital OH&S steward TerriWilmer refused to remain silent aftera recent violent incident erupted atthe Vancouver Island facility whereshe has worked since 1976.

The incident is currently beforethe courts, but Update can reportthat a hospital visitor allegedlymade repeated weapons-relatedthreats to a NRGH staff member.She immediately told the chargenurse, who then contacted theRCMP. The person who purportedlymade the threats was eventually arrest-ed following a high speed car chase.

But the next day the individual wasreleased from jail and allowed toreturn, unsupervised, to NRGH. “Wewere shocked to learn this person wasreturning to the hospital after reported-ly making violent threats the daybefore,” says Wilmer. “All staff werevery upset by this incident and many ofthe nurses felt that it would be unsafeor even life-threatening to work.”

Wilmer says the facility’s lack of aformal Violence Prevention Program,as mandated by the WCB (see sidebarat left), heightened the feeling of fearand confusion amongst hospital staff.“There is a draft of a ViolenceProtection Program for VIHA, but it iscurrently unavailable to staff as it is yetto be formalized.”

The OH&S steward adds that afterthe incident management promised

to do “everything possible” to pro-tect hospital staff

by providing extrasecurity.

“We felt that the least they could dowas to supply around-the-clock securityon the ward.”

Instead, she adds, “there was noRCMP officer assigned to the floor andthere was no warning informationabout the person posted around thehospital or even on the unit where theincident occurred – not even a photofor staff to know who to watch for.”There was also no immediate debrief-ing, as mandated by the board (a ses-sion wasn’t held until one week later).

On the evening of the person’srelease from prison, Wilmer was aloneat the nursing station when the indi-vidual walked onto her unit. At thatmoment there was no security present,as promised, and no manager on-site.

BCNU members are standing up and speakingout to stop violence against nurses

Silent No More

| CAMPAIGNING FOR CHANGE |

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F E B R U A R Y / M A R C H 2 0 0 5 13

“I was frightened,” says Wilmer, “andwondered if I should hide, call out orrun.” Security was contacted andarrived on the unit quickly. But it was“an unnerving experience for all of thestaff.”

Fortunately, nothing happened toWilmer and her co-workers thatevening. But she remains disappointedwith management’s response to thenurses’ demand for information andprotection.

“I was told if there was an after-hours violence problem to contact theon-call manager in Duncan, becausethere is no manager on-site to answer

calls after five pm. There reallyshould be someone here in Nanaimoto deal with problems like this. Weare nurses and should be caring forour patients not running around deal-ing with violence concerns.”

In an effort to protect her co-work-ers, Wilmer contacted WCB, whicharranged for an immediate meetingbetween staff and management. Shortlyafterwards the board issued a directiveto NRGH to complete a risk assessmenton violence. NRGH management haspromised to complete it “as soon as pos-sible” and will “report our progress tothe WCB on April 30, 2005.”

More meetings are planned andWilmer remains hopeful that a ViolencePrevention Program will be imple-mented at the Nanaimo facility.

“If it wasn’t for Terri acting in thebest interests of her co-workers andpatients and calling in WCB,” saysBCNU Pacific Rim chair RhonL’Heureux, “I believe nothing wouldhave happened. The situation wouldhave been ignored.”

Unfortunately for BCNU members,threats of violence like the one recentlyfaced by the Nanaimo nurses areoccurring at a frightening rate in ourovercrowded ERs and understaffedsurgical units, as well as in long termcare facilities and in the community. Soare other physical forms of violence –everything from stabbing, punching

and kicking to choking, clawing andbiting.

“It’s time to end this senseless vio-lence,” says L’Heureux, “by having thegovernment and the health authoritiesmake this issue a top priority. Weurgently require all levels of manage-ment, particularly the health authorityboards, to implement some firm poli-cies and guidelines to deal with vio-lence in the workplace.”

“We need more than lip service todeal with this issue,” agrees BCNUexecutive councillor and provincialOH&S chair Len Rose. “In the US,many employers have policies thatcharge the person responsible for theviolent incident on behalf of theassaulted employee. We need a similarsystem in BC.

“We also need a province-wide sys-tem of identifying people with a histo-ry of violence, so nurses can be alertedwhen they enter the system.”

Wilmer says more joint OH&Smeetings are planned at NRGH to dealwith violence issues and she remainshopeful that a violence prevention pro-gram will be implemented at theNanaimo facility.

“I look forward to working withother BCNU members and manage-ment to quickly implement a Violence

Prevention Program – before anotherincident occurs. I’ve learned as anOH&S steward that nurses must alwaysremain proactive when it comes tohealth and safety issues.”

Implementing a WCB-mandatedViolence Prevention Program is a goodplace to start addressing the problem.So is putting into practice the WCB’sPreventing Violence in Health Care:Five steps to an effective program (seesidebar below).

It’s designed to “help health careorganizations to develop, implement,and maintain effective workplace vio-lence prevention programs or toimprove existing programs.”

“It is also critical for nurses involvedin violent incidents,” says Rose, “to fillout an incident report and contact theirworkplace steward – even if they’re notinjured – so the episode is entered intothe system and becomes something theemployer must deal with. Nurses alsoneed to charge anyone who is violent orassaults them.

“BCNU OH&S stewards should alsobe actively involved in investigating violent incidents.

“Their investigation can help toidentify the root causes of violence andpropose plans for implementing pre-ventative measures.” �

Establishing a working groupand enlisting support.

Conducting a risk assessment:• gathering information• obtaining input from staff• inspecting the workplace• analyzing all of this

information• recording and communi-

cating results.

1

2

3

4

5

Five steps to preventing violence

Developing and implementingcontrol measures:• looking at options• making decisions• implementing control

measures.

Providing education and training.

Conducting an annual reviewto prevent violence.

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14 B C N U U P D AT E

| KNOW YOUR RIGHTS |

In the current reality of BC’s healthcare system, where an aging work-force tries to cope with crushing

workloads, malfunctioning or non-exis-tent equipment and an increasingnumber of patients with dementias,nurses’ health and safety is underthreat.

Although OH&S stewards and theBC Occupational Health and SafetyAgency for Healthcare are workinghard to address this, the reality is thatmany nurses sustain injuries or devel-op illness and are unable to resume thefull demands of their jobs, either for aperiod of time, or indefinitely.

That’s where Duty to Accommodatecan be implemented so that nurses cancontinue to carry out meaningful workin their chosen occupation.

WHAT IS DUTY TO ACCOMMODATE?Employers and unions in Canada arerequired to make every reasonableeffort, short of undue hardship, toaccommodate an employee who comesunder a protected ground of discrimi-nation within human rights legislation.

For BCNU members, the right toseek accommodation comes from theHuman Rights Code of BritishColumbia as well as from our collectiveagreements, which subscribe to theprinciples of the BC Human RightsCode.

Although this description looksstraightforward on paper, terms suchas “reasonable” and “undue hardship”have meant that many arbitrations andcourt cases have taken place over theyears to try and clarify the limits toaccommodation.

There are a number of types of dis-crimination, such as religious convic-tions, that could initiate an accommo-dation, but the focus in this article will

be on accommodations as a result of adisability.

Disability has been defined as “anillness, injury or disfigurement thatcreates a physical or mental impair-ment and thereby interferes with a per-son’s physical, psychological and orsocial functioning.” Entrop v. ImperialOil Ltd (No. 6)

A more specific definition foraccommodation then is “a process tofind ways to ensure that an individual’sdisability does not limit their participa-tion in the workplace more than is rea-sonably necessary.”

JOINT RESPONSIBILITIESCarrying out a Duty to Accommodateinvolves many players. Labour lawyerMarjorie Brown explains: “returningdisabled employees to work is a three-way street, involving the union, theindividual and the employer. However,it is the employer’s duty to accommo-date, which the union must facilitateand which the individual must cooper-ate with.”

“The obligation to identify jobs theemployee can do and examine modifi-cations of tasks for the employee restswith the employer.”

This was re-iterated in a September2004 consent award from arbitratorJoan Gordon, who stated: “The employ-er has the primary obligation; theunion and the employee have an obli-gation to participate in the search and,where a solution is identified, to acceptreasonable accommodation.” Gordon,September 10, 2004 BCNU andVancouver General Hospital

The following month, the CanadianIndustrial Relations Board determinedthat in matters of accommodation, aunion is expected to “go beyond its‘usual’ procedures” and apply “an extra

A HUMAN RIGHTS ISSUE

Duty to accomBILL C-45: MAKING EMPLOYERS ACCOUNTABLEIt has always been extremely difficult toconvict individuals and corporations ofcriminal negligence arising from work-related health and safety issues.

But Bill C-45, which became lawacross Canada last year, now holdsorganizations and their employeesaccountable for serious injuries ordeaths.

If, for example, a registered nursesuffers a serious back injury in a workarea that has been documented asbeing poorly designed, and managersdismissed the legitimate concerns aboutthe design, the managers could be heldcriminally accountable for not makingthe necessary repairs.

Bill C-45 was prompted in part bythe recommendations of the publicinquiry into the 1992 Westray coal minedisaster in Nova Scotia that killed 26workers. A subsequent inquiry foundmanagers were more concerned aboutprofits than worker safety. But no onefrom Westray’s management team wasever convicted of criminal negligence inthe tragedy because they could not beheld accountable under the CanadianCriminal Code.

Today, the new law allows for eachlevel of an organization to be heldaccountable for its actions, or lack ofactions. It provides judges with the abili-ty to fine organizations up to $100,000;or sentence a convicted employer up to10 years in prison for an injury causedby criminal negligence and up to lifeimprisonment in cases involving death.

CORRECTIONThe December issue of Update includedan article on the proposal by theProvincial Health Services Authority tocontract out surgeries at Children’sHospital to private clinics. The storyincorrectly stated that the PHSA hadalready contracted out the surgeries. In fact, PHSA management had onlyissued a Request For Proposals andeventually decided (after Updatewent to press) not to proceed with the scheme.

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F E B R U A R Y / M A R C H 2 0 0 5 15

“Unions have proven flexible inworking with employers in accommo-dating disabled employees, includingwaiving certain collective agreementprovisions, such as posting require-ments. And unions have been sensitiveto employee morale issues and recog-nize the detrimental effect, for exam-ple, of having a nurse on a unit onlyadministering medication while theother nurses performed a full range ofnursing work might have.”

She adds: “arbitrators have tendedto focus on whether anaccommodation results inprohibitive financial costor results in employing adisabled employee in anon-productive capacity.

“It will be an unduehardship if a proposedaccommodation is so

expensive as to threaten the economicviability of the business or place severeconstraints on operations.”

“It will also be an undue hardship ifa proposed accommodation results inthe employer creating a position that isnon-productive or of little use to theemployer.”

WELL-DEFINED PROCESS CRITICAL TO SUCCESSAlthough every accommodation variesbecause of an individual’s circum-stances, labour relations officers andstewards involved all emphasize theneed for developing a well-definedprocess.

But this is not always as easy as itshould be. In fact, it took the above-mentioned consent award to settle agrievance on the issue at VancouverGeneral Hospital.

The award sets out the duty toaccommodate obligations, calls for

employer-provided education programsfor management and OH&S stewards,and defines a Duty to Accommodateprogram to be implemented.

Key elements of a Duty toAccommodate process include:

• the provision of clear and unequivo-cal medical evidence of the disability,which sets out an employee’s function-al limitations and modifications neces-sary to address the limitations

• clarity on the privacy rights ofemployees and the proper manage-ment of medical information

• evaluation of the suitability of thenurse’s own job and whether it can bemodified if necessary

• evaluation of the physical environ-ment to determine if changes can bemade for the accommodation

• access to vacancies in order to evalu-ate their suitability for an accommoda-tion

• providing training if it will supportaccess to an appropriate position

• considering the reorganization ofwork functions to create a position thatcan be performed

• alteration of work schedules, includ-ing provisions for time off for medicaltreatment.

THE UNION’S HELP IS CRUCIALIf you are injured or develop an illnessthat threatens your ability to return towork, contact a BCNU OH&S stewardas soon as you are able. If you can’treach a steward, call the BCNU officeand ask for assistance. Given the com-plex nature of accommodations, theearlier the union can begin advocatingon your behalf, the smoother theprocess should go. �

measure of care in representing theemployee.” Pineau, October 12, 2004CIRB Decision no 291

But that’s something BCNU OH&Sstewards have been doing for a longtime. In 1999, then OH&S stewardCarol Duffus commented, “It takestime, and like a marriage agreement, itneeds the commitment of all partiesinvolved, lots of understanding andmuch patience”

This understanding and patienceextends to colleagues at the workplace

who will be working with the nursebeing accommodated. Because unlessthe process is fully understood, resent-ment may occur if, for example, theaccommodated nurse is unable to worknight shift.

Impacts such as these are evaluatedunder the heading of undue hardship.Marjorie Brown says “there is no setlegal test to determine what constitutesundue hardship, but the factors whichhave been listed by the Supreme Courtof Canada include impact on the collec-tive agreement, safety, financial cost,employee morale, interchangeability ofthe workforce and facility and the sizeof the employer’s operations.

“As the accommodation jurispru-dence has developed, the financial andoperational implications of accommo-dation have taken greater precedenceover concerns such as employee moraleand impact on the collective agree-ment,” she states.

mmodate

“It takes time, and like a marriage

agreement, it needs the commitment

of all parties involved.” — Carol Duffus

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ductory speech from BCNU presi-dent Debra McPherson, followedby a panel of OH&S activists whoeach described some of the healthand safety campaigns they havehelped to organize.

Verna Leger, a health and safetyactivist with almost 50 years ofexperience in the field, discussedthe history of workers’ safety in BCand around the globe. She said oneof the lessons she has learned overthe years is that “you just have tokeep up the fight for workplacehealth and safety.”

Even when we have a victory,she says, employees will try to turnit into a defeat.

St. Paul’s Hospital RN andVancouver Metro chair FrankGillespie described how the con-cerns of ER nurses over the con-tracting out of cleaning services atthe large Vancouver facility helpedlaunch an investigation into hospitalcleanliness.

“Staff were very concerned aboutthe profound changes going on in theirworkplace as a result of the contractingout of cleaning services to Aramark, amultinational based in the US.

“They wanted to examine how thosechanges were affecting patients andstaff.

“The report, Falling Standards,Rising Risks, demonstrates just howbad the situation has become.” (Youcan view the study by following thelinks at www.bcnu.org.)

“We found it wasn’t just dirty, it wasfilthy and unsafe for our patients andstaff.”

Rosita Escobar, from Guatemala’sAssociation of Women in Solidarity,spoke on the life-threatening health

“Our health is not for sale,”McMaster University labour studiesprofessor Robert Storey told delegatesto BCNU’s Occupational Health andSafety Conference last November. “Ourarms are not for sale. Our lungs are notfor sale.

“What makes employers think theycan poison me and get away with it andthen compensate me later after I’vebeen made sick?”

Storey paraphrased those fierywords from a veteran Ontario OH&Sactivist. But he could have been talkingabout the health and safety of nurses inBritish Columbia and the attitudes offar too many of our employers.

During his speech, Storey alsourged the nurses to “mobilize, mobi-lize, mobilize, mobilize,” adding that“OH&S is a passion that gets underyour skin. And you can’t get it out. Usethat passion to bring health and safetyissues back into the workplace and tomake it a core issue for your union.”

Storey was just one of the inspira-tional speakers to address 150 nurses,retired RNs and nursing students fromaround the province at the two-day con-ference. It was organized to help devel-op the BCNU vision on occupationalhealth and safety concerns and pushoccupational health and safety issues tothe top of BCNU’s agenda in 2005.

Conference objectives included tak-ing a critical and creative look at OH&Sissues within BCNU and engaging del-egates in a dialogue on the future of ourunion’s health and safety programs.

Delegates also examined ways toincrease activism, and to add to ourknowledge and understanding of mus-culoskeletal injuries and how they canbe reduced.

The conference began with an intro-

Our Health Is Not For Sale

Delegates to BCNU’s Occupational Health & Safety Conferencehelp chart a new course to attain safer workplaces

16 B C N U U P D AT E

| WORKING SAFELY |

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F E B R U A R Y / M A R C H 2 0 0 5 17

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18 B C N U U P D AT E

figures at your fingertips. But what youdo have to be is good with ideas thatresonate with nurses.” �

and safety issues facing Guatemalangarment workers and the deaths anddisappearances of trade union mem-bers in the Central American nation.Her moving speech pointed the finger of blame for many of Guatemala’s prob-lems at multinationals which jumpfrom country to country in search of the lowest wages, benefits and safetystandards.

Saskatchewan Union of Nursespresident Rosalee Longmoore talkedabout SUN’s recent successful cam-paign to reduce needlestick injuries.SUN joined forces with the ServiceEmployees International Union lastyear to lobby for the mandated use ofretractable needles and other safety-engineered medical devices.

Last October, the Saskatchewan gov-ernment introduced the necessary reg-ulations which will dramatically reducethe number of injuries and deathscaused by blood-borne diseases (seepage 23).

On the second day of the confer-ence, delegates heard from BCNU’sexecutive councillor and provincialOH&S committee chair Len Rose, BCFederation of Labour’s OH&S and envi-ronment director Lynn Bueckert andMae Burrows, executive director of theLabour Environmental Alliance Society.They discussed the topic of linking withothers in our health and safety work.

There was also a panel on muscu-loskeletal injuries that included NinicaHoward, a researcher with WashingtonState’s Safety and Health Assessmentand Research for Prevention program;Chris Back, an ergonomist with the BCOccupational Health and SafetyAgency; and BCNU staff members LaraAcheson and Tuula Sillantaus.

“When we recently polled our mem-bers on what their priorities are onOH&S issues,” BCNU president DebraMcPherson told conference delegates,“83.7 per cent reported being very orsomewhat concerned about MSI issues(see page 20).

“That interest speaks volumes abouthow concerned they are about muscu-

loskeletal injuries. That high awarenessamongst our members about MSI pro-vides us with a big opportunity to con-tinue to organize around the issue.”

BCNU’s 2005 budget reflects mem-bers’ concerns about MSI. It providesfor 16 worksite campaigns focusing onOH&S issues, with an emphasis oncampaigns aimed at preventing muscu-loskeletal injuries.

Throughout the conference, dele-gates frequently broke into small work-shop groups to discuss OH&S issues,generate ideas and develop health andsafety campaigns at their worksitearound the province.

“The upcoming provincial electionprovides nurses with an opportunity topush OH&S issues to the top of thepolitical agenda,” McPherson told dele-gates in her closing remarks. “We mustmake sure that we ask politicians whatthey are doing about the health andsafety of nurses and what they plan todo in the future.

“OH&S activists don’t have to beexperts on all of the issues,” she added.“You don’t need to have all the facts and

| WORKING SAFELY |

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F E B R U A R Y / M A R C H 2 0 0 5 19

It has been almost two yearssince I became chair of BCNU’sOccupational Health and Safety com-mittee. There have been some bigchanges since then, including BCNUCouncil making OH&S one of our toppriorities. That is leading to a resur-gence of interest in OH&S and a re-examination of how we deal with theissues.

In 2004, BCNU sponsored its firstOH&S conference. The two-day eventbrought over 150 stewards, members,retired RNs, young nurses and stu-dents together to discuss OH&S issuesand the ways BCNU should addressthem. We also polled our members onthe issues and where they want us tofocus our time and resources on theirbehalf. And we surveyed our OH&Sstewards and regional OH&S reps as tohow they saw their role in the unionand what they need help with.

We are compiling this informationand booking regional OH&S stewardplanning days in all of our regions in

2005. The idea is to look at the prob-lems each region faces and draft a planto address them at the regional andprovincial levels. This way our stewardswon’t feel they are addressing theseproblems alone. Also, with more peo-ple working on the same issue, weshould have more successes.

I’m also excited about BCNU’s newpartnership with the BC LabourEnvironmental Alliance Society.

BCNU is working with the BCOccupational Health and SafetyAgency for Healthcare (OHSAH) tointroduce consistent policies and pro-cedures to deal with this problem.

We will also be lobbying ourprovincial government to follow thelead of Saskatchewan and Manitobaand mandate the use of retractableneedles and other safety-engineereddevices. This is not only smart for allhealth care workers, but will also takethe danger of dirty needles out of ourparks and towns.

The upcoming years will havetheir health and safety challenges. Butwe are committed to keeping ourmembers safe by continuing toaddress their OH&S concerns. Thelabour movement was originally start-ed to deal with working conditionsand health and safety issues. We needto get back to that style. We will knowwe have reached our goal, when allour members can quote their rights tosafe working conditions as easily asthey can quote their rate of pay. �

LEAS brings together peoplefrom the environmental andlabour movements and helpsthem cooperate on commonissues.

BCNU will be working withLEAS this year to look at ways toremove toxic chemicals andproducts from our workplaces.All health care workers know wework with huge amounts of bio-hazard waste, chemo agents andbiotoxins. We’re just now learn-ing the long-term effects theyhave on our health and thehealth of our families.

There were at least two inves-tigations in BC health care facil-ities in 2004 into what are con-sidered cancer clusters. Theseare worksites with much higher thanaverage rates of cancer. How many oth-ers are there that we do not knowabout?

We will be working with LEAS todraft a workshop – based on the train-

the-trainer model – tolook at how to protect our-selves and find safe alter-natives. The workshopwill also hopefully beexpanded to include waysto make our homes muchsafer and more environ-mentally friendly.

In 2005, BCNU will also focus onviolence in the workplace. Incidents ofassault and abuse are on the increaseagain – which isn’t surprising given thelonger waiting lists and additional com-petition for fewer services. We need toimplement true zero tolerance policiesagainst violence in all of our worksites.Anyone who assaults a health careworker must be charged and prosecut-ed to the full extent of the law.

TOP PRIORITY “BCNU is committed to keep-ing our members safe” says BCNU OH&S committee chair Len Rose.

A note from Len Rose, BCNU’s OH&S committee chair

“We need to implement true zerotolerance policies against violence

in all of our worksites.” — Len Rose

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20 B C N U U P D AT E

| WORKING SAFELY |

B CNU Council hopes to workhard to help members addressthe key OH&S concerns that

they expressed to the union in a recenttelephone poll.

The poll indicated that almost three-quarters of BCNU members have putthe health and safety of their patientsahead of their own health and safetyduring the course of their work as RNsand RPNs.

The poll of 500 BCNU memberswas taken last fall as part of a drive byCouncil to make OH&S one of the toppriorities of the union and integrateOH&S into union activities at all levels.The poll was conducted by the socialresearch firm Mustel Group. Results ofthe polling can be considered accurateby plus or minus 4.5 per cent 19 timesout of 20.

Of the nurses who reported thatthey have put patients’ health and safe-ty ahead of their own, more than halfsaid they do that frequently, includingmore than 20 per cent who say theywork that way very frequently.

According to the poll, by far themost common way nurses are riskingtheir own health and safety is in lifting,mobilizing and catching patients (55per cent).

Almost one-quarter (24.5 per cent)say they’ve put themselves at riskthrough exposure to bodily fluids.Some 22.5 per cent cite lack of staff andexcessive workload.

A major risk factor cited by commu-nity nurses (17 per cent) is going into

private homes without informationabout the social conditions or diseaseconditions they might encounter.

Nurses acknowledged they putthemselves at risk in order to care forpatients even though the vast majority(86 per cent) say their own health and

safety is equally as important as thehealth and safety of their patients.

Nurses were asked to identify themain factors leading them to put thehealth and safety of patients ahead oftheir own. Some 38.2 per cent identi-fied a lack of staff and excessive patientloads, while 31.3 per cent cited the acu-ity of their patients and 21.9 per centcited their understanding of their stan-dards of practice.

When asked to identify their single

Risking our own health

Polling shows nurses frequently jeopardize their own health andsafety to care for patients. Members cite workload, heavy lifting,exposure to bodily fluids and violence as key OH&S concerns

biggest concern regarding their per-sonal level of workplace health andsafety, the most common answer wasmusculoskeletal injuries from liftingpatients or other heavy loads (16.2 percent), followed by exposure to infec-tious diseases (11.3 per cent), excessiveworkload (10 per cent), lack of staff (8.9per cent), physical assaults by patientsor family members (7.1 per cent), con-cern about remaining healthy/beingable to work/protecting myself (7 percent) and stress in the workplace (5.9per cent).

Community and long term carenurses cited physical assaults as theirsingle most common workplace con-cern much more frequently than acutecare nurses.

Acute care nurses reported muscu-loskeletal injuries and exposure toinfectious diseases as their most com-mon concerns. In long term care,excessive workload was listed as theirmost common concern, followedclosely by MSI.

Overall the strongest expressions ofconcern were for excessive workload,MSI and stress, followed by exposureto infectious diseases, needlestickinjuries, physical assaults, verbalassaults, exposure to toxic substancesand work unit design.

Some 44 per cent of nurses say theyhave become ill at some point as aresult of their work, while 59.7 per centsay they have been injured at work.Some 55.7 per cent of members polledsay they have missed time from work

Don't know/ refused

3%

Somewhat infrequently

31.9%

Very infrequently

11.2% Very frequently

21.1%

Somewhat frequently

32.8%

Percentage of nurses who put patients' health and safety ahead of their own

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F E B R U A R Y / M A R C H 2 0 0 5 21

because of an illness or injury at work.A majority of nurses say they know

where to take a health and safety con-cern to get it resolved, say their work-place has an occupational health handsafety committee and that their occupa-tional health and safety nurses areaccessible. But barely 20 per cent of themembership are aware of any BCNUactivity in their workplace on occupa-tional health and safety.

Members were asked “If there is onearea of health and safety that the unionshould put its resources into whatwould that be?”

By far the strongest response wasfor BCNU to address staffinglevels/workload (28.2 per cent), fol-lowed by musculoskeletal/back injuryprevention programs (15.6 per cent),stress/burnout (11.2 per cent), educa-tion/training on OH&S issues (7.8 percent) workplace violence/abuse (7.6 percent) and infection control/preven-tion/needlesticks (6.3 per cent).

Community nurses rated stress/burnout ahead of MSI (15.7 per centcompared to 12.9 per cent) and stressrated higher among long term carenurses as well (12.1 per cent).

This year’s BCNU budget providesfor 16 campaigns on OH&S issues,with a focus on preventing MSI.

Our union is addressing members’workload concerns through the nurs-ing policy discussion process thatdeveloped in last year’s bargainingprocess, including the push for moreregular positions.

BCNU is also supporting memberswho want to help organize worksitecampaigns on workload/staffing con-cerns or want to use ProfessionalResponsibility Forms to improve work-load and staffing. �

going to private homes with no information on surroundings

lack of staff/ workload

exposure to bodily fluids

lifting/mobilizing/ catching patients

lack of staff/ workload

exposure to bodily fluids

lifting/mobilizing/catching patients

17%

22.5%

24.5%

55.9%

Most common ways nurses are putting their own health at risk in order to care for patients

Community nurses

All members

33.7%

20.8%

28.8%stress in workplace

ability to remain healthy at work

physical assaults

lack of staff

excessive workload

infectious diseases

musculoskeletal injuries from lifting patients/other heavy loads 16.2%

11.3%

10%

8.9%

7.1%

7%

5.9%

Single biggest concern regarding their personal level of health and safety in the workplace

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22 B C N U U P D AT E

| WORKING SAFELY |

Colleen O’Connor says theWCB’s right to refuse unsafe work reg-ulation really does protect workers.

She was forced to invoke the regula-tion last November at InvermereDistrict Hospital, where she has caredfor patients since 1991, after experienc-ing a dangerous respiratory reaction fol-lowing exposure to a mixture ofunknown gases.

No one knows for sure what causedO’Connor’s reaction, but most staff atthe eight-bed East Kootenay facility fear

it was a combination of X-ray chemicals,drain cleaners, laboratory chemicalsand backed-up sewer gases.

“We’ve been complaining about thesmell for several years,” says O’Connor.“But in mid-October it was really bad ontwo shifts that I worked. When I cameback for my third shift I could reallytaste it in my throat. I was feelingwheezy and had a burning throat.

“The next day I returned to work andcould smell it as soon as I came in thedoor. The other nurses and doctor alsocomplained. My throat was burning andI couldn’t talk. I eventually went home.We called in WCB, which wrote uporders that were supposed to rectify thesituation.”

Her next shift was a real nightmare.“Within 15 minutes of walking in thedoor I had no voice and my throat wasburning again. I was feeling wheezyand sick. But I was the nurse in charge,so I remained until my supervisorarrived. She told me to leave, but I said‘No. I’m invoking my right to refuse towork and I’m requesting WCB comesin and investigates the problem today.’

“Before going home I was givenRecimic epi to counter my severe respi-ratory problems.”

After invoking herright to refuse unsafework, O’Connor didn’treturn to work for over amonth. Instead, theemployer paid her to workon policy and proceduremanuals at home.

Meanwhile, her co-workers contin-ued to document the problem.Although no one suffered as severe areaction to the odours as O’Connor,many RNs experienced other troublingproblems such as constantly runningnoses that stopped after leaving theworksite, burning throats and sore lips.

O’Connor is now back caring for herpatients. But she has no regrets aboutusing the WCB right to refuse unsafework regulation.

“It worked for me and I would reallyrecommend others do the same whenthe situation warrants it. But just makesure you document the problem faith-fully and follow the regulations (seesidebar) to a tee.” �

The Workers’ Compensation Actprotects nurses and other workersin BC from performing unsafeduties. It also guarantees that nodiscriminatory action be takenagainst workers who comply withthe following procedures includedin the Occupational Health andSafety Regulation:

3.12 (1) Procedure for refusal: A personmust not carry out or cause to be car-ried out any work process or operate orcause to be operated any tool, appli-ance or equipment if that person hasreasonable cause to believe that to doso would create an undue hazard to thehealth and safety of any person.

3.12 (2) A worker who refuses to carryout a work process or operate a tool, appliance or equipment pursuant tosubsection (1) must immediately reportthe circumstances of the unsafe condition to his or her supervisor oremployers.

3.12 (3) A supervisor or employerreceiving a report made under subsec-tion (2) must immediately investigatethe matter. . . .

If the investigation does not resolve thematter Article 3.12 (5) states that “boththe supervisor, or the employer, and theworker must immediately notify a[WCB] officer, who must investigate the matter without undue delay andissue whatever orders are deemed necessary.”

Article 3.13 makes it clear that no discriminatory action can be takenagainst a worker who “acted in compli-ance with section 3.12 or with an ordermade by an officer,” and that “tempo-rary assignment to alternative work atno loss in pay to the worker until thematter in section 3.12 is resolved . . . “

RIGHT to REFUSE

Unsafe WorkRIGHT to REFUSE

Unsafe Work

Invermere RN invokes WCB regulation Right to Refuse Unsafe Workto protect herself and co-workers

“My throat was burning and I

couldn’t talk. I eventually went

home.” — Colleen O’Connor

WORKING SAFE

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F E B R U A R Y / M A R C H 2 0 0 5 23

It’s time for the BC government to follow the lead ofother provinces and mandate the use of retractable needlesand other safety-engineered medical devices.

Last October, Saskatchewan became the first province tointroduce such regulations. The aim of the new rules is todramatically reduce the number of injuries and deathscaused by blood-borne diseases such as HIV-AIDS throughneedlestick injuries and other cuts.

“We commend the provincial government for taking thisprogressive action that will make our professional environ-ments and our communities safer,” Saskatchewan Union ofNurses’ president Rosalee Longmoore said in Vancouverwhile attending BCNU’s November 2004 OH&SConference.

“For the cost of pennies,” she added, “nurses and otherhealth professionals will be protected from preventable andpotentially deadly injuries simply by replacing conventionalneedles.”

SUN joined forces with the Service EmployeesInternational Union last year to lobby for the life-savingchanges. SEIU research reveals that Saskatchewan wasspending over $1.4 million a year on testing and treatingworkers injured by needlesticks, and that “the governmentcan eliminate 90 per cent of those costs” with the new regu-lations. SEIU also states that each needlestick injury cost anaverage of almost $2,000 to test and treat.

Safety-engineered devices include retractable needlesand catheters, plastic vials and self-sheathing scalpels.There are several types of safe needles, which work by eitherretracting the needle with a simple press of a button or witha safety shield which snaps into place after use.

Late last year Manitoba announced it will soon imple-ment regulations similar to Saskatchewan’s. As well, 24American states and the US federal government haveimplemented legislation requiring safety-engineereddevices. The US government reports that in the year afterthe law took affect in 2001, needlestick injuries plummetedby 51 per cent.

Despite the obvious health and financial savings, the BCgovernment has so far refused to introduce the life-saving

regulations. But several health authorities have taken actionon their own and are moving towards a needless system toprotect nurses and other health care workers. (For more infor-mation on the VIHA policy see page ??).

While BCNU applauds these positive changes, anythingless than a complete province-wide conversion will lead to atwo-tier system with some nurses being fully protected whilethe lives of others remain at risk.

“It’s extremely positive that VIHA introduced thesechanges,” says BCNU South Islands co-chair Jacquie Ferrier.“But it’s time for the BC government to do the right thing andbring in province-wide legislation that will protect all healthcare workers from needlestick injuries.

“We need regulations so there will be no more BevHolmwoods,” says Ferrier, referring to the former BCNUmember and Victoria Royal Jubilee Hospital nurse whoreceived an accidental needlestick injury in October 1991.That incident led to her contracting Hepatitis B and C, andultimately to her death on December 9, 1991.

“Each year, during the Day of Mourning event in Victoria,”says Ferrier, “Bev’s death reminds me and other nurses thatsomething as simple as needlestick injuries, which occur on aregular basis, can actually take someone’s life. That’s reasonenough to take pro-active measures and implement thechanges immediately.”

“BCNU is currently lobbying the provincial governmenton the issue and will be raising the question with candidatesrunning in the provincial election,” says BCNU OH&S chairLen Rose. “If the politicians do not act on this, then we will belaunching a campaign after the election.” �

BCNU demands the provincemandate the use of retractableneedles and other safety-engineeredmedical devices

SAVING LIVES BCNU says it is time for the provincial govern-ment to ban the use of unsafe needles.

Cutting Needlestick Injuries