FAQ: COVID-19 and Staying Safe on the Job
- When can I safely come back to work?
- I’m at high risk for becoming seriously ill if infected by the novel coronavirus. How do I keep myself as safe as possible?
- How can I minimize my exposure at work, in general?
- How can I minimize my exposure if I’m working with or around possible or confirmed COVID-19 patients?
- What about remote work and alternative work models?
- How can I file a complaint with the Occupational Safety and Health Administration if I feel that my right to a workplace free from recognizable hazards is being violated (General Duty Clause)?
- What PPE is NUHW fighting for?
- Should I be wearing a mask at work, even when PPE isn’t called for?
- My employer says they can’t disclose the number of exposed or infected employees, or the number of infections at the hospital, because of privacy issues. Is that true? What should they tell me?
- For EVS Workers: How long do I need to wait before going into a COVID-19 patient’s room for terminal cleaning?
- For EVS Workers: What if the room had a patient with suspected COVID-19 (a PUI)?
- For EVS Workers: What about cleaning products?
- For EVS Workers: How do I safely handle trash & laundry?
When can I safely come back to work?
For return-to-work determinations for employees on home isolation due to COVID-19 infection or due to exposure to a suspected or confirmed COVID-19 case, workers should have reached complete symptom resolution and have 2 negative tests 24 hours apart per CDC guidelines.
It is NUHW’s position that this test-based strategy is the gold-standard protocol for return-to-work decisions and should be operationalized immediately. The CDC also recommends an alternative non-test-based strategy which NUHW cannot support because of the paucity of data on which this alternative is based.
I’m at high-risk for becoming seriously ill if exposed to the novel coronavirus. How do I keep myself as safe as possible?
Employees who are considered to be at high risk for developing severe illness if they contract COVID-19, including those who are immunocompromised, should not be assigned to confirmed COVID-19 cases or wards, nor to ED triage areas for possible COVID-19 patients. Those who request medical accommodation should be placed in other clinical work areas or should be offered assignments in non-patient care areas or areas with lesser exposure, with no changes to pay and benefits.
Employees requesting medical accommodation may be protected by the Americans with Disabilities Act (ADA). Employers and employees may wish to consult relevant resources from the U.S. Equal Employment Opportunity Commission (EEOC), including “What You Should Know About COVID-19 and the ADA, the Rehabilitation Act, and Other EEO Laws,” and “Pandemic Preparedness In The Workplace And The Americans With Disabilities Act.”
How can I minimize my exposure at work, in general?
In other countries, worker-to-worker transmission inside of healthcare facilities has been a common means by which workers have become infected with the virus. Insist that supervisors modify huddles and other meetings so they can be held in conference rooms and other spaces that allow for as much space as possible between employees (minimum 6 feet), as recommended by social distancing guidelines. Furthermore, social distancing should also be practiced in break rooms. Employees should not congregate in break rooms. Be mindful of high-touch surfaces and equipment in break rooms (eg., microwaves, refrigerators, etc.). Eat your meals in spaces that allow you to maintain 6-foot social distancing, including in outdoor areas.
All employers should provide staff with training on all COVID-19 protocols that are needed for the safe and effective execution of their jobs. New training should be immediately provided if new protocols emerge or old protocols are updated as more information about this pandemic is disseminated.
Training should cover the following topics as recommended by Cal/OSHA: signs and symptoms of COVID-19; modes of transmission of COVID-19 and source-control procedures; tasks and activities that may expose employees to COVID-19; appropriate uses of methods (and these methods’ limitations) for preventing or reducing exposure to COVID-19 including appropriate engineering and work practice controls, decontamination and disinfection procedures, and use of personal and respiratory protective equipment; selection of PPE, its types, proper uses and limitations, location, donning and doffing, handling, cleaning, decontamination and disposal; proper use of respirators; what to do if an exposure incident occurs; and the facility’s surge plan.
In particular, PPE training should be provided to all employees who provide direct patient care (eg, nurses, nurses aides, respiratory therapists and imaging technologists) and others who might come in contact with residents or their environment (eg, environmental services, dietary services, maintenance workers). This includes providing a written protocol and video training on how to don and doff PPE, followed by an in-person competency check and one-on-one training as needed and upon employee request.
In-person refresher training should be provided to all employees upon request.
Under no circumstances should nursing staff be relieved or covered by non-nursing staff. Unlicensed employees should not be required to perform duties that are the responsibility of licensed professionals (MDs, NPs, RNs, LVNs etc.) as they do not have the appropriate level of training.
How can I minimize my exposure if I am working with or around suspected or confirmed COVID-19 patients?
First, your hospital should create dedicated staff teams to deliver care on units that care for patients with confirmed or suspected COVID-19 infections. If confirmed or suspected COVID-19 patients must be transported, have nurses prepare patients for transport and then meet the transporter outside of the room to minimize exposure; have nurses receive patients outside of the room if possible. Use transport routes that minimize exposure to other workers and patients. If a transporter must enter the room, disinfect bed rails and provide transporter with appropriate PPE, per NUHW recommendations for personnel providing direct care.
- Meal trays should be delivered outside of the ward, and distributed by nursing staff within the ward. Dietary workers should not circulate within COVID-19 wards, or enter the rooms of PUIs or COVID-19 patients to distribute or retrieve trays or items. Disposable trays and dishware should be used whenever possible.
- All non-urgent outpatient procedures, including imaging and fluoroscopy, should be rescheduled. Transporting patients should be kept to a minimum, and examination should be performed at the bedside whenever possible. When performing chest radiographs on PUIs or COVID-19 patients, who may cough or breathe forcefully, staff should be wearing the PPE that NUHW recommends for personnel providing direct care. If examinations must take place in the radiology department, the rooms should be cleaned and disinfected properly (link to EVS fact sheet).
What about remote work and alternative work models?
When it will not compromise patients’ health, alternatives to in-person services should be implemented to decrease the potential exposures to healthcare workers and patients. This includes the use of telehealth technology and rescheduling elective or non-urgent procedures if needed to decrease the strain on facilities confronting COVID-19 related demands.
If it will not compromise patient care, all departments that can do so should convert to remote working or telehealth. For example, mental health care appointments should be conducted over phone or video, including mental health consultations with patients in the ED. If mental health workers must enter the ED, they should be given full and appropriate PPE, per NUHW’s recommendations.
How can I file a complaint with the Occupational Safety and Health Administration if I feel that my right to a workplace free from recognizable hazards is being violated (General Duty Clause)?
Contact your steward or union representative to file a complaint with OSHA. Visit www.dir.ca.gov/dosh/Complaint.htm if you’re in California and labor.hawaii.gov/hiosh/files/2013/01/FileAComplaint-rvsd-12-18-14.pdf if you’re in Hawaii. See this guidance from National COSH.
What PPE is NUHW fighting for?
NUHW opposes the weakening of PPE standards by both Cal/OSHA and the CDC. Decisions about PPE for healthcare workers should be dictated by scientific evidence and the safety of caregivers–not supply chain failures.
NUHW insists that all employers must provide PPE for airborne precautions, in addition to PPE for contact and droplet precautions, to all healthcare workers who care for patients with suspected or confirmed COVID-19 infections:
- NIOSH-certified N95 respirator or other respirator with equivalent or higher protection, gown, eye protection — goggles or face shield which covers the front and sides of the face — and gloves.
- Powered air-purifying respirators (PAPRs) with high-efficiency particulate air filters are required for employees who perform aerosol-generating procedures.
NUHW insists that employers take immediate steps to secure an adequate supply of respirators and PAPRs, along with PPE for droplet and contact precautions, for the protection of healthcare workers Furthermore, NUHW requests that employers provide the union with a daily inventory of PPE available at all care sites staffed by NUHW members.
Should I be wearing a mask at work, even when PPE isn’t called for?
Your employer should provide a mask (which covers the mouth and nose) to all people who enter your healthcare facility including patients, employees, physicians, trainees, and visitors regardless of whether they have respiratory symptoms or not.
Employers should institute a universal masking policy to help decrease the asymptomatic spread of COVID-19, (which the CDC’s Director states is occurring) and keep you and your coworkers healthy so you can continue your essential work.
Employers should provide each employee with a new mask at the beginning of each shift. If the mask becomes soiled or wet at any point throughout the shift, the employer should provide a replacement. The mask should be discarded at the end of each shift prior to leaving the facility.
A universal mask policy is a minimal and rudimentary precaution. It is not a replacement for appropriate PPE that is donned and doffed by healthcare workers each time they deliver patient care to or work in areas occupied by a person under investigation (PUI) for COVID-19 infection or patients confirmed to be COVID-19 infected.
My employer says they can’t disclose the number of exposed or infected employees, or the number of infections at the hospital, because of privacy issues. Is that true? What should they tell me?
As of early April 2020, numerous employers, including UCSF and Keck USC, have been regularly disclosing the number of COVID-19 infected patients and employees, the number who have been tested, the aggregate results of those tests, and the general location of workplace exposures. HIPAA laws should not prevent employers from such aggregate reports, which do not include identifying information about patients or employees.
If you have been exposed to a co-worker who is infected with COVID-19, NUHW expects your employer to inform you of the exposure while also protecting your coworker’s privacy. If you receive this notification, and you know the identity of the person to whom you were exposed, please be respectful of their privacy and do not disclose this information to others. Healthcare workers should be notified if they will be involved in the care of, or entering the room of, a PUI or confirmed COVID-19 patient. If you were unknowingly exposed to a patient, and you were not aware of their COVID-19 status, and believe you should have been, notify your union steward or representative.
For EVS Workers: How long do I need to wait before going into a COVID-19 patient’s room for terminal cleaning?
Wait for the room to be properly ventilated before going in. In a typical treatment room, it takes 69 minutes for the virus to be removed from the air, before you can safely enter. For some rooms, it may take less.
Talk to your steward or NUHW organizer if you don’t think you are being given enough time.
When you enter the room after waiting, you should wear a surgical mask, gown, and gloves.
For EVS Workers: What if the room had a patient with suspected COVID-19 (a PUI)?
Take all the same safety precautions as you would with a patient who has tested positive for COVID-19.
If the hospital directs you or a coworker to act in a way that you believe threatens your safety, or the safety of others, contact your NUHW organizer.
For EVS Workers: What about cleaning products?
Hospitals should use products registered with the U.S. Environmental Protection Agency (EPA) to kill this virus, and provide instructions and training on their proper use.
CAUTION: Some products may cause/worsen asthma. If you have coughing, red eyes, wheezing, sneezing, or a runny nose when using a new product, notify your manager and NUHW organizer immediately.
For EVS Workers: How do I safely handle trash & laundry?
As long as you have the right PPE (at least a surgical mask, gown, and gloves for terminal cleaning), you do not need to take any special precautions with trash.
The hospital should have special rules for laundry from isolation rooms — follow these rules for laundry from all PUIs and confirmed COVID-19 patients.
Linen room workers should at least be given gloves and surgical masks.