Healthcare Workers At Risk (So Patients Are Too)

(Soiled plastic linen bags in the tunnels of NYP/Columbia Hospital, courtesy of Louis Henderson)

When word came down to staff at NewYork Presbyterian Hospital-Columbia University Medical Center that they were to switch out the standard linen laundry bags for thin plastic ones, it seemed – at first – like a harmless enough directive from management.

But this one small substitution was to have serious repercussions. For the flimsy plastic bags were not built to withstand the multi-story drop through the metal laundry chutes. As a result, they were tearing during the fall then splitting open upon impact.

Though this might have been nothing more than an annoyance for workers elsewhere, at say a hotel, it was decidedly more dangerous for the staff at the hospital because those broken bags were filled with items contaminated with blood, feces, vomit, and various other bodily fluids.

As biological byproducts spewed across the basement floor, workers – who had to collect and repack the strewn linen – were exposed to a proverbial ‘laundry list’ of potentially infectious pathogens.

These hazardous working conditions were reported to the Department of Labor’s Occupational Safety and Health Administration in July 2014, and the hospital was fined $201,000, records show. “Management knew that these bags were deficient yet continued using them, even though they posed a potential health hazard for employees. This must change,” said OSHA’s Kay Gee in a statement at the time.

Yet in the two years since incurring the fine, things haven’t changed, workers say. Despite its status as one of the best hospitals in the country (according to US News and World Report), the OSHA case remains open, the plastic bags remain in use, and workers say they continue to be at risk.

Management, when approached for comment, declined to respond.

Though healthcare employees may operate under the mantra “first do no harm”, the same cannot be said for the environment in which they work.

Data from the Bureau of Labor Statistics shows that healthcare workers face a higher likelihood of workplace-related injury or illness than workers in either the construction or manufacturing industries – two sectors renowned for their inherent dangers.

“Many people do not consider hospital jobs to be high risk, but hospital employees face a different kind of risk than construction workers,” said Edward E. Knauss, IV, a lawyer at Metzger Wickersham, P.C., in Harrisburg, Pennsylvania. “Musculoskeletal injuries are common. One of the most prevalent injuries we see in hospital employees is lower back injury from patient lifting.”

Staff also have to contend with hazards such as airborne pathogens, noxious chemicals, sharp instruments, and even combative patients. “The hospital environment is busy and fast-paced, so there is more possibility for workers to suffer injuries from trips and falls,” adds Knauss. “We also see a lot of accidental needle sticks, which carry the risk of infection.”

With so many potential threats to employees, appropriate precautionary measures from hospital management are essential.

Under the OSHA of 1970, employers have a duty to provide a safe workplace for their employees. Yet some hospitals are failing to live up to this legislated benchmark.

For example, in 2015, OSHA fined Cooper University Hospital in Camden, New Jersey for 15 violations related to exposing employees to needle-stick injuries and bloodborne pathogens.

The John L. McClellan Veterans Memorial Hospital in Little Rock received 15 notices of violation for repeatedly exposing its employees to hazards such as electrocution and amputation.

Meanwhile, West Haven Medical Center in Connecticut was cited for multiple violations (including 12 repeat offences) that would carry a $480,920 fine in the private sector.

So why is employee safety being sacrificed?

Many reasons are cited – including insufficient training, staff, and awareness.

Even public perception can play a role. George De Valle, a perioperative patient assistant at New York-Presbyterian /Weill Cornell Medical Center, shared his experience. “When I first started, we were told to always wear contact gowns,” he said, referring to the bright yellow smocks worn by staff to protect from infectious pathogens. “Then a new policy was introduced, banning the gowns while staff are transporting patients through the hospital. Management said they make the public nervous and scared.” Though De Valle loves his job, he questions the decision. “I’m touching the bed, I’m touching the patient… I’m exposed to all of these things and you guys don’t want me to protect myself because it doesn’t look nice? What if the patient has Ebola?!”

With a recent study revealing that most hospitals barely break even, it’s no surprise that budgetary constraints are also a major factor.

Former certified nursing assistant, Jennifer Hecker Bonawitz gave a telling example from her time at Frankford Hospital Healthcare System (now Aria- Jefferson Health) in Philadelphia. “To save money on the budget, they got rid of housekeeping. They trained all of us nurses to do the housekeeping and then take care of the patients. Of course, our caseload didn’t go down, but we did it. The patients did suffer, but we had to make it work.”

Bonawitz also went on to experience violence in the workplace. At age 23, she was seriously injured trying to restrain a combative patient. “It was only a matter of time before one of us got an injury that would lead to permanent damage,” she recalls. Despite undergoing surgery, Bonawitz continued to experience pain. Unable to find a suitable role in the hospital, she was forced to leave her profession and pursue a different career. Now 39, she still thinks management handled her case poorly. “I was trying to save a man’s life, and it ruined mine.”

This type of incident is all too common in hospitals. “There is a very unfortunate attitude, especially among nurses, that “Violence is just part of the job, ” says professor and associate chair for research at Michigan State University, Judith Arnetz, PhD, an expert in hospital working conditions. “That acceptance – even if it’s a reluctant acceptance – is a problem. I mean, in what other job would you put up with it?”

For the average American, this issue of staff safety in hospitals might seem irrelevant; something the industry needs to sort out for itself. But experts say that isn’t so.

For starters, healthcare is the fastest growing sector in the US. With more than 18 million people working in the industry, it’s more likely than ever that you or someone you love will be affected.

But even more importantly, when it comes to hospitals, employee safety and patient safety go hand in hand. “When hospitals fall short in training their employees about best safety practices and fail to provide their staff with assistance in situations that involve injury risk – like manual lifting – it affects the overall quality of patient care,” says Knauss. “For example, not only can manual lifting severely hurt workers, it can also put patients at risk of broken bones from falls and other preventable injuries.”

Louis Henderson, a union maintenance worker at New York Presbyterian-Columbia Hospital, sums up the issue succinctly: “If we’re not okay, we’re putting other people’s lives in danger.” His frustration with his employer’s failure to act is palpable. “They want us to love the patients, but they’re not doing that themselves. If they were, they would give the workers the proper tools they need to protect both themselves and the patients in that institution.”

The good news – for staff and patients alike – is that change is achievable, and it doesn’t take a brain surgeon to spot opportunities for improvement.

“Support and encouragement from hospital management is key,” says Knauss. “Hospitals should have ongoing training for their employees – especially any time there are changes in work environment and/or any new or increased safety risks.”

Meanwhile, organizers and managers from both 1199SEIU (Service Employees International Union; United Healthcare Workers East) and New York Presbyterian- Columbia Hospital declined to comment on this story, and workers like Louis Henderson continue to feel helpless and isolated. “From my knowledge, people here done gave up,” he says. “They just feel like they don’t have nobody to help them… That’s how it is. You just got to, like, put your nose down and do the work.”

Sources:
Louis Henderson; Maintenance Manager, NYP/Columbia Hospital, 646.763.4012, nyp1199Lhenorg@gmail.com
Keithly Bramble, Jr: Director of Laundry and Patient Transport, NYP/Columbia Hospital, 212.305.6505 kab9081@nyp.org
Rosa Martinez: Phlebotomist, NYP/Columbia Hospital
George Del-Valle: Perioperative Patient Assistant (PPA), NYP/ Weill-Cornell Hospital, 646.245.5760
Justine Martinez, RN: Operating Room/ Cardiothoracic Surgical Team, NYP/ Weill-Cornell Hospital, 917.860.4466, jmartinez328@gmail.com
Jennifer Hecker Bonawitz, (former CNA): Frankford Hospital Healthcare System, 215.9908370
Judith Arnetz, PhD, MPH, PT: Professor, Associate Chair for Research, Department of Family Medicine Clinical Center, Michigan State University, 517.884.0436/ 616.234.2823, judy.arnetz@hc.msu.edu
Bennet J. Battista: 1199SEIU organizer, 212.857.4303/646.221.0969, bennett.batista@1199.org
Edward E Knauss, IV, Esquire: Partner, Metzger Wickersham, PC, Board certified in civil trial law, Certified specialist in workman’s’ compensation law by the Pennsylvania Bar Association, 717.2388187, www.mwke.com

Studies:
Judith Arnetz: (January 2017): Data Driven Approach May Reduce Violence to Hospital Employees,
https://www.sciencedaily.com/releases/2017/01/170112162514.htm