This week, National Nurses United called on the federal Occupational Health and Safety Administration to inspect all hospitals owned and operated by HCA Healthcare and issue citations against the hospital giant for "willful violation" of workplace safety hazards, which NNU said "could reasonably be expected to cause death or serious physical harm."
NNU urged OSHA to seek a federal court injunction to order HCA to immediately abate what the nursing group called "dangerous" conditions, including failing to notify workers when they've been exposed to COVID-19 and pushing those who are or may be COVID-19-positive, but not showing active symptoms, to continue working.
Ultimately, fines for willful violation of up to $134,937 per facility could be leveled, or up to nearly $2.3 million if applied to all the facilities named in the complaint.
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Such unsafe behavior, warns NNU in the complaint, not only leads to spread of the virus amidst a still surging pandemic, but "as a result, nurses and other healthcare workers at HCA facilities are in imminent danger of serious physical harm or even death."
"Six months into a virulent pandemic, the science has proven how unsafe conditions put frontline caregivers at extreme risk. That is the backdrop to the COVID-19 deaths of more than 1,500 healthcare workers, including nearly 200 RNs," said Malinda Markowitz, RN, president of the National Nurses Organizing Committee, an NNU affiliate which represents HCA RNs.
"HCA's callous disregard for the safety of the nurses and their coworkers who have put their lives, their coworkers, and their families on the line every day, is deplorable," Markowitz continued. "They must be held accountable."
WHAT'S THE IMPACT?
In the complaint, NNU cites 17 HCA facilities in Florida, Kansas, Missouri, North Carolina and Texas affected by the allegedly dangerous conditions.
An RN at Osceola Regional Medical Center in Kissimmee, Florida, identified as "RN Doe" in the complaint, became ill with COVID-19 after contact with a nursing assistant who – the RN only learned through word of mouth – was later confirmed COVID-19 positive. At no point, she said, did the employer notify RN Doe of her exposure, even though HCA knew the nursing assistant worked with her shortly before quarantining due to the coronavirus.
In mid-June, she began exhibiting symptoms of COVID-19 including digestive issues and loss of her senses of smell and taste. The complaint states, "The employer denied her request for a COVID-19 test on the grounds that she was not exhibiting fever, shortness of breath or cough."
On or about June 21, "RN Doe was forced to seek out a test at a public testing site on her own. Despite knowing her symptoms, her manager continued to put her on the schedule. On or around June 23, Ms. Doe received her test result – she was positive for COVID-19."
"After 14 days of quarantine, the Employer's Employee Health department instructed her to come back to work if she was asymptomatic, irrespective of whether she was still COVID-19 positive," the complaint said. "RN Doe sought out another COVID-19 test on her own, and once again tested positive. Her doctor extended her sick leave, and indeed, she is still very ill."
At Mission Hospital in Asheville, North Carolina, several RNs performed aerosolizing procedures without appropriate personal protective equipment (N95 respirator masks) on a respiratory failure patient confirmed to be COVID-19 positive shortly thereafter. According to the complaint, HCA and Mission have failed to test – or in many cases, even notify – all nurses who were exposed to COVID-19.
In another instance at Mission, RNs in the neurology unit worked closely with a technician confirmed to be COVID-19 positive. HCA and Mission failed to notify these nurses of their exposure. When one RN notified the employer that she had been exposed and sought out testing, her request was denied.
The complaint emphasizes how a hospital environment becomes a hot spot when employers fail to ensure safe workplace conditions. RNs regularly must share space and equipment such as computers, cabinets, desks, phones, bathrooms, and nursing stations. Moreover, RNs share breakrooms, where people generally have their masks off because they are eating or drinking.
It's virtually impossible to maintain social distancing during certain protocols and procedures, such as patient lifts and baths, the complaint alleges. Some routine patient care tasks can last for at least 15 to 45 minutes, and they require prolonged contact between workers. There is a high likelihood that nurses may contract COVID-19 from asymptomatic coworkers.
HCA is one of the wealthiest hospital system in the U.S. It made $1.1 billion in profit in the second quarter of 2020, and it received $1.4 billion from the CARES Act, as well as an additional $300 million since June 30. The system did not immediately return a request for comment.
THE LARGER TREND
The NNU complaint is the second such complaint brought forth against HCA Healthcare in just the past week. Late last week, Service Employees International Union-United Healthcare Workers West brought a lawsuit against HCA for allegedly "recklessly" facilitating the spread of COVID-19 among its workers and the Riverside, California community.
The lawsuit, filed in the Superior Court of California, alleges RCH forced employees to work without adequate personal protective equipment, including masks, gowns, hairnets, gloves and facial shields; required employees to work despite having COVID-19 symptoms; pressured employees not to take precautionary measures against COVID-19 exposure, such as sanitization, if they hindered efficiency; ignored worker complaints about lack of PPE; had inadequate contact tracing, and pressured workers to ignore workplace-safety measures.
They are seeking monetary compensation and a declaration from HCA that it committed a public nuisance and unfair business practices for its alleged acts.