Daniel Ross: The head of the Hawaii Nurses Association lobbies for more support for those on the front lines of COVID-19 care

How many nurses are members of the Hawaii Nurses Association/OPEIU Local 50 and where do they work?

We have approximately 4,000 members in 30 bargaining units at 24 different facilities across the state. The vast majority are RNs (registered nurses), but we also represent LPNs (licensed practical nurses), CNAs (certified nursing assistants), respiratory therapists and radiation therapists. Most of our members are on Oahu, but we also have facilities on Kauai, Maui and Hawaii island, as well as a couple of dialysis nurses on Molokai. The Queen’s Medical Center is our largest employer, followed by Hawaii Pacific Health, which owns Kapiolani, Straub and Wilcox medical centers.

How are Hawaii hospitals handling the most recent surge of coronavirus cases?

There are very dedicated individuals at all the hospitals trying their best to provide safe care. But the strain is huge and many are feeling overwhelmed. There are practices in place now that six months ago would have been unheard of due to safety considerations. The nurses at Queen’s Punchbowl and Straub are particularly feeling the strain of overwork and less-than-ideal safety conditions.

As a whole, the hospitals have failed to be proactive and plan ahead. Their actions are largely reactive. There is a sentiment that financial considerations have been put ahead of worker safety. They did not staff up or adequately stockpile PPE (personal protection equipment) when they had the opportunity to do so late last year. There is a general lack of transparency. … We don’t know how much PPE is on hand at any time. … Decontamination methods (for reusing N95 respirators) were approved for emergency use and should be used when there are no new N95 masks available — not to save money by reusing six times a piece of equipment designed to be used once, which appears to be happening at some hospitals.

What is it like for nurses working with COVID-19 patients compared to those with other serious illnesses?

The PPE is the biggest difference; it takes time to put on and take off the PPE safely. It is a nurse’s instinct to rush to help someone in trouble. Now, even if a patient has fallen or has coded, we have to stop and carefully don all the PPE before entering the room. If we don’t and then fall ill, we won’t be able to help anyone. On the mainland, nurses have died from COVID-19 when they contracted it after rushing to perform CPR without safely putting on all the PPE first. I believe it causes real psychological injury to health care workers to have to stop for safety when you know that quick intervention saves lives.

Are you confident that the safety protocols in place in Hawaii hospitals are adequate to protect nurses?

No. There is not enough known about the virus. The Centers for Disease Control and Prevention has continually decreased or lessened its guidelines, not because of science, but to protect hospitals that were not providing equipment up to the standards. We had to fight to get what we have now. … As the strain gets worse, more things are likely to fall to the side. Nurses have expressed feeling like they are expendable.

What should hospitals and/or policymakers be doing to prepare for what could be a worsening of the pandemic in Hawaii?

We need a stockpile of PPE, perform screening tests of health care workers, and hire more nurses. PPE were not stockpiled when we saw this pandemic heading our way, and since spring we have had trouble getting supplies. To save money, hospitals staff nurses to the bone, with no safety margin. We have many new graduate nurses still having trouble getting hired. They need to be hired and given the experience so that when issues arise we have a core of trained nurses to rely on. We should all have been tested and have routine testing of health care workers to ensure we are not unknowingly spreading the virus.

Management prefers to stick its head in the sand because it is afraid of having to quarantine more workers. I understand that concern, but ignoring a problem doesn’t make it go away. If things continue to worsen, we will be facing a severe shortage of staff for which I don’t see a short-term solution.

Bonus thought

It is so frustrating to hear people act as if this is all a farce. It is very real. Shutting down gatherings and wearing masks has a very real effect of slowing down transmission. If this is not done, our hospitals will be quickly overwhelmed and people will die. Not just from COVID-19, but from all the other reasons for which they come to the hospitals. There will be no health care workers available to help the heart attack, stroke or trauma victims.

THE BIO FILE

>> Current job: Registered nurse and president of the Hawaii Nurses Association (HNA).

>> Personal background: I was born at the old Kaiser Hospital in Waikiki, and grew up in Kaimuki and Pearl City. I graduated from Kaimuki High. I live in Kaimuki, on property originally owned by my great-grandmother, with my wife (also a nurse) and teenage son. My adult daughter lives next door.

>> Professional background: I have been an RN on an orthopedic unit at Queen’s for 28 years, with a 4-month break to do a travel assignment in Portland prior to getting my RN. I also was a licensed practical nurse and worked for agencies and at Castle Medical Center, before that I worked in California as a nurses aid and LVN. I started as a union steward about 10 years ago, was active on the negotiations team for my unit, then did a term as vice president before being elected president of HNA. Representing nurses to me is a lot like nursing, in that it is about helping people.

>> Personal interests: I used to teach SCUBA on the side. I’ve been a certified SCUBA diver since I was 17. I love the ocean and spearing my dinner.

>> One more thing: I believe in social justice and to fight for what I think is right. I have many faults, but try to do the right thing always.