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Nurses and other healthcare workers face increased violence on the job

Covid-19 is already responsible for killing some 3,500 healthcare workers across the United States. Now America's nurses say they're being subjected to another chilling aspect of the ongoing pandemic — increasing workplace violence.

The National Nurses United (NNU) surveyed 15,000 of its members last fall. As astounding 20% responded said they have been physically attacked on the job.

Healthcare workers are five times more likely to be victimized on the job than other workers overall, according to the U.S. Bureau of Labor Statistics (BLS). The BLS found that healthcare workers accounted for 73-percent of all nonfatal workplace injuries and illness due to violence in 2018. Nurse labor leaders say the pandemic has made matters worse.

The ongoing coronavirus pandemic is exacerbating violent outbursts from patients.

On February 9, Gregory Patrick Ulrich, a 67-year-old man grappling with opioid addiction, was arrested after he shot up the Allina Clinic Crossroads health clinic in Buffalo, Minn. Lindsay Overbay, a 37-year-old mother of two and medical assistant working at the facility later died. Four others recovered from gunshot wounds.

Ulrich is facing second-degree murder and attempted murder charges, but that's the criminal justice system's swift and clear response. The worker safety side of the equation is entirely different, an underfunded and hobbled system that could protect workers better in many ways, reducing death and misery.

Assaults in ERs, Offices

Assaults in emergency rooms, doctor's offices, and even hospital lobbies all add to the dangers facing nurses in the tense social conditions fostered by the pandemic.

NNU insists that the ongoing coronavirus pandemic is exacerbating violent outbursts from patients and that hospital employers aren't doing enough to protect long-suffering healthcare workers. NNU is the largest union and professional association of registered nurses with 170,000 members.

Allysha Shin, a member of the California Nurses Association and the National Nurses Organizing Committee, is a registered nurse who's still dealing with the trauma of being battered and kicked in the face while attempting to care for a distraught patient at the University of Southern California's Keck Medical Center in Los Angeles.

Shin's entire ordeal, in which hospital security was reportedly slow to respond, lasted what to Shin were 30 very long minutes. The blows the veteran nurse suffered ultimately forced her to miss the next two shifts at work. Shin blames hospital bosses for failing to have adequate safety standards in place. She and other nurses want enforcement of safety standards – and the writing of adequate standards by each employer of nurses.

"They will say it was inevitable," Shin says of her attack in 2016. "But I'm here to tell you, nothing could be further from the truth — the patient's history made this incident predictable."

Underreported Workplace Violence

News about working conditions gets spotty attention in America where labor reporters at major news organizations have gone from few to virtually extinct. So DCReport has been documenting America's weak worker safety enforcement and the unnecessary risks faced by w0orkers because the federal Occupational Health and Safety Administration has far too small a budget to fulfill its duties.

A half-century ago about 190 workers died on the job each week. That number was down to about 100 in 2019, BLS data shows. But that's still a costly toll on society aided by members of Congress who have held down the budget for enforcing job safety laws and imposed rules that weaken enforcement, all in the name of fighting supposed overregulation of business.

Many of the most ardent foes of more effective worker safety enforcement proclaim their devotion to the sanctity of human life yet disregard the safety of workers in occupations from construction and mining to nursing.

Jean Ross, NNU co-president, says that the threat of criminal prosecution alone cannot prevent workplace violence — and that several factors directly associated with the ongoing coronavirus pandemic are, indeed, contributing to an ugly escalation of violent incidences like the kind Shin endured.

Not Enough Workers

A disruption in mental health services is one of the factors. Short staffing — a chronic pre-existing condition at hospitals nationwide — is another.

"If they're not going to supply us with enough staff, this is going to make it 100 times worse," Ross says.

Back in June, when the Covid-19 death toll was around 100,000 people, Michelle Gonzalez, a 31-year-old nurse at Montefiore Medical Center in New York City, described what it was like trying to care for multiple patients in the middle of a pandemic.

"The days that I had up to four [patients], I came home and cried like a baby," Gonzalez said at the time. "Your body cannot physically do that. You can't be at two places at once. So, you just run to room to room to room — neglecting your own body's needs. Not eating, not drinking because you can't take off the mask. Not going to the bathroom for 12 hours."

Tens of Thousands Hospitalized

As of March 1, there were 47,352 Americans hospitalized with Covid-19, according to the COVID Tracking Project. Of that number, 9,802 were in Intensive Care Units struggling for life — 3,245 of them on ventilators, a last-ditch treatment which few survive.

Fear of Covid-19 is also forcing some patients to delay seeking necessary medical attention and that, too, is adding to simmering tensions, according to Ross.

"People aren't coming in early enough" to get vital care at hospitals, Ross says. "Maybe they're in sepsis. That's hard to control. A simple UTI (urinary tract infection), can make people go off the wall."

Sepsis occurs when the body's response to infection goes into overdrive and assaults organs. Unless treated early it can result in death.

Visitor Issues

Visiting family members can be both a hindrance and a help to nurses and other healthcare workers aiding the sick.

"There are more things we have to say no to — [some] people don't respond well (to being told), 'You must wear a mask,'" Ross says. "More patients and their families are acting up. Employers don't want to hear about it and sweep it under the rug."

Reporting violent incidences is voluntary, however. So, the actual number of healthcare workers being attacked on the job is probably a lot higher than statistics show.

Rep. Joe Courtney (D-Conn.) pointed out that nurses are often told to just "shake it off."

Nurses and their allies hope that the change in presidential administrations will put Courtney's 2019 Workplace Violence Prevention for Health Care and Social Service Workers Act on the fast track.

The measure, updated and reintroduced last month, seeks to compel employers to investigate workplace violence incidents, risks, or hazards as soon as practicable. It would also mandate training and education of employees who may be exposed to workplace violence; impose record-keeping requirements; and prohibit discrimination or retaliation against employees for reporting workplace violence incidents, threats, or concerns.

The bill garnered enough votes to pass in the House in the previous Congress but died in the Senate during the Trump administration.

"The Senate was a graveyard for lots of good bills," Rep. Courtney says. "This one failed [when] the Trump administration was doing nothing at the Department of Labor. For four years, he just basically dismissed this as not a priority. I hope [incoming Labor Secretary Marty] Walsh gives this attention."

States Lead

Similar legislation aiming to establish enforceable safety standards and training in deescalating violence has already been adopted in California and Minnesota. But the nurses' union says national standards are necessary because while nurses are taught how to recognize medical needs, they aren't taught criminology.

"I've been a nurse for 40 years — I didn't take violence 101," says Ross.

NNU, along with 44 allied unions and organizations, continues to push the U.S. Centers for Disease Control and Prevention [CDC] to update its Covid-19 safety guidelines to reflect the dangers that aerosols — fine particles emitted when breathing, speaking, coughing, sneezing or singing — pose to healthcare workers.

Nurse Pat Kane, executive director of the New York State Nurses Association, says many of the thousands of healthcare workers killed by the novel coronavirus could have been saved had the CDC recognized the threat of aerosols before the long-predicted pandemic was recognized more than a year ago.

"The healthcare and other essential workforces have been devastated by Covid-19 infection and thousands have died due to their occupational exposure," Kane said in a statement. "Many of those exposures could have been avoided if the CDC had recognized the wealth of data that proves that SARS-CoV-2 is spread through inhalation of airborne virus particulates."

SARS-CoV-2 is the virus that causes Covid-19, its number derived from the year when it was first identified as a novel, or new, coronavirus.

Kane says her 42,000 members and all other healthcare workers "deserve federal guidance that fully recognizes the risk of airborne exposure and recommends controls that effectively limit this exposure."

The American Hospital Association frets the costs of the pandemic. It recently released a report estimating that the pandemic could cost hospitals between $53 and $122 billion in 2021.

Ross noted that the hospital owners have not issued a similar report focused on the lethal risks their nurses and others take every day. Evidently, says Ross,

"Our lives aren't as important as money."

Trump administration's vaccine failure leaves workers unprotected

The Trump administration's failure to develop a plan to distribute COVID-19 vaccines along with persistent problems with the rollout are spreading fear among American workers forced to risk exposure to the killer virus.

"I don't feel safe," Phil Andrews, a Petco dog groomer in Miami, said last week. "I don't feel that the companies have our backs. I don't look forward to going in."

Nearly 200 cases of the pernicious British variant of COVID-19 have been confirmed in Florida. Other variants, including problematic ones from Brazil and South Africa, are also spreading fast.

Public health officials worry that pernicious and highly infectious mutations will spread faster than Americans are vaccinated because of the Trump failure to create a plan to get vaccines into people's arms.

Public health officials worry that pernicious and highly infectious mutations will spread faster than Americans are vaccinated.

The stress and anxiety of having to interact with customers all day without vaccination or adequate personal protection equipment have made life small for T.J. Daniels, a Petco employee in Colorado.

"I'm going to work and heading home so I don't have to deal with any more people than the hundreds I have to see at work," he says.

No Vaccine Soon

Daniels expects he'll have to wait until summer to be vaccinated.

COVID-19 sent Daisy Cruz to a Tennessee hospital last July. "I don't wish that on anyone," said the Honduran immigrant, who used to do construction work. "When you are there on the bed, the boss is not telling you how you are going to pay rent. The boss should support us in surviving."

Cruz and her colleagues at the Workers' Dignity center in Nashville, like millions of other workers across America, say that they have no idea how they will obtain the vaccine or when.

The Biden administration took steps to expand vaccine distribution and establish a new Emergency Temporary Standard (ETS) to protect workers on the job. Its goal is 1 million vaccinations a day for 100 days, while the Trump administration reached that level only once in its last 40 days. But even at the pace Biden proposes, it would take all year to vaccinate Americans, many of whom have said they will refuse to be inoculated.

Worker advocacy groups, however, are not content to simply let the process play out. They are determined to keep applying pressure.

On Feb. 3, the National Council for Occupational Safety and Health (COSH) issued its own eight-point National Agenda for Workplace Safety and Health. The same week, United For Respect (UFR), a national non-profit advocating for the rights of U.S. workers, called for a mass vaccination effort that prioritizes public-facing retail workers.

Now in its second year, the worldwide coronavirus pandemic has taken the lives of more than 465,000 Americans with another 3,000 dying each day. It's also upended the lives of roughly 27 million other people who survived, but still don't fully understand the lasting implications of being infected.

Workplace Spreading

The workplace is a known vector for virus spread, but it's unclear how many American fatalities represent frontline workers. COVID-19 killed more than 2,900 American healthcare workers last year, according to an estimate by the nonprofit Kaiser Health News. The actual figure may be much higher.

Lack of hygiene for the homeless adds to the dangers faced by many essential workers in hospitals, transit and other front line jobs, an expose in the San Francisco Public Press, a nonprofit news organization, showed in graphic detail last spring.

So far, the distribution of vaccines seems not to align with essential worker risks.

In New York City, where people of color dominate in healthcare and other essential services jobs that come with the greatest risk of infection, white people account for 48-percent of the 300,000 vaccine shots administered thus far. Whites are less than 43% of the city population and their share of jobs at high risk of infection is lower, illustrating the structural racism in fighting the virus.

Transit Workers' Risks

Transit workers are among those most at risk. The Metropolitan Transit Authority in New York recently began posting an ongoing memorial throughout the transit system honoring 136 bus operators, conductors, motormen and others the virus has killed so far.

Some MTA workers have long contended that the agency failed to stress the importance of personal protection equipment during the early days of the pandemic. Others, including Jersey City train operator Hannington Dia, say their union let them down, too.

"We asked for protection," Dia said at a Tax the Rich rally in January at New York's Zuccotti Park, site of the 2011 Occupy Wall Street demonstrations. "We asked for masks at that point when it got really bad in March. But you know what the union said? They basically parroted management's line.

"Management said that since the CDC [Centers for Disease Control] said we don't need masks, we're not going to give them to you. We wanted to be secure and we told the union, and the union did nothing but parrot their goddamned lies."

TWU Local 100 President Tony Utano, however, says the union has been at the forefront of safety throughout the pandemic and that Dia is simply wrong, and his anger is misdirected.

Union Gets Masks

"While the MTA mishandled the pandemic in the early stages, TWU Local 100 fought and pushed them on the issues of masks, work rules, cleaning, you name it," Utano told me in an email. "The union even went out and obtained 10s of thousands of masks during a global shortage and started distributing them before the MTA did."

According to Utano, some 20,000 at-work COVID-19 tests have successfully identified hundreds of asymptomatic workers and more than 5,000 transit workers have been vaccinated.

TWU Local 100's membership is 46% Black people, 17% Hispanic people and 12% Asian people.

Black people age 45-54 face a nine-fold higher risk of dying from the virus than the public overall. The awful statistic is "no doubt driven by who had to keep working during the pandemic," said Dr. Mary Bassett, director of the Francois-Xavier Bagnoud Center for Health and Human Rights at Harvard University. "It's a sad statement on where we are now,"

"This disparity has not only held for who gets exposed and who gets sick, it has also carried on to who gets vaccinated," Dr. Bassett said.

Dr. Bassett also noted that President Joe Biden wears an N95 mask under his cloth mask to protect himself from the virus.

A White House spokesperson confirmed the president's practice as a matter of personal preference.

"If he thought that made him safer, you can imagine that a person doing deliveries, stocking shelves, interacting with irate customers, might feel a lot safer if they got to do the same thing," Dr. Bassett added.

A study in The British Medical Journal found grocery store workers in customer-facing roles are five times more likely to test positive than peers who don't come into contact with customers.

That small study also found that problems with depression among workers who used public transportation or ride shares to commute while "those able to commute on foot, by bike or in their own car were 90% less likely to report depressive symptoms."

Deadly Distinctions

Andrews the dog groomer is HIV positive, but at 54, he just misses the age criteria for early access to the vaccine.

Restaurant workers, first responders, public safety workers, home attendants and people over 65 are among those eligible for a shot in New York City. But obtaining an appointment is virtually impossible due to a reported lack of vaccine. That problem extends across much of America, although some states that voted for Trump seem to have better supplies of vaccine.

Allegra Brown delivers groceries for Amazon Fresh in New Jersey, a state that has so far confirmed 11 cases across six counties of a more contagious variant of COVID-19. She says workers like her need N95 masks and a vaccine "now — today."

"Of all the people in New Jersey who have gotten the vaccine so far, only 3% have been Black," she says. "My workplace at Amazon is full of Black and Brown people who are getting COVID and bringing it home to their families all the time. There's no reason for the shortage of vaccines other than structural racism, corporate greed and political gain."

Those applauding the actions Biden has taken thus far to roll out the vaccine and strengthen workplace safety standards say it's still too early to access effectiveness of Biden's approach.

Biden "inherited a very chaotic process from the previous administration," Bianca Agustin said. She's research director at United for Respect, a multiracial group seeking to improve working conditions, especially for women and people of color.

"We need more vaccines immediately, and Biden should be doing whatever it takes to make that happen. I think that he has acted swiftly. So, in the coming weeks we'll see if that produces significantly more vaccine available to the public across states," Agustin said.

The nation has "completely failed" its workers, according to Rep. Andy Levin, the suburban Detroit Democrat who is vice-chair of the House Committee on Education and Labor.

"What matters is workers taking action, workers taking to the streets," Levin told me. "We need a lot of change and we need everybody in the game."

He wants to "activate people" in his district to "get involved in direct action."

Change can't come soon enough for workers like Brown, who says her job delivering groceries for Amazon is more dangerous now than it was last summer.

"This needs to be fixed now," Brown said.

Here's what federal workers want from Biden in the wake of Trump's union-busting tactics

Federal workers who saw their rights to collective bargaining, due process, and workplace representation eviscerated under Donald Trump have an enormous hill to climb to reclaim all they've lost.

As president, Trump — who had a decades-long history of sticking it to workers long before entering politics — did all he could to hurt the federal workforce.

Trump issued three union-busting executive orders on May 25, 2018, that affected some 700,000 American Federation of Government Employees members at Defense, Environment, Social Security, Veterans Affairs and more.

'There is a certain amount of trust we need to regain. Not only trust … but respect.'—Linda Ward-Smith, president of American Federation of Government Employees Local 1224

The damage became clear less than two years later when union members needed workplace safety measures to minimize the risk of contracting COVID-19. Their right to health protections had been gutted.

Felicia Sharp, president of AFGE Local 1410, said that when the pandemic hit Defense Department management had a blunt message to union representatives: "We don't have to talk to you."

Workers Died

The results were predictable. "Employees have died because of the protections ripped out of their contract," David Cann, an AFGE field director, told reporters.

"The great majority of contacts have been gutted as a result of the Trump executive orders," Cann said. "We've been hamstrung by the outgoing administration to do the mission."

Workers with grievances or facing dismissal, including concerns about their risk of contracting COVID-19, found they no longer were entitled to union representation under Executive Orders 13836, 13837 and 13839. Team Trump kicked union representatives out of their government offices, increasing labor-management antagonisms rather than working to smooth them over. Individual workers found themselves alone and facing off against bosses, personnel specialists and government lawyers.

President Joe Biden revoked Trump's trio of anti-union executive orders on his second full day in office. Team Biden says that was just the first step in helping government workers get back on track.

Everett Kelley, the union's national president, said: "The last four years have been incredibly rough on our civil servants." Biden's revocation of the three Trump executive orders marked "a new day of hope — and we are glad to have our seats at the table."

The National Treasury Employees Union, which has 150,000 members, also elated. It said Biden's Jan. 22 actions "restored balance and stability to labor-management relations in the federal government by revoking a series of executive orders that had done nothing but disrupt the workplace and disrespect career civil servants."

Tony Reardon, president of the Treasury Workers union, said "This is a good day for public service because the President of the United States has declared, once again, that working for the federal government is a noble pursuit and that our government will respect your service."

Trump Era Contracts Remain

Union contracts signed under the Trump regime remain in effect. The AFGE wants to renegotiate. But agencies that spent the Trump era aggressively tuning out their employees and their union representatives aren't rushing to reestablish good communications with AFGE locals, union leaders told me.

"We have not heard from agencies that they are ready to negotiate," Cann said.

Linda Ward-Smith, president of AFGE Local 1224, believes Trump's executive orders emboldened government managers to be openly hostile to union members and dismissive of their input and concerns. "Management decided they didn't need to talk to the union," Ward-Smith said. "As a union president, I feel like I've been fighting a war for the last three years."

Ward-Smith and others worry that the damage from the anti-union Trump era may be lasting, perhaps fatal to resolving disputes without extensive litigation. The reason? Relationships that depended on trust on each side have been weakened and, in some cases, shattered in good part because Team Trump held unions in contempt despite Trump's carefully polished image as the champion of what he called the Forgotten Man.

"There is a certain amount of trust we need to regain," Ward Smith declared. "Not only trust… but respect."

Ralph De Juliis, president of the AFGE Social Security Administration Council of union locals, was blunt: "Agency leaders are being given a pass. There is no working with these people. Kick them laterally — but get them out of labor relations."

No Respect

De Juliis wants both Social Security Commissioner Andrew M. Saul, whose appointment by Trump lasts into 2025, and Deputy Commissioner David F. Black replaced.

According to De Juliis, the Trump appointees are responsible for undermining employee morale, creating an anti-union environment and forcing Social Security Administration workers to accept "the worst labor agreement in a decade."

"They have no respect for SSA public servants," De Juliis said. "The management/employee relationship is terrible."

Asked about this, Mark Hinkle, a Social Security Administration spokesman, said there would be no comment.

Nicole Cantello, president of Local 704 with 430 members who work for the EPA's Region 5 headquarters in Chicago, said her member's woes are tied to Trump's attacks on that agency, especially scientists. Trump appointed the notorious climate change denier Scott Pruitt to run the agency 2017, then stripped EPA workers of their collectively bargained contract and "inserting the worst provisions from [Trump's] executive orders."

The struggle, she said, became to keep the union from collapsing. "We kept enough of the agency intact, so that when help came after four years, it could be resurrected. Biden acted quickly to right a wrong. EPA scientists can now put their full weight into battling climate change," Cantello said.

The AFGE wants the Biden White House to direct all federal agencies to "review, suspend and revoke" any actions and policies that resulted from Trump era actions. We'll watch for further Team Biden actions affecting the collective bargaining rights of federal workers

Biden Administration hampered in rolling out COVID-19 workplace protections

U.S. workers continue to get sick and die from COVID-19 largely because the Trump White House refused to safeguard them with federally enforceable protections.

That isn't going to change immediately under President Joe Biden's executive order aimed at Protecting Worker Health & Safety because rules made by Congress say it takes time to implement life-protecting policies.

The Occupational Safety & Health Administration (OSHA) should have moved months ago to establish an "emergency temporary standard" governing workplace protections in the time of COVID-19.

The Trump Administration did very little to protect people. Trump left office with no plan to distribute the vaccines for which Trump claimed credit.

Because of the incompetence, delays and inaction by Team Trump the pandemic has already killed more than 425,000 people in the U.S.—more Americans than died in World War II. The Centers for Disease Control & Prevention now predicts the death toll will reach 500,000 people by March 1 and that deaths will continue for months to come.

Teamsters Union Plan

On Jan. 19, Trump's last full day in office, the Teamsters released a set of national legislative priories that include strengthening OSHA's enforcement capabilities, as well as establishing a new emergency temporary standard to deal with the coronavirus. OSHA has long been under attack by corporate interests who claim it adds costs to business, cutting into profits.

The Trump Administration did very little to protect people. Trump left office with no plan to distribute the vaccines for which Trump claimed credit.

A year ago a new emergency temporary standard was urged by Rep. Bobby Scott (D-Va.), who chairs the House Committee on Education and Labor. In a letter to then Labor Secretary Eugene Scalia, Scott said that OSHA's infectious disease standard had been left to "languish" for about a decade. "OSHA must take swift action to protect healthcare workers, and by extension, the American public," Scott wrote.

OSHA Failing Workers

"The safety of America's frontline healthcare workers and, by extension, the health of the entire nation will depend on OSHA's ability to ensure the safety of the nation's health care infrastructure," Scott wrote. "Absent timely action, OSHA will be failing frontline healthcare workers, its mission, and the nation."

That sense of urgency, coupled with the botched rollout of the COVID-19 vaccination program, has only grown more acute with time. Still, there is a process, and it could be another two months before OSHA, its budget well below what is needed to protect workers, establishes the kinds of enforceable workplace protections that Trump didn't enact.

"We want more, of course — we know that there is an extreme amount of urgency," Jessica Martinez told me. She is co-executive director of the National Council for Occupational Safety and Health, which plans to release its own national agenda for worker health and safety on Feb 3.

"There is a process of setting a standard and we hope that it moves quickly through the bureaucracy of government," she said, acknowledging how procedural rules hinder the speed with which the Biden administration can act.

Labor groups last year called for action from the Trump Administration. The failure to act contradicted Trump's inaugural address promise that "I will fight for you with every breath in my body – and I will never, ever let you down."

States Act on Their Own

Several states decided not to wait for federal action. They moved earlier to expand worker protections in the face of the ongoing coronavirus pandemic. California established a new emergency standard for COVID prevention on Nov. 19. A new Virginia work-safety rule takes effect this week, but without paid leave provisions like the California law.

Although more than 25 million cases of COVID-19 nationwide attest to the need, insiders argue that Biden is prohibited from circumventing required analysis and outright directing OSHA to establish a new emergency standard because employers would only challenge its validity in court.

"There is nothing on paper at this point that makes any of this proposal enforceable," Martinez conceded. "Now, with that said, I think that it's important to note several factors: One is that the government has been intentional about including these guidelines — something we have not heard from the former administration. Second, there is some real leadership that has been announced — folks that have been committed many years to understand the importance of engaging workers, worker advocates and the process of putting priorities around worker safety and health."

In addition to issuing the executive order on Protecting Worker Health & Safety on his first full day as president, Biden also tapped three people with extensive backgrounds in worker health and safety to protect workers. Jim Frederick will be OSHA's deputy assistant secretary; Chip Hughes as named deputy assistant secretary for pandemic emergency response; and Ann Rosenthal was appointed senior advisor.

"We're hopeful that with this leadership it is a step in the right direction and there will be a more concrete commitment to making many of these processes more enforceable," Martinez added. "Also, some clear guidance in ways that allows workers to have a seat at the table."

Interest in workplace safety and competent leadership have never and likely never will be enough to safeguard American workers, however. That is going to take the kind of "street heat" from working people that earlier this month compelled the California State Assembly to introduce a bill aimed at protecting fast-food workers and the organized labor action that secured a roughly 10% raise for members of Teamsters Local 202 working at the Hunts Point Produce Market in New York City.

"Only strong worker participation is really going to get anyone anywhere," a congressional aide with extensive knowledge of OSHA's operations recently told me. "It's harder than just snapping fingers — nothing happens by itself in Washington."

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