Some nurses refusing to work, citing unsafe COVID-19 work conditions at LHSC

The London Health Sciences Centre is not providing the equipment nurses need to do their jobs and some are refusing to work in what they call unsafe conditions, their union said Monday.

Nine nurses, who usually administer chemotherapy at the Regional Cancer Clinic, did not work after reporting unsafe conditions to the Ministry of Labour.

They were not given any masks, said James Murray, the president of the Ontario Nurses Association (ONA) Local 100, which represents nurses at University Hospital and Victoria Hospital. 

"They're scared. They want to be able to provide care, but if they get sick, they won't be able to do that," Murray said.

"They're not given a mask. None whatsoever. They're not refusing to provide care, they're asking for proper personal protective equipment (PPE) so they can provide the care these patients need." 

The cancer clinic nurses are asking for surgical masks and eye protection before they deal with patients, he said. Patients coming in for their chemotherapy appointments Monday were waiting until the Ministry of Labour had assessed the situation. 

Over the weekend, nurses at University Hospital and at the COVID-19 assessment centre at Carling Heights Optimist Community Centre also refused to work, saying they didn't have the proper equipment to do their jobs. 

"The screeners were requesting N95 masks. They're taking swabs from patients and to do that they have to get quite close," Murray said. 

LHSC didn't respond to questions from CBC News about the work refusal at the cancer clinic. In a statement, the hospital said "Our top priority continues to be ensuring the safety of all patients, staff, and physicians at London Health Sciences Centre (LHSC). The COVID-19 situation is very fluid and we continue to modify our operations as a result of provincial directives."

The hospital said it is providing necessary PPE in accordance with a directive from the Ministry of Health. 

Usually, ministry inspectors are dispatched to a workplace to do an assessment when a work refusal happens. However, Murray said the ministry has been doing its assessments over the phone, and did not agree with the nurses' request for masks. 

CBC London reached out to the Ministry of Labour for comment about the work refusals. No response was provided. 

'Conservation' measures implemented

But in a memo sent to staff, LHSC said it is implementing "conservation measures" for PPEs.

"Across the organization work and teams will be structured to conserve the use of PPE (especially N95). This will include limiting who goes into spaces requiring contact/droplet precautions," the memo states. 

"Patients with similar needs for precautions will be placed together and the frequency of entry to spaces requiring contact/droplet precautions will also be limited."

N95 masks are a "critical resource," the memo states, and the hospital spells out strict measures for how to conserve them, including planning who goes into and out of a room so masks don't have to be re-applied. 

The mask shortage is not unique to London, and is in fact being felt across the country. Ontairo Premier Doug Ford warned Monday that a shortage of masks, gloves and gowns looms as the number of COVID-19 cases increases daily. 

Four masks per shift

At LHSC and St. Joseph's Health Care's urgent clinic, the memo sent to staff said that those looking after patients must wear eye protection and a surgical mask with face shield at all times. 

"Each person in these areas will receive 4 masks (shields) for each shift, unless circumstances require additional PPE such as when it is soiled," the directive states. 

It mandates staff who work with COVID-19 or suspected COVID-19 patients to wear more protective equipment, including an isolation gown, gloves, and Level 2 masks. 

In its statement, LHSC said one work refusal last week by nurses was dismissed by the ministry of labour. 

"We recognize that the quickly changing nature of this public health emergency is creating anxiety and uncertainty for our care teams and we are working through the well-established processes to resolve any work refusals and clarify misinterpretations regarding appropriate PPE use," the hospital wrote.