The Canadian Federation of Nurses Unions (CFNU) and RNU have updated their COVID-19 position statement.
While we maintain all health care workers at risk of exposure to COVID-19 should be provided with and have access to a fitted N-95 respirator, the revised statement acknowledges that risk varies greatly depending on the caregiver, patient, environment and situation.
It recognizes the critical importance of a point-of-care risk assessment in determining the appropriate personal protective equipment (PPE), in particular the appropriate mask to be worn. The statement emphasizes that individual health care workers are best positioned to determine the appropriate mask required based on the situation or their interactions with an individual patient.
If you assess that an N95 Mask is required, you should proceed with using an N95. If your assessment determines risk is low, you may decide that a surgical mask provides adequate protection.
CFNU’s position statement also calls for government and employers to designate airborne precautions and the use of N95 respirators at ALL times in ALL clinical areas considered aerosol-generating medical procedure “hot spots” (e.g. ICU, ER, OR, RR, and trauma centres that manage COVID-19
Our updated position recognizes the skill and expertise of registered nurses and nurse practitioners and emphasizes the critical importance of your own critical thinking and professional judgment.
I have been told not to use an N95 mask. What should I do?
Do a point-of-care risk assessment (evaluate the situation and your interactions with the patient).
Decide what you feel is the appropriate PPE.
If your assessment determines a surgical mask can be used, proceed with your nursing care.
If your assessment determines that an N95 should be used, speak to your manager or designate. Inform them you will be using an N95
If your manager directs you to treat the patient without an N95, you have the option to refuse unsafe work under the Occupational Health & Safety Act.
What’s the procedure for refusing unsafe work?
Tell your manager you are refusing unsafe work.
Provide your safety concerns and reasons for the refusal based on your assessment.
Contact your workplace Occupational Health and Safety representative immediately. (Your manager can help identify your rep. You may also find information on the employer intranet or OH&S bulletin board).
Follow-up with your OH&S representative in writing (email is fine).
Management will then investigate.
If your employer fails to provide an N95 respirator, the next step is to report it to the Occupational Health and Safety Division of the provincial government (the OH&S Committee should be able to provide details on making this contact). Also, contact RNU Provincial Office. During after hours, email email@example.com.
While the matter is being investigated by the Occupational Health and Safety Division, your employer may assign you other duties.