Manitoba Nurses Union - Positions Statements - Occupational Health and Safety

Positions Statements - Occupational Health and Safety

1. Musculoskeletal injuries

Preamble

Lifting and transferring patients is an essential component of a nurses’ working life. The repetitiveness and variability of these procedures increases the potential risk of a musculoskeletal injury and accounts for approximately 75% of all nursing occupational injuries. In addition, stress, insufficient staffing, heavy workloads, a lack of or inadequately maintained equipment and poor ergonomics may significantly contribute to musculoskeletal injuries.

aOnce injured, nurses may face a cycle of pain, frustration and/or rejection from the workplace.

Musculoskeletal injuries often take a long time to fully heal which may result in nurses leaving the profession.

The Manitoba Nurses’ Union in representing its members’ occupational health concerns will strive to ensure nurses are able to maximize a safe and healthy environment.

Back to top

Patient Advocacy

Nurses as professionals and acting as patient advocates will strive to provide patients with compassionate, effective and high quality nursing care.

Right to Know

Nurses have the right to know when there is a potential for musculoskeletal injury in the workplace. They also have the right to know the appropriate methods used in prevention of musculoskeletal injuries.

Policies and Procedures

Every health care facility must have appropriate policies and procedures in place dealing with musculoskeletal injuries including:

a.Prevention

b.Education

c.Safety

d.Ergonomics

e.Rehabilitation with early return to work programs.

There must also be an effective system in place for reporting musculoskeletel injuries and corresponding report forms must be readily available. These forms must have clear direction for their completion.

Right to Participate

It is essential that Manitoba Nurses’ Union members at the local level participate in the development and implementation of these pollicies and procedures.

Education

The Manitoba Nurses Union will take a proactive stance in encouraging members/locals to become more knowledgeable and educated about methods and programs to minimize potential musculoskeletal injuries.

It is the employer’s responsibility to ensure nurses have access to prevention programs and education on a continuous basis. These programs must include:

a. Proper safety techniques

b. Transferring and transporting techniques

c. Appropriate use of equipment

d. Methods of reducing potential injuries

Equipment

The Manitoba Nurses Union recognizes it is the employer’s responsibility to provide nurses with easy access to safe and proper equipment, i.e., high/low beds, hoyer lifts. This equipment must be of sufficient quality and quantity.

Accurate Patient Classification

It is the Union’s position that the many existing patient classification systems do not accurately reflect the nursing car needs of the patients. It is the employer’s responsibility to ensure there is appropriate staffing and resources to match the nursing are needs of the patients. The Union encourages employers to institute a patient classification system which more accurately reflects nursing care needs. This would greatly assist in reducing musculoskeletal injuries for nurses.

Compensation

Nurses should have better access to the Workers Compensation system. It is the Union’s position that the Workers Compensation Board and employers play a primary role in the reduction of musculoskeletal injuries in the workplace.

Note: The Manitoba Nurses Union have put the Workers Compensation Board on notice there will not be a significant reduction of workplace injuries until there is increased commitment by employers and the Workers Compensation Board, for educational, prevention, rehabilitation and resource allocation in the workplace.

Nurses’ Right to Refuse

The Union supports a nurse's right to refuse to perform dangerous work under Article 43 of the Workplace Health and Safety Act when the nurse believes she may be placed in an unsafe situation that may cause a musculoskeletal injury.

Back to top

2. Occupational stress

Preamble

The Manitoba Nurses Union believes occupational stress for nurses has been dramatically rising. Contributing factors include: excessive workloads, a lack of resources and staff, a lack of input and control into decision-making, increased patient acuity and rapid technological change. This stress is compounded by ever-increasing standards and expectations of employers, physicians, licensing bodies and society.

The Manitoba Nurses Union, in representing its members’ occupational safety and health concerns, will strive to ensure nurses are able to maximize the potential of a safe and healthy working environment.

Patient Advocacy

Nurses as professionals, and acting as patient advocates will strive to provide patients with compassionate, effective and high quality nursing care.

Right to Know

Nurses have the right to know the potential of health and safety hazards when

a. Exposed to prolonged and/or excessive stressors

b.The symptoms and manifestations of prolonged and excessive workplace stress

Policies and Procedures

It is the responsibility of the Employer to implement proactive and preventative policies and procedures to prevent and deal with occupational stress. These policies and procedures must include:

a.Stress identification

b.Methods of stress reduction

c.Effective coping mechanisms

d.Stress management

Right to Participate

It is essential that Manitoba Nurses Union members at the local level participate in the development and implementation of these policies and procedures.

Education

The Manitoba Nurses Union will take a proactive stance in encouraging members/locals to become more knowledgeable and educated on the issue of occupational stress and stress management.

The Employer must provide proper orientation, with effective ongoing education programs including:

a. Stress identification

b. Causative Factors

c. Symptoms and manifestations

d.Appropriate and effective methods of coping

Right to Refuse

The Manitoba Nurses Union believes occupational stress may contribute to workplace injuries, illness and a reduction in the quality of worklife.

The Union believes nurses may be exercising their Right to Refuse by prematurely leaving the nursing profession.

Back to top

3. Nurse abuse

Preamble

Violence and/or abuse is an expression of negative emotion that hurts or causes harm through verbal, physical, sexual or psychological means directed towards staff members. This may be a symptom of a situation. Abuse may be subtle or overt.

The Manitoba Nurses Union in representing its members occupational health and safety concerns will strive to ensure nurses are able to maximize the potential of a safe and healthy working environment. (Notice: Staff Abuse – refers to any expression of negative emotion directed toward a staff member(s) that hurts or causes harm through verbal, physical, sexual or psychological means. Abuse, assault and violence are terms used interchangeably in the literature to describe behaviors ranging from verbal abuse and emotional harm to criminal activities such as common assault (which includes threats accompanied by gestures) and aggravated assault (which includes wounding, maiming, disfiguring or endangering life).

Nurses are the front line contact in potentially abuse situations.

Patient Advocacy

Nurses as professionals and acting as patient advocates will strive to provide patients with compassionate, effective and high quality nursing care.

Right to Know

Nurses have the right to know when potentially abusive persons/situations may exist in the workplace.

Policies and Procedures

Every health care facility must have appropriate policies and procedures in place with respect to dealing with abusive persons or situations in the workplace. These policies and procedures must include:

a.Clear understanding of nurse abuse, i.e. rights, responsibilities, reporting and prevention

b.Recognition of potential abusive situations and methods of diffusion

Clear direction from facility boards of directors on the issue of nurse abuse and how to prevent and deal with it

Proper facility security measures

e.Education on legal parameters surrounding abusive situations.

Right to Participate

It is essential that Manitoba Nurses’ Union members at the local level participate in the development and implementation of these policies and procedures.

Education

The Manitoba Nurses Union will take a proactive stance in encouraging members/locals to become more knowledgeable and educated with respect to abuse in the workplace.

The Employer must provide proper and adequate orientation with ongoing education in dealing with abuse.

It is essential all nurses report and document the incidences of abuse to their immediate supervisors, this may be brought to the attention of the local and/or workplace safety and health committee to facilitate effective resolution.

Security

It is the responsibility of the Employers to provide a safe working environment to minimize the potential for abuse. The Manitoba Nurses Union will take a proactive stance to minimize/eliminate the risks of abuse.

The Manitoba Nurses Union recognizes the increased risks where nurses work alone.

The Manitoba Nurses Union expects Employers to arrange for immediate response by law enforcement agencies or similar security agencies.

The Manitoba Nurses Union expects Employers to provide appropriate security, i.e. security guards, one way doors, call systems.

The Manitoba Nurses Union expects adequate personnel to maximize the potential for a safe and secure work environment.

Right to Refuse

The Manitoba Nurses Union will support nurses’ right to refuse dangerous work under Article 43 of the Workplace Health and Safety Act when:

a.There are inadequate or no-existent protocols for dealing effectively with abusive people;

b.There is inadequate quantity or quality of protective equipment and security measures;

c.Nurses have not received adequate orientation and inservice education in dealing with incidents of violence or abuse; and/or

d.An Employer attempts to dissuade a nurse from documenting or reporting incidents whether it be informally (to the facility) or formally (to the authorities) or taking legal recourse or action.

Reference: Manitoba Workplace Safety and Health Act.

Back to top

4. Communicable diseases

Preamble

Communicable diseases in the health care workplace have been taking a significantly higher profile in recent years. The Manitoba Nurses Union in representing its members occupational health concerns will strive to ensure nurses are able to maximize the potential of a safe and healthy working environment.

Patient Advocacy

Nurses as professionals and acting as patient advocates will strive to provide patients with compassionate, effective and high quality nursing care.

Right to Know

Nurses have the right to know the potential health and safety hazards associated with communicable diseases hazards in the workplace.

The Manitoba Nurses Union supports the practice of universal blood and body fluid precautions for all patients.

The Manitoba Nurses Union also support nurses having the right to know all patients diagnosis for whom they are required to give care in order to adequately meet all clinical needs of patients.

Policies and Procedures

a.Every health care facility must have appropriate pollicies and procedures with respect to dealing with major communicable diseases in the workplace.

b.These policies and procedures must be consistent with recognized standards, i.e. Centre of Disease Control: Atlanta and Health and Welfare Canada.

c.Testing of high-risk patients may be performed when deemed appropriate by the physician or the employer with consent of the patient. The Manitoba Nurses’ Union locals should have input into the development of policies and procedures in such testing.

d.Mandatory Testing – The Manitoba Nurses’ Union is not convinced that mandatory testing of all patients or staff would be either accurate or beneficial. Reference the Center for Disease Control – Atlanta MMUR August 21, 1987 Vol. 36, No. 25, page 145.

Right to Participate

It is essential that Manitoba Nurses Union members at the local level participate in the development and implementation of these policies and procedures.

Education

The Manitoba Nurses Union will take a proactive stance in encouraging members/locals to become more knowledgeable and educated about current measures to protect nurses from accidental transmission of communicable diseases in the workplace.

The Employer must provide proper prevention and effective education with respect to communicable diseases.

Equipment

The Manitoba Nurses Union recognizes it is the Employer’s responsibility to provide nurse with easy access to safe and proper equipment including appropriate storage containers and gloves. This equipment must be of sufficient quality and quantity.

Right to Refuse

The Manitoba Nurses Union will support nurses’ right to refuse dangerous work under Article 43 of the Workplace Health and Safety Act when:

a.There are inadequate or non-existent protocols for treatment of patients with communicable diseases;

b.There is inadequate quantity or quality of protective equipment;

c.The nurse has had inadequate orientation and inservice education on appropriate safety and health measures in dealing with communicable diseases;

d.An employer attempts to dissuade a nurse from following proper communicable disease precautions.

Note: If nurses observe the above are not in place, contact your workplace safety and health committee and local immediately.

Back to top

5. Communicable diseases - Addendum - Hepatitis vaccines

Introduction

Hepatitis A and Bo pose a serious health hazard in the workplace. There is clear evidence to support vaccination against these diseases as an effective preventative measure to reduce the risk of contracting Hepatitis, and to reduce the severity of the disease after exposure.

Access to Vaccination

All nurses potentially face exposure to Hepatitis. Locals and nurses should identify potential exposure risks within the workplace. The objective should be that all nurses have access to Hepatitis immunization on a voluntary basis. This should be at no cost or loss of income to the nurse.

It is the Manitoba Nurses Union position that the Employer is responsible for the provision of appropriate vaccinations and/or preventative measures, i.e. Hepatovax B, HBIG (Hepatitis B Immune Globulin), ISG (Immune Serum Globulin) and other appropriate vaccines. Hepatitis vaccines and/or preventative measures should be administered within the recommended time frames.

Exposure to Hepatitis

Each facility must have policies and procedures to monitor nursing staff after mucous membrane exposure and/or any needle stick injury.

The Union will treat exposure and/or contracting of Hepatitis as a work related injury and compensable under the Workers compensation Act unless it can be clearly proved otherwise.

Back to top

6. Communicable diseases - Addendum - Needle stick injuries

Preamble

Although the majority of needle stick injuries create only minor localized tissue damage, there is the grave potential of contracting a life threatening disease through this route.

Patient Advocacy

Nurses as professional and acting as patient advocates will strive to provide patients with compassionate, effective and high quality care.

Right to Know

Nurses have the right to know potential health hazards that can occur from needle stick injuries.

The Manitoba Nurses Union supports the practice of universal blood and body fluid precautions (Universal Precautions) in caring for all patients.

The Manitoba Nurses Union also supports nurses who are providing direct care to have the right to know the patient’s diagnosis. This is essential in identifying potential health hazards which may result from needle stick injury. Knowledge of diagnosis assists in facilitating appropriate identification and care of persons affected by needle stick injuries.

Policies and Procedures

Every health care facility must have appropriate policies and procedures with respect to prevention of needle stick injuries and appropriate care of nurses who have a needle stick injury.

These policies and procedures must be consistent with recognized and current standards of care, re: Health and Welfare Canada, and Centre for Disease Control Atlanta;

MNU strongly recommends appropriate testing should be performed on all patients with whom contaminated needles have been identified as the causative agent. The Manitoba Nurses’ Union Locals should have input into the development of policies and procedures for this testing.

Support confidentiality and follow-up procedures must be available for patients and those who receive needle stick injuries.

Right to Participate

It is essential that the Manitoba Nurses Union members at the Local level participate in the development and implementation of these policies and procedures.

Education

The Manitoba Nurses Union will take a proactive stance in encouraging members/locals to become more knowledgeable and educated concerning measures to reduce risk or incidence of needle stick injuries. It is the expectation of the Union that facilities/employers provide proper prevention and education with respect to prevention of needle stick injuries. All injuries must be reported with an appropriate WCB injured worker form.

Equipment

The Manitoba Nurses Union recognizes that it is the Employer’s responsibility to provide safe and proper equipment to facilitate the prevention of needle stick injuries. This equipment must be easily accessible and in sufficient quality and quantity. Sharps containers must be easily accessible, of sufficient size and puncture proof.

Right to Refuse

The Manitoba Nurses Union will support nurses’ right to refuse dangerous work under Article 43 of the Workplace and Safety Act when:

a. There are inadequate or non-existent protocols for identification for prevention identification and follow-up of needle stick injuries.

b. There is inadequate quantity and quality of protective equipment;

c. The nurse has had inadequate orientation and inservice on the handling of needles and syringes;

d. The Employer attempt to dissuade a nurse from following the protocols for presentation, identifications and follow-up of needle stick injuries.

Note: If any nurse observes the above are not in place, contact your Workplace Safety and Health Committee and Local immediately.

The Manitoba Nurses Union does not support random or selective mandatory testing of patients/clients or staff in the event of a needles stick injury. We support the individuals right to decline treatment although access to all relevant information is necessary.

Back to top

7. Anitneoplastic drugs

Preamble

Antineoplastic drugs are used to treat cancer patients in health care facilities. These drugs have significant toxic properties which pose an occupational health risk to nurses if special precautions are not taken. The Manitoba Nurses Union in representing its members occupational health concerns will strive to ensure nurses are able to maximize the potential of a safe and healthy working environment.

Patient Advocacy

Nurses as professionals and acting as patient advocates will strive to ensure patients undergoing cancer treatment with antineoplastic drugs have access to compassionate effective and high quality nursing care.

Right to Know

Nurses have the right to know the mutagenic, carcinogenic and local tissue damage properties associated with exposure o antineoplastic drugs. Nurses have the right to know the potential hazards associated with the preparation, administration, storage and disposal of antineoplastic drugs.

Policies and Procedures

Every health care institution must have appropriate policies and procedures with respect to handling of antineoplastic drugs including preparation, administration, storage and disposal.

There should be specific policies and procedures in place with respect to cleanup of spills and/or patient body fluids containing antineoplastic drugs.

Right to Participate

It is essential that Manitoba Nurses’ Union members at the local level participate in the development and implementation of these policies and procedures.

Education

The Manitoba Nurses Union will take a proactive stance in encouraging members/locals to become more knowledgeable and educated as to safe and proper handling of antineoplastic drugs in the workplace. The Employer must provide proper orientation and effective education programs to support safe handling of antineoplastic drugs.

Equipment

The Manitoba Nurses Union recognizes it is the Employer’s responsibility to provide nurses with easy access to safe and proper equipment of sufficient quality and quantity for the preparation, administration, storage, spill cleanup and disposal of antineoplastic drugs.

This would include items such as proper vertical laminar flow hoods with HEPA filters, latex gloves, luer-lock syringes, and appropriate sharps containers.

Right to Refuse

The Manitoba Nurses Union will support a nurses’ right to refuse dangerous work under Article 43 of the Workplace Health and Safety Act when:

a. There are inadequate or non-existent protocols with respect to handling antineoplastic drugs;

b. There is inadequate quantity and quality of appropriate protective equipment;

c. The Nurse has had inadequate education including orientation and inservice training in the preparation, administration, storage, spill cleanup and disposal of antineoplastic drugs, and/or

d. An Employer attempts to dissuade a nurse from following proper protocols in handling antineoplastic drugs.

Back to top

8. Waste anaesthetic gases

Preamble

Anaesthetic gases are therapeutic agents administered to maintain loss of sensation, with or without unconsciousness, during surgical procedures, dental procedures, and labour and delivery. These gases can cause both short and long term health risks to nurses if appropriate precautions are not taken to eliminate/minimize exposure. The Manitoba Nurses’ Union, representing its members’ occupational health concerns, will strive to ensure nurses are able to maximize the potential of a safe and healthy environment.

Patient Advocacy

Nurses as professionals and acting as patient advocates will strive to ensure patients undergoing anaesthesis have compassionate high quality care.

Right to Know

Nurses have the right to know the potential hazardous effects that exposure to waste anaesthetic gases have on the reproductive system, central nervous system, the liver and the kidneys. There are potential carcinogenic, teratogenic and mutagenic effects of exposure to waste anaesthetic gases.

Nurses have the right to know the potential hazards associated with:

a. Absent, ineffective or antiquated scavenging equipment;

b. Inappropriate maintenance procedures;

c. Inappropriate ventilation and air exchanges;

d. Inappropriate anaesthetic techniques (i.e. inappropriate flushing of hoses); and

e. Inadequate and inappropriate monitoring of waste anaesthetic gas levels.

Policies and Procedures

Health care facilities must have policies and procedures in place with respect to waste anaesthetic gases, which outline appropriate:

a. Scavenging equipment;

b. Regular maintenance procedures;

c. Ventilation and air exchanges;

d. Anaesthetic techniques, and; monitoring of waste anaesthetic gas levels.

Right to Participate

It is essential that Manitoba Nurses’ Union members at the local level participate in the development and implementation of these policies and procedures.

Education

The Manitoba Nurses Union will take a proactive stance in encouraging locals/nurses to become more knowledgeable and educated in the prevention of exposure to waste anaesthetic gases in the workplace.

Equipment

The Manitoba Nurses Union recognizes it is the responsibility of Employers to provide easily accessible safe and proper equipment in sufficient quantity and quality to protect nurses from waste anaesthetic gas exposure. The operating room and post anaesthsia/recovery room must have appropriate:

a. Scavenger systems

b. Inspection and maintenance systems

c. Patent system of hoses

d. Anaesthetic equipment

e. Number of air exchanges and ventilation

Health Hazard Testing

Due to the serious health hazard risk, it is the Employer’s responsibility to provide:

a. Voluntary testing for possible exposure to waste anaesthetic gases which would be administered at no cost or loss of income to the member;

b. A registry of those nurses who have worked in areas where exposure to waste anaesthetic gases has occurred, and;

c. Regularly scheduled and random air sampling for all areas where there is potential exposure to waste anaesthetic gases using appropriate threshold limit values.

Right to Refuse

The Manitoba Nurses Union will support a nurse's right to refuse dangerous work under Article 43 of the Workplace Health and Safety Act when:

a. There are inadequate or non existent protocols with respect to waste anaesthetic gases;

b. There are inappropriate scavenger systems and/or inadequate ventilation and air exchanges;

c. There are inappropriate inspection and maintenance procedures;

d. There are inappropriate anaesthetic techniques;

e. There is inappropriate monitoring of waste anaesthetic gas levels;

f. There is inadequate inservice and education in regards to safe handling of anaesthetic gases and their emissions, and;

g. The Employer attempts to dissuade a nurse from reporting unsafe working conditions related to waste anaesthetic gas exposure.

Back to top

9. Explosive devices/bombs

Preamble

Nurses are professional caregivers whose primary responsibility is the nursing care of their patients. Since the nurses’ responsibility is the delivery of nursing care for which they have been trained and educated, nurses should not be involved in the search and/or disposal of explosive devices or bombs. The Manitoba Nurses Union, in representing its members’ occupational health concerns, will strive to ensure nurses are able to maximize the potential of a safe and healthy working environment.

Patient Advocacy

Nurses as professionals and acting as patient advocates will strive to provide patients with compassionate, effective and high quality nursing care even when the patient’s environment is threatened by explosive devices and/or bombs.

Right to Know

Nurses have the right to know when the threat of explosive devices/bombs exist in the working environment.

Policies and Procedures

Every health care facility must have appropriate policies and procedures in place with respect to explosive devices/bombs in the workplace. It is the Manitoba Nurses Union position that nurses are not trained, nor are they the appropriate personnel to perform bomb search or disposal procedures. The Manitoba Nurses Union expects Employers to provide specific procedures in the event a nurse receives a telephone call or verbal or written indication of a bomb threat.

Right to Participate

It is essential that Manitoba Nurses Union members at the local level participate in the development and implementation of these policies and procedures.

Education

a. The Manitoba Nurses Union will take a proactive stance in encouraging members/locals to become more knowledgeable and educated in their role, with respect to patient care in the event of any disaster plan implementation.

b. The Employer must provide proper orientation and effective education on the implementation of disaster plans.

Right to Refuse

The Manitoba Nurses Union will support a nurses’ right to refuse dangerous work under Article 43 of the Workplace Health and Safety Act when:

a. Nurses are expected or directed to search or dispose of explosive devices/bombs and/or

b. An Employer attempt to dissuade a nurse from following safe protocol with respect to explosive devices/bombs.

Back to top

10. Radiation

Preamble

Nurses have been exposed to radiation in the workplace for many years from radioisotopes, fluroscopy, portable X-rays and radioactive implants. The Manitoba Nurses Union, in representing its members' occupational health concerns, will strive to ensure nurses are able to maximize the potential of a safe and healthy working environment.

Patient Advocacy

Nurses as professionals and acting as patient advocates will strive to provide patients (receiving radioactive tests or therapy) with compassionate, effective and high quality nursing care.

Right to Know

Nurses have the right to know the risks of exposure to radiation in the workplace.

Policies and Procedures

Every health care facility must have appropriate policies and procedures for nurses assisting with diagnostic and therapeutic procedures involving radiation.

Right to Participate

It is essential that Manitoba Nurses’ Union members at the local level participate in the development and implementation of these policies and procedures.

Education

a. The Manitoba Nurses Union will take a proactive stance in encouraging members/locals to become more knowledgeable and educated on methods to minimize nurses’ exposure to radiation.

b. The Employer must provide proper orientation and effective education to protect nurses from exposure to radiation.

Equipment

The Manitoba Nurses Union recognizes it is the Employer’s responsibility to provide nurses with easy access to proper equipment (i.e. lead aprons neck collars, bed shields). This equipment must be of sufficient quality and quantity.

Nurse working in areas where there is a potential for high risk exposure, must be effectively monitored on a regular basis.

Rotation and Staffing to Reduce Risk of Radiation Exposure:

In areas where significant exposure to radiation is possible, staffing rotation must allow nurses to have their exposure to patients receiving radiotherapy, kept to a minimum.

Nurses who are pregnant have increased risk to the fetus and should minimize/eliminate exposure to radiation.

Right to Refuse

The Manitoba Nurses Union will support a nurse's right to refuse dangerous work under Article 43 of the Workplace Health and Safety Act when:

a. There are inadequate or non-existing protocols for care of patients undergoing treatment or diagnostic procedures involving radioactive substances.

b. There is inadequate quantity and quality of regularly maintained protective shielding and personal monitoring equipment.

c. The nurse has not had adequate orientation and effective inservice to equipment or procedures, and/or

d. An Employer attempts to dissuade a nurse from following proper protocol and precautions in minimizing exposure to radiation.

Back to top

11. Chemicals in the workplace

Preamble

Chemicals are widely used in health care facilities. These chemicals may have significant toxic properties which may be unknown to nurses in the workplace. The Manitoba Nurses’ Union, in representing its members’ occupational health concerns, will strive to ensure nurses are able to maximize the potential of a safe and healthy working environment.

Patient Advocacy

Nurses as professional and acting as patient advocates will strive to provide patients with compassionate, effective and high quality nursing care.

Right to Know

Nurses have the right to know the potential health and safety hazards associated with the preparation, administration, storage, disposal and spill clean-up of chemicals.

Policies and Procedures

Every health care facility must have appropriate policies and procedures with respect to dealing with chemicals in the workplace. These policies and procedures must be consistent with *WHMIS regulations. The WHMIS regulations include:

a. Inventory of controlled products

b. Labelling

c. Material Safety Data Sheets (MSDS’s)

d. Health Hazard Regulation Requirements

e. Prevention and Monitoring Plans

f. Training and Education

Right to Participate

It is essential that Manitoba Nurses Union members at the local level participate in the development and implementation of these policies and procedures.

Education

a. The Manitoba Nurses Union will take a proactive stance in encouraging members/locals to become more knowledgeable and educated re: chemicals and the WHMIS regulations.

b. The Employer must provide proper orientation with effective educational programs to support this regulation.

Equipment

The Manitoba Nurses Union recognizes it is the Employer’s responsibility to provide nurses with easy access to safe and proper equipment, i.e. WHMIS/MSDS binders. This equipment must be of sufficient quality and quantity.

Right to Refuse

The Manitoba Nurses Union will support a nurse’s right to refuse dangerous work under Article 43 of the Workplace Health and Safety Act when:

a. There are inadequate or non-existing protocols with respect to handling chemicals/WHMIS.

b. There is inadequate quantity and quality of appropriate protective equipment.

c. The nurses have had inadequate WHMIS education, including orientation and inservice in handling of chemicals.

d. An Employer attempts to dissuade a nurse from following protocols in handling chemicals in the workplace.

*WHMIS – Workplace Hazardous Material Information System

Back to top

12. Asbestos

Preamble

There is no known safe level for airborne asbestos fibers. Asbestos contamination in health care facilities is a growing occupational health concern. As asbestos is a know carcinogen, the Manitoba Nurses Union, in representing its members’ occupational health concerns, will strive to ensure nurses are able to maximize the potential of a safe and healthy working environment.

Patient Advocacy

Nurses as professionals and acting as patient advocates will strive to provide patients with compassionate, effective and high quality nursing care.

Right to Know

Nurses have the right to know the potential health and safety hazards associated with asbestos. They also have the right to know if they are working in an asbestos contaminated area.

Policies and Procedures

Every health care facility must have appropriate policies and procedures with respect to asbestos. There must be the following:

a. Safe and effective methods of inspection and/or removal, along with regular inspections to ensure the integrity of any encased asbestos.

b. Regularly scheduled and random air sampling as part of the inspection process.

c. Workplace Health and Safety Committees and Unions must have access to inspection results.

d. Procedures must be in place for safe capsulation or removal of asbestos that is “friable” (soft or loosely bound and/or broken down).

e. The Employer must ensure that only authorized and qualified personnel, following recognized standards, inspect, handle and remove asbestos safely.

Right to Participate

It is essential that Manitoba Nurses Union members at the local level participate in the development and implementation of these policies and procedures.

Education

a. The Manitoba Nurses Union will take a proactive stance in encouraging members/locals to become more knowledgeable and educated re: asbestos and its hazards.

b. The Employer must provide proper orientation with effective education when asbestos is to be encased or removed from facilities.

Health Hazard Testing

Due to the serious carcinogenic properties, risk of asbestosis and other health hazards, it is the responsibility of the Employer to provide:

a. Asbestos exposure testing at no cost or loss of income to the member, and;

b. A registry of employees who are working in potentially high asbestos contaminated environments to be filed with the Workers Compensation Board.

Right to Refuse

The Manitoba Nurses Union supports a nurses’ right to refuse dangerous work under Article 43 of the Workplace Health and Safety Act when:

a. There are inadequate or non-existent protocols with respect to the handling, removal, or working in proximity to asbestos contaminated areas, and;

b. There is inadequate quantity and/or quality of appropriate protective equipment, and;

c. An Employer attempts to dissuade a nurse from following proper protocol, or reporting asbestos contamination or leaks.

Note: This type of asbestos was commonly used under suspended ceilings as fireproofing and thermal, or acoustical insulation. These potentially hazardous areas must also be part of the regular inspection process.

Back to top

13. Laser devices

Preamble

The use of lasers is increasing in health care facilities. This use presents a hazard in that the laser beam can cause damage to the eye and other tissue. The plume generated by the laser beam on tissue also has potential side effects. The Manitoba Nurses Union, in representing its members’ occupational health concerns, will strive to ensure nurses are able to maximize the potential of a safe and healthy environment.

Patient Advocacy

Nurses as professionals and acting as patient advocates will strive to provide patients with compassionate, effective and high quality nursing care.

Right to Know

Nurses have the right to know the potential hazards and negative side effects associated with the use of lasers in the workplace.

Policies and Procedures

Every health care facility must have policies and procedures with respect to the safe use of lasers to protect staff and patients. Policies and procedures should be consistent with each specific laser machine and should include the use of:

a. A designated staff person who has the authority and responsibility for maintenance, safe handling and security of the laser machine;

b. Only properly trained personnel and physicians should operate lasers;

c. Proper plume extraction*

d. Specifically designed laser masks;

e. Proper protective eye wear specific to each type of laser;

f. Proper tissue protection from laser beams;

g. Endotracheal tubes must be laser safe for specific E.N.T. procedures

h. Proper fire extinguishers readily available (i.e. Halogen)

i. A routine monitoring, maintenance and inspection program;

j. Appropriate warning sign must be used.

Right to Participate

It is essential that Manitoba Nurses’ Union members at the local level participate in the development of these policies and procedures.

Education

The Employer must provide an orientation, in-service and certification program to ensure all staff dealing with lasers are safely and appropriately trained.

Equipment

The Manitoba Nurses Union recognizes it is the Employer’s responsibility to:

a. Provide a designated trained person with overall authority and responsibility for the safe operation of lasers;

b. Appropriate laser plume scavenging system;

c. Appropriate personal protective and safety equipment;

d. Appropriate instructions readily available;

e. Warning signs posted for all lasers.

Right to Refuse

The Manitoba Nurses Union will support a nurses’ right to refuse dangerous work under Article 43 of the Workplace Health and Safety Act when:

a. There are inadequate or a lack of written safety policies, procedures and protocols;

b. Inadequately trained or untrained personnel;

c. Inadequate or non-existent scavenging systems;

d. There are inappropriate inspection and maintenance procedures;

e. There is inadequate in-service and education in regards to safe handling of laser machines;

f. The Employer attempts to dissuade a nurse from reporting unsafe working conditions related to laser one.

*Note: The smoke produced from vaporized tissue during laser surgery is defined as laser plume.

Back to top

14. Biomedical waste

Preamble

Biomedical waste includes:

a. Human anatomical waste;

b. Microbiology lab waste;

c. Human blood and body fluid waste;

d. Waste Sharps.

Biomedical waste in the health care workplace has been taking on a significantly higher profile in recent years. The MNU, in representing its members’ occupational health concerns, will strive to ensure nurses are able to maximize the potential of a safe and healthy working environment.

Right to Know

Nurses have the right to know the potential health and safety hazards associated with biomedical waste. The MNU supports that procedure be in place to prevent inappropriate contact by nurses with biomedical waste in the workplace.

Policies and Procedures

a. Every health care facility must have appropriate policies and procedures with respect to dealing with biomedical waste;

b.These policies and procedures must be consistent with current recognized Canadian standards;

c.Policies and procedures must be in place in every health care facility to safely handle and dispose of biomedical waste. The method of handling and disposal of these wastes are as defined in current recognized Canadian Standards;

d.There must be single use waste containers, i.e. Sharp containers; waste-holding plastic bag; or cardboard container.

Equipment

The Manitoba Nurses Union recognizes that it is the Employer’s responsibility to provide nurses with easy access to safe and proper equipment of sufficient quality and quantity for the handling and disposal of Biomedical Waste.

Sharp Containers – must be colour-coded and labelled with the biohazard symbol. Sharps container must be sturdy enough to resist puncture under conditions of use and to point of disposal. Lids must be tightly secured and, if used for cytotoxic wastes, the cytotoxic hazard symbol should be displayed. It is strongly recommended for containers to have fill lines and simplified movement for removal when full. Containers must be designed to prevent removal of discarded contents. Sharps containers should be conveniently located close to the point of disposal. (The outer cabinet or holder must be labelled as containing Sharps – “Caution! Waste Sharps” or an equivalent.)

Plastic Waste-Holding Bags – must be sturdy enough to resist puncture under conditions of handling and disposal. Must be colour-coded and labelled as necessary with biohazard or cytotoxic symbol.

Cardboard Containers – must be colour-coded and labelled with the biohazard symbol, rigid, closeable, leak-resistant and capable o being sealed.

Right to Participate

It is essential that Manitoba Nurses Union members at the Local level participate in the development and implementation of these policies and procedures.

Education

The Manitoba Nurses Union members will take a proactive stance in encouraging members/locals to become more knowledgeable and educated about current measures to protect nurses in the handling and disposal of biomedical waste.

Right to Refuse

The MNU will support nurses’ right to refuse dangerous work under Articles 43 of the Workplace Health & Safety Act when:

a. There are inadequate or non-existent protocols for handling and disposal of biomedical waste;

There is inadequate quantity or quality of protective equipment;

The nurse has had inadequate orientation and inservice on appropriate safety and health measures in dealing with the handling and disposal of biomedical waste;

An Employer attempts to dissuade a nurse from following proper biomedical waste precautions.

Note: If nurses observe the above are not in place contact your Occupational Health & Safety Committee and Local immediately.

Back to top