Safety issues pit nurses against United Hospital

Photo by Analise Pruni

The COVID-19 pandemic has caused much consternation among nursing and health professionals who have complained that their safety is not being adequately protected.

Cliff Willmeng, a registered nurse at United Hospital in St. Paul, said he was harassed by hospital management and wrongfully terminated for raising concerns about the use of scrubs and other health issues for workers.

He said the incident that led to his firing began when he recorded a phone conversation between himself and a supervisor regarding protocols on scrubs. “I spoke to her and I asked her what was the holdup about giving us hospital-issued scrubs, because the whole point of having these things at a hospital is to contain infection,” said Willmeng.

Although fairly new to the Twin Cities area, he has been an R.N. for 12 years. He also produces a workplace podcast in which he posted the conversation between him and his supervisor.

“I’m the first nurse that I’ve ever heard of that was fired for a violation of uniform policy,” Willmeng said. He added, however, that the problem was much bigger than scrubs.

“She told me that infection control was saying that it wasn’t indicated [that] we have to worry about COVID-19 being transported on our scrubs,” he said. “I was speechless. The idea that COVID-19 can’t remain viable on textiles is totally foreign to the medical community.”

“Hospital management has been unresponsive to nurses’ concerns,” said Brittany Livaccari, also a registered nurse at United. “Nurses have asked, pleaded, and finally just grabbed scrubs to protect themselves and their families from this horrible virus. And our nurses are being disciplined.”

Willmeng said he demanded use of hospital-issued scrubs rather than personal ones to avoid bringing the virus into his home. After several calls and disciplinary meetings, he still refused to take down the recorded phone call.

 Allina Health, which is part of the Allina Health System, provided the MSR with the following statement explaining their decision to terminate Willmeng and their scrub policy:

“Allina Health’s employees are the foundation of our organization. Without them, we would not be able to serve the health care needs of our communities. It is never easy to part ways with an employee. Our preference is always that education and coaching efforts will be successful.  But we cannot appropriately retain employees who willfully and repeatedly choose to violate hospital policies designed to protect our patients and staff.”

 According to the company, scrubs are not considered Personal Protective Equipment (PPE). “Allina Health adheres to the latest guidance from the CDC and MDH in relation to Personal Protective Equipment (PPE), which do not consider hospital-issued scrubs as PPE. At a time when all health care systems are managing limited supplies, Allina Health has carefully weighed and adopted policies for the use and distribution of those supplies, such as scrubs for staff,” the company statement continued.

“The entire reason you put on a hospital gown is to protect your scrubs from getting infected,” said Willmeng. “The medical term is droplet precaution. And it has already been proven that the virus can live on textiles. The hospital gown only goes to our knees and it doesn’t cover the times when patients come in and you don’t know that they are COVID-positive and you have been interacting with that patient for three to four hours.”

According to the American College of Emergency Physicians COVID-19 field manual, “Hospital organizations should assist healthcare workers in taking the necessary precautions to limit risk, including providing fresh scrubs.”

Willmeng doubled as a Minnesota Nurses Association union steward at the hospital, helping organize the department and enforce worker rights and contracts. He constantly tried to inform his colleagues of their union rights.

“Over the course of the last six weeks,” Willmeng said, “the triangulation and harassment and the escalation of conflict in reprisals for frontline staff, either putting on those scrubs or being overly vocal, it just worsened. Anybody putting on hospital-issued scrubs [was] being interrogated while they were being assigned patient care duties.”

“I thoroughly believe that they’re going to fire me if I keep trying to keep myself and my family safe by wearing the scrubs,” said Zetella Caauwe with a nervous laugh. “This week I am having a bit of an existential crisis. Do I keep my job and do something that I believe is unsafe, or do I keep doing what I think is safe and then find myself terminated? I’ve never been terminated before. I don’t have that kind of record.”

Caauwe is a former coworker of Willmeng’s and has been a nurse at United Hospital for 23 years. She believes his pushback against hospital management was the real reason behind his firing.

“Cliff was a problem for them. Cliff called them out,” Caauwe said. “Cliff understands how unions work and was very vocal. He stood up for his rights and the rights of others.”

Caauwe currently has two disciplinary strikes against her and believes she is not far behind Willmeng in losing her job. The issue of scrubs has led not only to intimidation from management, she said, but is also affecting patient care.

“Every time they see you wearing the [hospital issued] scrubs, they will approach you and ask two questions: Did you bring your scrubs with you and are you willing to change?” Caauwe noted. “They have pulled nurses out of patient rooms, so they have pulled nurses away from patient care.”

Caauwe pointed out that she has been on what she called “unit council” for many years. “It’s a group of employees who are interested in policies and procedures, things that are going on in the E.R. and how we can make things better,” she said.

Both Caauwe and Willmeng have numerous safety grievances against United Hospital outside the context of hospital-issued scrubs, including the use of N-95 masks.

“We’re not using N-95s, we’re misusing them,” Willmeng said. He added that employees are instructed to use one N-95 mask over the course of one day, rather than one single exposure to a patient with an airborne illness. He also cited failure to follow infection containment measures regarding “red zones” of COVID-19-positive patients and exposure to those zones.

“United Hospital didn’t write the narrative on this, but the more the staff are stepping up and trying to advocate for patient safety and workplace safety, the harder the pushback from management,” Willmeng asserted.

He plans to pursue litigation against the hospital, and Caauwe has filed a retaliation allegation.

“We need to start to work together across hospitals and workforces to really do what working class people have always done when we are under systemic attack, and that is to band together and fight collectively for the things that we need,” Willmeng said. “I aim to get my job back at United and return to the front line. That’s where I want to be.”