Seachange Bulletin #110

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Some Important Nursing Position Statements of Immediate Relevance:

Armed Conflict: Nursing's Perspective
<http://www.icn.ch/psarmed.htm>
International Council of Nurses, Adopted in 1999

The International Council of Nurses (ICN) strongly opposes armed conflict
under any circumstances. ICN's particular concern focuses on the grave
consequences for affected civilians, refugees and displaced persons,
including severe impairment of health and violation of basic human rights.
Women, children and older persons living in conflict zones are especially
vulnerable, and require access to appropriate care and counselling to assist
them in maintaining or rebuilding sound physical and emotional health. ICN
condemns the growing number of children serving as soldiers in armed conflict
and the deployment of child soldiers regardless of any claims of volunteerism
on the part of the children. ICN believes nurses have an important role to
play in addressing the impact of emergency and long term health needs of
refugees, other civilian populations and wounded armed forces personnel and
demands protection for all health professionals providing care and relief
personnel in conflict zones. In cases of armed conflict ICN urges national
nurses' associations to:
· Call upon their governments to ensure the immediate provision of
humanitarian assistance, including health care, to refugees and displaced
persons and to facilitate open and co-ordinated access of international
humanitarian organisations in the affected regions.
· Examine the implications for their countries and to undertake
co-operative action with local branches of government, UN agencies and
non-governmental organisations at national and local levels to provide
adequate health services for all those in need, irrespective of ethnicity.
· Safeguard non-discriminatory access to health care for wounded
military and paramilitary personnel and prisoners of war.
· Promote the systems required for the public reporting of massacres of
civilians and other serious human rights violations, the accurate and timely
investigation of these reports, and the deployment of human rights monitors
when necessary.
· Strengthen the establishment of national institutions to protect and
promote human rights.
· Lobby for demobilisation, rehabilitation and reintegration of all
child soldiers into safe and healthy environments. ...

Towards Elimination of Weapons of War and Conflict
<http://www.icn.ch/pswar.htm>
International Council of Nurses, Adopted in 1999

The International Council of Nurses (ICN) considers world peace to be a
prerequisite for development and necessary in order to foster health. We urge
world leaders to do their utmost to prevent war and armed conflict of any
kind. ICN rebukes the accidental or deliberate use of nuclear, chemical and
biological agents; all of which undermine health and threaten survival. To
this end, the International Council of Nurses supports:
· The Universal Declaration of Human Rights.
· The Ottawa Convention on the Prohibition of the Use, Stockpiling,
Production and Transfer of Anti-Personnel Mines and on Their Destruction.
· Work aimed at the elimination of weapons used in conflict and war.
ICN calls on national nurses' associations to:
Work towards the elimination of nuclear, chemical and biological weapons and
land mines. Nursing associations can do this by:
· Collaborating with human rights groups, lawyers, national disaster
prevention agencies, health groups, the mass media and others to create a
united front against the production, distribution and use of these weapons.
· Educating the public and nurses about the social, economic,
environmental and public health consequences of nuclear, chemical, biological
weapons and landmines.
· Assisting nurses to develop strategies for action to reduce the
threat of these weapons.
· Lobbying national governments to stop the manufacture, distribution
and importation of such weapons.
· Joining groups working to eliminate these weapons, such as Physicians
for Social Responsibility, youth and women's action groups and others.
Work to prevent the consequences of all types of weapons by:
· Actively participating in disaster response and preparedness plans.
· Preparing health personnel at all levels for the problems and demands
associated with caring for the victims of such weapons. ...

International Social Framework
<http://www.sun-nurses.sk.ca/mem_pos_state.html#SOCIAL PROGRAMS/POLITICAL
ACTION>
Saskatchewan Union of Nurses

The Saskatchewan Union of Nurses will:

Work to promote:

. world peace
. an end to all terrorism
. food, shelter, clothing, education and health for all people
. the eradication of poverty and ignorance
. democracy
. truth, honesty and respect for people everywhere
. an end to racism
. proper working conditions globally
. the protection of the earth's environment

1. Urge governments to include women in the peacemaking process.
2. Call for national and international policies based on democratic
principles and human rights framework, which promote women's equality.

Rationale:

. we oppose all personal and national acts of violence and acts of terrorism
in any and all forms;
. we understand that workers are always on the front lines of all conflicts
and disasters;
. we now find ourselves facing a conflict that may involve us, and our
children, in a never ending war;
. women are usually the first victims of fundamentalism, war, and injustice,
and women are often the first to develop alternatives to violence;
. true peacemaking must include women and their respective organizations in
the process of finding solutions to international terrorism and war.

Resolution on War and Violence as a Last Resort
<http://www.nysna.org/publications/report/2002/oct_nov/actions.htm>
Actions of the 2002 Voting Body - Convention of the New York State Nurses
Association

WHEREAS, the Code of Ethics for Nurses states that "nurses respect the
inherent dignity, worth, and uniqueness of every individual," that "the
nurse's primary commitment is to the patient whether as individual, family,
group, or community," and that "the profession of nursing, as represented by
professional associations and their members, is responsible for articulating
nursing values . and shaping social policy," WHEREAS, the toll that a
protracted war takes on human life and the social and economic fabric of a
society, particularly on a nation's most vulnerable population, is
devastating and intolerable, even when referred to as "collateral damage,"
WHEREAS, no specific event has occurred in the recent period that indicates
that Iraq poses any immediate threat to the United States, WHEREAS, the
American people have suffered deeply as a result of the September 11, 2001
tragedies and a preemptive military strike in Iraq would inflict comparable
suffering, injury, and death upon countless innocent Iraqi people, and
WHEREAS, in accordance with the Code of Ethics, NYSNA has been in the
forefront of speaking out about important health and social issues of our
time, therefore be it RESOLVED, that NYSNA support a multi-national
diplomatic approach to ensuring Iraq's compliance with the current United
Nations resolution regarding arms inspections, and be it further RESOLVED,
that NYSNA affirm that war and violence must always be the last resort to
responding to conflict, and be it further RESOLVED, that NYSNA educate its
members about the effects of war on health and societies, and be it further
RESOLVED, that NYSNA communicate to appropriate policy makers its concern
about a unilateral preemptive strike as a means of resolving Iraqi
non-compliance with United Nations inspections.

In Support of Peaceful Action
<http://www.mnnurses.org/Headlines/Peace%20Resolution.htm>
Minnesota Nurses Association, Adopted by House of Delegates, October 23, 2002

Whereas, war kills and maims people (non-combatants, women and children as
well as combatants) and rarely permanently resolves the problems and
conflicts which lead to war and violence: and Whereas, Nurses are dedicated
to the support, well being and health care of all people; and Whereas, Nurses
place themselves in harms way as they care for the victims of war; Therefore
Be It Resolved That, MNA and its members support peaceful and just
resolutions to international disputes; and Be It Further Resolved That, MNA
support legislation which promotes international peace and justice; and Be It
Further Resolved That, MNA support legislation to prevent violent acts and
war in international disputes.

Letter to George W. Bush
<http://www.mnnurses.org/Headlines/Letter%20to%20Bush.htm>
Minnesota Nurses Association, December 5, 2002

The White House
1600 Pennsylvania Ave.
Washington, DC

Dear President Bush:

The Minnesota Nurses Association wishes to apprise you of our concern
regarding a war with Iraq. As the professional organization representing over
16,000 Registered Nurses in Minnesota, we feel we approach this issue from a
unique perspective. The shape of any war on terrorism will demand a concerted
and skilled response from the nation's health care workforce, nurses being
the most numerous and essential providers of care. We are also the mothers,
fathers, sisters and brothers of the young men and women who will be called
upon to sacrifice their lives for our country. Our organization is working
actively with government agencies and other institutions in our state and
nationally to make sure that care will be provided should we need to respond
to a public health crisis, whether it is a call for mass immunizations, an
epidemic, or mass casualties. We are opposed to any war decision made without
a thorough public debate. We do not feel this kind of debate has been
held. We are concerned for the following reasons:
§ As in our last war on Iraq, the people who will suffer the most will be
Iraqi citizens. Thousands will be killed, injured, and left homeless as the
result of a war. In that condition, they are all the more vulnerable to a
despot like Saddam Hussein, and less able to overthrow him and install a
legitimate government in his place.
§ We believe that the focus of our war on terrorism will be diluted by an
action in Iraq. We have not yet succeeded in destroying Al Quaida, or in
capturing Osama Bin Laden. Should we not pursue this to a successful
conclusion before we divert our attention to another war?
§ We speculate that Iraq has weapons of mass destruction. That is also true
for other rogue nations like North Korea and Pakistan. We have not heard a
clear public policy formulated to respond to these conditions.
§ We are concerned that our stance on Iraq is being influenced by the United
States' dependence on Mideast oil.
§ Unless we have the backing of other nations, in dollars, in troops, as well
as in diplomacy, a unilateral action on our part will sow the seeds for
future terrorists and hatred of the United States. This in turn will bring
attacks to US soil.
Please pursue all peaceful courses of action available. The Registered Nurses
of Minnesota will serve this country with distinction in the event of a war,
but we must raise our voices to ensure that all diplomatic and peaceful
initiatives are exhausted. Thank you for your attention.

Sincerely,
Monica Vollmuth, MA, RN CNP

MNA's Position on Peaceful Action
<http://www.mnnurses.org/Headlines/MNA%20Position%20on%20Peaceful%20Action.htm
>
Minnesota Nurses Association Executive Director Erin Murphy

This week we have received calls and emails from members wondering how MNA
would decide to send a letter to President Bush about military action in
Iraq. Anticipating other questions, here is a synopsis of how MNA got from
there to here. The utmost decision-making body of MNA is the House of
Delegates, who are representatives elected by members. This body meets
annually in the Fall to debate, amend and adopt resolutions, policies, bylaws
and motions that set the course for the organization. The House of Delegates
is a hardworking, deliberative body of nurses from all over the state that
thoroughly reviews the language and meaning of documents before
passage. Once a position is adopted, it becomes the position of the
organization and of the membership as a whole. Last October the House of
Delegates adopted a resolution entitled "In Support of Peaceful Action" which
is included for review. Resolutions are brought by any member of MNA or by a
structural unit of MNA such as an elected commission or a bargaining unit.
Resolutions are generally reviewed prior to the meeting of the House of
Delegates. Additionally, a resolution can be introduced during the course of
the House if it meets certain criteria. Delegates carefully and thoughtfully
debated the merits of this resolution. And, after debate, they did vote to
support the resolution. The MNA Board of Directors, also elected members
responsible for oversight of the organization, chose to make operational the
action of the House of Delegates by sending a letter to the President. The
letter was drafted, reviewed, sent and published in the Minnesota Nursing
Accent. We have not received a response from the President. Some members are
now individually questioning, why would MNA take such a stand? Review of the
resolution provides answers. The statement "Nurses are dedicated to the
support, well being and health care for all people," is in line with the
mission of MNA. Nurses, as responsible citizens in a democracy, are asking
the Administration tough questions about military action. The MNA nurses have
joined other organizations such as the National Council of Churches in their
civic right to express positions about any governmental action.

Vaccinate Against War Not Smallpox
<http://www.massnurse.org/News/2003/01/massnurse/smallpox4.htm>
Massachusetts Nurse, January/February, 2003

As health care professionals, some of us are being called upon to receive the
smallpox vaccine. We are being asked to become vaccinated against a viral
disease that we had been told was eradicated. The obliteration of this
disease marks one of the highest points of international cooperation.
Governments with opposing ideologies, governments that were on a daily alert
against each other, governments that were funding armed conflicts against
each other all cooperated in eradicating smallpox. Western scientists
cooperated with tribal healers, communists cooperated with capitalists,
dictators cooperated with democratic leaders, people of all religions
cooperated with each other. Yes, Muslims, Christians, Jews, Hindus,
Buddhists, pantheists and atheists all cooperated to erase the threat of
smallpox from the world.

Now the American people are being told that the scourge of smallpox is near
upon us. We are being told that the international era of cooperation in
combating worldwide diseases is over. We are being told that our health care
system will protect us, that our armed might will protect us.

As health care providers who are likely to be called upon to accept the
smallpox vaccine, we say NO.

We say NO not out of fear for our own health. Every day we face the risk of
infectious diseases at work. We have never shied away. We say NO not out of
fear of side effects to the vaccine. We do not believe ourselves to have any
risk factors for a bad reaction since we were vaccinated as children and had
no problems. We say NO because vaccinating in the face of no known threat is
wrong. It represents the use of health care as an extension of an aggressive
military posture. A posture which our government has put forward prior to
national debate. The posture that we as a nation have not only the right but
also the responsibility to launch preemptive war.

There is no true evidence of anyone preparing a smallpox attack. Those who
are knowledgeable enough to launch a mass smallpox attack via aerosol
distribution are also knowledgeable enough to know that it would not only
backfire politically but that smallpox would spread world wide, affecting
their people as well. Those who are fool enough to use suicidal methods to
spread smallpox would ultimately be defeated, since we were able to defeat
the original smallpox epidemics when the virus was spread by individuals
unwittingly infected

The government is using the fear of smallpox as a political tool to rally
support for a wrong and possibly criminal policy. It reminds one of the
1950s. Those of us who were children then remember the fear of the communist
nuclear attack. In gym classes, in civics classes and in health classes we
were shown films of what would occur if the Russians sent atomic bombs and
missiles at us. We had regular air raid drills to prepare us for this event.
We sat under our desks and in hallways with our heads between our legs. We
were told not to look at the flash of the explosion lest it blind us. Ads for
backyard fallout shelters were in all the media. Fear abounded and bred
hatred and a pro-war politic. A politic which led our democratically elected
government to fund dictators throughout the world. A politic that led our
democratically elected government to support military overthrow of
democratically elected governments. A politic which led government officials,
charged with protecting our own freedoms, to brand the civil rights movement,
the voting rights movement and even some of our unions and environmental
movements as conspiracies run from Moscow. Let us not go there again.

We must use our healthcare abilities to build an international commitment to
peace and human rights. Let the example of smallpox eradication be used to
build further cooperation. There is new work being done on drugs to conquer
malaria, to diminish the effects of HIV. Let us use this and other work to
enhance international unity instead of hate and fear. Let us use our wealth
and knowledge to aid people in developing clean water and safe sewage
systems. Let us use our democracy as an example for others. We can do that by
not supporting dictators, royal families and governments that hoard their
countries' wealth for a few while oppressing the human rights of the
majority. Let us wage a peaceful campaign against all Weapons of Mass
Destruction in all countries and by all governments.

As healthcare professionals we have pledged first to do no harm. We have
pledged to use our skills to help all those in need regardless of their
beliefs or their position in society. We will accept the smallpox vaccination
when it is part of a worldwide effort to eradicate the disease. In that event
the healthcare workers of Iraq would be inoculated as well.

Barry Adams, RN, Boston, Massachusetts
Iris Biblowitz, RN, San Francisco, California
Amelia M. Cabral, RN, Taunton, Massachusetts
Catherine DeLorey, RN, Boston, Massachusetts
Mike D'Intinosanto, RN, Winchendon, Massachusetts
Sandy Eaton, RN, Quincy, Massachusetts
Robert Fine, RN, Arlington, Massachusetts
Susan Flowers, RN, Indiana, Pennsylvania
Teana Gilinson, RN, Stoughton, Massachusetts
Patty Healey, RN, Northampton, Massachusetts
Peggy Lynch, RN, Cambridge, Massachusetts
Michael Lyon, MS, San Francisco, California
Deborah Blaisdell Martin, RN, Waltham, Massachusetts
Jim Moura, RN, Dorchester, Massachusetts
Marc Sapir, MD, MPH, Berkeley, California

(Editorial Comment: Since the above op-ed piece was submitted for
publication, it has received additional signers, whose names are not included
here. - SE)

California Nurses Association Statement on the Iraq War
<http://www.laborstandard.org/Iraq/CNA_ag_war.htm>
Adopted by the CNA Board of Directors, February 2, 2003

The California Nurses Association joins with scores of other health care
advocacy groups, nurses, and labor organizations and local governments to
oppose a unilateral war by the Bush Administration against Iraq.

CNA condemns all acts of terrorism. CNA supports peaceful efforts to promote
disarmament and the elimination of all nuclear, chemical, biological, and
other weapons that inflict large scale destruction.

CNA believes that international disputes are best resolved through the role
of broad based international organizations, particularly the United Nations,
to promote a peaceful end to conflict and social and economic justice, not
through unilateral intervention.

Whereas the Code of Ethics for Nurses underscores, "the nurses' primary
commitment is to the patient whether as individual, family, group or
community," and that the "profession of nursing is responsible for
articulating nursing values and shaping social policy," CNA has particular
concerns about the health and social impacts of a war with Iraq.

The first Persian Gulf War produced up to 3,000 casualties among Iraqi
civilians, according to Human Rights Watch, and devastating long term health
consequences for untold numbers of Iraqis and Americans. Some 160,000 US Gulf
War veterans have endured chronic disorders, at 12 times the rate of non-Gulf
War veterans, with cancer, birth defects, memory loss and other elements of
Gulf War syndrome.

A new war with Iraq would likely cause even more immense casualties and human
suffering. Presently, 13 million Iraqi children according to the Independent
Study Team, "are at a grave risk of starvation, disease, death and
psychological trauma." A United Nations contingency planning report estimates
up to 500,000 Iraqis would require medical treatment, and another three
million would face dire malnutrition and require therapeutic feeding. The
outbreak of cholera, dysentery, and other epidemics would be likely. The
report also projects up to 900,000 refugees would need food and shelter, and
endure continuing casualties from land mines.

US personnel participating also face unknown direct casualties and likely
long term health effects, such occurred to the 130,000 Gulf War troops,
according to the US Department of Defense, who were exposed to chemical
weapons as a result of the US bombing of one Iraqi arms depot.

At home, the pending war would also have serious consequences for public
health and the social safety net. The Congressional Budget Office estimates
the war would cost between $9 billion and $13 billion each month, prompting
draconian reductions in public spending on health care and other social needs.

The increase in defense spending in advance of the war coincides with a
growing health care crisis in our nation and cutbacks in vital funding for
public hospitals, community clinics, disease prevention programs, and our
emergency response network.

Unilateral US military action against Iraq is likely to increase retaliatory
attacks against US civilians, placing a further strain on our overburdened
health care system.

Plans by the Bush Administration for smallpox vaccinations for up to 10
million RNs and other health care workers and emergency personnel demonstrate
our concern. Local health departments across the US are reporting that many
health care programs, including cancer and tuberculosis screenings,
immunization clinics for children, and children's dental programs are being
curtailed as funds are diverted for the smallpox program. The smallpox
program is also risky. The Institute of Medicine says the program lacks
adequate safeguards.

The CNA Board of Directors will communicate our position to our elected
representatives and to CNA members, and conduct an educational campaign for
CNA members on the consequences of the war.

Civilians Pay in War
Nurses, physicians, midwives, physiotherapists and dentists join in saying
civilians pay the terrible price for war in death, injury and disease
<http://www.icn.ch/PR4_03.htm>
International Council of Nurses, February 5, 2003

Geneva - Speaking with one voice, the international organisations
representing a broad spectrum of the world's health professions have spoken
out against all armed conflict. The terrible health consequences of even
conventional war are borne overwhelmingly by civilians, with especially
catastrophic effects on women and children's physical and mental health.
Death and debilitating injury are coupled with threatened access to safe
water, sanitation and food, undermining the health of a population and
creating circumstances favourable to epidemic diseases. As infrastructure,
homes and communities are destroyed and people seek safety, more families are
added to the already huge population of 12 million refugees and 6 million
displaced persons worldwide. Precious resources, financial and human, are
diverted to war inevitably at the expense of investment in health, health
systems and education. According to the World Health Organization, about 35
people are killed every hour as a direct result of armed conflict. In the
20th century, an estimated 191 million people lost their lives directly or
indirectly as a result of armed conflict, the majority civilians. Because of
the overwhelmingly negative effects on health resulting from war, these
health professions oppose any armed conflict and have chosen to speak out at
this time. We strongly encourage governments and ruling parties to find
non-violent and democratic means to resolve conflicts and bring about peace.

Statement for Peace
<http://www.anfvic.asn.au/news_briefs/news_peace.htm>
ANF (Vic Branch) Council, February 11, 2003

Wherever there is armed conflict, nurses are involved because they provide
care and comfort for the injured and dying. The people most affected by war
and sanctions against governments are children under five, older people,
those with chronic conditions and women of childbearing age. In modern
warfare, the displacement of people, the disruption to water supplies, poor
sanitation, intermittent power supplies and the destruction of transport and
communication system lead to malnutrition, dehydration, illness, injury and
death. Estimates suggest that for every wartime fatality there are up to
three people wounded. According to the International College of Nursing, up
to 90 per cent of the victims of such hostilities are civilians. Therefore,
The ANF (Vic Branch), in line with many international nursing organisations,
opposes all wars under any circumstances.
In the case of the threatened war on Iraq, the ANF (Vic Branch) accepts a
United Nations report prepared last month that estimates that a US-led war
would create nearly one-million refugees needing outside resettlement and 7.2
million displaced people internally. The displaced people in immediate danger
because of a lack of health services would include 4.2 million children under
five and 1 million lactating women. The ANF (Vic Branch) Council therefore
endorses the following resolution:
1. The ANF (Vic Branch) recognises that the possibility of a war against Iraq
and campaigns for security and protection from terrorism are current
realities confronting ANF members and their families.
2. The ANF (Vic Branch) unequivocally condemns terrorism. Brutal acts of
terror directed against civilians and aimed at maximum loss of lives cannot
be excused, rationalised, justified or defended under any circumstances.
3. The ANF (Vic Branch) opposes any unilateral declaration of war with Iraq:
i. The ANF (Vic Branch) supports the resolution of the United Nations
Security Council which calls on Iraq to surrender all its chemical,
biological and nuclear weapons and their delivery systems, and to allow UN
inspectors unfettered access to any location inside Iraq to search for and
destroy such weapons. In the event that Iraq fails to comply with the terms
of the UN resolution, the issue must be referred to the UN for further
deliberation.
ii. The issue of Iraq is different, distinct and separate from the campaign
against terrorism.
4. Every effort must be made to:
. ensure availability of enough time and resources for effective UN
inspections;
. increase diplomatic pressure on the Iraqi regime to destroy any weapons of
mass destruction;
. ensure the well-being of Iraqi civilians;
. see a cessation of the long term trade and economic blockade of Iraq which
has primarily hurt the ordinary people rather than the Iraqi Government;
. provide continuing protection of ethnic minorities in Iraq; and
. provide for a long-term peaceful resolution of the current situation.
The ANF (Vic Branch):
. Opposes the Howard Government's rush to support a US led war against Iraq.
. Deplores the cynical linkage by the US Government of support for the war
with free trade negotiations between America and Australia.
. Commends the governments of Australia, Canada and New Zealand for the joint
statement to further co-operate on controlling biological weapons, and urges
them to increase their diplomatic efforts in opposing all weapons of mass
destruction.
. Calls upon the Australian Government to support strengthening the
implementation of existing treaties and conventions for the elimination of
nuclear, chemical and biological weapons.
. Calls upon the Australian Government to actively work towards UN mandated
international inspection of all countries developing and producing weapons of
mass destruction.
. Calls upon the Australian Government, and all political parties in
Australia, to develop a foreign policy based on peaceful and respectful
engagement with all nations.
. Calls upon the Australian Government, and all political parties, to avoid
incitement of a climate of suspicion and fear in Australia, and to promote
increased understanding of the diversity of Australian religious faiths
including Islam.
. Endorses the forthcoming weekend of community activities commencing on
Friday 14 February, and calls upon members participate in it.

INO Backs ICTU Anti-War Stance
<http://www.ino.ie/view_categories.php?cat_id=455&doc_id=3400&sCat=455&PHPSESS

ID=dc90ddc38e3f8275382d36063dde5f78>
Irish Nurses Organisation, February 11, 2003

The Executive Council of the Irish Nurses Organisation, at its meeting today,
Tuesday, 11th February 2003, unanimously adopted a motion supporting the
anti-war stance of the Irish Congress of Trade Unions. The Executive
particularly stressed the need for continuing the work of the UN weapon's
inspection team and all other means of diplomacy to address the issue without
resort to war and the inevitable killing of innocent people that will result.
The INO also calls upon as many of its members as possible to support the
anti-war demonstration which will take place in Dublin on next Saturday, 15th
February 2003. Speaking after the meeting INO President, Clare Spillane,
said: "Regardless of how difficult the situation appears we must not regard
war as inevitable. The INO strongly supports the ICTU stance on this matter
and asks that Nurses, Midwives and the general public participate in
Saturday's march thus conveying a strong message to governments all around
the world".

(In the spirit of the above documents, you are invited to seek ways to
express nursing's outrage at the current state of affairs and point to a
better world. Some have suggested organizing a nursing presence wherever
possible, in the thousands of local candlelight vigils or in the large
rallies such as on April 12th, through letters to the editor or in articles
in journals and newspapers. Would the formation of Nurses for Justice with
Peace make sense to you? Let us know. Let Seachange Bulletin reflect
nursing's surge into activism for healthy communities and a healthy world. -
SE)

Smallpox Update:

US Probes Death of Nurse Vaccinated for Smallpox
<http://asia.reuters.com/newsArticle.jhtml?type=healthNews&storyID=2452828>
Reuters, March 26, 2003

Atlanta - US health officials said on Tuesday they were investigating whether
the smallpox vaccine had contributed to the death last weekend of a Maryland
nurse and serious side effects in six other people recently inoculated
against the virus. The US Centers for Disease Control and Prevention, which
has been spearheading a campaign to vaccinate almost half a million
front-line healthcare workers and technicians, said it was recommending that
people with heart disease not be vaccinated until an investigation was
completed. "We're adding a temporary deferral for the smallpox vaccine for
persons who have been diagnosed with a history of heart disease," CDC
spokeswoman Karen Hunter said. Hunter added that the unidentified Maryland
woman had suffered from heart disease before being vaccinated. Earlier this
month, top US health officials said that reports of side effects linked to
the current smallpox program were overblown. ...

New alarm over smallpox vaccine
3 recipients had heart attacks, one fatal - link to coronary problems to be
explored
<http://www.sfgate.com/cgi-bin/article.cgi?file=/c/a/2003/03/26/MN28895.DTL&ty

pe=printable>
Sabin Russell, San Francisco Chronicle, March 26, 2003

Following the first reported death associated with its controversial smallpox
vaccine program, the Bush administration warned Tuesday evening that no one
with a history of heart disease should volunteer to be immunized. In a
hastily called telephone news conference, the head of the Centers for Disease
Control and Prevention disclosed that three female health care workers, all
in their 50s, have suffered heart attacks after receiving the vaccine. Dr.
Julie Gerberding, director of the CDC, said one of the heart attack victims
remained on life support. She also noted that four others recently vaccinated
had suffered other heart problems. According to the Associated Press, the
dead woman was a Maryland nurse who was vaccinated on March 18 and died five
days later. Her death is the first to be linked to the smallpox vaccine -
considered the most dangerous ever administered to the general population
because it is expected to kill 1 or 2 of every 1 million people who receive
it. As a precaution, the CDC is amending the list of conditions that would
disqualify a volunteer from getting the smallpox vaccine. It will now include
those with a history of heart or coronary disease. ...

Feds warn heart patients on smallpox shot
<http://www.bayarea.com/mld/mercurynews/5480665.htm?template=contentModules/pr

intstory.jsp>
Laura Meckler, Associated Press, March 26, 2003

Washington - Health officials are recommending that people with heart disease
not get vaccinated against smallpox as authorities investigate a possible
link between the vaccine and heart problems. The vaccination has never been
associated with heart problems before, but the warning and the investigation
came Tuesday, after a Maryland woman died of a heart attack and six others
became ill after being inoculated. "I think we want to err on the side of
safety," Dr. Julie Gerberding, director of the federal Centers of Disease
Control and Prevention, said Tuesday. Gerberding emphasized that officials do
not know whether there is a connection and said the national vaccination
program, off to a slow start, must move forward to prepare for the
possibility of a bioterror attack with smallpox. ...

Smallpox vaccine is reviewed after second fatal heart attack
<http://www.boston.com/dailyglobe2/087/nation/Smallpox_vaccine_is_reviewed_aft

er_second_fatal_heart_attack+.shtml>
Laura Meckler, Associated Press, March 28, 2003

Washington - A second health care worker has died of a heart attack after
receiving the smallpox vaccine, and officials are investigating whether
vaccinations are to blame for cardiac problems seen in 17 people who have
been inoculated. The vaccine has never been associated with heart trouble,
but as a precaution, the Centers for Disease Control and Prevention is
advising people with a history of heart disease not to be vaccinated until
further investigation is complete. CDC officials said yesterday there was
some evidence the smallpox vaccine has played a role in heart inflammation.
They were less certain whether three recent heart attacks were related to the
vaccine. In New York state, officials halted smallpox vaccinations altogether
while the heart disease issue is sorted out. Also yesterday, an expert panel
advising CDC raised questions about the government's vaccination program. The
Institute of Medicine suggested the CDC was moving too quickly beyond its
first stage of vaccinations, which include public health and hospital
workers, into a second stage, which includes a large group of emergency
responders. The report, released yesterday, called on the federal government
to compensate people injured by the vaccine. On Capitol Hill, lawmakers
struggled to do just that, but a House vote scheduled for yesterday was
abruptly canceled amid questions about whether Republicans had enough votes
to beat back a somewhat larger Democratic compensation plan. ...

Illinois, New York suspend smallpox vaccinations
Actions follow fatal heart attacks of 2 care workers
<http://www.chicagotribune.com/features/health/chi-0303280297mar28,1,7172017.s

tory>
Jeremy Manier & Peter Gorner, Chicago Tribune, March 28, 2003

Health officials in Illinois and New York suspended all smallpox vaccinations
Thursday while investigators review the deaths of two health care workers who
suffered fatal heart attacks after being immunized. The states moved more
quickly than the federal Centers for Disease Control and Prevention, where
the only recommendation experts gave Thursday morning was that people with a
history of heart disease should not get vaccinated against smallpox. Federal
officials also are looking at 15 other civilians and military personnel who
have had non-fatal heart problems after being immunized. The new problems are
the most serious setback yet for the federal smallpox vaccination program,
started by the Bush administration to protect a contingent of doctors, nurses
and other emergency workers in the event of a biological attack with the
deadly virus. The vaccine had not been known to cause heart problems among
Americans who were vaccinated as children. But concerns about liability and
other known side effects have led many hospitals and counties to opt out of
the program, resulting in just 27,000 civilians being vaccinated - far fewer
than the 450,000 government planners had projected. Virginia Jorgensen, 57, a
nurse from St. Petersburg, Fla., died of a heart attack she suffered 17 days
after getting the vaccine. Jorgensen's husband Robert said he had asked his
wife, who had a history of heart disease, not to take the vaccine. "She was
in the first group to volunteer," Jorgensen said. "I tried to talk her out of
it, but she said `No way.'" ...

California Nurses Association Calls for Halt to State Smallpox Vaccination
Program
<http://www.calnurse.org/cna/press>
California Nurses Association, March 28, 2003

The California Nurses Association (CNA) today called on California hospitals
and the Department of Health Services to end the controversial smallpox
vaccination program. The call came in response to the news today that health
officials in Illinois and New York have suspended all smallpox vaccinations
while investigators review the deaths of two health care workers who suffered
fatal cardiac arrests after being vaccinated. "It is long past the time when
people should be left to make individual determinations as to whether the
vaccine is safe," said CNA President Kay McVay, RN. "The state must act to
protect the public and the tens of thousands of nurses and other healthcare
workers who could be put at serious risk. It is now the responsibility of
those administering this controversial program to demonstrate beyond serious
doubt that people agreeing to be immunized are not taking their lives or
well-being into their own hands." On March 27, the Center for Disease Control
and Prevention recommending the vaccine not be administered to people with
heart problems. According to the Chicago Tribune, an investigation is
underway into the situation surrounding 15 other people who have experience
heart problems after being immunized. CNA opposed the plan from its inception
and implementation at the first of the year and has actively discouraged its
50,000 Registered Nurses from receiving the vaccine. Since the plan was
issued by the federal government there has been a groundswell of opposition
to the vaccination program among health care providers, hospitals and
caregivers. Over 350 hospitals and nurses organizations, including those in
Texas, Rhode Island, Wisconsin, Connecticut, Massachusetts, and New Jersey
had refrained from participating. As of last Friday only 807 health care
workers have received the vaccine in California.

ANA Urges Members to VOTE NO on the Smallpox Emergency Personnel Protection
Act
Contact Your House Member - Tell Them to Vote NO on HR 1463
<http://www.nursingworld.org/gova/federal/news/hr1463.htm>
American Nurses Association, March 28, 2003

ANA urges Members to VOTE NO on the Smallpox Emergency Personnel Protection
Act (HR 1463). This bill fails to protect nurses. It does not provide
adequate education, prescreening, surveillance, and compensation - and it
will not result in increased vaccinations. The smallpox vaccine is a live
virus. It has the worst record of negative side effects of any vaccine in the
world. It is imperative, as a matter of public health, that those being
vaccinated understand the risks of the vaccine to themselves and their loved
ones, and be prescreened for conditions that require them to avoid the
vaccine. The smallpox inoculation site can shed the live virus for up to
three weeks. In the 1960s, more than 20% of the adverse vaccination events
occurred in secondary contacts. Therefore, the vaccination program poses a
risk not only to nurses, but also to their patients and families. The
American Nurses Association (ANA) has, since November 2002, been trying to
work with the Administration to formulate a strong smallpox vaccination
program that will encourage nurses to volunteer to be immunized.
Unfortunately, the Smallpox Emergency Personnel Protection Act (HR 1463),
which will come to the floor as early as Monday, March 31, fails to do this.
The Republican Leadership in the House has denied the Democrats the
opportunity to offer a stronger alternative. It is imperative that all
Members show their opposition this bill, a strong NO vote will allow ANA to
negotiate a stronger bill in the Senate.
.The recent death of a MD nurse and FL nurse's aide only underscore the need
for proper education, prescreening, and surveillance. Nurses and other first
responders will continue to feel uncomfortable about the vaccine until they
receive the reliable information and prescreening needed to make an informed
decision.
.Members of the armed services received personalized education, and free and
confidential prescreening prior to the administration of the vaccine. This
process properly screened out one-third of the potential recipients. ANA u
rges Congress to enact legislation that would provide the same level of
protection to civilian nurses. HR 1463 fails to do so.
.HR 1463 fails to require adequate funding for the administration of the
smallpox vaccination program. The National Association of County and City
Health Officials (NACCO) estimates that it costs $204 per person to properly
administer the vaccine. States and localities are absorbing millions in
uncompensated costs related to this program. NACCO reports that the
uncompensated costs of the smallpox vaccination program are leading 79% of
local public health officials to divert funds from other needed bioterrorism
efforts.
.HR 1463 contains an insufficient, unfunded, compensation program. Many
nurses will continue to choose not to be vaccinated until they are assured
that the government is willing to take care of them if they are harmed by the
vaccine. The Administration is basically asking healthy nurses to place
themselves (as well as their patients and families) at risk for the common
good. The vaccination has no tangible benefit for nurses; it is sought in the
name of homeland security. ANA does not believe that its members should be
made to bear this public risk alone. HR 1463 contains an unacceptable
lifetime cap on wage replacement and fails to ensure that funds will be
earmarked for the compensation fund.

3d death plagues smallpox program
Some put vaccinations on hold pending probe
<http://www.boston.com/dailyglobe2/088/nation/3d_death_plagues_smallpox_progra

m+.shtml>
Randolph E. Schmid, Associated Press, March 29, 2003

Washington - A 55-year-old National Guardsman died this week from a heart
attack, the Pentagon said yesterday, in the third such death that followed a
smallpox vaccination. The Defense Department is joining the Centers for
Disease Control and Prevention in postponing vaccinations for people with
heart disease until a possible link is investigated, said Dr. Bill
Winkenwerder, assistant secretary of defense for health affairs. In Florida,
where a health worker died this week after a heart attack, officials
suspended their smallpox vaccination program. New York put its program on
hold early this week. In Massachusetts, Baystate Medical Center in
Springfield also suspended its immunization program for health care workers.
The hospital had begun recruiting, but had not actually vaccinated anyone,
said Barry Waite, a hospital spokesman. When hospital officials have a
sufficient comfort level here with the program, they will move forward, Waite
said. Yesterday, a federal advisory committee was considering how many people
should be excluded from the vaccination effort. One option being considered
would exclude anyone over age 50. At the Pentagon, Winkenwerder said the
soldier who died also smoked and had high cholesterol. An autopsy showed that
he had had coronary disease. Winkenwerder said it appears unlikely that the
vaccine caused the man's death. ...

News Affecting Nurses: California

Nurses may have won battle for union labor representation
<http://www.avpress.com/n/westy3.hts>
Bob Wilson, Antelope Valley Press, March 26, 2003

Lancaster - Antelope Valley Hospital's registered nurses appear to have won a
yearlong battle to obtain labor representation from the California Nurses
Association. A count Monday night of signature card votes cast by nurses last
year showed a majority of the 529 registered nurses eligible to participate
in the balloting supported unionization. The results could mean all of the
hospital's registered nurses will be represented by the CNA. The cards were
counted Monday by Louis M. Zigman, an independent arbitrator agreed upon by
both the CNA and the hospital. "Today is a great day for Antelope Valley
Hospital nurses and patients," said Gycela Ethridge, a registered nurse who
works in the 382-bed medical facility's intensive-care unit. Colleen Sichley,
a registered nurse in the hospital's mental-health unit, said she was
ecstatic and exhausted after the count. "It's been a long road, but we're
finally happy that we will be able to sit down at the bargaining table and
talk about better patient care, bringing in more nurses and discussing a
pension plan that nurses can actually survive on after taking care of
patients for years and years," Sichley said. ...

News Affecting Nurses: Massachusetts

Mediator Calls for Talks Between UMass Memorial Medical Center
Nurses And Management As Negotiations Stall Over Staffing Issues
Talks are First to be Held Since Hundreds of Nurses Picketed on March 13th
<http://www.massnurses.org>
Massachusetts Nurses Association, March 21, 2003

Worcester - A federal mediator has arranged for the resumption of contract
talks between the registered nurses of UMass Memorial - University Campus and
hospital management on Tuesday, March 25, 2003. The session was arranged
several days after more than 200 bargaining unit RNs conducted informational
picketing and leafleting during a snow storm outside the facility. Poor
staffing at the facility was the key reason behind the nurses' desire to
picket and it is the key issue preventing a contract settlement. "Our
staffing ratios are not just inadequate, they are patently dangerous in some
cases," said Kate Maker, RN, local unit chair. ...

America's Staff Nurses Cite Better RN-to-Patient
Ratios As Top Solution to Nursing Shortage
MNA Cites Report as Further Evidence for MNA Sponsored Legislation
- An Act to Ensure Quality Patient Care -
To Regulate Registered Nurse-to-Patient Ratios in Massachusetts Hospitals
<http://www.massnurses.org>
Massachusetts Nurses Association, March 28, 2003

Canton - A study reported in this month's issue of the American Journal of
Nursing shows that more than 85 percent of nurses surveyed believe limiting
the number of patients each nurse must care for is the most important
solution to a growing staffing crisis in America's hospitals. More than 80
percent of the nurses surveyed report being understaffed, nearly 70 percent
report having less time to spend with patients and they identified increased
workload and burnout from these conditions as the key reasons for nurses
leaving the hospital bedside. In fact, similar to previous studies, this
study again found that nearly one in three nurses is considering leaving
their position in the next five years. The study provides further strong
evidence to support efforts by a growing coalition of nurses and patient
advocates seeking to pass legislation to regulate RN-to-patient ratios in
Massachusetts hospitals, according to the Massachusetts Nurses Association
which filed the bill, HB 1282, An Act to Ensure Quality Patient Care and Safe
RN Staffing. ...

Join the St. Vincent Hospital Nurses' Candlelight
"Solidarity" Vigil for Safe Staffing and a Fair Contract

Monday, March 31, 2003, 6:30 - 7:30 PM
Worcester Medical Center, Summer Street Entrance

On the third anniversary of the date of their historic 49-day strike for safe
patient care, the registered nurses represented by the Massachusetts Nurses
Association at St. Vincent Hospital are taking to the streets once again for
a candlelight "solidarity" vigil to draw attention to their efforts to
convince Tenet Health Care to provide safe staffing and a fair contract to
ensure quality patient care.

You Need to Know:

.Contract talks with management, which had been proceeding relatively
smoothly have taken a negative turn over the last eight weeks as Tenet Health
Care one of the largest for-profit health care corporations in the world,
became embroiled in a series of financial scandals, including federal
investigations for improper billing of Medicare. As Tenet has embarked on a
corporation-wide cost cutting plan, nurses have witnessed a deterioration in
Tenet's commitment to meet safe and agreed upon staffing guidelines and a
hardening of their positions at the negotiating table.
.Over the last eight weeks, the hospital has repeatedly violated agreed upon
staffing guidelines, forcing nurses to care for 7, 8 and even 9 patients at a
time. According to a study in the Journal of the American Medical
Association, when these guidelines are violated and nurses are assigned 7 - 9
patients, a patient's risk of death increases by as much as 38 percent.
.Tenet has come to the table with a proposal to change current contract langu
age to expand the practice of "floating" nurses from one area of the hospital
to another where they are not competent to practice. It is analogous to
asking a math teacher to also teach French. In the hospital setting, such
practices can be dangerous.
.Back in 2000, one of the other issues leading to the strike vote was Tenet's
excessive use of "flex" positions. Flexing refers to the practice of
requiring a nurse to leave work when the hospital deems there are too many
nurses on staff that day. Nurses sent home are forced to use their own
benefit time to compensate for their loss of pay. The hospital has greatly
expanded the practice and is seeking language in the contract to allow for
more than 80 percent of the nursing staff to be "flexed."
.The hospital has a salary proposal on the table that would place senior
nurses between $5 and $7 below their counterparts at other Worcester
hospitals. The hospital has already lost 9 operating room nurses in the last
six months because of the lack of a competitive salary.

What Nurses Want:

.A commitment by Tenet to adhere to the existing staffing guidelines so that
patients are guaranteed a safe level of nursing care.
.To maintain the current limits on "floating" of nurses to ensure that
patients are only cared for by nurses who are competent to provide the care
they require.
.To maintain limits on the number of "flex" positions to no more than 30
percent of the nursing staff in accordance with industry standards in
Massachusetts.
.While the nurses are not seeking parity with other Worcester hospitals, they
are seeking a competitive wage to allow them to recruit and retain nurses to
provide the care patients deserve.

Support the St. Vincent Nurses
Support Safe Patient Care

News Affecting Nurses: Tasmania

Nurses back staffing plan
<http://www.examiner.com.au/story.asp?id=169166>
Michael Lowe, The Examiner, March 27, 2003

A deal that would end the long- running hospital staffing dispute has been
overwhelmingly backed by nurses and is set to be formally adopted next week.
Australian Nursing Federation members in Hobart voted yesterday to accept the
in-principle agreement on the nursing-hours-per-patient-day model, the
process proposed by the unions to resolve staffing disputes in the State's
three biggest hospitals. ANF branch secretary Neroli Ellis said yesterday
that the vote at the Royal Hobart Hospital followed unanimous votes this week
at the Launceston General and North-West Regional hospitals. Mrs Ellis said
the nursing unions and Health Department would return to the Industrial
Relations Commission on Wednesday to ask for a consent order between the
parties, meaning the model became part of the enterprise bargaining
agreement. She said the 10-page agreement meant an additional 61 full-time
equivalent nurses plus 12 education nurses could be employed immediately, and
would be in place within a year. She said 400 nurses had allowed their
registration to lapse in Tasmania during the past four years, "so extra staff
are out there". Importantly, the agreement allowed nurses to determine the
skills mix on each ward, according to clinical need. Mrs Ellis said another
important feature was a system to monitor workloads and grievance process
that resolved disagreements in 15 working days. ...

News Affecting Nurses: USA

US seeks overtime-pay rule update
Changes could aid low-wage workers, hurt some others
<http://www.boston.com/dailyglobe2/087/business/US_seeks_overtime_pay_rule_upd

ate+.shtml>
Diane E. Lewis, Boston Globe, March 28, 2003

Labor Secretary Elaine Chao proposed new regulations yesterday that would
guarantee overtime payments to 1.3 million low-wage employees but could
disqualify thousands of white-collar workers earning more than $22,000 a
year. The proposed regulations, which are subject to a 90-day public review,
would raise the salary level below which workers automatically qualify for
overtime from the current $155 per week to $425 per week. The proposed
increase is the first in 28 years. While opponents and supporters agree that
the salary test needed to be updated, they sharply disagreed over other
proposed changes that the department estimated may exempt about 640,000
white-collar workers from collecting overtime pay after logging more than 40
hours per week. Among those workers are professionals, executives, and
administrative staff earning an average of $50,000 per year, according to a
study commissioned by the department. Employees covered by union agreements
mandating overtime would not be affected.
...

Some Workingclass Web Sites on the War:

Doctors and Nurses Against The War
<http://www.internationalanswer.org/WarNotHealthy.html>
Health Community Against the War
<http://www.healthnotwar.cedant.com>
Health Workers Against Smallpox Vaccinations
<http://www.healthworkers.org>
LabourStart Iraq Page
<http://www.labourstart.org/iraq>
Massachusetts Labor for Justice with Peace
<http://www.unionwebservices.com/laborfjwp>
Military Families Speak Out <http://www.mfso.org>
New York City Labor Against War
<http://groups.yahoo.com/group/LaborAgainstWar>
UE: No to War!
<http://www.ranknfile-ue.org/notowar.html>
United for Peace & Justice
<http://www.unitedforpeace.org>
US Labor Against the War
<http://www.uslaboragainstwar.org>
Veterans Against the Iraq War
<http://www.vaiw.org/vet/index.php>

Web Directory:

AARN <http://www.aarn.org>
Australian Nursing Federation
<http://www.anf.org.au>
California Nurses Association
<http://www.calnurse.org>
Canadian Federation of Nurses Unions
<http://www.nursesunions.ca>
CCDS <http://www.cofc.org>
Irish Nurses Organisation <http://www.ino.ie>
Labor Party
<http://www.thelaborparty.org>
LabourStart <http://www.labourstart.org>
Maine State Nurses Association
<http://www.mainenurse.org>
Massachusetts Ad Hoc Committee <http://www.massadhoc.org>
Massachusetts Green Party
<http://www.massgreens.org>
Massachusetts Nurses Association
<http://www.massnurses.org>
MASS-CARE <http://www.masscare.org>
New York Professional Nurses Union <http://www.nypnu.org>
New Zealand Nurses Organisation <http://www.nzno.org.nz>
PASNAP <http://www.pennanurses.org>
PNHP <http://www.pnhp.org>
Revolution Magazine <http://www.revolutionmag.com>
Seachange Bulletin
<http://www.seachangebulletin.org>
Southern Arizona Nurses Coalition
<http://SAZNC.homestead.com>
Union Web Services <http://www.unionwebservices.com>
United Health Care Workers <http://www.uhcw.org>

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