Thread by @EurekaJustice

#CovidIsNotOver #auspol #SafeHealthCare
Some know I recently had surgery & managed to ensure I was provided a Covid-safe environment in a Queensland Public Hospital.

As promised – here is how I achieved that.

A 🧵

But first – I want to acknowledge some privileges I enjoy & which may not be available to everyone.
I am in Australia where we have universal health care – though access is not equal depending on your location.
I am a white, educated woman
I am an experienced HCP & Health admin.

1ST - COMMIT THIS TO MEMORY:

Understand that NOTHING takes precedence over Legislation.

Not Federal Government Public Health or Health Dept policy. Certainly NOT State Govt PH or Health Dept Policy.

AND DEFINETELY NOT Private Hospitals policies.

Your statutory rights AND the statutory obligations of Registered Health Professionals / employees / management WILL ALWAYS trump ANY “policy”.

ALWAYS.

Now – how to get them to protect you?

I have learnt that trying to discuss the science behind covid and use of masks/air filtration is POINTLESS.

I have found the BEST approach is to appeal to their “caring about patients” policies.

Occasionally, guilting them into “caring about your anxiety” will be enough.

Mostly, they’ll start with the policy stuff though.

Interrupt as politely as possible and let them know you are NOT interested in getting into a scientific debate and if they DON’T care enough to help you feel less anxious, you are left with no choice but to invoke your legal rights.

Explain that you are VERY SORRY to have to go to these lengths, BUT you have rights under:

1. The Australian Charter of Patient Rights
2. The Work Health and Safety Act 2011 (Qld)
3. The various Code of Conduct’s applying to all AHPRA Registered Health Care Professionals. and..

4. The Australian Commission on Safety and Quality in Health Care Infection Prevention and Control Poster - Airborne precautions poster | Australian Commission on Safety and Quality in Health Care

Collectively, these documents afford you the right to:

SAFE, EVIDENCE BASED CARE

TO FEEL SAFE WHEN ACCESSING CARE

FOR ALL PRACTICABLE MEASURES TO BE USED TO PREVENT AVOIDABLE HARM

As a result you require:
. All persons coming into your immediate airspace FOR ANY REASON to use a well-fitted N97/PPF2 quality mask
. A HEPA filter with a min CADR of 6 air exchanges/hr to be in your immediate vicinity and turned on at all times (with a clean filter!)

. Staff to ensure your own N95/PPF2 quality mask to be fitted firmly to your fact at all times when you are unable to monitor it yourself (asleep/under anaesthetic/effects of pain or sedative medications).
. If oxygen therapy is required, a Hudson mask can be applied OVER

your N95 mask and deliver O2 effectively. Levels can be accurately monitors using a SAO2 probe.
. If direct visualisation of your face is deemed necessary, oxygen therapy is to be provided via a well fitted non-rebreather mask (a mask which only delivers o2/air from the tubing).

Additionally, you DO NOT CONSENT to:
. ANYONE displaying obvious respiratory symptoms being in your immediate air space – whether or not they are using a N95 mask or HEPAs are operating. This includes staff/other patients/visitors.

If ANYof these requests are not met AND you contract ANY airborne pathogen illness within the known incubation period following possible exposure, you WILL pursue ALL available measure for redress.

Options include – complaints to the various state/territory health complaints commissions / WorkSafe Australia / complaints to AHPRA – Australian Health Practitioner Registration Authority / Civil legal action.

Now – how likely are you to get a successful outcome? Probably small. However, because LEGISLATIVE obligations are involved, the complaint agencies are OBLIGED to conduct an investigation. It takes LOTS of time. It’s a PITA. You can tie them up in paperwork for MONTHS.

Dr’s insurance companies will get shitty with them.
Most will do what you ask just to SHUT YOU UP!! LOL!!!

I know we WANT them to WANT to do the right thing.

But at this stage - I'm just happy if I can get them to actually DO IT!

Let them know you will have a FULL respiratory viral and bacterial PCR done prior to any scheduled admission AND perform RAT tests daily for several days in advance and following admission/treatment. Get your GP to give you a path form for the PRC test to have on hand if needed.

I will attach the document I sent to my hospital Executive Manager prior to admission for scheduled surgery.
My surgeon was on board, but I needed to be able to ensure I had a cooperative anaesthetist AND post operative care in the ward after the operation.

Several phone calls followed. I was assured all staff would comply.
Pre-op telehealth check-ins with anaesthetist & OT nurse confirmed they were all on board
The nurses EXACT words: “there is an Executive Management DIRECTIVE on your file MANDATING all staff wear N95’s!!!)

Everything went (reasonably) well. Noone was nasty. They all were walking on egg-shells.

There were a few red faces when I pointed out to a couple of staff that it wouldn’t have required an Executive Director Mandate if my request had been for a vegetarian diet...

... or if as a woman if Islamic faith, I’d requested no direct care by male staff.

So WHY should it have taken legal threats when I simply asked to be kept safe from airborne infections?

I was put in a single room post-op. Door closed. All staff masked up.

I could hear nothing by coughing & spluttering from the rooms down the corridor, 24/7!
I have attached links to the various documents referred to above and the document I emailed to the hospital exec.
Make no mistake, this is a stressful, scary process –
even for a seasoned pro.

You have to be brave and strong and stand your ground.
Your personal supports have to back you up 100%. You have to be prepared to look them in the eye and DARE them to deny you care or compromise your care because you demand they wear a mask to protect you.

As noted above – not everyone will be in a position to do this. But the more of us that do – the more health care services of all kinds will NOT be able to pretend they didn’t know what their LEGAL obligations are or how to protect patients.

We can but hope one day, enough of us are asking, that we hit a critical mass and it becomes mainstream!

Go get ‘em #CovidSafeers

References/links to laws & Codes:

1. The Australian Charter of Patient Rights My Health Care Rights Poster A4 ()

2. The Work Health and Safety Act 2011 (Qld)- Work Health and Safety Act 2011 - Queensland Legislation - Queensland Government (or your State equivalent)safetyandquality.gov.au

3. The Australian Health Practitioner Regulation Agency - Shared Code of conduct (), Medical Board of Australia - Good medical practice: a code of conduct for doctors in Australia, +ahpra.gov.au

Nursing and Midwifery Board of Australia - Professional standards (), and Psychology Board of Australia - Code of conductnursingmidwiferyboard.gov.au

4. The Australian Commission on Safety and Quality in Health Care provide clear advice on the mitigation of airborne pathogens. Infection Prevention and Control Poster - Airborne precautions poster | Australian Commission on Safety and Quality in Health Care

Twitter won't let me attach my document. I'll keep trying though. Any tips on how to attach a word doc or pdf appreciated! 😜