The National Voice for Direct-Care RNs Washington D.C. 888 16th Street NW Suite 640 Washington DC 20006 phone: 800-287-5021 fax: 202-974-8303 Oakland 2000 Franklin Street Oakland CA 94612 phone: 800-287-5021 fax: 510-663-2771 President Barack Obama The White House Washington D.C. 1600 Pennsylvania Avenue Via Electronic Mail October 15, 2014 On behalf of registered nurses and other health care workers across the United States we understand that the only way to adequately confront Ebola crisis, that the World Health Organization has termed the most significant health crisis in modern history, is for the President to invoke his executive authority to mandate uniform, national standards and protocols that all hospitals must follow to safely protect patients, all healthcare workers, and the public. Every healthcare employer must be directed to follow the Precautionary Principle and institute the following: • Optimal personal protective equipment for Ebola that meets the highest standards used by the University of Nebraska Medical Center • Full-body hazmat suits that meet the American Society for Testing and Materials (ASTM) F1670 standard for blood penetration, the ASTM F1671 standard for viral penetration, and that leave no skin exposed or unprotected and National Institute for Occupational Safety and Health-approved powered air purifying respirators with an assigned protection factor of at least 50 — or a higher standard as appropriate. • There shall be at least two direct care registered nurses caring for each Ebola patient with additional RNs assigned as needed based on the direct care RN’s professional judgment with no additional patient care assignments. • There will be continuous interactive training with the RNs who are exposed to patients. There will also be continuous updated training and education for all RNs that is responsive to the changing nature of disease.  This would entail continuous interactive training and expertise from facilities where state of the art disease containment is occurring. • If the Employer has a program with standards that exceed those used by the University of Nebraska Medical Center, the higher standard shall be used. The Ebola pandemic and the exposure of health care workers to the virus represent a clear and present danger to public health. We know that without these mandates to health care facilities we are putting registered nurses, physicians and other healthcare workers at extreme risk. They are our first line of defense. We would not send soldiers to the battlefield without armor and weapons. In conclusion, not one more patient, nurse, or healthcare worker should be put at risk due to a lack of health care facility preparedness. The United States should be setting the example on how to contain and eradicate the Ebola virus. Nothing short of your mandate, that optimal safety standards apply, will be acceptable to the nurses of this nation. Sincerely, RoseAnn DeMoro Executive Director National Nurses United Cc: National Nurses United Executive Committee