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May 22, 2013
If we want a fighting chance against hospital infection, we're going to have to
pay our janitors more. That's the finding of one U.S. hospital.
In B.C., underpaid hospital janitors are a relatively recent occurrence. In
2002, the Campbell government tore up collective agreements in a spasm of
ideology. Thousands of were laid off and replaced with lower-paid workers. The
justification provided by the government, and strongly echoed by our local MLA,
was that many of these workers were overpaid for what they did.
That ideology was wrong in so many ways. Here's one. Janitors are the front-line
workers in the battle against drug resistant bacteria says science author Maryn
McKenna in Scientific American. Hospitals are reducing infection by training and
paying janitors better.
"The kinds of expenditures that truly improve patient care are often not
directed at the top of their pay scale, with the famous specialists, but rather
at the bottom, with the anonymous janitors."
It's a serious problem. A recent survey found that one in twelve Canadian
hospital patients were either colonized or infected with a superbug. Some were
merely carriers and others were actually infected. Carriers spread superbugs to
other patients, especially the elderly and those with weakened immune systems.
Carriers can become infected themselves. Up to 60 per cent of carriers will get
pneumonia or bloodstream infections from MRSA (methicillin-resistant
Staphylococcus aureus). MRSA is part of a deadly trio including VRE (vancomycin-resistant
Enterococcus) and Clostridium difficile. All three deadly bugs will kill about
9,000 Canadians annually.
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Most of us are familiar with the poster bug for infection, MRSA, either
directly by name or through the public hand washing campaigns aimed to
prevent it's spread. MRSA is relatively easy to control compared to it's
deadly partners because it's carried on the hands and clothing of patients
and visitors.
VRE and C. diff are carried in the intestines. When patients suffer from
diarrhoea, those bacteria contaminate the air and equipment around them.
They are very persistent compared to MRSA.
Low-paid janitors are not trained or motivated to remove VRE and C. diff. To
complicate things further, English is often a second language making
communication difficult. Since they can't earn a living wage, workers are
not going to stick around long enough to develop the skills necessary to
control deadly bacteria.
VRE and C. diff have a double wall that requires different cleaning agents
and techniques. They survive in low-nutrient environments such as glass,
plastic, and metal. They lurk on inorganic surfaces such as keyboards, bed
rails and privacy curtains. Janitors not only need to know which cleaning
materials to select, they need to know where the high-contact hot spots are
in a hospital room.
Hospital janitors need to be paid according to skills required for the job.
They must be trained and respected as a valuable part of a health-delivery
group. As members of a "clean team," N.Y.U Vangone medical centre saw a
reduction in infection. Janitors, administrators realized, know better than
anyone else which rails are touched most frequently and which handles are
hardest to clean.
The Vangone medical centre program reduced infection, and the desperate
last-minute use of antibiotics, to the extent that janitors were made part
of an on-going clean team.
Janitors who can make a living wage not only improve their lives and those
of their families, they enhance the health care of us all. I hope the Clark
government will correct this wrong.
David Charbonneau is the owner of Thompson Studio
He can be reached at
dcharbonneau13@shaw.ca
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