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The University of Michigan Health System and a union representing 5,000 nurses have agreed to what the union believes is the nation's first contract intended to protect nurses treating Ebola patients.

The contract language sets standards for a litany of issues, from nurses' Ebola training and personal protective gear to how medical procedures will be handled, such as drawing blood, disposal of fluid waste and suctioning.

The agreement limits to four hours the time nurses can spend in a sick patient's room wearing heavy protective equipment and ensures that they won't have to give up pay or vacation days if they're quarantined or become ill.

Nurses in Michigan and nationwide have alleged that they are inadequately prepared to care for Ebola patients, lacking both the training and proper equipment to deal with the potentially deadly disease. Two nurses at Texas Health Presbyterian Hospital in Dallas contracted the virus while caring for Thomas Duncan, a Liberian national who died of the disease Oct. 8. Both have recovered.

Research conducted by the Michigan Nurses Association showed that hundreds of nurses in the state do not feel adequately prepared to care for an Ebola patient.

The contract language hammered out at UM in Ann Arbor may become a template for other health systems struggling with employee concerns about Ebola, according to John Karebian, executive director of Michigan Nurses Association.

"We believe these can be building blocks for what other systems do, not only in Michigan but across the country," Karebian said. He said 40 UM nurses have volunteered to treat Ebola patients, should the need arise.

"Nurses have stepped up and volunteered to care for Ebola patients," said Katie Oppenheim, RN, president of the University of Michigan Professional Nurse Council. "Now they can do so knowing that their lives and their income will be protected should they become exposed to the Ebola virus."

"We are very glad to have reached this agreement, because nurses are critical to our Ebola preparedness effort," a University of Michigan Health system spokesman said late Monday. "Working together, we will be ready for anything that may occur."

No Ebola cases have been detected in Michigan, but the Michigan Department of Community Health has monitored 14 people who traveled to Michigan from the West African countries hardest hit by the virus: Liberia, Guinea and Sierra Leone. Five are being actively monitored, and nine have completed their monitoring cycles.

Meanwhile Monday, an emergency room doctor who was New York's first Ebola patient has recovered and is to be released on Tuesday, health officials said.

The city Department of Health said Monday in a statement that Dr. Craig Spencer, who attended Grosse Pointe North High School and Wayne State University, "has been declared free of the virus."

Spencer, 33, tested positive for the virus on Oct. 23, just days after returning from treating patients in Guinea with Doctors Without Borders. He has been treated in a specially designed isolation unit at Manhattan's Bellevue Hospital, a designated Ebola treatment center.

The UM contract focuses heavily on safety for nurses. In addition to standards for training and personal protective equipment, provisions include:

■A nurse will not lose salary or have to use paid time off or extended sick leave if quarantined because of suspected exposure to the Ebola virus, or being infected with it.

■The hospital will pay for all medical treatment and follow-up, including psychological testing if warranted.

In addition, nurses who have been quarantined or are recovering from the Ebola virus may return to their previous position, hours of work and shift once declared Ebola free.

Under CDC guidelines, individuals at any risk of exposure to the virus should be actively monitored until 21 days after the last potential exposure, even if they show no symptoms. "Active monitoring" means the state or local public health authority assumes responsibility for keeping in regular communication with potentially exposed people, including checking daily for symptoms and fever, rather than relying solely on people to self-monitor and report symptoms.

The guidelines are not mandatory.

But governors in New York and New Jersey instituted mandatory 21-day quarantines for travelers from West Africa; Connecticut's governor Monday ordered all travelers from Liberia, New Guinea and Sierra Leone to undergo "active mandatory monitoring" for 21 days. The state would then issue quarantines as deemed "necessary."

The 21-day cycle expires Tuesday for Kaci Hickox, a Doctors Without Borders volunteer who returned to Newark airport after treating Ebola patients in West Africa on the day New Jersey announced its new Ebola regulations. Hickox was sequestered for days while battling New Jersey politicians. She was eventually allowed to return to her home state of Maine.

The Associated Press contributed.

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