Last week, the largest nurse’s union in the US urged hospital employers to increase safety measures to protect nurses from the growing Covid-19 pandemic, which is pushing all hospital workers—but especially nurses—to operate with minimal support.
“This is a national emergency and far too many hospitals are still failing to ensure that our caregivers, who are placing their own safety at grave risk, have the protections they need to stay at the bedside for their patients,” National Nurses Union executive director Bonnie Castillo said in a press release.
Overcrowding at hospitals in New York City has forced officials to build makeshift clinics in a convention center, in a field in Central Park, and at the stadium used for the US Open. Beds set up inside the New Orleans Convention Center will be used as a space for patients to recover. Several hospitals in Boston have reported more than 345 positive Covid-19 cases among medical personnel. And Louisiana has expedited the licensing of new doctors and nurses in a bid to get ahead of a possible shortage of medical staff.
Sal Rosselli, president of the National Union of Healthcare Workers, told Quartz that hospitals were totally unprepared for this degree of crisis. “Among the acute care hospitals none are prepared for this, none have adequate equipment, none do adequate training,” he said. Rosselli told Quartz that testing hospital workers is of utmost importance to ensure they don’t pass the illness along to their families, other patients, and coworkers, but that it’s not happening on a large enough scale. He said his union is pushing for hospitals to supply hotel rooms to hospital staff that have been exposed to Covid-19 patients to better implement quarantines.
Rosselli blamed in part the privately-run American healthcare system itself. “Decisions are made based on the bottom line as opposed to providing adequate access to healthcare itself. So if the system was near capacity before this crisis happened, now it’s in total chaos. Total chaos. Are there adequate numbers healthcare workers? No. Not an adequate number of nurses, not an adequate number of respiratory therapists, et cetera, et cetera. There aren’t because that’s where the industry has evolved to at this point,” he said.
Hospitals and manufacturers around the country are now scrambling to keep up with the increased demand for the personal protective gear (PPE) that is required for nurses and others to treat patients with communicable diseases. Nurses have reported being unable to find N95 masks, gloves, and other protective gear. Hospital staff have complained about a lack of top-down guidance on best practices to protect themselves in the face of Covid-19. In early March, the National Nurses Union released a survey of 8,200 nurses. It found that less than half had received information from their employers on how to respond to Covid-19 cases.
Case study
In recent days, New Orleans has emerged as a new hotspot for the spread of coronavirus in the US. There have been more than 1,834 cases and 101 deaths reported so far, which puts the city on pace to be one of the worst-hit in the country. As hospitals are flooded with patients seeking treatment, nurses in the city are being pushed to their limits with inadequate protective gear and a shrinking workforce as staff begin to show Covid-19 symptoms. This trend can be seen all over the country—nurses on the frontline are finding working conditions unsustainable and potentially dangerous.
Last week, a nurse using the pseudonym Emma Guillory published a guest post in Big Easy Magazine, a local independent publisher in New Orleans. Writing anonymously to protect her job, Guillory said the deteriorating working conditions plaguing nurses and hospital staff as cases of coronavirus flooded New Orleans hospitals.
“The thing that is the most messed up to me is that people at different levels and economic classes within the hospital are getting different levels of equipment,” Guillory told Quartz in a phone interview.
She said that low-pay workers, such as the hospital staff who transport gurneys, provide food trays to patients, and clean hospital rooms, receive even less protective equipment than nurses. The hierarchy of who receives protective gear often shows preferential treatment to doctors and high-level staff, she said. At University Medical Center where Guillory works, she said these workers are paid between $10-$12 per hour—and very little is being done to protect them.
Guillory said that hospital staff usually receive plastic isolation gowns that are intended to be used once and thrown out after leaving a patient’s room. At first hospital staff were not getting these gowns at all, but now they receive one per shift. Staff are then told to use a bleach wipe to disinfect the gown and then hang it up to dry so it can be used again.
Working alongside possible Covid-19 positive colleagues is another source of stress for nurses and hospital staff. Guillory points out that even though some nurses have taken sick leave, others continue to work while displaying mild symptoms—like a dry cough or loss of their sense of smell—because qualifying for a test requires an individual to have a fever. “You only qualify for a test at my facility if you have a fever. And so otherwise if you have these low-grade symptoms, you can’t be tested and they want you to work,” she told Quartz.
Comms crisis
Nurses say that inadequate communication from hospital administration is a source of continuous frustration on the frontlines across the country, not just in New Orleans.
Nicholas Olaverria, a registered nurse at Memorial Hermann Hospital in Houston has worked several shifts on the ICU floor. He said that nursing staff often experience the most exposure to Covid-19 patients (and patients who are being evaluated for infection) because physicians are able to give orders while standing at the door.
“It starts with the support system that nurses have and that support system doesn’t really exist. It’s interesting because now with Covid happening, it’s like our healthcare system is put under a microscope and everyone in the world is finally seeing how the Western world deals with healthcare and sick patients,” Olaverria said. “Nurses have had issues with support with getting PPE and appropriate supplies from day one before coronavirus even developed. But now that it’s become an issue, we are dealing with issues from hospital administration not really listening to our concerns.”
“It’s a process and it’s a learning curve for all of us, but I really hope once this is all over, this really changes the way we see our healthcare system, honestly,” Olaverria said.
Guillory also pointed out issues with communication for hospital staff that have less formal training in the medical field. Many employees receive no instruction on how to best protect themselves, especially those who are pregnant or might have an existing condition such as asthma or an auto-immune disease.
“It just appears that there is no plan at all.”