Who Will Be Left to Care for You?

Submitted by Maureen Kroning, RN EdD

Tags: acute care care coronavirus COVID-19 healthcare workers nurse workload nursing Pandemic

Who Will Be Left to Care for You?

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It is sadly too late to help many our front line healthcare workers who have contracted the deadly COVID-19 virus. We need to find a way to help the rest NOW in order to save their lives and in turn they can save your life.  A colleague teaching in a RN to BSN program sent this heartbreaking email:  

"Hello Everyone,

I just wanted to share that I received a disturbing phone call from one of my students today.  She was calling me from her hospital bed in NY City where she is suffering from COVID-19.  She did not sound well at all.  Her breathing was very shallow and rapid. Her voice was weak.  She was on oxygen.  She lost 5 colleagues this past week -some only in their 30s. 
 
Needless to say, I told her not to worry about her school work right now; to use her strength to get better.  Leave it to a nurse to feel badly that her work isn't getting done! I can't even describe how that call affected me.  She told me it was ok if I call her in a few days to check on her. I hope she is able to answer.  If you pray, please do so for her and all of those caring for these patients. 
 
I hope you are all well and stay that way.  

Thanks for listening.      
Mary"

The email is telling us what healthcare workers are facing, that they are becoming infected at higher rates, rates that are not being reported. We must do something to protect our front-line staff and in fact anyone essential employee! 

I work as a Nursing Supervisor in an acute care hospital just 45 minutes from NYC. The hospital situation is dire to say the least. The entire hospital is basically all COVID-19 critical care patients. The situation front-line staff, patients and families face daily makes me and my colleagues feel heartbroken and helpless. Healthcare workers are the only one there to care for a families loved one, to be there to hold their hand as they recover or in the heartbreaking event that they may die. These brave selfless healthcare workers come in each day to find they must try and save a life and too often to endure the horrific heartbreaking situation of many critically ill patients they will not be able to save. Most people will never see the healthcare devastation firsthand. It truly is a feeling of overwhelming emotional pain to see your patient and now so many of your patients take their last breath alone without the support of their family/friends by their side and buried without a proper ceremonial burial, a wake, mass, a Shiva. 

At the hospital, nurses as well as other front-line and ancillary staff do not receive the proper Personal Protective Equipment (PPE). Nurses are told to use the same N95 mask for a week and keep it in a paper bag after each shift and to bring it back when they work again. They are given one gown for the entire shift. Several nursing gowns can be seen hanging from a single Intravenous pole in the hallway. There is no area to properly don and doff PPE, no area designated as a d-contamination area, there is not nearly sufficient staffing and many nurses find themselves caring for critical care patients without the proper support, resources, skill set or training. 

In the Nursing Office which is approximately 150 square feet the support staff in charge of scheduling employees, the nurse in charge of patient placement and the nursing supervisors all share the office. If you have ever worked in a hospital, you know how busy the nursing office can be but today it is about 100 times busier. For instance, at the change of shift staff looking for PPE or are displaced assigned to work on unit that has a greater need pile into the office standing just inches apart from each other and from those working in the office. Throughout the day staff come in and out frequently to the office in full PPE to ask for help with various requests. There is absolutely no social distancing occurring. While at a drive through testing site the situation is often remarkably different.  

Recently, I have been testing individuals for COVID-19 at a New York Department of Health (NYDOH) drive through testing site. It was both shocking and upsetting at the total opposite working conditions there compared to that of the hospital. At the testing site you work 2 hours on, 2 hours off, the pay was good, three amazing catered meals, RNs working quality to help you maintain infection control measures, a d-contamination unit to take off PPE and plenty of staff there to assist with any supplies or request you have. At the site, the 6 feet Centers for Disease Control (CDC) recommended social distance protocol was strictly enforced. I felt protected, valued and appreciated working at the NYDOH drive through screening/ testing site. 

Yet, at the hospital healthcare workers care for patients who are the sickest with a high COVID-19 viral load making them both highly infectious and highly contagious which puts the healthcare worker at great risk for contracting the virus. While, working at the hospital, I felt scared and angry for the lack of: PPE, infection control, qualified critical care staffing and the enormous risk nurses, nursing students and all the front-line staff are taking each and every day and doing so working endless hours to care for others. The working conditions at each hospital can greatly vary. There are hospitals that employees feel protected, supported and valued by their administration. For these hospitals worked fast to create whole units with negative pressure rooms for COVID-19 patients, they moved all patient care equipment such as IV and ventilators outside the patient rooms to limit the virus exposure to staff and provided monetary incentive for working extra hours so staff can have the help needed to provide patient care. Sinfully, there are hospitals that worry about the added cost to the institution. Yet, what they need to consider is what the cost will be to replace the staff that will develop this deadly virus. Hospital need to protect their healthcare workers at all cost for employees are their most valuable resource.   

I was so upset to see this stark difference between the hospital setting and that of the testing site that I reached out and talked to a few NYDOH workers at the testing site in the hope that perhaps there was something they could do.  I told them the dire horrendous conditions nurses are working in at our local acute care hospitals and in just about every hospital around the country. 

I explained to anyone that would listen that it is only a matter of time before every healthcare worker is infected with COVID-19.  We need to do something NOW but I and many others are at a loss on how to make a difference, how to help make things better for myself, my co-workers, our patients, our communities and society. Each one of our healthcare workers leave work and will likely need to go fill up their cars at the gas station, will need to go to the pharmacy, will need to go food shopping and will go home to provide care to their own families. If you are reading this and think you are not at risk you are mistaken. We are all at risk in this country and we must act NOW. 

I am beyond sad for all our brave nurses and so very proud of all my fellow RNs and all the front-line staff that continue to fight for their patient’s lives. They are true heroes. 

The situation needs a major government directive NOW but how does that happen in time to save the lives of those we so desperately need and love, the same ones that will be called to save your life.     

Sincerely,
Maureen Kroning EdD RN