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Not only are hospitals in Bay Area Kaiser keeping COVID-19 and virus-free patients in the same nursing units, but we are now learning that nurses must also commute between infected and uninfected people – and patients don’t. are not informed.
“I had two patients who were HIV positive and two who were not,” Walnut Creek Kaiser nurse Jill Leon told me, describing a recent change.
Leon dons protective clothing before entering the rooms of coronavirus patients and removes them on leaving. But, she said, she has to work a full shift, caring for those with and not the disease, while wearing the same N-95 mask. “We are given one per shift,” she says.
Nurses I interviewed at hospitals in San Jose, Santa Clara, Antioch, Walnut Creek, and San Rafael say they or their colleagues were assigned a mix of COVID and non-COVID patients on the same shift of job. In emails, staff at the Santa Rosa and San Leandro facilities reported similar practices.
Julie Glage, a nurse in San Jose, said she had raised the mixing issues with the administrators “and they responded that they had no instructions not to mix patients.”
Perhaps the most disconcerting, uninfected patients are not told they are sharing staff and floors with people, often in adjacent rooms, who have contracted coronavirus. Colleen Gibbons, a nurse at San Rafael Hospital, said nurses had been warned that educating patients would violate federal medical privacy law.
It’s not just the assigned nurses who go between COVID and non-COVID wards, it’s also the doctors, nurses who fill meal breaks or provide additional assistance when needed, and assistants who often turn around, clean up. , bathe, walk and feed the patients.
I reported last week that Kaiser was keeping patients with and without the virus in the same nursing units at his Oakland hospital. I learned the practice after an elderly and immunocompromised relative hospitalized in a mixed unit at Kaiser Institution in Oakland tested positive for the coronavirus on the ninth day of their stay, after testing negative on the first, third and third. sixth day – suggesting she was probably infected while She was there.
Kaiser declines to say how often they mix patients in the same nursing units or how many patients have contracted the deadly virus as a result. Dr Michael Vollmer, the regional epidemiologist for Kaiser Northern California, in an interview on Wednesday, said providing the data would discourage patients from seeking the necessary treatment.
But nurses’ accounts indicate the mixture is common in hospitals in the Kaiser Bay area. And, contrary to what Kaiser suggested last week, we are now learning that nurses need to care for both infected and uninfected patients at the same time.
In response to questions emailed last week, Kaiser’s spokesperson Kerri Leedy wrote: ‘At one point a nurse is assigned either to patients with COVID-19 or to patients who don’t. do not have COVID-19, but not both at the same time. Asked about it this week, Leedy wrote that the previous answer only applied to Oakland Hospital.
It is not known how risky mixing practices are.
Dr George Rutherford, professor of epidemiology at UCSF, said his hospital aims to keep coronavirus patients and their nurses separate from uninfected patients. But, with proper infection control, the practice of mixing is probably not too worrying, he said. “The problems would come from breaches of infection control.”
Jane Thomason, senior industrial hygienist for the California Nurses Association, said there is a “risk of transmission between patients and between health care providers when you have these types of mixed units. The magnitude of this risk is difficult to determine because hospital data is poor, she said.
It was probably inevitable that Kaiser had to resort to such mixing measures to deal with the latest wave of patients, which has operated many hospitals in the Bay Area and California. What is particularly troubling is the lack of transparency.
Patients deserve to know when they share units with infected patients. Kaiser’s answer to the transparency problem is circular. Asked last week if Kaiser is warning COVID-free patients of those infected nearby, Leedy replied, “This is definitely information that is available to patients and families on request, and we don’t have the intention to refuse them. ” The catch, of course, is that they should know how to ask.
But it is not certain that they would get an answer if they did. Vollmer, the epidemiologist for Kaiser in Northern California, said patients are not being informed due to patient confidentiality.
Monica Rizo, a nurse at the Antioch Medical Center, said non-COVID patients sometimes inquire after seeing special precautions taken with rooms of infected patients. When nurses urged their managers to educate patients, Rizo said, “There was no answer – nothing.”
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