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| Michigan Radio
COVID-19 wreaks havoc on nurses months after pandemic begins
Months after the pandemic began to overwhelm the U.S. healthcare system, nurses at UNC Hospital in Chapel Hill are still working tirelessly.
Fearing a staff shortage as COVID-19 hospitalizations soar to new records, several major Michigan health systems are telling employees to report to work, even if they have recently had close or family contact with a person with COVID-19.
As long as they are asymptomatic, these employees are required to do their jobs while awaiting test results, according to the policies of Michigan Medicine, Beaumont Health, Munson Healthcare and others.
Several health systems claim that these results are available within 24 to 48 hours. But in areas where testing shortages cause delays, those results can take up to five days, including at Munson Healthcare, northern Michigan’s largest healthcare system.
Munson employees have been instructed to report for work even if “your local health department asks them to quarantine,” as long as they are asymptomatic and await test results.
“You are an essential worker because you are in the health field,” read the staff instructions. “You can still work to work (sic) even after exposure as long as you are asymptomatic.
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“Besides coming to work, you should quarantine yourself at home. It simply means leaving your home to come to work. In addition to coming to work, please follow other Department of Health guidelines. This can include self-monitoring and limiting exposure to others, even within your own household. ”
For some hospitals, like Michigan Medicine, these policies were first enacted in March during the initial push. But now, as the spread of COVID-19 in the community increases, more healthcare workers are concerned about the risks these policies could present to patients and their colleagues.
Michigan Medicine staff recently received an internal message from the leadership of the health care system “dealing with the confusion” about the coronavirus exposure policy:
“Some concerns were raised about one of the questions about the ResponsiBLUE health screening tool,” the post read. “Currently, asymptomatic employees who have had close or family contact in the past 14 days with someone recently diagnosed with COVID-19 are offered OSH testing around day 5. These employees continue to work while awaiting test results (assuming they remain asymptomatic). “
“This message really baffled me,” said a Michigan Medicine employee who works in the healthcare system supply chain. The employee asked not to be appointed for fear of risking his job. “It seems like it goes against everything we say to the public. Why would you encourage hospital staff to come in if they’ve been in contact (with someone with COVID-19)? ”
Due to understaffing, Mercy Health staff in Muskegon are also being asked to work on COVID-19 floors while awaiting test results, said Kevin Lignell, spokesperson for SEIU Healthcare Michigan, the union representing the workers. .
“According to our president (SEIU), if you have exposure you are not exempt from anything unless you start showing symptoms,” Lignell said in an email Thursday. “We have (health workers who are) spouses and parents (and) who live with HIV positive people who work in both COVID and non-COVID areas.”
But at Henry Ford Health System, health workers deemed to have “high-risk exposures” are quarantined for seven days, tested on the seventh day and, if negative, can return to work the next day, the door said. -says David Olejarz.
“For exposures deemed to be moderate or low risk, an asymptomatic employee can return to work with full PPE protection and self-monitoring for symptoms,” he says.
But some nurses say that requiring exposed workers to return to their jobs before receiving a clean checkup could backfire.
“It should be a matter of common sense that any nurse who fears having COVID-19 after exposure to the virus should be able to self-quarantine without risking income until it is clear that they are safe. to get back to work, ”says Jamie Brown, president of the Michigan Nurses Association and critical care nurse at Ascension Borgess Hospital in Kalamazoo.
“We cannot continue to take care of our communities if we get sick ourselves. Nurses and healthcare professionals are the last line of defense in this pandemic, “Brown said.” We need to be able to access tests quickly to ensure that we are able to protect our patients, colleagues and others. ourselves. “
The possibility of catastrophic staff shortages
But health systems with these policies say they are needed to avert an impending crisis: staff shortages. All hospitals, from small rural community sites to sprawling urban systems, share the same concern.
“It’s really the staffing issue that has come to the top of the list by members of our hospitals statewide,” Brian Peters, CEO of the Michigan Health and Hospital Association, told a conference. release at the beginning of the month.
“So it’s not necessarily a problem of lack of hospital beds. But it’s really a matter of great concern when you talk about the availability of staff, especially our frontline caregivers, (they) themselves test positive. So this is clearly our main concern.
Unlike spring, when COVID-19 hit places like New York City and the Detroit metro area hardest, no area has been untouched by the current outbreak. Which means a much tighter national labor market for critical health care workers.
“When we all have the need (for staff), this will be the critical resource that we seek,” Spectrum Health CEO Tina Freese Decker said in a press call on Nov. 12.
At St. Mary Mercy Livonia Hospital, Chief Medical Officer Dr Matthew Griffin said 39 staff are out of work with COVID-19.
“The infection rate of healthcare providers during this wave of the pandemic appears to be higher than it was in the spring,” Griffin said Thursday. “Most health care systems in Michigan and across the country are affected.”
Dianne Michalek, director of marketing and communications for Munson Healthcare in Traverse City, says she does not know the current number of staff in quarantine.
“… (But) I can tell you that this is only a fraction of a percentage of our total staff across the system, but on an upward trend as the spread of the community increases in our area.”
Use of CDC guidance, no cancellation of procedures
Health systems also invoke CDC guidelines, which outline “emergency capacity strategies for health facilities”, including allowing asymptomatic health workers “who have had unprotected exposure to SARS-CoV-2 (the virus that causes COVID-19) but are not known to be infected to continue working. “
Asked about its employee exposure policy, a spokesperson for Trinity Health Michigan (which includes Mercy Health) said, “As with many healthcare systems, Trinity Health Michigan follows current CDC return-to-work guidelines for health workers. ”
Exposed employees are still required to take other safety precautions, said Aaron Gillingham, director of human resources at Beaumont Health.
“It is possible, after one of our nurses has spoken to an employee who may (have) a household member or family member who has tested positive for COVID, to return to work, provided they following the CDC’s guidelines regarding masking, and paying very close attention to their symptoms, ”Gillingham said.
Such policies are now “commonplace in hospitals,” Michigan Medicine spokeswoman Mary Masson said, because these workers “are considered essential.
“… There are also emergency recommendations from the CDC to allow exposed healthcare workers to continue working amid staff shortages.”
But many of those same health systems have delayed adoption of another strategy recommended by the CDC: cancellation of elective procedures.
“Canceling all non-essential procedures and visits” is one of the first mitigation measures listed by the CDC in this guide. “Shift HCP (healthcare personnel) who work in these areas to support other patient care activities in the facility. Institutions will need to ensure that these health professionals have received the appropriate orientation and training to work in these areas that are new to them.
But industry executives say canceling some of these procedures creates very real dangers for non-COVID-19 patients, especially those with cancer or other serious conditions. And when Governor Gretchen Whitmer issued a mandatory cancellation of elective procedures in the spring, it resulted in serious financial hardship, including layoffs.
“We clearly don’t want to be in a position where we have to stop elective procedures, or non-emergency activities, going on in our hospitals for two reasons,” Henry Ford Health System CEO Wright Lassiter said on November 12.
“The first & mldr; don’t we want the Michiganders to have to delay necessary care. We therefore want to be available to the communities we serve, for all the care they need. And secondly, the other practical problem as well is that it has a significant impact on the financial viability of our organizations.
“And so we’re obviously working very hard to make sure that, firstly, we can provide the highest quality and safest patient care, but also that we have financially viable health facilities serving our communities.
But for some workers, like the Michigan Medicine supply chain worker, it seems healthcare systems are asking staff to shoulder most of the burden.
“… And I can’t help but think it’s for monetary gain. They want to do surgeries. We don’t feel like we are taking the proper precautions. It feels like people are sitting at home, going to work at home, yelling at other employees to do this and that, and ignoring the environment (in which they work). ”
The Detroit Free Press, Bridge Michigan and Michigan Radio have teamed up to report on Michigan hospitals during the coronavirus pandemic. If you work in a Michigan hospital, we would love to hear from you. You can contact Kristen Jordan Shamus at [email protected], Robin Erb at [email protected], or Kate Wells at [email protected].
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