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BISMARCK, ND (AP) – Like many medical workers around the world, Fargo emergency nurse Adam Johnston cannot escape the grim reality of the coronavirus pandemic. He follows him everywhere: at work, where people die on every shift; at the grocery store, where people denounce his city’s mask requirement; and at home, where he has trouble sleeping.
He’s made it through the long months, including the current virus wave in North Dakota, which is among the worst in the United States, finding solace with his fellow nurses on brief breaks where they can exchange advice on the fight. against insomnia or simply venting frustrations. But he and many other nurses fear things will get even more difficult now that Governor Doug Burgum has cleared. besieged state hospitals are using infected but asymptomatic workers to treat patients with COVID-19.
“This is going to make you question every time you want to sit down and have a five-minute snack with one of your colleagues,” said Johnston, president of the state Emergency Nurses Association. “You’re always going to think, ‘Am I 6 feet from them? Am I safe? Am I not? ‘”
Burgum said his move could help hospitals in North Dakota, which are at or near capacity after an increase in cases that started over the summer and has only gotten worse. But Johnston and many other nurses feel he is placing another burden on them while resisting the imposition of joint safeguards to stem the spread of the virus that may be less politically acceptable in the Conservative state.
Like some of his Republican counterparts in other states who have had big spikes in COVID-19 cases, Burgum has for months taken a business-friendly approach that places the onus of slowing the virus on individuals rather than on government mandates, to protect “both lives and livelihoods.” It wasn’t until Friday that he finally gave in and ordered a statewide mask warrant and some restrictions on businesses and gatherings.
The hands off approach did not work. After avoiding the explosion of cases that many other states experienced at the start of the pandemic, the virus has spread to North Dakota, which now regularly breaks its daily records of cases and deaths.
Burgum’s decision, which is authorized under guidance from the Centers for Disease Control and Prevention, reflects the scarcity of medical personnel in one of the hardest-hit regions of the country, said Dr Thomas Tsai, assistant professor at the Harvard’s School of Public Health. He said hospitals across the country were considering such options as the number of cases skyrocketed.
This is the case in South Dakota, which allows the practice but where none of the large hospitals are currently using infected workers.
In the spring and early summer in places like New York, medical workers from across the country were able to fly and volunteer, bringing relief to hospitals. But Tsai said the virus was now so widespread that there was little hope of such relief in North Dakota.
The state’s main hospitals have pushed the Burgum administration to allow them to treat patients infected but asymptomatic with COVID-19.
“We applaud the governor for another tool we can use,” said Michael LeBeau, director of Sanford Health Bismarck, which is developing protocols that allow these employees to work in a dedicated COVID-19 unit after it is over. deemed safe for its employees. and patients. He said he expects the hundreds of health workers at his hospital to support the movement once the right safeguards are in place.
But Tessa Johnson, who heads the North Dakota Nursing Association, said the group had interviewed hundreds of its members this week and that “we’re not at all happy” with the decision.
“I know nurses who leave work every day and cry in their cars before they go home to see their children,” Johnson said. “I don’t know how much we can take.”
According to CDC guidelines, asymptomatic infected medical workers who intend to treat COVID-19 patients should take their temperature before each shift and confirm that they are free of symptoms. Workers with even mild symptoms are not allowed to treat patients.
Dr Marcus Plescia, chief medical officer of the Association of State and Territory Health Officials, stressed that hospitals will need to determine whether appointing infected employees is a violation of HIPAA laws, although he said the Strict use of protective gear in COVID units should prevent infections from spreading among hospital staff, even if colleagues don’t know who is infected.
But the rule change could also put internal and external pressure on infected staff members to work when they should be home recovering, Plescia said.
Many nurses say they are already at a breaking point and some are starting to feel hopeless.
“We’re so stretched out and there’s no end in sight,” said Kami Lehn, a nurse at a hospital in Fargo, which is North Dakota’s largest city and which adopted its own requirement last month. mask. although this does not penalize non-compliance. “We don’t know how long it’s going to last, if it’s at its peak or if it’s going to get worse.”
The grief is the hardest part, she says.
“There are a lot of losses that are difficult to bear,” she said. “Families drop off loved ones at the door, thinking everything will be fine, and sometimes not.”
Health workers fear that even if co-workers with asymptomatic infections are limited to COVID-19 units, they could still spread the disease in break rooms, cafeterias, washrooms and other common areas.
Kristin Roers, hospital administrator and Republican Senator from Fargo, said Burgum’s decision will help hospitals continue to treat patients. But she also acknowledged that this presented a dilemma for hospital staff. Roers, who is also a registered nurse, is working more and more with patients due to the shortage of staff.
“I can totally understand the worry,” she said. “But I mean, what do you do when there’s no one left to take care of the patients?”
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Groves reported from Sioux Falls, SD
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