COVID-Positive Nurses Working: Irresponsible or Smart?
On Monday, November 9th, the governor of North Dakota announced COVID positive healthcare providers (HCP), without symptoms, will be allowed to continue working in COVID-19 units in hospitals and nursing homes. Is the decision a step in the right direction or simply irresponsible? Read on to learn more.
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On November 12th, the CDC reported 94% of U.S. jurisdictions are experiencing an increase in COVID-19 cases. Hospitals are having to consider creative ways to stretch resources as admissions rates continue to climb. In North Dakota, hospitals are at 100% capacity, lacking needed beds and facing dire staffing shortages.. Hospital administrators asked state leaders to allow asymptomatic COVID-positive healthcare providers (HCP) to continue working in COVID-19 units in hospitals and nursing homes to help with staffing.
CDC Crisis Guidelines
The CDC published a set of guidelines to provide relief during the pandemic when staffing shortages reach crisis level. This includes developing criteria to identify staff suspected of having the virus (or have tested positive) who are well enough to return to work before meeting the CDC’s Return to Work Criteria. The employee must be willing to continue working or suspected having COVID-19 or actually testing positive. Other considerations include:
The type of HCP shortage that needs to be addressed.
Where the HCP is in the course of their illness.
The type of symptoms they are experiencing
What interaction they have with patients and other facility HCPs (do they work in direct patient care, telemedicine, etc).
The type of patients they care for (patients who are not COVID-19 positive).
The governor reported other states are already using this strategy already. However, the governor’s spokesman lacked available information on any other states that have this policy in place.
Nurses Pushback
If you are a nurse (or any HCP), your internal “this is just wrong” alarm may be going haywire at the thoughts of working while COVID- positive. The North Dakota Nurses Association (NDNA) released a statement recommending additional public health measures be mandated before implementing the policy. For example, North Dakota doesn’t have a statewide mask mandate at this time.
The president of the NDNA, Tessa Johnson, argues “The governor has put this policy out and still, no masks are required. It feels like a slap in the face to nurses right now”. Johnson also made these arguments against nurses working while testing positive for the virus.
The policy has protections built in for patients and co-workers, but these don’t work in real life. For example, if a COVID-positive nurse is only caring for other COVID-19 patients, they will still use common areas, such as bathrooms, elevators, break rooms and hallways.
Rural hospitals are often connected to a long-term care facility, with the same nurse caring for all the COVID-19 patients. How would virus spread be prevented in these situations?
As the most trusted profession, would nurses lose credibility with the public by working COVID-positive? Especially after nurses have been pushing the importance of social distancing and staying home to prevent virus spread.
Will employers retaliate if a virus-positive nurse is unwilling to work, or will their decision be respected by the facility.
Could More Be Done?
The CDC provides other strategies to alleviate staffing shortages during the pandemic. But, are hospitals and nursing homes doing what the CDC considers “baseline” to ease the problem? Take a minute to consider your employer and ask yourself “Does my facility….?.”
Understand the minimum number of staff to provide a safe work and patient environment?
Communicate with local, federal, state, and health partners to identify additional HCPs to help when needed, such as:
Hiring additional HCPs, such as retired nurses and nursing students
Adjusting staff schedules
Rotating HCP to patient support positions.
Providing adequate orientation and training
The Guilt We Carry
The pandemic is placing a healthy dose of guilt on nurses all across the country (and world). We know nurses have a high work ethic and are dedicated to both patients and their co-workers. Saying “no” to care for ourselves often results in feelings of guilt. I can only imagine the unbearable guilt nurses may experience thinking they passed the virus to a vulnerable patient.
What Do You Think?
Would you be willing to work if you tested positive for COVID-19?
