Nursing Nightmare in Covid Unit

[Nurse Beth, MSN]

Hello Nurse Beth,

I have a situation with which me and my coworkers need urgent help. A month ago, we got a 6 hour warning that we are now a Covid unit (we were a specialty cardiac unit before). No one got a choice, and was told if they didn't want to do it, they could quit. Fast forward a month: we were originally told that we would be taking 4 covid patients/nurse, as well as have an RN serve as "runner "- being stuff to the rooms to conserve PPE and time, since it takes a while to don and doff PPE.

We also normally have a secretary, and 3 CNAs when we're full. The reality- this whole week we've been pushed to take 6 patients each, only given 2 CNAs for 24 rooms, no secretary, and as of today- no runner. These patients are sick, turn from bad to worse quickly, and most are total care bc they're so weak. In addition, RTs refuse to come to the unit "to limit exposure" so we have to do all treatments, inhalers, etc. The same excuse is used by dieticians, PTs, OTs, IV team, and Foley team. Oh- and dietary aids no longer being the trays to patients- we're expected to somehow deliver the trays for all 3 meals while struggling to give meds and provide care.

We get no hazard pay or bonuses of any kind, were told we're not allowed overtime- all because our productivity is low. So, basically, we were told that until productivity improves, we won't be getting more staff. Now- the rest of the hospital- nurses are on call at home drawing unemployment. In house staffing office?- their nurses magically disappeared, but turns out they've been on call bc they refuse to work with covid patients. This is beyond unsafe, and never in my 10 years as a nurse did I think this could ever happen. The most disgusting part- this is happening not bc of shortage of nurses (there are plenty at home!!) but bc the hospital wants to make profit. This is supposedly a non-profit hospital.

So me and my coworkers are stuck- other hospitals in the area aren't hiring bc of slow business, and if we quit to save our sanity, backs, and licenses we won't quality for unemployment. So far, in the last 2 weeks, 5 out of 15 RNs quit...not to mention or patients, who are going through one of the scariest ordeals or their lives are barely getting the most minimal of care no matter how fast we run- the load is simply unrealistic. In the beginning, other nurses would come and help, but lasted only a shift *some less*, before saying that they will never return bc this is the worst nightmare they've seen.

So basically, the rest of the hospital gets to choose not to come help, but we're stuck there, being loaded up with more and more and more. Both of our CNAs today were crying in the break room bc they were so exhausted and felt so bad bc no matter how hard they worked, they still struggled to complete the most necessary tasks- vitals, food, water. I've talked to a couple of my friends in other states- they said this is horrible, and completely not the case at their hospitals. We're all looking for other jobs, but who's going to take care of these patients?!

So, I am asking if there are ANY ways to improve this situation, or hold someone accountable for this endless abuse of staff, as well as patients not receiving care they deserve? Or is our only option is to leave, and feel terrible bc there is no one to take care of these people? They've hired 2 travel nurses, which costs way more than paying straight pay and just getting other nurses who are sitting at home to help. This is an absolute nightmare. Also, at 6 patients a piece, providing all of the other disciplines' care exposes is to crazy high exposure. The other day when I was a runner I was expected to help nurses (I was in 19! covid positive rooms), be a secretary, and at one point was sent to another unit to pull a cardiac sheath, then return, take a patient, and with that, go back to being a runner and a secretary...and the 3rd CNA. Please advice- any thoughts are deeply appreciated.

Dear Worst Nightmare,

Unbelievable. Actually, it is believable, because in nursing, nurses typically do not have a voice. In California, there are laws to govern nurse-patient-ratios , and nurses in every other state need to band together and do the same for themselves and their patients.

A lot of times hospitals will cut staff when productivity drops. Productivity is a function of nursing care hours (staff) and patient care hours (census). If the budgeted census drops, productivity drops, so staff is decreased. At some point, though, the model makes no sense. For example, if a cardiac nursing unit is considered productive at a census of 25, staffing includes a monitor tech. If the census drops to 18, the monitor tech may be pulled.

But a monitor tech, like a secretary, is needed whether the census is 25 or 5. Such positions should be fixed, outside of productivity numbers. An example of a fixed position is the nurse manager - there's a nurse manager regardless of census.

In your case, you are doing others' jobs- PT, OT, Dietary, RT, secretary- and your patient load has increased by 50%. You are gowning in and out of isolation for each patient, and you are hyper-exposed to a virulent virus responsible for causing a worldwide pandemic.

if you live outside of California, and if you do not have a union, there is little or no recourse outside of quitting, getting fired, or getting sick. And you are right- this kind of focus on the bottom line and disregard for nurses happens at for-profits and not-for-profits alike. CEOs at both are well compensated. Not-for-profit means a desirable tax status for the organization, but not necessarily desirable working conditions.

I hope your story gets read by many, and I thank you so much for telling it. Be safe.

Best wishes,

Nurse Beth

Start your job search today!

[LovingLife123]

Welcome to COVID.

[Littleblackdog, ADN, BSN, RN]

What a horror story! If you have a union (doubtful), PLEASE go NOW to see them. IF not, I would write a letter of resignation saying just what you have said here, and remember: we are caregivers but we are NOT sacrificial lambs!! We have an obligation to care for ourselves as well as to care for others, ad we must have enough staff and PPE to do it. I repeat: WE ARE NOT SACRIFICIAL LAMBS>

[CrunchRN, ADN, RN]

That is a horrible situation. Maybe try to get some press exposure?

[Nurse SMS, MSN, RN]

Does your state have Safe Harbor? I would be calling it every single shift. It doesn't excuse you from patient care, but it protects your license when that care inevitably falls short.

[ctamuty]

Do we work at the same hospital? ?

I could have written your post myself. It is all very exhausting, and only getting worse. But we're "heroes," right?

Sending hugs.

[PJG RN]

I agree with Crunch RN. ... I think you have to figure out a way to get media involved, all the while protecting yourself, (ie: to keep the hospital from taking action against you because you made the compliant). ... I know a lot of people are saying, “You’re a nurse. You signed up for this.” But that is farthest from the truth. Most nurses when they became nurses, did not sign up to be in a situation like the current pandemic. It’s dangerous, and outright unsafe the way they are forcing nurses to work. ... Do you have other hospitals in the area to which you can reach out, to see how they are handling COVID? Maybe they can have suggestions? My thought is if you can compare notes, find a “friend” who is willing to be the face to a complaint, and start complaining to the media, you will bring attention to the plight, and maybe get some action. ... One thought is if family members of the COVID patients, got wind of how their family members were being treated, (or not getting treated due to the dire situation), there would be action taken. Hospitals don’t like negative press, and family members can certainly bring that. (I’m assuming your hospital has a ‘no visitation’ rule right now. That’s what they are doing in lower parts NY state). ... I wish you the best. Sorry you are in such a tough spot.

[THAT Nurse., MSN, RN, APRN]

I am not a lawyer, so you'd have to consult one. This however seems promising:

https://www.workplacefairness.org/unions-retaliation#1

IOW, start forming one very publicly. Even if it never gets off the ground you should get some protection, and publicly bring light to the misdeeds and dangers of your hospitals practice.

[THAT Nurse., MSN, RN, APRN]

Found this today, good example of what I wrote yesterday. Good luck to the LPN doing this.

https://www.chattanoogan.com/2020/6/13/410499/Some-Erlanger-Nurses-Considering.aspx

[Littleblackdog, ADN, BSN, RN]

On 5/24/2020 at 4:07 PM, Nurse Beth said:

Hello Nurse Beth,

I have a situation with which me and my coworkers need urgent help. A month ago, we got a 6 hour warning that we are now a Covid unit (we were a specialty cardiac unit before). No one got a choice, and was told if they didn't want to do it, they could quit. Fast forward a month: we were originally told that we would be taking 4 covid patients/nurse, as well as have an RN serve as "runner "- being stuff to the rooms to conserve PPE and time, since it takes a while to don and doff PPE.

We also normally have a secretary, and 3 CNAs when we're full. The reality- this whole week we've been pushed to take 6 patients each, only given 2 CNAs for 24 rooms, no secretary, and as of today- no runner. These patients are sick, turn from bad to worse quickly, and most are total care bc they're so weak. In addition, RTs refuse to come to the unit "to limit exposure" so we have to do all treatments, inhalers, etc. The same excuse is used by dieticians, PTs, OTs, IV team, and Foley team. Oh- and dietary aids no longer being the trays to patients- we're expected to somehow deliver the trays for all 3 meals while struggling to give meds and provide care.

We get no hazard pay or bonuses of any kind, were told we're not allowed overtime- all because our productivity is low. So, basically, we were told that until productivity improves, we won't be getting more staff. Now- the rest of the hospital- nurses are on call at home drawing unemployment. In house staffing office?- their nurses magically disappeared, but turns out they've been on call bc they refuse to work with covid patients. This is beyond unsafe, and never in my 10 years as a nurse did I think this could ever happen. The most disgusting part- this is happening not bc of shortage of nurses (there are plenty at home!!) but bc the hospital wants to make profit. This is supposedly a non-profit hospital.

So me and my coworkers are stuck- other hospitals in the area aren't hiring bc of slow business, and if we quit to save our sanity, backs, and licenses we won't quality for unemployment. So far, in the last 2 weeks, 5 out of 15 RNs quit...not to mention or patients, who are going through one of the scariest ordeals or their lives are barely getting the most minimal of care no matter how fast we run- the load is simply unrealistic. In the beginning, other nurses would come and help, but lasted only a shift *some less*, before saying that they will never return bc this is the worst nightmare they've seen.

So basically, the rest of the hospital gets to choose not to come help, but we're stuck there, being loaded up with more and more and more. Both of our CNAs today were crying in the break room bc they were so exhausted and felt so bad bc no matter how hard they worked, they still struggled to complete the most necessary tasks- vitals, food, water. I've talked to a couple of my friends in other states- they said this is horrible, and completely not the case at their hospitals. We're all looking for other jobs, but who's going to take care of these patients?!

So, I am asking if there are ANY ways to improve this situation, or hold someone accountable for this endless abuse of staff, as well as patients not receiving care they deserve? Or is our only option is to leave, and feel terrible bc there is no one to take care of these people? They've hired 2 travel nurses, which costs way more than paying straight pay and just getting other nurses who are sitting at home to help. This is an absolute nightmare. Also, at 6 patients a piece, providing all of the other disciplines' care exposes is to crazy high exposure. The other day when I was a runner I was expected to help nurses (I was in 19! covid positive rooms), be a secretary, and at one point was sent to another unit to pull a cardiac sheath, then return, take a patient, and with that, go back to being a runner and a secretary...and the 3rd CNA. Please advice- any thoughts are deeply appreciated.

Dear Worst Nightmare,

Unbelievable. Actually, it is believable, because in nursing, nurses typically do not have a voice. In California, there are laws to govern nurse-patient-ratios , and nurses in every other state need to band together and do the same for themselves and their patients.

A lot of times hospitals will cut staff when productivity drops. Productivity is a function of nursing care hours (staff) and patient care hours (census). If the budgeted census drops, productivity drops, so staff is decreased. At some point, though, the model makes no sense. For example, if a cardiac nursing unit is considered productive at a census of 25, staffing includes a monitor tech. If the census drops to 18, the monitor tech may be pulled.

But a monitor tech, like a secretary, is needed whether the census is 25 or 5. Such positions should be fixed, outside of productivity numbers. An example of a fixed position is the nurse manager - there's a nurse manager regardless of census.

In your case, you are doing others' jobs- PT, OT, Dietary, RT, secretary- and your patient load has increased by 50%. You are gowning in and out of isolation for each patient, and you are hyper-exposed to a virulent virus responsible for causing a worldwide pandemic.

if you live outside of California, and if you do not have a union, there is little or no recourse outside of quitting, getting fired, or getting sick. And you are right- this kind of focus on the bottom line and disregard for nurses happens at for-profits and not-for-profits alike. CEOs at both are well compensated. Not-for-profit means a desirable tax status for the organization, but not necessarily desirable working conditions.

I hope your story gets read by many, and I thank you so much for telling it. Be safe.

Best wishes,

Nurse Beth

Hard for her to stay safe, given her work conditions! Everyone, repost this on FB and get this letter read!