I am experiencing the same, but at a substance abuse/detox facility in a non-union state, however, we entered this mess with a skeleton staff, due to the inability to retain nurses. It is a complete disaster, within a disaster. I don't even know where to begin, but here goes....
The DON walked out at the end of February and had verbalized concern about COVID-19 at the end of January. Our client base, in detox, has increased from 7 beds in 2016 to 32 beds currently. Our nursing staff was 1/10 in 2016 and is now, at best, 2/32, sometimes 1/32 on nights. We have not only started admitting clients 24 hours, but are admitting higher acuity clients and more clients with dual diagnosis. We are accepting clients who are arriving via Lyft and Uber, whose drivers will stop at the liquor store, or anywhere else, if they request it. As a result of this, we have no way to know what substances or how much they have used on their way to us. We obviously do testing as part of the admissions process, but If someone takes a handful of Xanax in the parking lot, we have no way of knowing that. Over the last few months, we've had 2 APRN's resign, as well as RN's and 4 more RN's who were hired but didn't even finish orientation before they quit. We have all been working overtime, I have been working 4/12's weekly, just to cover all of the open shifts. We have had at least 3 LNA's resign and have had the same retention problems with any new LNA hires. We are all beat up, physically and emotionally from working too many hours, but just like anywhere else, we care about our colleagues as well as our clients so the guilt sets in when we know someone is working short. With all this against us, they continue to admit 24/7 without skipping a beat. In the past 2 months they have hired 4 administrators, 4 Utilization people and numerous admission screeners, however none of these folks have any medical credentials, so the their expectations make for uncontrolled, unsafe, extremely stressful situation. When the previous DON voiced concerns about implementing the 24 hour admissions, he was told to basically figure it out because it was going to happen.
Now here we are in the middle of this pandemic. Up until 3 days ago, the only precaution from COVID-19 that we we had in place, was having our temp taken upon arrival for our shift, no gloves, no masks, just take your temp. Three days ago, we received an email with instructions to wear gloves and paper masks while doing admissions, that was it. The catalyst for this was a client having symptoms and being tested, but curiously, any follow-up for his visit to the ED, including a test RESULT, has never been reported, uploaded, or much less, discussed. The new admin's intervention was to quarantine the client, but not anyone else in the building and strongly suggest that it not be discussed. It's completely unsafe, unethical and unbelievable but even worse than that it's disheartening. We (the nursing staff) are somewhat of a "family" and we all are very united in our fight against addiction. We all used to love coming to work. Now, not so much. We are concern for client safety as well as our own, but we are also extremely concerned about liability and the risk of putting our licenses in jeopardy if there's a tragedy.
So, now for the current situation. Last Sunday, one of the nurses, who is over 65, called out for her three shifts, after COVID-19 made its appearance. Shouldn't have been a big deal, but due to staffing, it was. It spread us all pretty thin. I woke up with a temp of 101.9 and a cough on Wed morning, so I called and said I wouldn't be in that night. I have Crohn's and have been taking prednisone so I was a little concerned. They were not. They were actually pissed. I woke up Thursday morning, had a temp, called and told them again I wouldn't be in and their response was to inform me that, "due to the circumstances", I would need a Dr's note to return to work. The next call I made was to my doc who promptly wrote a letter telling them I was quarantined until I had been symptom free for 72 hours. The next email that went out from Admin was an offer for a $500 bonus for any staff that referred a nurse to them. Nice.
I have been out of work since then, had a temp of 101.2 today. In the time I've been gone, they have not stopped or even slowed admissions, which come in from all over the country, usually via another facility or homeless shelter, or anywhere. The clients are still housed in in a communal situation, with no thought of social distancing. I am being job-shamed for not being there, which I expected, unfortunately I don't feel guilty. I feel bad about my colleagues working short, but not guilty and I'm actually not sure I'm going back when I'm able to. I am seriously torn. Ethically, I don't feel I can. Physically, I know I can't. Emotionally, I'm sad about all of it. Healthcare has become a business. I don't think I'm interested anymore. I'd rather go work at McDonalds than be part of anything that puts money before people. I hope you all stay safe and well out there. It's gonna be a long ride.