South Jersey health-care workers respond to state’s call to action, while others are kept home by their employer’s coronavirus policies

At the end of her first nursing shift in a North Jersey hospital, Ana Almonte shuffled into the college dorm that would be her makeshift home three nights a week until July. She was alone, but couldn’t stop thinking about the dozens of severely ill patients and harried medical workers she’d met in that overstuffed hospital.

“It really crashed on me,” said Almonte, a 34-year-old nurse with Virtua Health System in Camden, who has taken a second, temporary job in the epicenter of the state’s coronavirus outbreak. “I just felt very lonely. I felt really sad.... I didn’t tell my husband that or anyone. It’s just something I said, ‘OK, I’m going to have to get through this.’”

As COVID-19 cases surge in New Jersey, pushing hospitals near capacity, especially in the northern counties, the state has put out a massive call for volunteers and loosened regulations to enable more people to respond. The state is reactivating medical licenses for recently retired providers, issuing temporary licenses for out-of-state and out-of-country doctors, and suspending rules that require physician assistants and nurse practitioners to get a doctor’s permission before performing certain tasks, such as prescribing narcotics.

“As your health commissioner and a nurse, I am asking for all hands on deck at this moment,” New Jersey Health Commissioner Judith M. Persichilli wrote in an email sent to all medical providers in the state that included a link to sign up.

But at the same time, health systems in the Philadelphia area are still gearing up for a surge of patients, like those North Jersey and New York City have seen. And in some cases, their strategies to preserve resources and medical staff conflict with the state’s call to action.

Jefferson Health has banned employed providers from volunteering — even on their days off — outside its health system, for instance at city or state-run testing sites or hospitals in North Jersey that are short-staffed due to a surge of patients. Private-practice doctors who work at Jefferson facilities are discouraged from volunteering at other locations, and those who do are required to quarantine themselves for 14 days before returning to Jefferson.

“We are humbled to hear from so many providers willing to give of their time to help others,” Brandon Lausch, a spokesperson for Jefferson, said in an email. “However, we must be prudent about what we are imminently facing in Southeastern Pennsylvania and New Jersey — and be prepared to manage what lies ahead with the staff we have.”

The policy irked some Jefferson doctors in New Jersey, who no longer have caseloads of non-urgent and elective surgeries but have so far not been needed to help with coronavirus cases either.

“In the meantime, you’re just sitting on your butt all day doing nothing, when in North Jersey, they really need help,” said a hospitalist who works in New Jersey and who asked not to be named for fear that speaking out could jeopardize his employment with Jefferson. “It’s not like they have to fear we’re going to bring it back or something when you’re already working in a hospital with COVID-19.”

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A spokesperson for Cooper Health declined to answer questions about its policies for providers who want to volunteer at off-campus coronavirus treatment sites.

Virtua does not have a specific policy for the coronavirus, but generally speaking, providers must get permission to volunteer their medical services outside the health system, Daniel Moise, a spokesperson, said.

Almonte recently completed a seven-month contract position at Virtua Our Lady of Lourdes Hospital in Camden, and has accepted an employed position working three 12-hour shifts a week at the hospital, starting April 20. Though it will mean just one day off a week, Almonte said she will coordinate her schedule in Camden so that she can still work three days in North Jersey.

“It was something I wanted to do. I wanted to make a difference,” said Almonte, who has a contract through a private nursing agency to work at a hospital in North Jersey three days a week. She declined to name the hospital because she did not have permission to speak about her work there.

Despite her eagerness, Almonte’s mood sunk when she walked into what she described as “like nothing I’ve ever seen.”

“I got to the hospital, and you just felt the heaviness,” she said. “The whole place is desolate. There’s not one visitor in sight.”

The ICU was overcrowded with severely ill patients whom doctors and nurses struggled to attend to even as more volunteers and contract workers arrived. Some days, protective equipment was so scarce that Almonte kept her mask on for hours without so much as a sip of water, because removing and replacing it would risk exposure.

One of the most harrowing scenes of her short time at the North Jersey hospital: the elderly COVID-19 patient who died but remained in her ICU bed, eyes open, for hours until someone had time to prepare her body for the morgue.

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At the end of three 12-hour shifts, Almonte drives back to Cherry Hill, but she won’t truly be able to go home for months. Worried about the possibility of infecting her husband and her two daughters, Almonte will be staying in a borrowed 2017 Winnebago Fuse that takes up nearly their entire driveway.

“After what I’ve seen ... I can’t go in the house. I can’t stay in the house with them,” she said.

Almonte connected with the RV’s owners, Deb and Ron Madison of Medford, through a Facebook group, RVs4MDs, which is matching RV owners with medical workers in need of isolated places to stay while working with coronavirus patients.

The Madisons take the Winnebago on the road every year to visit family and friends out West. When a friend told Deb about the Facebook group, she said she felt compelled to help.

They dropped off Bess, the name Ron gave to the 24-foot long beauty he traveled all the way to Idaho to buy, at the Almontes’ home at the beginning of April.

“It was just really emotional. Your instinct is to put your arms around each other and hug,” Deb Madison said, “but obviously we couldn’t.”

Almonte said she is grateful because the RV enables her to stay close to her family, even if she can’t be part of their regular routine. Before the pandemic, she and her husband often cooked dinner together, and they ate as a family. They love to watch movies together, and at night, Almonte reads 6-year-old Milania verses from her children’s Bible. Almonte is considering taking up a perch outside her daughter’s bedroom window at story time.

“I feel like just knowing I’m right outside, just right outside, will be comforting for them,” she said.