The numbers public health experts use to track the coronavirus pandemic — death counts, percentage positive rates — are rising at an alarming rate. But what my nurse colleagues and I are experiencing at the bedside, inside and outside the COVID units, is free fall. Plummeting morale. Sinking staff levels. Shortages in beds, in people, in equipment, in medication, and, most critically, in active, solution-seeking leadership.
Any single one of these deficits is dangerous. Together, they are disastrous.
Staffing shortages, in particular, can feed a downward spiral. Nurses who are overworked, assigned to care for too many patients, are more likely to get injured or sick themselves. They then have to leave work, further exacerbating the hospital’s existing staffing shortage. In one Pennsylvania hospital, so many ICU nurses are out sick with the virus that management recently mandated that no ICU nurse who is well and able to come in to work can have any time off.
This isn’t fair to nurses, who — nine long months in — are intellectually, physically, and emotionally exhausted, or to acutely ill COVID patients, who are desperately in need of attentive care. And given that this isn’t our first experience with a deadly and dramatic surge in the pandemic, it points to a severe lack of preparation — a deficit that our nurses are taking on the chin.
Hospital management and our legislative leadership must act now:
We urge hospitals to bring in more staff. With the virus raging throughout the country, nursing help is an increasingly competitive market. But it is possible to bring in ample agency nurses. Trinity Health Systems brought nearly 200 agency nurses to St. Mary Medical Center in Bucks County to replace our members when they went on strike in mid-November. If hospitals are willing to shell out money to fight their nurses and try to break a strike — and, believe me, they are — they need to be willing to spend at least a fraction of the same sum to get desperately needed help for their staff nurses, who are overworked and exhausted beyond measure.
We urge Gov. Tom Wolf and our federal-level representatives to push hard — to jump up and down and clamor — for federal aid. We need another CARES Act. We need the help it makes possible. And we need it now.
We urge our elected leaders to consider reopening an emergency overflow site such as Temple University’s Liacouras Center and other excess-demand locations. Our city hospitals are currently at or over capacity, and there is no end in sight. As one of my Temple University Hospital colleagues, a COVID ICU nurse, said, every day is a new surge. Every day. With Christmas just around the corner, the numbers are only expected to grow. We also believe Gov. Wolf should consider activating the National Guard to assist in this effort and in implementing safe practices in nursing homes, as it did in the spring.
We urge hospitals to closely adhere to the Pennsylvania secretary of health’s recent order limiting elective procedures. This, too, is about staffing. When you reduce elective procedures, you free up staff and add beds to help in the COVID ICUs.
Finally, we urge the state legislature to prioritize and pass safe-staffing legislation in the coming legislative session and create a presumption of work exposure for any health-care worker diagnosed with COVID-19. Enforceable safe-staffing standards — or, limits on the number of patients that can be assigned to a single nurse based on the patients’ degrees of illness — literally saves lives. Study after study shows it and nurses on the front lines know it.
All of the major acute-care hospitals in the region represented by PASNAP are profitable. They give their executives handsome compensation packages. It’s time for them to spend money on staffing. We have provided excellent care, endangering ourselves and our families, for nine long months. It’s time for them to step up, too.
Health-care workers deserve protection and safety on the job, including workers’ compensation if we contract COVID at work and safe-staffing standards. We have rules governing how many children a child-care provider can care for — why don’t we have a law mandating limits on how many patients a nurse can be assigned, for the safety of both the patients and the nurses?
The 8,500 members of PASNAP, in conjunction with our allies in SEIU Healthcare PA, District 1199C, and the AFL-CIO, have been fighting for this since the pandemic began. We need our representatives to start fighting for us.
Maureen May, R.N., is a longtime Temple University nurse and president of PASNAP, the Pennsylvania Association of Staff Nurses and Allied Professionals.