Corona Virus Update 3/30

We are 24 days since our first confirmed case of Covid-19 in Connecticut. We have had 2,571 confirmed cases (up 578 since yesterday), 36 dead, 517 hospitalized, 14,600 tested.

Right now I am very upset. I have been on calls all day with  local connecticut leaders and have heard their horror stories about the lack of and the rationing of PPE, especially N95 respirators and difficulty with PTO when they are forced to stay home because of illness or quarantine. Members not being notified that one of the patients they had cared for tested positive.  

Then I was on a call with Randi and leaders from around the country and heard their stories. 25 of our nurses in New York hospitalized, 2 on ventilators. Ohio has a nurse on a ventilator. Washington state had one nurse lose custody of her child to her ex-husband because she could endanger the child by bringing home Covid-19, and a doctor who was fired for speaking out.

Then I tune in for the Governor’s daily task force press conference and sitting with him are his “Health System Response Team,” his “experts” he said. The CEO of the Connecticut Hospital Association, and the presidents of Yale, Hartford Healthcare, Nuvance. These are the very people that are telling the public one thing while they do another.

I am insulted for the Healthcare Professionals of Connecticut.

I am very disappointed. 

You are disappointed.

But we must not be silent.

We must not give up.

Governor Lamont Announces Governor’s Health System Response Team  Posted on March 30, 2020  HARTFORD, CT) – Governor Ned Lamont today announced details on the latest collaboration to assist in the state’s coordinated response to the COVID-19 pandemic. He is appointing the CEOs of three of the largest hospital systems in Connecticut – Hartford HealthCare, Nuvance Health, and Yale New Haven Health – to serve as co-chairs of the Governor’s Health System Response Team. In coordination with the Connecticut Hospital Association and the state’s other hospitals, the health care leaders will advise the governor, the Department of Public Health and the rest of the state’s Emergency Support Functions in the Unified Command structure on the proper allocation and distribution of needed resources, supplies, and personnel, throughout the duration of the public health emergency. The co-chairs of the Governor’s Health System Response Team include: Jeffrey Flaks, President and CEO of Hartford Healthcare: Backus Hospital, Charlotte Hungerford Hospital, Hartford Hospital, The Hospital of Central Connecticut, MidState Medical Center, St. Vincent’s Medical Center, Windham Hospital John Murphy, MD, President and CEO Nuvance Health: Danbury Hospital, New Milford Hospital, Norwalk Hospital, Sharon Hospital Marna Borgstrom, CEO Yale New Haven Health: Bridgeport Hospital, Greenwich Hospital, Lawrence & Memorial Hospital, Yale New Haven Hospital, Yale New Haven Children’s Hospital The three hospital systems represent close to 70 percent of the state’s hospital infrastructure across 14 acute care hospitals and numerous additional facilities. The CEOs will also work in close collaboration with the Connecticut Hospital Association to ensure that all hospitals are represented in discussions on resource allocations. This group has already been consulting on a regular basis with the Lamont administration prior to the confirmation of the first positive case in the state, and that work will provide the foundation of the plans and actions as the state’s health care system handles an expected surge of COVID-19 cases. Governor Lamont said, “Our state is going to get through this by working together, and that includes making sure our hospitals are at the table working directly with my administration to ensure they have access to the resources they need. These are experts in the healthcare field and our state is incredibly fortunate to have such experience providing counsel as we look to keep as many of our residents safe and healthy as possible.” Flaks said, “I am inspired every day by my colleagues in health care across the state. They are true heroes, working in challenging times. Our focus is clear: we are doing all we can to stop the spread of COVID-19, protect the health and safety of our patients and our colleagues, and make sure we are ready to serve Connecticut and those affected by the virus. This is a once-in-a lifetime public health emergency and there is no doubt – together, we are stronger.” Dr. Murphy said, “As we continue to navigate through this unprecedented health emergency, we know our collective response for the people of Connecticut will be stronger because of this collaborative approach.” Borgstrom said, “A virus like COVID-19 does not differentiate by town, city or state lines. It doesn’t respect how big or small a hospital is when it strikes a community. If we are to be successful in fighting the spread of COVID-19, we need to work together across regions and across health care systems.” Jennifer Jackson, CEO of the Connecticut Hospital Association, said, “Connecticut’s hospitals are prepared and committed to fighting COVID-19 together. The ongoing, strong collaboration among all hospitals across the state will improve the care for Connecticut patients battling this disease.” We have expressed our displeasure  with the governor’s office. Below.........these are ther REAL Healthcare Experts,

Danbury has 6 nurses confirmed with Covid and Janice has requested nurses to send an email to our union office when they have symptoms.

 Senator Julie Kushner is working with the 3 Locals at the hospital to improve the situation. The Locals have held firm on PPE, including N95 for all Covid patients, rule out or positive tested. 

A couple of letters from Danbury nurses

Dear Janice,
I know you will get a lot of letters like this from nurses right now...
I have willing floated out of the acute rehabilitation unit over the last 2 weeks. I had even sent an email to my manager which explained that I would be willing to work with the COVID-19 patients. I am 60 years old with little responsibilities at home other than my husband and pets. My first place to be floated was to 9 East on March 24^th and 25^th.
I was to 'orient' to the floor/9 East. First the nurses we worked with were great! Honestly, I went home physically and mentally exhausted! I never stopped running those two shifts. I do not know how they did it without the extra help, there were 2 of us from rehab! I started IVs, admitted and discharged patients, gave 9 pm medications, cleaned up patients, and went for things and medications needed by nurses and PCTs while in an isolation room. It was hectic, patients needing close care and monitoring, others being admitted and discharged.
Last week the nurse patient ratio was 1:4, again let me reiterate that there were 2 extra nurses, and the manager as well! Yet despite the 'extra' help everyone was busy. Patients lives are at stake, their requirements and oxygenation needs change quickly. Safety of the patients and the nurses should especially be important at this time. The most important indication or requirement needed for this 'safety' is to have the proper amount of staff and not overburden the frontline workers. Patient and nurse 'protection' includes proper staffing. It would be different if there was not 'enough' nurses or PCTs, but daily personnel are being down staffed.
I understand the ratio of nurse to patient is now 1:5. I can only shake my head in sadness and disbelief that the ratio has so changed! These patients can become acutely ill quickly, the reason they have been admitted and not sent home is that their chest x-rays and/or CT scans clearly indicate Coronavirus!
I am concerned that the N95 masks, and face shields, hair covers are somewhere watched over by a manager in a office so that we would not use too many! If one is needed, you must search for the manager to give you one! We need to make sure that we are adequately although ('adequate' should not be the 'norm'), protecting ourselves. We should be at no time denied anything that is important in protecting ourselves and our patients.
This is not the time to be frugal with supplies or patientcare. Frontline workers: whether it is a nurse or PCT should be protected by proper PPE and more than adequate staffing! I was told when on 9 East that we were only 'supposed' to go into rooms 4 times a shift, obviously not always possible. That can only happen if there is enough staffing so that we can spread out the amount of time with each patient with enough staff to monitor the patient.
I am so proud of the young nurses I worked with on 9 East, some barely out of school, some with young families. They are not afraid to do their jobs! But they are being sent out in the battlefield, it is a war to save these patients, but the right workers and amount of workers as well as the 'weapons' needed need to be correct. An analogy would be sending a fireman to battle a house fire with a squirt gun. COVID-19 patients are house fires and as we know can not be 'put out' without enough people and equipment.
I am concerned as well of the possible cross contamination of patients and workers. Should there not be 'clean' and 'dirty' nurses. Nurses who work on the COVID-19 patients in my opinion should not be working on other floors who do not have COVID patients?! Or at least a semblance of trying to do so? Even if it means perhaps slightly overstaffing the COVID-19 floors? And should there be any double rooms for patients right now? Due to the possibility of transmission, patients may have COVID-19 without exhibiting any symptoms yet.
This crisis has given us as nurses and should give Nuvance Health an opportunity to learn, consider short- and long-term visions of what is possible. More 'shared governance' and understanding among the work force. We as nurses can be brave and ask for a better hospital environment and working conditions. This crisis requires us collectively to favor people (our patients and employees) ... to favor people over profit. We also must realize that this or another crisis are not going away. Our 'essential' work as nurses need to be rewarded and valued. Which in turn will benefit Nuvance Health.
I also cannot believe that we are 'saving' our protective equipment such as masks in brown paper bags for further use.
I am also concerned about the stress and possible depression among our health care workers, it needs to be addressed and we need support. One such supportive measure can be better staffing levels, not 'adequate', not leaving work physically and mentally exhausted.
Another big issue is childcare issues due to school closings, a study by researchers at Stanford University and the University of California  suggest a loss of 8% of staff, some have put it up to almost 20%! Perhaps there could be a consideration of 4-hour shifts for nurses?!

Thank you for letting me vent, Sincerely,
Jannis RN

Hello Kelly,

     I am sending you the information from a nurse on 12 Tower this weekend that was emailed to me.  It is so important that you understand the clinical end of things to get our concerns heard.

       

Hi Janice,

Here is the info on my experience this weekend on 12T. I worked fri, sat and sunday.

 " On Friday we were being pushed to go to 5 patients. we pushed back on this but it continued throughout the weekend. On sunday 2 nurses were at 5:1. After much calling and discussion with AHM we were sent a helper from the OR. She was a huge help but 5:1 is too many. 4:1 is more manageable. Although this may change as our acuity is going up. As of yesterday, pts with increasing oxygen need are being placed on NRB masks and placed in prone position on the floor. These pts are very high risk and high acuity. If they move off onto their back their oxygen sat are dropping and we are then having to renter the room too often. We also need more Rn helpers. We cannot use PCTs as helpers when we are giving meds or needing oxygen to be adjusted. .I am all for trying to delay or avoid intubation for these patients but we need to be able to safely and adequately monitor them with adequate staff. There are multiple staff RNs being cancelled ,downstaffed every shift while we are drowning. I told AHM manager that their lack of sending adequate staffing will kill both patients and staff.Staff offering to come help and are being told "no we don't need you" while I am in tears on 12T. AHM just shakes her  head and says "I hear you" but sends no help.

 We Have also been instructed to discard our N95 mask at the end of our shift  after caring for COVID19 + patients. We are a rule out floor. When i left yesterday my patients did not have results back. So I am to save my mask for the next shift. I am not back until Thursday. These patients will be gone then and I  have no way to know if any of them came back positive or not. So what to do with my mask. I don't want to waste but don't want to risk re wearing a contaminated mask. We were not allowed face sheilds form materials as we were told they are not necessary. Yet all of 9t nurses are wearing them. Even on the rule out side. Told we are not to wear the bouffants as not needed. Yet they are being worn in other areas including outside where the testing is being done. I have tested/reswabbed multiple patient s this weekend.  Why are their not clear consistent standards for PPE throughout the hospital. WE ALL need to have the same standards for safety and they need to be clear and consistent.

  I am wasting PPE as I have had to leave a room to go get a med from med room as there is no RN available to do it. This is a waste of PPE and the time it takes to doff and re don again. Plus I am in and out of rooms too much.This is risking all the staff.  We need helpers to safely don and doff as we have been instructed  to do. Often no one is available and there is a pt need and we go in. This is unsafe and I will file unsafe every shift for this reason alone.

  We are keeping our computers outside the rooms as they cannot be plugged in and there are not enough to go in each room. As a result we need to take our meds and scanner into the rooms and scan with the door shut. If there is no RN outside the door to make sure meds are scanned and are correct ( also to get past the alerts ie. 1st dose education, pain assessments,etc) we are risking our patients. A PCT can't do this!!!

 . Lack of support form ancillary services .

'     Yesterday the light in the staff bathroom needed a new bulb. Facilities stated they could only come to the floor for a critical need. How is this not a critical need. The BR is pitch black. I guess now we have to just not use the bathroom.

  We are now being asked to sign for meal trays so we can be held responsible when pts complain their food is not hot. If I have just left a room I am not going back in to deliver a tray. I also will not sign for trays or be held responsible for cold food when I am just trying to keep someone alive. This is ridiculous.

  Walgreens will not deliver meds to the unit. At least yesterday they came up to the elevator bank with them so I could send my pt home with their meds.

The lack of support form the hospital after our whole staff was exposed  has been discussed in a prior email. I am one of the "lucky" ones who did not become ill. I'm still not sure I shouldn't have been tested. I have asked our staff members to email you about their individual experiences with this exposure.

  Sorry it is a lot. Thank you again for your support."

     

      Nurses are exposed to Covid and testing negative and willing to work although being told they need to stay home while using their PTO.  They are basically being locked out of work and they should be paid.

              

              Sincerely,

                    Janice

Norwich Democratic Town Committee reached out to me to ask how they could help the Nurses of Backus Hospital with a donation. We’re very appreciative and trying to see how we can work it out. Already, the Plainfield Police Union has donated lunch a couple of times to the Plainfield ED.

I am confused by this that came out from Hartford Healthcare because they state that “Strick PPE guidence for droplet and airborne precasutions continue to apply, yet they restrict staff caring for “rule out” patient s to surgical masks.

From: "Gravell, Emily" <Emily.Gravell@hhchealth.org>
Date: March 30, 2020 at 7:02:03 AM EDT
To: Backus Everyone Distribution List <BackusEveryone@hhchealth.org>, Windham Hospital Staff <WindhamHospitalStaff@hhchealth.org>
Subject: RE:  COVID-19 | 3.27 East Region- Staff Update



Good morning-

In an effort to keep staff informed on latest COVID-19 policies and updates impacting the East Region, you will begin receiving a daily update. Please find the latest information below and attached (for printing purposes): 

What you need to know today:

Personal Protective Equipment (PPE)

• Each employee will be given 1 surgical mask after screening Friday through Monday.
• Staff working in patient care areas should wear a mask at all times.
• Strict PPE guidelines for droplet and airborne precautions continue to apply.

This weekend #UniversityHealthProfessionals #union member, @uconnhealth research assoc Elifho Obopilwe retrofitted masks to #GetUsPPE for #Coronavirus frontline caregivers. #COVID19 #UConnHealthLabor @AFTHealthcare @AFTHigherEd @AFT_PE @AFLCIO @ConnAFLCIO (credit Gus Mazzocca) https://t.co/u7eMMD6aIn

The VNA of SE CT reports L&M may stop doing community (drive up) testing shortly due to a lack of tests. They would be available for hospital testing and healthcare workers.

Brief summery of where L&M RN's are.

Organized By Field Rep 3/13/20- A Quad coalition was formed of the 4 L&M locals a demand to bargain was sent on issues beginning to arise such as close of depts. and lack of PPE. This group also had follow up conference call last night to plan if Hospital doesn't meet our demands. A MOA going to hosp. wed with response request by Thurs.

L&M has not met to discuss our demands at the hospital. The VNA I think has had movement.

The hospital led by HR 6 days a week since 3-16-20 has had a conference call with the Union Presidents and Field Rep.

Todays report of Numbers is 

3+ covid patients on Resp floor and 2 rule outs

2+covid in ICU 1 vented and 1 rule out.

We have has patients come from Fishers Island, New York by ferry

We have outpatient depts. closed decrease of staff and forced to use PTO.

Not following contract language. We are requesting retraining so these nurses can get EPIC training from IT. 

Testing is being done on our campus. RN's from VNA manning that station.

Todays #'s 657 Tests have been done

31+Covid in community 

255 results pending.

We have had employees exposed to +covid pts. and hosp. not testing or isolating telling them to wait for symptoms.

Some units PPE improved but not all. Reusing N-95. Lack of shields for PaPrs a problem.

Thanks 

will kept you posted

Dale Cunningham

Sec/Treasurer AFT Local 5049

Some Other updates from HHC Locals

Natchaug:

• MOU: Sent us MOU (same as all HHC locals). We submitted a counter proposal. No further discussion on MOU. Having regular discussions with HR over a number of topics, with a decently collaborative relationship.
• N95/Surgical Masks: All employees can have a surgical mask. They do not have any N95s. HHC stopped fit testing them for it several years ago. I complained to HR and they said no one with COVID-19 would stay there since they are behavioral health. But then there was a COVID-19 patient who was not transferred to another hospital.
• Other info: At least three nurses tested positive for COVID-19. Several more out waiting on test results.

Backus:

• MOU: Sent us MOU (same as all HHC locals). We submitted a counter proposal. Had two follow-up convos with HR and their lawyer. Couldn’t reach an agreement.
• Contract extension: Still have not gotten a response on an extension. They told us that they plan to agree to it, just trying to figure out how long the extension should be.
• N95/Surgical mask: Policy keeps changing, but believe it is the following. N95 for aerosol procedure only and can be used several times. Surgical mask/face shield/gloves for other covid patients (confirmed and rule out). Surgical mask for all employees, but just heard rumor today that employees may have to reuse the same mask for a week.

UHP:

• MOU: Union rejected MOU until there is more of a need for one.
• N95/Surgical mask: Researching, will update tomorrow. 

Bridgeport nurses (HHC at home): 

• Sent us MOU (same as all HHC locals). We submitted a counter proposal. No further discussion on MOU.

To the best of my knowledge, please help me fill this in (and please let me know if I’m wrong)

N95 use.                   Rule out     Positive test   “High risk” procedure 

HHC.                             N.                   N.                           Y

UConn.                          Y.                    Y.                           Y

L&M.                               Y.                 Y.                           Y

VNA SE CT.                    N.                 N.                                             

Danbury/NM.                 Y.                   Y.                          Y

Prospect.                        Y.                   Y.                           Y

Johnson.                         

CHS. 

You know by now what out position is on PPE. Full Airborne precautions for suspected (rule out) or confimed Covid-19 patients.

PTO time should not need to be used under most circumstances. Paid Administrative Leave should be offered. (See your field rep for individual cases, we have a legal opinion)

MOU’s should be reasonable and negotiated, not imposed.

Contract extensions are reasonable and employers should not deny them.

You are working incredibly hard and I know you are tired and worried. You are worried you’ll bring the virus home to you family, that you’ll spread it to others patients, and that you’ll become ill yourself.

I can’t promise you anything but this.

I will not stop fighting for you.

Jan will not stop fighting for you.

Randi will not stop fighting for you. 

YOU are the experts.

YOU are the hero’s. 

Thank you and be safe,

John Brady RN

Vice President

AFT Connecticut