July 22nd, 2020

Nation Reliant on HCW to Take on Enormous Personal Burden - Beware the Future of Nursing

What I most want policy makers, health care administrators, and my bosses to understand is the untenable nature of the immense personal burden that we are relying on healthcare workers, including nurses, to take in the absence of resources, infrastructure, policies, and support. We consistently lack: adequate PPE, adequate staff, adequate mental health resources, adequate risk management resources including alternate options for housing or childcare, adequate testing for the community and for HCW with sufficiently fast turnaround time, adequate screening for employees/visitors, adequate safety measures/infection control practices at work, adequate policies for keeping sick or potentially sick HCW at home and providing those who contract the illness with appropriate care and support... I could go on. We are asked to take on substantial risk to ourselves and our families in the absence of proper PPE and alternate housing. We are asked to do this even when our health systems will not test us if we get sick, will not take us off work if we have an exposure. We are asked to take on the emotional burden of witnessing the illness and death wreaked on our communities and sitting bedside with patients who die alone without appropriate access to mental health resources and support. We are asked to take on all of this for the same amount of pay as many people are making at home on unemployment - and I point that out NOT because I disagree with the unemployment aid. I wish the federal government would approve an extension of the extra $600 to incentivize businesses to stay closed and make it possible for people to stay home. But the fact of the matter is that we are performing a public service that the entire country is dependent on that has become far more dangerous and traumatic than it was when we signed up. And if people want us to keep doing that, we need more support. Nurses are getting sick, some are dying. Some healthcare workers' mental health has suffered, and we know we have already lost Dr Lorna Breen if not others to death by suicide. Other nurses have left the profession and still others are contemplating their future exit. Nursing already had problems. We were already overworked and understaffed and underpaid and our insurance has gotten worse and worse as years go by. Many of us were already working in dangerous environments that included accepting risk of personal harm - like in the ER where we are routinely physically assaulted and verbally abused by our patients. But now that we see what we are expected to endure and the utter abysmal nature of the response of the federal government and hospital administrations to our circumstances, and as the public sees what we are expected to endure, I fear for the future of nursing. What would I change? We need decisive, rapid, substantial action and leadership at a federal level. We need states and the federal government working together to secure and distribute PPE and other supplies - not fighting to find it and then shipments get intercepted by the feds. We need the government to mandate and incentivize domestic production of PPE and ventilators and swabs and reagents. We need funding for public health departments. We need widely available, accurate, rapid testing for every community. We need weekly testing for nurses who care for covid patients, just the same as nursing home staff are required to receive in my home state of Michigan. We need hazard pay. We need free, consistent, high quality mental health resources. We need policies consistent with science and best practices rather than policies based on supplies. We need hospital scrubs. We need adequate supplies of contact gowns, N95s, surgical masks, face shields, hair covers, disinfectant wipes, shoe covers. We need adequate screening for employees and visitors. We need everyone at the hospital who is physically able to do so to keep their mask on, appropriately covering their nose and mouth. WE NEED FIT TESTING. Seriously we shouldn't be having to fight with administration over getting freaking fit tested on our PPE. This is long enough so I will stop here - but these are some of the things I would change.

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