Nurses say they are being pressured to go back to work while still ill from coronavirus – NJ.com

Fighting body aches and chills and “walking like a drunk,” a veteran critical care nurse in Essex County said she continued to report to work, until her daughter described feeling just as lousy as she did.

When her test came back positive for COVID-19, the respiratory disease caused by the coronavirus, she called the human resources office at Clara Maass Medical Center in Belleville to let them know she would not be in.

“They downplayed my symptoms and told me I should be back in five days, maybe seven days,” said the nurse and single mother who requested anonymity because she said she feared retaliation.

“I am trying to gather all my energy and make myself feel better,” she said. “To be honest, I am scared.”

Five nurses, who say they either tested positive for COVID-19 or have symptoms, spoke to NJ Advance Media about their concerns in the workplace. The nurses, who work at hospitals in Essex and Bergen counties, said they understand the enormity of the disaster and how badly they are needed at work, but they said they don’t feel like management is concerned enough about their safety. And they said they can’t fathom how it makes sense to be sent back to work when they could possibly infect others.

On Monday, the state Department of Health issued guidance for COVID-19-infected health care workers. Those with symptoms should stay home for seven days after symptoms first develop and for three days after the fever subsides without the aid of medication, whichever period is longer. Asymptomatic health care workers who test positive should stay home for a week after their first positive test, or longer if symptoms arise, the memo said.

The state policy says when employees develop “mild” symptoms, “they must cease patient care activities, don a face mask (if not already wearing), and notify their supervisor or occupational health services prior to leaving work.”

Debbie White, president of Health Professionals and Allied Employees, the largest health care worker union in New Jersey, said these guidelines appear stricter than those issued by the U.S. Centers for Disease Control and Prevention.

In comparison, the CDC policy says a worker who tests positive should not return until the fever is gone without medication, and there has been an “improvement” in respiratory symptoms and two tests taken at least 24 hours apart come back negative.

The CDC’s guidelines also present hospitals with a loophole, White said. Hospitals may decide “the recommended approaches cannot be followed due to the need to mitigate HCP (health care professionals) staffing shortages,” according to the CDC policy.

Based on conversations with her members, it is clear some hospital executives in N.J. are following the looser CDC guidelines because staffing shortages are everywhere, White said.

“It’s absolutely horrifying employees that are contagious can be brought back to work,” White said.

White said the public might expect the hospitals wouldn’t want employees who are still sick taking care of patients. “If they tell you to come back, are you insubordinate if you say no? My perception is this is an overly broad caveat by the CDC and they have put the public and other employees at risk,” she said.

Rebecca Smith, a spokeswoman for RWJBarnabas Health, the parent company for 11 acute-care hospitals including Clara Maass, said in a statement that after consulting with the state health department, “all facilities have determined that it is appropriate to have health care providers with all levels of exposure to COVID-19 continue to work if there is no evidence of even mild symptoms consistent with COVID-19.”

“To protect our patients and employees, health care providers with known COVID-19 exposure will be screened prior to each shift in a non-clinical designated space for fever, cough, sore throat, shortness of breath or GI symptoms prior to reporting to their department,” Smith’s statement said. “Employees are required to wear a surgical mask for 14 days following exposure. Healthcare workers who test positive for COVID-19 should stay at home and self-quarantine if their symptoms are mild and isolate themselves from others. If respiratory distress occurs, they should go to the ER or call 911″.

“If employees have signs or symptoms of illness, they should not report to work,” Smith’s statement said.

New Jersey’s hospitals, especially those in the northern and central part of the state, are overwhelmed. Health Commissioner Judith Persichilli said on Saturday there were 4,000 patients in the hospital who have tested positive for COVID-19 with another 2,000 patients awaiting test results. There are 1,494 patients in intensive care units, with 1,263 on ventilators, Persichilli said.

When asked to reconcile the differences between the CDC’s and the state health department’s guidance on infected workers, Persichilli wrote in an email to NJ Advance Media that affected workers “should follow Department of Health guidance.”

What awaits these returning nurses, respiratory therapists and other personnel in critical care units is an untenable workload.

Last week, critical care nurses were assigned five patients on ventilators each, said another ICU nurse from Clara Maass who said she tested positive for the virus. The ratio for this time-consuming and labor-intensive job is usually two but no more than three patients per nurse, she said. On Saturday, the ratio climbed to one to six, she said.

Clara Maass alerted the state health department it was “divert” status for at least a portion of every day from Monday through Saturday, according to the state website. It means a unit or the entire hospital does not have enough staffing, beds or both to accept new patients.

“The people who are out sick are trying to get well and go back to work. But it will be a cycle,” she said. While she was home awaiting her test results, she said human resources called every day for four days asking if she was ready to come back to work.

“The health care workers are getting forced back to work even before their tests are back,” she said.

In the ICU, employees are issued one gown per patient, which they leave hanging in the patient’s room and slip on when they return, three critical care nurses said.

Between administering medications, checking vital signs, suctioning airways, “you are at high risk of catching it,” said another ICU nurse at Clara Maass who was sidelined with a recurring fever last week.

Between the rationing of personal protective equipment, or PPE, and the pressure to return to work before she has recovered, the critical care nurse who said she infected her child said she is feeling resentful. She’s aware of 20 employees who are infected.

“If you had taken care of the nurses — taken care of us — we can take care of patients,” she said.

“I felt like a soldier being thrown on the front line and getting riddled with bullets with no ammunition.”

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Susan K. Livio may be reached at slivio@njadvancemedia.com. Follow her on Twitter @SusanKLivio.