In an ongoing effort to win the on-the-job protections that their nurse colleagues at Berkshire Medical Center (BMC) so desperately need in order to stay safe while caring for their patients during this overwhelming COVID-19 crisis, the elected nurse leaders for the RNs’ union, the Massachusetts Nurses Association (MNA), confronted hospital management yet again on Thursday, April 2, via letter, and laid out exactly what is needed to maximize safety for RNs. This included:
- Universal N95 precautions
- A non-punitive COVID-19 absence policy
- An end to “cancelling nurses” and sending them home, and instead use all available RNs to assist on COVID-19 and “rule-out” units where extra nursing support is desperately needed
The letter from the union [included at the end of this release] was accompanied by a request that hospital management respond to the letter and engage with the union’s elected leaders by noon on Friday, April 3. Management never responded to or acknowledged the letter.
Meanwhile, in their own data that the hospital submits to the MNA daily, management reported that of the 101 nurses who have been quarantined due to exposure to a COVID-positive patient, an astounding 86 of them worked on non-COVID floors and units at the time of their exposure — clear proof that staff throughout the hospital are at risk of contracting and spreading the virus, primarily through interaction with asymptomatic patients.
Even still, management refuses to acknowledge the reality of its own data and continues to make dangerous decisions and implement short-sighted policies that jeopardize caregivers. These include:
- Dictating that surgical masks will suffice for nurses and caregivers who work throughout the hospital (i.e., in all units other then COVID-positive designated units).
- Changing their policies so that COVID-exposed nurses are now required to work without a two-week quarantine. Meaning, if infected, nurses will be in the hospital and working — using a surgical mask only — while they wait to see if they develop symptoms of COVID-19. These two weeks are well documented as being the most dangerous period for asymptomatic transmissions.
- Changing their policies so that COVID-positive nurses who are out of work must now use their own earned benefit time to recover.
- Creating additional COVID floors and units while rationing the more than 16,700 N95 masks that management says it has stockpiled.
"We understand the problems with the N95 supply chain, and nurses are being incredibly careful about conserving the masks,” said Mark Brodeur, a float pool RN and union leader. “But management should be giving N95 masks to every staff member who enters a patient room in order to stop the spread and flatten the curve right here inside of our own hospital. Keeping us safe now will allow us to keep caring for our patients."
“We have to stop the spread of Coronavirus amongst our staff,” added Barbara Connor, an endoscopy RN and union leader. “Universal personal protective equipment [PPE] is the only way this will happen."
For one 20-year RN at BMC, the issue of COVID-exposure due to lack of PPE is all too familiar. She worked on a “non-COVID floor” with no protection and is now COVID-positive.
"I had been feeling very sick, trying for weeks to get tested, and finally this week was allowed to get tested and it came back positive for COVID-19,” explained the nurse, who has chosen to remain anonymous. “On my unit, we’re supposed to be a ‘non-COVID’ unit. However, on this unit, myself and other staff were exposed to patients who were COVID-positive. We were in close contact with patients but weren’t wearing any kind of masks, because at the time that I was exposed, management was telling us that we shouldn’t even wear surgical masks on my unit.”
“I developed a bad cough and was told to go to work with a surgical mask,” she continued. “Now that I’ve tested positive, I’m being told that I must use my earned time, even though this was clearly a work exposure. BMC should be providing every staff member with protection, especially N95 masks. If I had been protected, I wouldn’t have gotten sick and I wouldn’t be out of work right now."
April 2 Letter to BMC Management Regarding PPE, Need for Universal N95 Masking Policy, and Additional Steps to Ensure Safety of Nurses and Hospital Staff:
Dear Darlene Rodowicz,
On behalf of the MNA nurses of Berkshire Medical Center, we are writing to convey our emergent concern for the health and safety all of BMC’s frontline staff during this COVID-19 pandemic. Messages and protocols that frontline staff have received from BMC administration regarding the use of Personal Protective Equipment (PPE) are inconsistent with universal precautions that we know are necessary in order to protect against the spread of this highly infectious virus. We are painfully aware of the need to conserve PPE and work to find additional supplies. However, we cannot allow you to compromise the health and safety of our frontline caregivers. Too many of us are out of work, sick and/or quarantined due to inadequate PPE provided by BMC. In Italy, where frontline staff had more available PPE than we do here in the US, 30% of the healthcare workers still became ill. We cannot afford the loss of more frontline healthcare workers as we prepare for a possible surge of patients. On March 27, management reported to us that at that time, BMC held a stockpile of 16,700 N95 masks. That is why we are urging you to immediately adopt universal N95 precautions and other steps to protect our healthcare workforce now, flatten the curve, and protect our ability to care for the patients who will need us during the days, weeks, and months ahead.
Universal N95 Precautions
We are gratified that since March 27, BMC has been offering surgical masks and eye protection to all staff, in a significant improvement over the prior policy. However, we know that surgical masks do not offer effective protection against COVID-19. We appreciate BMC’s efforts to segregate patients who have tested positive and who are suspected COVID-19 onto separate units. However, it is a fallacy to believe that the coronavirus only appears in patients on “COVID-19/rule-out” units. At the end of this letter, please find evidence for asymptomatic transmission of coronavirus.* 75% of BMC nurses who have been exposed to patients who later tested positive were caring for patients on “non-COVID-19/rule-out” units. In recognition of the highly contagious nature of the virus and the likelihood of asymptomatic exposure, all inpatient and outpatient frontline staff should be provided with N95 masks, eye protection, hospital issued scrubs and gowns.
Non-Punitive COVID-19 Absence Policy
Judging from the language in a 3.31.20 email to all staff, there seems to be an attempt by Human Resources to default to the assumption that employees who test positive must have contracted the virus in the community rather than in the hospital and therefore, the employer will not consider their illness occupational. For weeks, our committee has raised concerns regarding the co-mingling of patients, failure to triage and segregate patients, and most significantly, the lack of appropriate PPE being provided to frontline staff. To suggest that none of these issues may have contributed to an increased likelihood of viral spread among the workforce is both ridiculous and reprehensible. Now, frontline staff members are being told they must use their own earned time to self-quarantine and recover. This is unacceptable. BMC is putting us in the direct path of this novel virus, and the employer should be supporting us, not penalizing us.
All Hands on Deck
We cannot imagine why, in the middle of this pandemic, BMC is choosing to send nurses home instead of sending them to floors that need the extra help! We are urging you to immediately stop cancelling nurses, and to recognize that the needs of isolation patients on COVID-19/rule-out units require extra nursing support. Staffing should be increased to reflect the acuity and complexity of these patients. Our members are ready, willing and able to provide the support needed, but too many of them are currently being told that their skills are not needed.
We are doing our best to provide needed care with limited resources, but we need to know that you will work to protect front line staff so that we can be here to care for our community when the surge hits. Please let us know by noon on April 3 how you plan to address these issues.
Sincerely,
Alex Neary, RN
Gerri Jakacky, RN
Mark Brodeur, RN
Kathy Cimini, RN
Barbara Connor, RN
Marie Geary, RN
Marie Mathews, RN
Ruth O’Hearn, RN
Cathy Pease, RN
Rebecca Schaffrick, RN
Amber VanBramer, RN
Darlene Wurtemberger, RN
