At One Colorado Hospital, ICU Nurses Warn Of 'Dangerous Workplace Conditions'
As the coronavirus pandemic puts pressure on hospitals across the country, ICU staff are in high demand. Many are working in environments where resources are stretched thin. At one Colorado hospital, ICU nurses have left their jobs over workplace conditions, alleging a disregard for safety by hospital administrators.
Aaron Cloud, who has treated dozens of COVID-19 patients at St. Anthony’s hospital in Lakewood, is one of them.
“When you open the door, all of the air sucks into the room so no germs or whatever the patient has can get out into the nursing station or the hall,” Cloud said.
He described IV pumps sitting in the hallways, their lines snaking under the doors. Those doors are marked with a cross of orange tape to signify that the patient inside has the Coronavirus. Cloud said most of those patients are on ventilators, and some are “proned,” a face down position that can improve lung condition.
“Just entering that room and that anxiety of knowing how dangerous this virus is — and you’re walking into that room — is emotional and you’re doing it multiple times a day,” another ICU nurse said. She asked us not to use her name to avoid any trouble getting a new job later on.
“These patients are extremely sick,” she said. “I have a lot of ICU experience and I’ve never seen anything like this. They’re really unpredictable. They crash out of nowhere. … We put family members on the phone so they can talk to them and it's heartbreaking listening to their desperation.”
Since they began to treat coronavirus patients last month, both of these nurses have left their positions at St. Anthony Hospital. Cloud says his departure is a response to a shortage of gear, particularly masks to protect against airborne particles.
“You may as well go in there without a mask. I feel like you’re getting more germs on your hands and face reusing that mask all day,” Cloud said.
State officials are coordinating the local manufacturing of personal protective equipment (PPE) although companies involved say those efforts are getting tangled up in red tape. Last week, the Colorado Department of Public Health and Environment activated non-binding crisis guidance for hospitals on how to manage PPE during a shortage.
These shortages persist across the country. Politico reported this week that the New York State Nurses Association is planning to sue the state’s health department over lack of protective gear, the first legal action of its kind since the outbreak began.
The other nurse says she left St. Anthony Hospital because of “team nursing,” a technique the hospital has been trialing. Instead of caring for one or two patients, ICU nurses would care for six to eight patients, with support from two other non-ICU staff members.
“Accepting that staffing radio, I felt like my nursing license was on the line,” she said. “And knowing even with being an experienced ICU nurse, there was no way I could take care of patients safely, even with support staff.”
According to the Colorado Hospital Association (CHA), other hospitals in the state are likely using this team nursing technique. In a blog post about resource availability during COVID-19, the Society of Critical Care Medicine, a non-profit focusing on the practice of critical care details team nursing or “care teams” as a way to treat a large number of critically ill patients but notes that “the level of care may not be the same as in the typical ICU in non-crisis times.”
Cloud did not give a specific example of how team nursing would impact patient care and has not done it himself but believes ICU nurses would need to spend a significant amount of time training the rest of the team.
“ICU care is just really exacting. Counting to the milliliter how much urine someone is producing. Counting to the mililiter what we’re putting into their IVs. Turning up sedation, turning it down to improve their ventilation,” he explained.
These concerns, and others like lack of hazard pay or retention bonuses, are laid out in a letter that a group of nurses sent to hospital administrators earlier this month. In response to questions about these concerns, administrators responded to KUNC with a statement:
During this unprecedented time, many frontline caregivers are experiencing their first pandemic. Centura has aligned with the Colorado Crisis Standards of Care Plan recommended by the Colorado Department of Health and Public Environment (CDPHE) which aligns with the CDC’s standards of care in response to COVID-19. These guidelines support the safety of our associates and the care of our patients and community.
St. Anthony Hospital administrators did not respond to a question about possibly using team nursing as a cost cutting measure but, broadly, Colorado Hospitals are suffering financially. The Colorado Hospital Association estimates a loss of $1.2 billion in revenue from the cancellation of non-emergency medical procedures.
Meanwhile, these nurses from St. Anthony’s say they’re two of many who have left the hospital recently. Now, they are planning for what comes next.
“I’m going to New Jersey to help out there. They’re one of the bigger hot spots in the nation. I leave on Friday,” one explained. “I'm nervous for sure...I know that it’s gonna be crazy there. They are experiencing a much larger scale of COVID patients than Colorado is. But I will be compensated for it. And I want to help.”
Aaron Cloud said that he is excited but also sad to leave for another hospital in the Denver area.
“I’m really just heartbroken to leave my team there. … When I look at who is still there, I do feel sorry that I'm not there to help them. That’s kind of the thing that’s made me the most upset about leaving,” he said.