More than a dozen registered nurses at Blake Medical Center in Bradenton, Florida, protested outside the hospital Friday, the third such protest since the pandemic began, saying hospital owner HCA Healthcare won’t give them N95 masks unless they are working with known COVID-19 patients, and doesn’t tell them when their patients later test positive.
As case counts in Manatee County climb, many patients have been admitted to the 383-bed hospital for other reasons, but later turn out to have COVID-19, said Candice Cordero, a telemetry nurse who works with stroke and cardiac patients in a step-down unit.
“We’re seeing more random patients test positive, and some have symptoms, but some don’t, or some are admitted for one thing, and start having (COVID) symptoms a few days later,” she told MedPage Today.
“We’re having a problem with the hospital being transparent with their numbers, and letting staff know when they’ve been exposed.”
The hour-long protest was called by members of the Blake Medical Center’s bargaining unit of the National Nurses Organizing Committee-Florida, an affiliate of National Nurses United. NNOC said in a news release that it has filed complaints about unsafe conditions at the hospital with the Occupational Safety and Health Administration. The statement said that at least four RNs at Blake have tested positive since late May.
The union further alleged that Blake Medical Center management requires RNs who have been exposed to COVID to continue working until they have COVID symptoms, does not test all patients prior to a procedure or operation, fails to provide PPE replacements for broken masks, and threatens RNs with discipline for raising safety concerns.
Officials for Blake Medical Center eleased this statement in response to the protest:
“In the midst of a global shortage of personal protective equipment (PPE), Blake Medical Center has been doing everything in our power to protect our caregivers and patient care teams throughout the pandemic and equip them to provide safe, effective care to our patients by following or exceeding Centers for Disease Control and Prevention (CDC) protocols.
“We have provided appropriate PPE, including a universal masking policy requiring all caregivers in all areas to wear masks, including N95s, in line with CDC guidance. While we currently have adequate supplies of PPE, we continue to provide safeguards that are consistent with CDC guidelines and help ensure the protection of our colleagues, not only today, but into the future as the pandemic evolves. The NNU fails to recognize the reality all hospitals nationwide are facing, that this pandemic has strained the worldwide supply of PPE, including masks, face shields, and gowns.”
Cordero said that recently one patient “was not properly screened in the ER who should have been on a COVID unit. That potentially exposed several nurses and the other patient in that room.”
When she complained to human resources officials, she said, she “was reprimanded verbally for speaking up and was told that if I did it again, I would receive discipline.”
The hospital should be testing all of its frontline workers regularly, she said. “We’re much more at risk of being exposed while at work than many other jobs out there. We really should be screened better than we are.”
Kim Brooks, who works in an ICU step-down unit for trauma and cardiac patients, assumes all of her patients are infected with COVID-19 and because of that, she said, she has bought her own N95 masks since the hospital won’t buy them for her.
“We know some of the nurses who are on non-COVID units are getting exposed to positive patients and now [some] are getting sick because they didn’t have N95 masks,” she told MedPage Today.
At the very least, the hospital should inform frontline workers when patients ultimately test positive on our floor, “so we can take precautions with our family,” Brooks said.
“Once we find out someone is positive, we do move them to a COVID unit. But sometimes there’s been a situation where that patient has been rooming with a COVID patient, and that patient is sometimes left on our unit to see if they turn out to be positive.”
By Cheryl Clark, MedPage Today
Following the May 25 death of George Floyd, nurses and other healthcare providers have been taking action not only to protest the deaths of Black citizens at the hands of police, but also to draw attention to the severe knock-on effects of racism on the health of Black communities, including an inordinate rate of mortalities from heart disease, diabetes, COVID-19, and other illnesses. Braving the risks of coronavirus, tear gas, pepper spray, and rubber bullets, nurses, who often see the fruits of social inequality at firsthand, have provided protestors with first aid as well as taking part themselves.
Nursing organizations have joined individual nurses in speaking out. American Nurses Association President Ernest J. Grant, PhD, RN, FAAN issued a moving statement, in which he remarked, “As a black man and registered nurse, I am appalled by senseless acts of violence, injustice, and systemic racism and discrimination. Even I have not been exempt from negative experiences with racism and discrimination. The Code of Ethics obligates nurses to be allies and to advocate and speak up against racism, discrimination and injustice. This is non-negotiable…. At this critical time in our nation, nurses have a responsibility to use our voices to call for change. To remain silent is to be complicit.”
“You clapped for us. We kneel for you.”
A mingling of professional training and empathy moved nurses such as Miami RN Rochelle Bradley to take a knee in remembrance of Floyd’s death. Bradley told CNN that “Kneeling here today for nine minutes and knowing that that’s how long George Floyd was on the ground with his airway compromised really bothered me as a nurse.”
For healthcare workers, the protests also reinforced their sense of unity in the era of COVID-19. In Boston, nurses who gathered to kneel in front of Brigham and Women’s Hospital carried a sign reading, “You clapped for us. We kneel for you.” One nurse interviewed, Roberta Biens, said, “I just want everybody to know they’re not alone, we’re with them and we’ll stand in front of them or behind them, wherever we need to be to support them.”
Minneapolis nurses appeared in force at the protests. One local ER nurse told the Insider, “COVID is a temporary and critical health crisis. Racism, through violence and disease, has been killing our patients since the hospital was built and will continue killing them long after COVID is gone.” And in an official statement, the Minnesota Nurses Association said, “Nurses continue to see the devastating effects of systematic racism and oppression targeting people of color in our communities. We demand justice for George Floyd and a stop to the unnecessary death of black men at the hands of those who should protect them.”
Hospitals in New York City united to stand behind the protests. The Gothamist scanned official Twitter posts and noted, “The six major hospital systems in the city–NYU Langone Health, Mount Sinai Health System, New York-Presbyterian, NYC Health + Hospitals, Northwell Health, and Montefiore Health System–have all posted publicly in support of the demonstrations…”
Weighing the Call to Civic Action Against Public Health Concerns
Medical practitioners are understandably divided about engaging in public assemblies while the coronavirus is still at large, but many believe the risk is worth taking. On June 8, World Health Organization (WHO) director-general Tedros Adhanom Ghebreyesus said, “WHO fully supports equality and the global movement against racism,” but added, “As much as possible, keep at least 1 meter from others, clean your hands, cover your cough and wear a mask if you attend a protest.”
Asked by Health.com about the danger of public protests, Natalie DiCenzo, an Ob-Gyn resident in New Jersey, responded that “the risk of remaining silent and complacent in the face of racism and police violence is also deadly. I believe that with the proper precautions, these protests can be done relatively safely when it comes to COVID-19.”
Nearly 2,000 US “public health professionals, infectious diseases professionals, and community stakeholders” also expressed direct support for the national protests in a widely circulated June 4 letter (initiated by faculty from the University of Washington School of Medicine). Following a statement that “White supremacy is a lethal public health issue that predates and contributes to COVID-19,” the letter recommended a series of safety measures to protect protestors from the virus. Among other issues it urged “that protesters not be arrested or held in confined spaces, including jails or police vans, which are some of the highest-risk areas for COVID-19 transmission, “ and that no use be made of “tear gas, smoke, or other respiratory irritants, which could increase risk for COVID-19 by making the respiratory tract more susceptible to infection…”
On Twitter, nurses participating in the protests offered their own practical suggestions. A DC pediatric nurse told attendees to bring gloves, sunglasses or goggles for eye protection, and “an extra mask. Yours will get hot and sweaty so switching it out halfway through is smart. If you have a cloth mask throw a bandana on top too…” Following participation in protests, some nurses have also taken the step of self-quarantining for two weeks.
Former Peace Corps volunteer and Nurse of the Week Logan Marx has “two passions and they don’t intertwine very well, so I’m choosing to follow both of them.” While he finishes his last semester at University of South Florida Nursing School and prepares to enter critical care nursing as a Coverdell Fellow—a special fellowship for returning Peace Corps members—Logan also works with children at a community program for expanding health education among Tampa’s migrant population.
Of the children’s program (at the Wholesome Community Church in Wimauma), Marx says, “From the start, I wanted to focus on kids because I just love working with them. One thing the Peace Corps does well is the training stage where we focus on understanding our community and the population we’ll be working with. When we find out what’s really happening and where there are holes, we can help them fill. [In Wimauma] we’d been doing health screenings and fairs with adults, and I noticed they’d put the kids in another room and have them color or something. I realized that’s where we need to focus.”
A native of Dallas, Texas, Marx feels at home in Latinx communities: “I had this incredible Spanish teacher who just gave me a love for the Latino culture. That opened my eyes to the possibility of studying abroad during college, which I did, which made me desire to know more, learn more, and experience more growth.” His background served him well after he joined the Peace Corps and worked in Guayaquil, Ecuador for three years. The experience in Guayaquil also inspired him to go into nursing: “Ecuador was my way of getting 2,000 hours of clinical experience. My whole experience in Ecuador completely changed my perspective on health care, and that’s what made me decide nursing was the route that I wanted to go,” he says.
Marx is eager to begin working as an ICU nurse after he graduates, but he hasn’t forsaken his other “passion.” In addition to noting that “ultimately, I think a Masters in Public Health would be great,” he also dreams of one day returning to the Peace Corps as an overseas director. For now, though, nursing is Logan’s ruling passion. According to USF Nursing News, “On his first day of clinical visits at Tampa General Hospital, he met a woman from the Dominican Republic who was preparing to have her leg amputated. He was able to converse with her and her family in their native language, and that seemed to make all the difference, for her and him.” As Marx says of the experience, “It just reassured me that nursing is the right path.”
For more details
on Logan Marx, visit here.
After years of opposition from the Florida Medical Association and seven years of passing in the state House but not in the Senate, the bill to allow Floridian Nurse Practitioners full practice authority has finally been passed. Starting in July 2020, advanced NPs who have accumulated at least 3,000 hours of experience under physician supervision will have the right to independently operate primary care practices in Florida without an attending doctor. To qualify, they will also have to complete minimum graduate level course work in differential diagnosis and pharmacology.
Under the new law, signed on March 11 by Florida Governor Ron
DeSantis, qualified NPs will be able to independently practice family medicine,
general pediatrics and general internal medicine. House Speaker Jose Oliva, who
made the bill a priority, praised the bill’s passage, saying, “Freeing
(advanced practice registered nurses) of the red tape that has historically
stopped them from working to the full extent of their education and training
will immediately improve access to quality care for all.”
In a compromise between the Florida House and Senate, while the bill grants full practice authority to advanced NPs, it does not cover physician assistants or certified registered nurse anesthetists. Calling the bill “a good first step,” the Florida Association of Nurse Anesthetists commented, “Although we are disappointed that the legislation did not include certified registered nurse anesthetists … we are pleased that some of Florida’s (advanced practice nurses) will be able to practice autonomously.” The group added, “Passage of this bill demonstrates Florida’s commitment to modernizing the way health care is being delivered in our state by ensuring that Floridians have full access to health care, particularly in rural areas that are often underserved.”
Florida Republican Representative Cary Pigman, a physician who has filed the bill multiple times in the state House, noted, “Beyond the classroom, the data from statewide experiments across the nation demonstrate without a doubt that nurse practitioners are highly skilled, highly trained, and highly eager to care for patients independently.” Pigman added, “Advance practice professionals achieve higher marks in patient outcomes, patient satisfaction, and they spend more time actually talking to patients.” For more details, visit here.
Our Nurse of the Week is Bethany
Baker, the first deaf nursing student to be admitted to the University of North Florida’s (UNF)
School of Nursing. Baker comes from a family of nurses, and although every
person on her mom’s side of the family is deaf in one ear, she was the first in
her family to be born fully deaf. Her deafness kept her from imagining a career
in nursing for herself, but at 27 years old, she is working toward a
post-baccalaureate degree in nursing and she hopes to pave the way for others
to follow in her footsteps.
Baker’s parents discovered
she couldn’t hear when she was 6 months old. She graduated from the Florida
School for the Deaf and Blind in 2009 and attended Gallaudet University in
Washington, DC, to pursue a degree in history. After graduating, she moved to
Tennessee where she started caring for a 96-year-old deaf woman, called Mama Ray,
which inspired her to pursue a career in the medical field.
While working for Mama Ray,
Baker took a certified nursing assistant class and worked in an emergency room
for six months. After Mama Ray died in 2016 at almost 100 years old, Baker
moved back to Florida to enroll in a nursing program. Baker has one year left
in the program and then she hopes to become a labor and delivery nurses or
operating room nurse. She also wants to work with more deaf patients in Florida
and advocate for deaf people who want to pursue any profession.
Baker is currently completing her clinical rounds at Flagler
Hospital where she has two interpreters with her at all times, provided by the
UNF Disability Resource Center. Her time as a nursing assistant in Tennessee
and as a student doing clinical rounds has led her to become an advocate for
deaf patients. One man in particular affected her deeply. At the hospital in
Tennessee, Baker met with a patient who was going to have open heart surgery
but had no interpreter. He had no information on the surgery he was going to
have or the pre- and post-operation processes. She doesn’t want to see other
patients with disabilities going through the healthcare system completely in
Baker’s nursing experience has also taught her how to communicate
with patients in different ways. She carries a pager for nurses to contact her
and uses a tablet to access a remote sign language interpreter to talk to
patients when an interpreter isn’t available in-person. She also convinced the
hospital she worked at in Tennessee to hire her interpreter who now remains on
staff working with deaf, blind, deaf and blind, and other handicapped patients.
Baker tells houstonchronicle.com, “For deaf people, I’m hoping to start this process and experiences and do great, and then I can really open some doors permanently for some other deaf people to get their foot in the medical door. I’m really happy that the program took a risk on me. I feel more empowered to do a good job. I know that I can do it, and I want to show them that I can do it as well.”
To learn more about Bethany
Baker, the first deaf nursing student to be admitted to the University of North
Florida’s (UNF) School of Nursing, visit here.
A potential nursing shortage is threatening Florida’s healthcare system and the state’s universities and colleges are devising creative solutions to graduate more nurses. The Florida Center for Nursing predicts a need for 114,000 more nurses by 2023 as the healthcare demand from baby boomers increases in tandem with retiring nurses. However, there are more potential students competing for nursing spots in schools than there are positions available. Florida universities report that they’re forced to turn away up to two-thirds of nursing applicants at the bachelor’s degree level.
One solution posed by Florida nursing schools is to change how registered nurses get real-world practice with patient care. Most programs require students to complete clinical hours to get hands-on experience outside the classroom but a shortage of nursing faculty has limited the ability to take on more students in real-world clinical settings. An increasing number of Florida nursing schools are offering simulation scenarios to give students comparable clinical experience.
Dr. Ora Strickland, dean of the Nicole Wertheim College of Nursing and Health Sciences at Florida International University, tells wfla.com, “We would be unable to accept as many as we do if not for the simulation center.”
Simulation training mirrors the hospital settings, allowing students to make decisions and then observe those decisions through on-the-spot feedback from nurse educators. Florida’s State Board of Nursing now allows students to complete up to half of their clinical hours in simulation labs based on clinical research on the effectiveness of simulation training. Simulation centers can also be used to educate nurse practitioners, nurse anesthetists, and other nursing graduate students.
To learn more about how Florida universities are working to find creative solutions to meet the demand for nurses, visit here.