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N.urse Leslie McKarney has grown accustomed to 16-hour shifts, skipping lunch, the nightly ritual of throwing all her clothes in the laundry and showering as soon as she walks in the door to potentially avoid infecting her children. She has even gotten used to triaging Covid patients, who often arrive in the emergency room so out of breath that they struggle to describe their symptoms.
But despite the trauma and exhaustion of the past eight months, she was shocked when North Dakota Governor Doug Burgum said last week that health workers who test positive for coronavirus but show no symptoms may still be referring to work. The order, which is in line with CDC guidelines to mitigate the staff shortage, would only allow asymptomatic health workers who test positive to work in Covid units and treat patients who already have the virus.
But many believe the idea endangers the workers themselves and their colleagues. It comes as North Dakota faces one of the worst Covid-19 outbreaks and faces a shortage of healthcare workers.
“We are worried that someone will die, frankly, because we didn’t get to them in time,” said McKarney, an emergency room nurse in Bismarck.
According to data from the Covid Tracking Project, more than 9,400 North Dakotans tested positive for Covid-19 last week alone. About one in 12 North Dakota residents is infected with the virus; nearly one in 1,000 died. In early November, the North Dakota Department of Health reported that there were only 12 ICU beds open across the state.
McKarney said Burgum’s order goes against everything she was taught as a nurse.
“If hospital administrators start forcing Covid-positive staff to go to work, it will be very scary. We are trained to do no harm, and asking Covid-positive and asymptomatic nurses to return to work is putting patients at risk. He’s putting the other staff members at risk. “
Nine months into the pandemic, it is clear that healthcare workers are already facing greater risks. Lost on the Frontline, a joint effort of Guardian and Kaiser Health News, is investigating the deaths of 1,375 health workers who appear to have died of Covid-19 since the start of the pandemic. Almost a third of those health workers were nurses.
McKarney described long shifts in an emergency room that began taking in patients overnight because the other wards at the hospital were unable to admit them. Nurses take extra shifts to cover colleagues who have fallen ill and take on multiple critically ill patients at the same time.
It’s a scene that takes place in hospitals across the country as the coronavirus spreads relentlessly. As of November 16, more than 11 million people in the United States had been infected with the virus, with health officials reporting 180,000 new infections in a single day. And the country is preparing for another milestone: it will soon exceed a quarter of a million deaths from Covid-19.
Healthcare workers are overwhelmed and exhausted. According to a recent National Nurses United poll, over 70% of hospital nurses said they feared contracting Covid-19 and 80% feared they could infect a family member. More than half said they struggled to sleep and 62 reported feeling stressed and anxious. Nearly 80% said they were forced to reuse single-use PPE, such as N95 respirators.
Inaction at the state and federal levels has left many health workers abandoned. When Governor Burgum issued the order that infected but asymptomatic nurses could report working in Covid units, North Dakota had not implemented any kind of statewide masking mandate, despite expert guidance that such a measure could significantly reduce the transmission of the virus.
Tessa Johnson is a registered nurse at a Bismarck nursing home and president of the North Dakota Nurses Association, who released a statement on Wednesday denouncing Burgum’s order that infected nurses continue to work.
He said the state could have done a lot more to ensure patients weren’t infected in the first place. “We asked and asked and asked for a warrant for the mask, and that didn’t happen,” he said Thursday.
On Friday night, Burgum turned around and issued a cloaking warrant, ordering people to cover their faces inside indoor businesses, public spaces, and outdoor public places where physical distances may be impossible.
“Our doctors and nurses who work heroically on the front lines need our help, and they need it now,” he said in a news release.
However, Johnson said there is a disconnect between what healthcare workers are experiencing within North Dakota healthcare facilities and how the general population perceives the virus. And that even before Burgum’s comments, some of his colleagues felt they had to choose between taking all precautions and a limited vacation period. “One of my closest friends, also a healthcare professional, told me the other day, ‘There is no way I can ever get tested unless I am very sick, because I don’t want to use my paid leave. . ‘”
McKarney, the emergency room nurse, said she hasn’t had time to process the stress of the past few months. He focuses on staying healthy, preparing for what he expects will be a tough winter, and keeping his patients alive. “We are willing to break our shoulders and work as hard as we can physically,” McKarney said. “But then asking us to enter as a potential infectious source is simply astounding.”
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