Detroit nurses battling to save patients and themselves from COVID-19
9 April 2020
Total coronavirus cases reached 20,346 in Michigan with 959 deaths on Wednesday. In the city of Detroit, where the pandemic is most severe, the confirmed cases hit 5,824 with 251 deaths according to the Michigan Department of Health and Human Services.
In Wayne County, where Detroit is located, there are 547 cases and 25 deaths per 100,000 people, a rate that is equivalent to or higher than several counties in the New York-New Jersey metropolitan area, where the pandemic has grown faster than anywhere in the world.
In the Detroit metropolitan area, including Wayne, Oakland and Macomb counties, the combined number of confirmed cases is at 16,259 (80 percent of state total) and the deaths at 821 (86 percent of state total).
The flashpoint of the health crisis in Detroit continues to be in hospital emergency rooms, where the patients are arriving in respiratory distress, and in the COVID-19 intensive care units, where individuals with the most severe and life-threatening conditions are being intubated and placed on ventilators to save their lives. In many cases, these measures are coming too late.
Nurses throughout the Detroit metropolitan areas are continuing to fight against conditions of understaffing, lack of personal protective equipment (PPE) and lack of testing. As in every major US population center, these are the most pressing issues. Hospital workers have been forced to engage in unified and independent action, with some turning to their communities during non-working hours to raise donations of materials and money to help deal with the crisis, and others taking up various forms of job action and protest.
As reported on the WSWS on Monday, a group of seven night-shift nurses at Sinai-Grace Hospital—a Detroit Medical Center (DMC) facility located in the northwest area of the city—were sent home early Monday morning after they conducted a sit-in and refused to work under unbearable and unsafe conditions.
In a video posted at the time they left the hospital, one of the nurses said, “You have to make a stand at some point to get a change.” The action by the nurses has won the support of other Sinai-Grace employees, as one coworker explained, “I support the actions taken by my co-workers who were pretty courageous to do what they did. After trying to get help, they reached a breaking point.”
The DMC Sinai-Grace nurse went on to describe the conditions in the hospital, “I haven’t been at this hospital for a long time, but I’ve worked in the medical field before and I have never seen anything like this. The place is more like a mad house rather than a health institution.”
The conditions facing hospital employees are growing increasingly desperate. On Monday, representatives from Henry Ford Health System and Beaumont Health—the Detroit area’s two largest hospital systems—reported large numbers of employees that have either tested positive or are showing symptoms of coronavirus infection.
Henry Ford Health System Chief Clinical Officer Dr. Adnan Munkarah reported that 734 employees out of 2,500 who have been tested are confirmed positive for COVID-19. With a total number of 31,600 employees, the number of confirmed cases represents about two percent of the staff. Incredibly, Dr. Munkarah told the local news media, “If we are to test the whole population, you are going to see large numbers of people who are testing positive. Testing positive is just a measure of how contagious this virus is.”
At Beaumont Health, Communications Director Mark Geary told Bridge Magazine that 1,500 workers, among them 500 nurses, “have symptoms consistent with COVID-19,” and are not working. These employees are not being tested and are instead being sent home for seven days and must be fever free for three days before they can return to work. Aaron Gillingham, a Beaumont human resources executive, said, “Employees are only tested if they present themselves at a Beaumont (emergency center) or curbside screening and meet the guidelines to be tested.”
A second nurse from DMC Sinai-Grace also confirmed the employee testing policy: “The worst is the testing situation. They’re refusing to test us if we don’t have a fever. We don’t have testing for staff, and if a nurse refuses to care for COVID-19 patients, they will get fired and can never work at Beaumont’s eight-hospital system again.”
Ultimately, it is the patients—whether they are hospital employees or not—who are suffering the most. Numerous reports indicate that patients are arriving at hospitals asking for help only to be turned away because their symptoms are insufficient for admission or even testing. When they come back later, they are often so sick that they require emergency attention that the hospitals are ill-equipped to provide.
As a nurse explained, “Anyone who comes in with mild symptoms is not even being tested and immediately get sent home. With the conditions of terrible poverty in this city, they are basically being sent home to die. Those patients who are admitted are in really terrible shape.”
The nurse explained that there are misconceptions about the ages of those becoming very sick from COVID-19 and the horror of the death toll, “We are talking about people of all ages, not just old people. During my shift, there was a 30-year-old man who had been intubated and then died after being in the hospital for a few days. The virus is attacking your lungs, your heart and other vital organs in the body. This is having a terrible emotional toll on us. We went into this business to save lives not to watch people being carried out in body bags.”
The shortage of PPE is a primary factor in the inability of hospital workers to perform their duties safely and also leading to the increasing numbers of staff testing positive or being sent home with symptoms. As of Monday, all three major Detroit hospital systems were within days of running out of face shields, N95 masks and surgical gowns.
The second DMC nurse explained, “The PPE should be discarded after every patient encounter so as not to infect other patients plus ourselves. They’ve given us one shield to use indefinitely and one mask for 13 hours. ... We are lucky that our N95s don’t have to be used indefinitely like other hospitals. We ran out of surgical masks and we can’t breathe inside N-95 masks. Infected and dirty equipment is not safe for our patients.”
Although Michigan Democratic Party Governor Gretchen Whitmer has said that FEMA is sending a slew of supplies within 48 hours, as of Monday the nurses we spoke with told a different story: “We have run out of sanitary wipes. Some RNs went to the dollar store to buy cleaning supplies to protect our patients. Our patients are too scared to come to the hospital because they know the nurses are already stressed out. My patient waited three days, until the pain was unbearable, to come in. He kept saying, ‘I’m sorry I’m here, I know you are busy.’
“My biggest concern is no hazard pay for all Americans on the frontlines. They do not broadcast how many nurses and doctors and dying, because it would prevent us from coming into work.”
Another nurse from Henry Ford Health System explained the conditions on her shift: “The ICU unit I’m on, the nurses have two, sometimes three patients at this time. The nurses like myself that have been redeployed to this unit are serving as ‘runners’ right now because we do not have ICU experience, and most are coming from outpatient sites.
“Our role as runners is basically supporting the nurses, we put our PPE on and help them give baths, turn patients, etc. so they don’t have to be in the rooms as long. If they go in for other reasons, we stand watch in case they need anything such as meds or supplies and go in and get it for them, so they don’t have to undress and redress. My colleagues are exhausted both mentally and physically. I’ve watched them all walk away again and again to gather themselves and let out a few tears throughout the shift.”