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MNA Proposes Safe Standards for Resumption of Normal Healthcare Operations, Calls for Frontline Worker Perspective in Re-Opening Plans in Governor Letter on COVID-19

05.05.2020

Massachusetts Nurses Association decries unsafe practices such as those by Tenet Healthcare at Saint Vincent Hospital and recommends safe criteria for resuming normal operations

CANTON, Mass. – Nurses and healthcare professionals represented by the Massachusetts Nurses Association have written recommendations for the safe resumption of normal operations at healthcare facilities and are calling on state officials to include the voices of frontline workers as COVID-19 re-opening plans are developed and implemented.

“While we anticipate moving toward more normal healthcare operations, we must be absolutely vigilant that facilities provide widespread testing, protective equipment and safe staffing levels,” said RN and MNA President Donna Kelly-Williams. “Up to this point, many decisions have been made that have not incorporated the perspective of nurses and healthcare professionals at the bedside. If we re-open hospitals and other parts of our society without listening to frontline workers, we place our ability to defeat this pandemic at grave risk.”

As stated in the MNA’s May 4 letter to Gov. Charlie Baker, “Throughout the pandemic… too many hospitals have been incapable of making prompt, appropriate decisions in the best interests of their staff and patients. We fear the desire to generate revenue through elective procedures could override the need to ensure proper protections are in place before resuming these procedures. Unfortunately, these fears are not unfounded.”

The irresponsible actions of healthcare employers like Dallas-based Tenet Healthcare demand rigorous and enforceable standards for the resumption of elective surgeries and other non-essential services. These standards must be created with input from healthcare workers on the front lines. Tenet has cut frontline staff at Saint Vincent Hospital in Worcester, creating unsafe conditions during the pandemic despite making public statements about the for-profit company’s superior financial position.

Read the full criteria recommendations within the May 4 MNA letter to Gov. Charlie Baker at www.massnurses.org/COVIDgovletter (PDF will open). See a video of MNA Executive Director Julie Pinkham discussing hospital resumption of normal operations: https://youtu.be/vb5zn8hGTQk.

Highlights of MNA Criteria for Resumption of Normal Healthcare Operations

Given the potential public health impact for premature resumption of full service at these facilities, there must be strict oversight of this process and no institution should be allowed to resume normal operations until these measures have been documented and verified.

  • Decline of COVID-19 Census. Before permitting a return to pre-COVID-19 operations, the level of COVID-19 admissions must decrease for a period of two weeks at the facility. This will help to ensure that what is observed is a trend and not an anomaly or lull.
  • Testing and Screening. To mitigate the risk of spreading the virus in healthcare facilities following a return to normalized operation, healthcare facilities must test all incoming patients. 
  • COVID-19 Designated Units. Facilities must cohort COVID-19 patients on designated floors and if those beds become insufficient, they have to stop elective procedures to assure they do not commingle patients.
  • Resumption of Standards. Prior to any return to normalized operations at healthcare facilities, the state must address several provisions that were suspended over the past two months to specifically address the anticipated COVID-19 surge, including the reinstatement of the ICU staffing law. This also includes sufficient staffing throughout the hospital. See more in the May 4 letter.
  • Transparency, Oversight and Enforcement. Facilities must provide a written plan regarding their plans for returning to normalized operations and the continued care of COVID-19 patients as well as attestation that they meet the state-designated census criteria to resume operations. This plan should be available to the public. There must be a designated reporting site with immediate investigation and enforcement for any violations.
  • Personal Protective Equipment (PPE). In order to return to elective procedures and admissions, there must appropriate PPE available to all staff who come in contact with COVID-19 positive or suspected COVID-19 positive patients. If a facility cannot provide frontline staff with the appropriate PPE, then that facility is not prepared to resume elective procedures.  

Read additional criteria at www.massnurses.org/COVIDgovletter (PDF will open). 

In its ninth letter to Gov. Baker, Secretary of Health and Human Services Marylou Sudders and the Massachusetts Legislature, the MNA, representing more than 23,000 frontline nurses and healthcare professionals in 85 healthcare facilities and the vast majority of RNs in hospitals statewide, calls on state officials and healthcare employers to immediately apply the experience and expertise of nurses and healthcare workers on the front lines of the COVID-19 pandemic.

Highlights of Ongoing COVID-19 Issues from May 4 Gov. Letter:

  • Occupational Presumption. We continue to be concerned by the insistence on the part of multiple healthcare facilities that workers who test positive for COVID-19 acquired the virus in the community rather than at work. The MNA is advocating for legislation that presumes healthcare workers are exposed at work for a number of reasons.
  • Provide Transparency for PPE. We have not yet seen full transparency regarding the distribution of PPE in the Commonwealth. Frontline staff continue to report that they do not have access to appropriate PPE, including those in behavioral health facilities.
  • Non-acute, inpatient settings. Issues persist at non-acute, inpatient care settings including behavioral health facilities, public health hospitals and group homes. These facilities should be maintaining designated COVID-19 units and take other steps.
  • Testing. Access to testing for healthcare staff continues to improve incrementally but is still not where it needs to be.
  • Bed, unit and facility closures. We continue to call for a halt to all bed, unit and facility closures. COVID-19 will not be over when the first surge passes and we must be mindful we are talking about loss of services it is important to remember that these losses and this current crisis should be viewed in the larger picture of access to healthcare.
  • Staff furloughs, shift cancellations and layoffs. The furloughs, shift cancellations and layoffs of staff have persisted throughout the COVID-19 state of emergency. While some hospitals and hospital systems have appropriately created programs to retrain and redeploy nurses to critical areas consistent with the intention of the call for elective procedure cancellations, others have not.
  • Transparency of financial assistance. In light of the tremendous economic assistance created through public dollars both at the federal and state level, there must be full transparency for the public on the allocation of those dollars for each of the facilities for whom they have been designated.
  • “Return to work” criteria. We again ask the state to establish a singular requirement communicated to and implemented by all institutions that includes two negative results at least 24 hours apart before the individual is permitted to return to work. 
  • Enlisting the public’s help. We support the directive released at the end of the week that the people should wear masks in public settings. In addition to this, we call on the governor to enact a number of additional measures.

Read the full May 4, 2020 MNA letter to Gov. Baker and more information at www.massnurses.org/COVID-19.

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Founded in 1903, the Massachusetts Nurses Association is the largest union of registered nurses in the Commonwealth of Massachusetts. Its 23,000 members advance the nursing profession by fostering high standards of nursing practice, promoting the economic and general welfare of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Legislature and regulatory agencies on health care issues affecting nurses and the public.


 

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