MNA Nurses Warn of Risks of Resuming Elective Procedures Without Precautions (Page 27)

FOR IMMEDIATE RELEASE

Contact:  Rick Fuentes
(o) 651-414-2863
(c) 612-741-0662
rick.fuentes@mnnurses.org

Amber Smigiel
(o) 651-414-2849
(c) 651-202-0845
amber.smigiel@mnnurses.org

(St. Paul) – May 4, 2020 – The Minnesota Nurses Association members are frustrated and disappointed with today’s decision to open the door for elective surgeries without adequate protection for workers. Nurses have warned the Governor, health officials, and hospitals that safety must come first before resuming elective procedures, including surgeries. With nurses currently unable to access adequate levels of PPE to address the COVID crisis, allowing elective procedures to resume will only put added strain on PPE distribution putting nurses, patients, and the public at risk.

Nurses have informed the Governor he will again be putting the wishes of the industry above the safety of nurses and other frontline workers. The pre-crisis PPE standards required that nurses regularly change masks and gowns with each patient and never reuse them. Deviation from these standards has resulted in unnecessary exposure of patients and workers to disease and was frequently met with discipline. Currently, however, reusing PPE for hours at a time is commonplace and PPE, specifically N95 masks, are being used upwards of 20 times until they disintegrate in some facilities.

Additionally, nurses have reported being forced to float between high risk non-COVID patients and COVID patients on the same shift, wearing the same PPE. Nurses believe that continuing this crisis standard of PPE use while adding non-essential surgeries will result in needless infection and death of patients and workers.

“MNA recognizes that resuming some healthcare procedures in the midst of a pandemic is a balance between ensuring that patients get the care they’ve been waiting for with the safety of those patients and the workers who care for them,” said Mary C. Turner, president of MNA.

In a letter of counsel to the Minnesota Department of Health, Turner laid out criteria that should be met before hospitals resume elective procedures, much of it based on recommendations from other expert healthcare organizations. This criteria included:

Prevalence of COVID-19 cases: there must be a sustained reduction in the rate of new COVID-19 cases in the relevant geographic area for at least 14 days before resuming elective procedures:

• PPE and supplies: There must be adequate supplies of Personal Protective Equipment (PPE) to meet pre-crisis CDC standards, medications, blood and bed capacity for planned inpatient surgery as well as outpatient surgery which requires an inpatient stay (which may be an observation status) due to patient’s not meeting discharge criteria.
• Staffing: healthcare facilities must have enough trained and qualified staff to safely care for elective surgery as well as COVID-19 patients, taking into account the increased need for breaks and time off to address worker exhaustion.
• Standards of care: health systems must prove they can safely care for elective surgery patients and COVID-19 patients without resorting to a crisis standard of care.
Screening and Testing: every employee, patient, visitor and vendor must be tested for fever and COVID-19-like symptoms; to reduce transmission of the virus by asymptomatic or pre-symptomatic people, every patient must be presumed to be a possible COVID-19 case and workers must take appropriate precautions
• Infection prevention: confirmed and presumptive COVID-19 patients and the workers caring for them must be kept separate from other patients and workers.
• Case identification: if a healthcare worker is exposed, they must be informed and placed on paid quarantine immediately for a minimum of 14 days, whether they exhibit symptoms or not.
• Oversight: front line healthcare staff must have a part in decision-making. Healthcare workers need a direct line to the Health Department to report concerns if healthcare facilities cannot meet these minimum criteria. Hospitals must report PPE levels daily to the state, employees and unions representing employees.
• Prioritization of elective cases: must be made based on scientific evidence, clinical judgement and patient need, rather than profit or cost-saving concerns.
• Community Considerations: some considerations for resuming elective surgeries will be different in small hospitals without COVID-19 admissions.

MNA nurses know it is essential that the conditions within hospitals assure both patients and workers that they will be safe, including nurses who are currently furloughed because of the stall on elective procedures.

“MNA nurses are eager to “get back to work” and provide patient care to those in need of elective procedures,” Turner said. “However, the risks to resuming elective procedures before healthcare systems can prove that workers and patients in all settings can be protected from infection, are deadly. We stress that healthcare systems must meet these minimum criteria before resuming elective surgery,” she continued in the May 2 letter.

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