nUrsi Leslie McCarney is accustomed to 16-hour shifts, skipping lunch, the night ritual of throwing all her clothes in the washing machine and bathing as soon as she walks through the door to avoid potentially infecting her children. She is even used to looking for patients with Covid, who often come to the emergency room so short of breath that they try to describe their symptoms.
But despite the trauma and exhaustion of the past eight months, she was shocked when North Dakota Gov. Doug Burgham said last week that health workers who are positive for coronavirus but show no symptoms can still report for work. The order, which is in line with the CDC’s guidelines for alleviating staff shortages, would 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 threatens the workers themselves and their colleagues. This happens when North Dakota faces one of the worst outbreaks of Covid-19 and struggles with a shortage of health personnel.
“We’re worried someone will die, to be honest, because we couldn’t get to them in time,” said McCarney, a nurse at Bismarck’s emergency room.
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 are infected with the virus; almost one in 1,000 has died. In early November, the North Dakota Health Department announced that there were only 12 open intensive care beds in the state.
McCarney said Burgum’s order contradicted everything she had been taught as a nurse.
“If hospital administrators start forcing Covid-positive employees to go to work, it will be very scary. We are trained not to cause harm, and the request of Covid-positive, asymptomatic nurses to return to work puts patients at risk. This puts colleagues on staff at risk. “
Nine months after the pandemic, it is clear that health workers are already at increased risk. Lost on the front lines, a joint effort by the Guardian and Kaiser Health News is investigating the deaths of 1,375 health workers who appear to have died from Covid-19 since the start of the pandemic. Almost a third of these health workers are nurses.
McCarney described long shifts in the emergency department that began accepting patients at night because other departments on the hospital did not have the capacity to receive them. Nurses take additional shifts to cover colleagues who have fallen ill and take on several critical patients at once.
This is a scene unfolding in hospitals across the country as the coronavirus spreads without delay. As of Nov. 16, more than 11 million people in the United States had been infected with the virus, and health officials reported 180,000 new infections in a single day. And the country is preparing for another stage: it will soon surpass a quarter of a million deaths from Covid-19.
Healthcare workers are devastated and exhausted. According to a recent study by National Nurses United, more than 70% of nurses say they are afraid of becoming infected with Covid-19, and 80% fear they may infect a family member. More than half said they struggled with sleep, and 62 said they felt stressed and anxious. Almost 80% say they have been forced to reuse disposable PPE, such as N95 respirators.
The inaction at the state and federal levels has left many health workers feeling abandoned. When Governor Burgum issued an order that infected but asymptomatic nurses could report working in Kovid’s units, North Dakota did not fulfill any mandate for a nationwide mask, despite expert guidance that such a measure could significantly reduce the transmission of virus.
Tessa Johnson is a registered nurse at the Bismarck Nursing Home and president of the North Dakota Nurses Association, which issued a statement Wednesday rejecting Burgum’s order that the infected nurses continue to work.
She said the state could have done much more to ensure that patients were not infected at all. “We asked and asked and wanted a mandate, but that did not happen,” she said on Thursday.
On Friday night, Burgum made a face-off and issued a mandate, ordering people to cover their faces in public indoor businesses and public outdoor venues where physical distancing may be impossible.
“Our doctors and nurses, working heroically on the front lines, need our help and they need it now,” he said in a statement.
Still, Johnson said there was a link between what health workers experience in North Dakota health facilities and the way people perceive the virus. And that even before Burgum’s comments, some of her colleagues believe that they should choose between taking all precautions and limited rest. “One of my closest friends, also a health worker, told me the other day: ‘There is no way I can get tested unless I’m very sick because I don’t want to use my paid leave. “
McCarney, a nurse, said she had not had time to process the stress in the past few months. She focuses on maintaining health, preparing for what awaits a difficult winter, and keeping her patients alive. “We’re ready to break our backs and work as hard as we can physically,” McCarney said. “But then asking us to come in as a potential source of infection is simply stunning.”