Editor’s Note: This exclusive report is based on continuing conversations with Nurse T., who works in a New York City ICU that serves a largely impoverished Black and Hispanic community.
New York, NY – June has finally come and we are in a lull. Work in the ICU looks like it has gone back to normal, but of course, it hasn’t. Like malignant hypertension (high blood pressure), the silent killer that slowly destroys the kidneys, the damage wrought by the pandemic is still present, eating away our hearts. At our souls.
Because we are not the same. We will never be the same. How could we be, when our hearts have been squeezed until they burst? How could we be when our eyes have cried and cried until we have no more tears? When our bodies have become numb from the fatigue, and our hopes have been suffocated by so much loss? So much death?
How can we do the same work again when our nerves are shattered to the point that we can’t sleep, we can’t eat, we fight with our family and we have lost the love for our patients that sustained us for years and year and years?
The Fall promises to be another challenge, perhaps as great as the one we faced this Spring. Perhaps greater. We will see seasonal flu bringing waves of patients in through the ER and the clinics. We will see more Covid-19 patients. And we will see our staff hollowed out by illness, fatigue, and despair.
Do you really expect me to march back into battle and face the same enemy when my hospital is no more prepared for war now than it was in February and March? The oxygen ports in the wards have not been upgraded to a high flow system, so once again, we won’t be able to hook up ventilators there and support our patients who suffer from pneumonia and septic shock.
The ICU doesn’t have negative pressure fans to blow airborne pathogens like Covid-19 out into the free-flowing wind, where they will be safely dispersed. And don’t tell me that influenza patients only require “Droplet Precautions,” which is nothing more than a simple room with a door that’s closed. No. I want to be protected by a negative pressure or a HEPA filter that removes the viral particles when the patient coughs or receives a breathing treatment, so that the pathogens won’t settle in my hair and on my arms and my clothes and my stethoscope. I want to be safe. Really, truly safe.
The hospital hasn’t provided us with effective washable, reusable face masks that achieve the N95 level of filtration, like the elastomeric masks that construction workers and industrial painters use every day.
Of course, the hospital doesn’t have the money that we need to make those and other improvements. It is not a profitable private hospital with wealthy donors and high-paying patients. Our reimbursement rates are criminally low. The Federal government and the private insurers reimburse the “Ritchie Rich” hospitals at a rate that is up to three times higher for the same procedures. My hospital can barely pay the wages and the expenses under normal times. In a crisis, we are stripped bare.
No. I do not want to face the same nightmare scenario in the Fall until the City pays a lot more into the hospital for the services that we provide to the poor.
I don’t want to gear up again with my four layers of clothing until I know that Stores has all of the best PPE’s on the market to protect us – and our families – against whatever pathogen is invading our facility full blast.
I don’t want to go through those Emergency Room doors every morning if New York State has not increased its reimbursement rates for poverty hospitals like mine big — BIG time — so that the institution can hire extra staff when we need it most, like traveling nurses, extra housekeepers, extra lab technicians and extra morgue attendants.
And I most definitely don’t want to go through hell again, risking my life and the lives of my family, until the Federal Government raises its Medicare and Medicaid fees to a reasonable rate that will sustain and allow improvements that we so desperately need, and until it gives out-and-out grants for structural improvements, like upgrading the oxygen delivery systems.
Then I will gladly tie up my hair, hang my stethoscope around my neck, tuck my nursing shears in my pocket, clip my watch to my uniform and march with my fellow hospital workers back into battle, because that’s the deal I signed up for. That’s the oath I swore as a nurse.
That’s the love I have for my patients and my co-workers.
I’m ready to go…will you have my back?
Timothy Sheard, RN (retired), worked in hospitals for over 40 years. He is an author of nine medical mystery novels and founder of Hard Ball Press, a social justice imprint.