Infection Preventionists Can Only Lend a Shoulder to Overworked Nurses

Nurses feel underappreciated and overused by hospital systems. That’s the main message last week when members of National Nurses United (NNU), a labor union boasting 175,000 members nationwide, staged protests across 11 states.

Bonnie Castillo, RN, NNU executive director, said in a statement that “the working conditions that our employers and the federal government are telling nurses and health care workers to endure are both grossly unfair and unsustainable…. We need permanent protections based on science, and we need them now because when nurses and health care workers aren’t safe, we cannot keep our patients safe.”

Nurses complain that an exodus of hospital employees from the workforce because of COVID-19 places extra strain on those who’ve remained on the job during the present Omicron surge. Many nurses are upset at new quarantine guidelines for health care professionals issued last month by the Centers for Disease Control and Prevention (CDC). They attempt to balance the safety of nurses against trying to keep hospitals as fully staffed as possible during the Omicron surge, and many nurses argue that the correct balance isn’t contained in the new recommendations.

The CDC shortened the recommended isolation time for health care workers exposed to COVID-19 in high-risk situations from 10 to 7 days. Because of staffing shortages, return-to-work policies for nurses might vary from hospital to hospital, and nurses complain that they are being told to return to work too soon after exposure to COVID-19.

How nurses are compensated—or not compensated—for time off, has also become a sticking point. Laura Gosselin, RN, a nurse in Maine, tells NBC News that last year when she had to quarantine because she’d contracted COVID-19, she had to use her vacation days, saying that that was “like a slap in the face.”

About working conditions during the Omicron surge, Gosselin tells NBC News that “we are just working our hardest and doing our best. I always felt like nurses were so respected and held in such high esteem. I feel like that has been pulled away. We still take care of our patients and want to take care of our community. But we deserve better. Our government and employer has let us down.”

Linda Spaulding, RN-BC, CIC, CHEC, CHOP, a member of Infection Control Today^®’s Editorial Advisory Board, says that she sympathizes with the nurses. “According to the CDC guidelines, if nurses are still sick at day 5, they shouldn’t be coming back to work yet. But they’re feeling pressure by their hospital to return to work because of the nursing shortage.”

This creates a frustrating situation for infection preventionists (IPs), as well.

“IPs can listen to the nursing staff but they’re pretty much powerless if the administration [of a hospital] is requiring them to return to work,” says Spaulding. “From what I hear from nurses, they’re going to try hard to take care of patients with COVID. But as soon as this surge is over, they’re going to leave nursing and if there’s another surge, we’re going to have even less staff than we have now.”

The question of another surge was raised yesterday at the World Economic Forum at Davos. Anthony Fauci, MD, the director of the National Institute of Allergy and Infectious Diseases and the chief medical adviser to President Biden, was asked if the Omicron variant—which appears to be less severe than previous variants—might effectively end the pandemic.

As STAT reports, Fauci said that “We don’t know, and we have to be openly honest about that.”

Other experts at the Forum warned that we can be hit with new variants of COVID-19 that we might not be able to handle. As STAT reports, Annelies Wilder-Smith, a professor of emerging infectious diseases at the London School of Hygiene and Tropical Medicine, told the Forum that “Omicron will not be the last variant. There’s a high probability we will have another variant coming up. The question is when and will it be less dangerous?”

On the other hand, other speakers highlighted the effectiveness of the vaccines and new therapies that are being concocted. However, they must be used globally, or the coronavirus will always have a place in which it can possibly mutate into a new variant. Even if vaccines can be distributed to countries that lack them, there’s no guarantee that they will get into arms, according to Richard Hatchett, who heads the Coalition for Epidemic Preparedness Innovations.

STAT: “Hatchett maintained a key issue right now is what he called ‘the last mile,’ a reference to ensuring that vaccines sent to low and lower-middle-income countries find their way into arms. Beyond sufficient supplies, there are concerns that many countries lack logistical and medical resources to vaccinate their citizens.”