Alex Kachik: Hello and welcome to Modern Healthcare’s Beyond the Byline, where we take a behind-the-scenes look at our reporting. I’m Alex Kacik, Senior Operations Reporter. Our acute phase and staffing reporter Ginger Christ joins me today to discuss labor shortages and new federal guidance on COVID-19 return-to-work policies. Thank you for coming to Ginger.

Ginger Christ: Thank you for inviting me Alex.

Alex Kachik: We published this last week about Guidance issued by the US Centers for Disease Control and Prevention on December 23, which provides advice for healthcare workers who have tested positive for COVID. There are different levels of agreement. The last two are contingency measures in a crisis. At the end of the contingency measures, they recommend that organizations, when they encounter staffing shortages, can bring back people who test positive after five days of isolation, even if they have symptoms, that is, mild symptoms, if they No negative tests were produced. So we spoke with some industry monitors, some nurses and frontline workers. What have you heard from healthcare providers about how it is implemented and how it affects their work?

read more: Nurses worry CDC guidelines will lead to more COVID-19 cases and deaths

Ginger Christ: Many of the health care professionals and associations we interviewed were clearly concerned. Throughout the pandemic, they have been raising concerns about the state of hospitals and healthcare facilities, in terms of things like infection control policies and personal protective equipment. So all I’ve heard from nurses and others is that they’re worried about this idea of ??not hurting. They worry about going to work and potentially exposing patients or colleagues, and then taking responsibility for it. And then possibly more spread of COVID and worse staffing. Alex, I know you’ve also spoken to nurses from several different health systems in different states and cities. What did they say to you?

Alex Kachik: I spoke to a nurse in Colorado and she forwarded me an internal memo that she wasn’t interested in. It said, “Employees and providers with symptoms of a runny nose, sore throat, body aches, or loss of taste or smell may continue to report to work unless symptoms worsen and you do not have to be tested for COVID 19.” Therefore, according to an August article in the U.S. A study in the Journal of the Medical Association, hospitals are using CDC guidance and these staffing shortages to say, “Look, we’ve got our backs against the wall. We’ve got nothing to do here. CDC says it’s okay,” believe, it The most contagious stages of the novel coronavirus were found to be before and after symptoms appear.

Alex Kachik: Hospitals house recently infected workers in the absence of immunocompromised patients, and inform patients and workers that they are operating under these emergency or crisis standards and how this will change operations, the guidance said. So it’s tough here because the CDC isn’t usually a decision-making body, and these workers are exhausted. Many of them have left the industry, compounding these shortages. At the end of the disclosure, Ginger, did you hear what the hospital was saying? What are these policies and how their operations might change if they communicate widely to their staff and patients?

Ginger Christ: Yes. The health systems I contacted generally indicated that they were adopting CDC guidelines. However, when I asked about disclosure, none of them responded to that article. They did say they would try, and many systems said they would try to prevent COVID-positive workers from working in areas with immunocompromised patients. However, none of them really answered whether they would notify patients or staff if a colleague or staff member came in while they tested positive for COVID. I know you talked to Stanford Health. what did they say?

Alex Kachik: At first, they sent me a very long statement that they were applying CDC standards, even if you have symptoms, and they are mild, and you don’t have a fever, you can come in. But after a few sentences, they said, “If you’re not feeling well, don’t come in.” So I asked them about this contradiction, and they said, “Thank you for pointing this out,” they revised, “First of all, if you’re not feeling well, , don’t come in.” So it’s hard here because hospitals in many cases want to do what’s best for their patients and staff, and they’re trying to digest that guidance and issue appropriate policies.

Alex Kachik: But one of the nurses said it speaks to some longstanding problems in healthcare that illustrate the vulnerability of this workforce, especially among nurses and respiratory therapists. I know Ginger, you’ve talked a lot about outgoing nurses. You write a lot about how nurses are leaving the profession and what has led to turnover in the past year or two. Your report shows why staff, doctors and nurses choose other careers and what are your takeaways?

Ginger Christ: Yes. As you said, there are some longstanding issues between employees and employers. I think a lot of these kinds of issues have surfaced during the pandemic, some of the issues that people are willing to address…like workplace issues, it’s an issue, but not necessarily life-or-death as it is now. Staff turnover was high as many nurses and others were exhausted. You know, they’ve been dealing with a pandemic since the beginning of 2020, they’re dealing with staffing issues, and it feels like they’re doing more and more and it’s not getting paid for it.

Ginger Christ: And you know, we saw healthcare professionals as heroes at the beginning of the pandemic, but now you’re also seeing a lot of hostility toward healthcare professionals. So that comes with a price, and that psychological factor. But at the same time, healthcare workers are going into these dangerous positions every day, going into these dangerous environments and doing the same things over and over again, and it’s definitely going to hurt them. um, yes. I know you had a similar conversation with an ICU head nurse.

Alex Kachik: Yes. This is a head nurse who is also the head of the Massachusetts Nursing Association. We didn’t mention that in the story, but she was at Brigham and Women’s College. For years, she said, they have criticized hospital administrators for not hiring enough nurses and having high workloads. I covered voting measures in Massachusetts, which I believe was in 2019. They tried to become the second state after California to pass a mandated nurse-to-patient staffing ratio, but were rejected. She said if it had passed, they might be in better shape now. As of now, they are closing beds. I don’t think it’s causing people to be turned away, but it’s just because they don’t have enough staff to take care of the beds.

Alex Kachik: From an infrastructure standpoint alone, a lot of capacity exists, but when it comes to staffing, that’s where the real bottleneck is. So one of the things we get into is the legal ramifications here. At least the attorneys I spoke with said the CDC guidelines were carefully designed to protect or insulate some of these health systems from potential lawsuits if some workers were to say they were exposed because of those policies. I don’t know if you’ve also heard lawsuits from your sources about whether this is disclosure or other workplace issues. Did you hear anything there?

Ginger Christ: Yes. It sounds like there might be some protection for workers just because this is a CDC recommendation. So there might be some protection there. However, when it comes to being like individual workers, this can vary from state to state, just based on their different rules on this. Another issue raised in disclosure alone is this morality. Like it may be legal to do so, but ethically, what should you do and how should you notify patients or staff of these potential COVID-19 exposures?

Alex Kachik: As of now, we’re hearing more and more hospitals go into crisis mode, which goes beyond what the emergency protocol says you can go back to work after five days of quarantine. It’s essentially like there are no limits. I know the Associated Press had a story earlier, I think yesterday, that some health systems were bringing in COVID-positive workers. So some of the providers we’ve spoken to do have concerns that not enough is being done to protect workers or patients based on the recommendations listed by the CDC.

Alex Kachik: But I guess it will take some time to work out. We have heard some initial reports of those who contracted COVID upon arrival at the hospital. Not necessarily from the hospital itself or when they were in that setting. It’s just that they weren’t admitted because of the primary diagnosis of COVID, which they later turned out to have. So this seems to be an ongoing issue. Ginger, have you heard anything from your sources when it comes to long-term changes in workplace conditions that may result from this?

Ginger Christ: Yes. I mean there’s been a lot of labor activity and union action throughout the pandemic, and we’ve seen a lot of places that weren’t unionized before. There’s been a lot of strikes, like paramedics standing up and demanding different conditions. From some of the contracts we’ve seen and some of the strikes, we’ve seen that the workers’ voice is indeed stronger than in the past.

Ginger Christ: Because they did show what some of their concerns meant and what those concerns meant, we’re seeing a difference… With Caesars’ contracts in California and some other western states, we’re seeing that they’re working on certain staffing Proportions and different things like paramedics feel like they’re in a safer position. Different infection control measures, different pay rules, and making sure people are rewarded for the sacrifices they make.

read more:
36K Kaiser workers plan one-day sympathy strike
Kaiser Permanente avoids strike with tentative deal

Alex Kachik: ginger. Thank you so much for sharing and sharing your reports and expertise with us. I’m very grateful.

Ginger Christ: Thank you so much for inviting me.

Alex Kachik: OK. And thank you all for listening. There is a link in the programme description if you would like to subscribe and support our work. You can subscribe to Beyond the Byline on Spotify or wherever you listen to podcasts. You can keep in touch with our work by following Ginger and I and Modern Healthcare on Twitter and LinkedIn. We appreciate your support.