Rhonda Bruce, Rehabilitation Assistant and Regional Vice President, BC Interior, Hospital Employees' UnionWhen the pandemic hit, all long-term care (LTC) sites had to have a COVID-19 safety plan. I am an Occupational Health and Safety Officer and I reviewed the plan with our manager. We thought our COVID-19 safety measures were adequate and we had no outbreaks all last year, till Christmas.
One activity worker, someone who organizes outings, games, social activities for residents, was re-assigned to do end-of-life calls with family members, taking an i-pad to the bedside and connecting the resident with the family in the last hours of their life. She crashed. She said "my job as a recreation aide is to do the fun stuff, activities and games. I'm not trained for this." During the first outbreak the Care Aides, on top of their regular duties, were assigned the work of preparing the bodies of residents who died, work normally done by the mortuary. That was really hard on them. An outbreak was declared at my site on January 5. I was not worried because we had our safety plan, but I have to say that nothing prepared us for what we would have to do. On my wing there were 11 patients and 10 tested positive for COVID-19. We were instructed on proper donning and doffing of PPE -- gowns, gloves, masks, goggles -- which has to be done in a certain order and methodically. The problem was that we were already short-staffed. Residents had to be isolated and eat in their rooms, some needing extra care because they had symptoms. Now every single time we entered a resident's room the PPE routine added about 10 minutes. One Care Aide was looking after 11 residents, 10 of whom had tested positive. Just imagine, for meals, it takes 20 minutes just to don and doff PPE to deliver and pick up the tray, times 11 residents in isolation, over three hours per meal. It was impossible. A big problem is that workers were not involved by Infectious Control in working out how to keep themselves and the residents safe. Infectious Control came in and issued orders but the "how to" was never discussed and we did not have enough staff. The first two weeks were exhausting and we could not provide the care that people needed. Once we finally had enough staff we could work calmly. There were no contaminations after the increase in staff, people could take their time, talk to the residents, spend some time with them. In a COVID-19 outbreak you live with heightened anxiety all the time. There is constant stress and concern for your residents who are isolated in their rooms, away from family and all social contact except with staff. There is constant fear of catching it, spreading it to residents, to your own family. There was one infectious control nurse for the south part of the Health Authority at the time of the first outbreak. Now, after a second outbreak, there are six. That took a year.
We are post-outbreak and on constant high alert. We have to make sure we don't get complacent and are concerned about the variants. Since about halfway through the outbreak we have had enough staff and that has been maintained and has to be maintained after this is all over. (Photos: HEU, CUPE)
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The first
outbreak in our community was at the residence attached to
the hospital. They had no clear safety plan. When COVID-19 hit the
system was already running on overtime. There was not enough staff.
Every site was supposed to have a plan for bringing in extra staff as
part of their COVID-19 safety plan but it wasn't until about five
days into the outbreak that the Health Authority made a request for
more Registered Nurses (RNs) and Licensed Practical Nurses (LPNs). No
extra care aides, dietary or housekeeping staff were provided. The
problem is that RNs and LPNs only do hands-on care for complicated
cases. For most residents the hands-on care -- feeding, dressing,
bathing, toileting, mobilizing -- is done by Care Aides. Out of 59
residents, 53 tested positive and 22 died. At one point there was one
Care Aide on an overnight shift caring for 59 residents, many of whom
were sick. That worker is off work now from the stress and is not the
only one.
Another
thing that we needed was debriefs. We didn't have any until we pushed
for them. We needed them to deal with the stress and how that affects
us, especially workers with conditions like asthma, high blood
pressure, auto-immune conditions, complex family situations. We did our
best to help each other out, for instance we made sure
that one worker whose mother had cancer was assigned to work that kept
them away from direct contact with residents, things like that. I got a
debrief for my unit and it helped a lot. Debriefs are important for
workers dealing with trauma and are needed immediately and not months
later which is what has happened, if they happen at all.