WITH more than 40 healthcare workers (HCWs) and employees found to be positive for Covid-19 since March, nurses at San Lazaro Hospital (SLH) raised their safety concerns to the government as they face “the most dangerous fight in our lifetime.”
The Department of Health acknowledged the problem, and gave assurances, when sought for comment, that it was awaiting an explanation from hospital officials. It did acknowledge earlier that the problem of overworked health workers runs across most state hospitals, and this is why it had been doing emergency hiring of workers.
The nurses assigned at SLH stressed that winning the fight against Covid is far from reach as they are not being provided with the proper gear.
“As of today, San Lazaro Hospital has more than 40 cases of positive Covid-19 personnel: doctors, nurses, admins, aids and staff. Half of which are symptomatics and confined while others are self-quarantined. With this number, our healthcare service to the public is being jeopardized due to the following: Limited number of staff resulting in too much physical, emotional and mental exhaustion, shortage of supplies of PPEs [personal protective equipment] and N95, staff handling positive cases are instructed to reuse for a 12-hour shift, limited transportation and accomodation, insufficient stress debriefing amongst staff assigned to Covid-19 patients unjust salary and unfair implementation of hazard pay,” the Filipino Nurses United (FNU) statement on July 9 read.
The nurses assigned at SLH said they need “all the help and all the prayers that our nation can offer as we watch the tremendous increase of Covid-19 positive cases in our country.”
They noted, “We were trained to handle infectious diseases for decades but apparently we are now becoming the victims.”
Asked for comment on the concerns raised by the SLH nurses, the Department of Health (DOH) said, “We recognize the issues raised by representatives of FNU nurses of San Lazaro Hospital.”
In a Viber message to BusinessMirror, the DOH said, “We have sought for updates from Dr. [Edmundo] Lopez on how to address their needs.” Lopez is Hospital Director of SLH.
Addressing the issues
On Sunday afternoon, the DOH forwarded the statement of SLH on the issue that “acknowledged with utmost importance the dedication” of the nursing staff in facing several outbreaks and epidemics through the years.
“We considered them important partners in the promotion of our mission and vision as the referral center of infectious diseases in the Philippines.,” the SLH said.
The SLH management it addressed the reported more than 40 cases of positive Covid-19 personnel: doctors, nurses, admin staff, and aides.
“Just like in other hospitals, there were healthcare workers who turned out to be Covid-19 infected. The cases mentioned are the cumulative cases starting in March when we started the HCW Covid-19 monitoring by identifying risk of exposure and symptom-based testing to determine occurrence of infections among our frontliners,” the SLH said. There were staff who tested Covid-19 positive are not involved in Covid-19 patient care.
On the issue of the limited number of staff resulting in too much physical, emotional and mental exhaustion, the SLH said, “It is true and normal to feel the physical, emotional and mental exhaustion during this time of the pandemic that we have been dealing with for almost six months.”
“To address this, the management agreed on the work schedule arrangement proposed and recommended by Supervisors and staff of the Nursing Division that allows less days of work in a week for them to have more rest days.
Also, psychosocial and debriefing sessions are regularly conducted by our psychiatrist to address the mental and emotional concerns of the staff. Regular rotations every 6 months to other department areas are also done for change of clinical work environment.”
The SLH added, “With our current occupancy rate of only around 20 percent and with the almost the same number of staff that took care of patients at even 80-100 percent occupancy rate prior to the pandemic (during dengue, leptospirosis, and measles outbreak), management DON’T see reasons or basis for their claim of understaffing. In fact, the standard nurse to patient ratio is being observed accordingly. (e.g. 1:1 and even 2:1 nurse to patient ratio, at certain instances, in intensive care areas.”
On the alleged shortage of supplies of PPEs and N95, the SLH said that as the center of infectious diseases, they are fully aware of the importance of PPEs and N95 use, being the main tools to protect frontliners against Covid-19.
“At the current rate of admissions and occupancy, our PPEs and N95 are still sufficient that can still last for a month. The management is closely monitoring and doing daily inventories to ensure that supplies of PPEs including N95 are always available to cater to the needs and protection of our frontliners. Moreover, we follow the guidelines on the appropriate and proper use of PPEs depending on the health care workers’ risk exposure activity or procedures in the care of COVID19 patients. For example, in aerosol generating procedures, full PPE protection which includes wearing of N95 is a must.”
On the issue of staff handling positive cases who are instructed to reuse their face masks for a 12-hour shift, the SLH said that reuse of N95 is allowed under certain conditions within the policy and infection and control guidelines recommendation.
The SLH also denied there is limited transportation and accommodation, claiming that they have been providing transport services through their outsourced providers aside from their in-house transport services for staff needing these services.
“We also provided and even increased the number of rooms for the hotel accommodations for our staff, in addition to the temporary lodging facilities provided to them for their stay in the hospital.”
The hospital management disputed the claim of the FNU on inadequate stress debriefing among staff assigned to Covid -19 patients.
“As cited above, regular stress debriefing sessions are conducted for HCW, particularly those assigned in Covid-19 areas, in close coordination with the hospital Psychiatrist twice a month.”
As to the unjust salary and unfair implementation of hazard pay, the SLH said that they are compliant in giving salaries and benefits in accordance with budget appropriation and guidelines.
“We would like to assure the hospital staff that their safety and welfare is an important concern of the hospital management in the fight against Covid-19,” the SLH said.
Cebu nurses
Last week in Cebu City, some nurses were reporteds to have gone AWOL (absence without official leave) or resigned from their work, and some expressed plans to resign due to the “fear of the unknown” as the infections in the city remained high.
This was already revealed by Philippine Nurses Association-Cebu Chapter president Joseph Descallar in a television interview.
The Cebu nurses are also complaining of low salary particularly in private hospitals, understaffing, and no hazard pay.
The DOH did not reply when sought for comment on the issue raised by Cebu nurses.
Not asking for more
The San Lazaro nurses stressed to the government, particularly the DOH, that the leaders of SLH have gone “above and beyond the benchmarks” set for health workers.
“We don’t ask for more, we don’t ask for fame. We are thankful for the recognition but what we need most is PROTECTION. We are now holding tight to the very end of our hopes. Don’t make us as bait to the enemy, do not make us quit!”
“We are just voicing our needs. We also want to be safe…we deserve to fight for our lives,” the group concluded.
Image credits: Eric Paul Guanlao
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