ICU Surge Capacity, Safe PPE and Housing for all Frontline Healthcare Workers, Liability Protection, Ethical Decision-Making Among Highlights of New Massachusetts Nurses Association COVID-19 Letter to Governor Baker

The MNA is advocating for a consistent approach to COVID-19 utilizing the expertise of frontline nurses and healthcare workers

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Massachusetts Nurses Association

Apr 07, 2020, 09:38 ET

CANTON, Mass., April 7, 2020 /PRNewswire/ -- The Massachusetts Nurses Association, representing more than 23,000 frontline nurses and healthcare professionals in 85 healthcare facilities and the vast majority of RNs in hospitals statewide, calls on state officials and healthcare employers to immediately apply the experience and expertise of nurses and healthcare workers on the front lines of the COVID-19 pandemic in a new letter to Gov. Charlie Baker.

The MNA also sent Health and Human Services Secretary MaryLou Sudders a letter expressing concern about Steward Healthcare's sudden closure of two ICUs in contradiction to state law and without public notice.

"To effectively combat this pandemic, government officials and healthcare employers must listen to frontline nurses and healthcare professionals," said RN and MNA President Donna Kelly-Williams. "The leadership at every healthcare facility and every level of government must implement the recommendations coming from those at the bedside. Nurses and other frontline healthcare workers know what will enable them to fight this outbreak while protecting their health, and the safety of their families and communities."

The April 7 Gov. Baker letter, the Secretary Sudders ICU letter, and a new video of MNA Executive Director Julie Pinkham providing a COVID-19 update, can be found at www.massnurses.org/COVID-19. The letter released today is the fifth the MNA has sent about the COVID-19 pandemic to Gov. Charlie Baker, Secretary Sudders and the Massachusetts Legislature. The MNA previously sent letters on March 14, March 19, March 24 and March 31.

Highlighted Updates in April 7 Letter:

Universal N95 Masking. The absolute priority of every nurse and healthcare worker on the front lines of COVID-19 is being able to use proper personal protective equipment (PPE), especially N95 masks. Healthcare facilities are not making N95 masks universally available, even though science shows asymptomatic people can spread the virus. Nurses at Brigham and Women's Hospital and at hospitals such as those owned by Trinity Health in Springfield and Holyoke, Steward Healthcare and Berkshire Medical Center have called for universal N95 masking because their facilities have refused to implement the safest standard of protection.

From the MNA April 7 letter:

"The disastrous effects of failing to follow this precautionary standard for infectious disease control have been made clear in the recent distressing and unforgivable losses at the Holyoke Soldiers Home. These deaths were not inevitable. Rationing of PPE for 'when the crisis come' is a misguided approach that does not improve the situation, but rather invites the crisis by allowing the virus to spread, creating the very crisis people thought they were preventing. Irresponsible rationing of PPE will exacerbate the spread of COIVD-19 and lead to greater loss of life."

ICU Surge Capacity. The MNA is calling for an urgent expansion of ICU capacity, staffing and training for staff redeployed to help in the ICU.

From the MNA April 7 letter:

"With approximately a one week remaining before the estimated surge in Massachusetts, this is the week where clear identification of expanded ICU beds, staff and training must occur. A plan on paper is not enough – the beds should be identified and confirmed by the Department of Public Health (DPH) using appropriate criteria and the staff and training must be communicated and implemented this week to be prepared. …"

"Most recently we have seen Steward Health Care close an ICU at Nashoba Valley Medical Center in order to unilaterally move ICU staff to Morton Hospital. While the clinical staff objected to the loss of ICU access at their hospital, particularly when a nearby cluster of COVID-19 outbreak was occurring, Steward still closed the ICU and furloughed the staff."

Housing is a Critical Need. We are seeing some improvements to housing availability for some frontline healthcare workers, but not nearly enough. Nurses and other healthcare workers need housing options so they can effectively fight this pandemic. Housing helps them safely go to work without jeopardizing the health of their families and others in their homes and communities.

From the MNA April 7 letter:

"Centralized coordination between the state and all hospitality facilities and university/colleges must happen to ensure access for those health care workers who cannot safely return home without putting their families at risk – either while working or exposed and in quarantine. Progress has been made but substantial geographic pockets without access persist, such as western mass, the MetroWest area as well as the north shore area. As we have noted in previous communications, some hospitals and hospital systems have done a good job at addressing this need, but others have not."

Liability Protection for Frontline Staff and Volunteers. Nurses and other licensed health care professionals, including volunteers and new graduates, are being redeployed to treat COVID-19 patients. This means that many will be working in new or unfamiliar practice areas. We need to be sure they are protected from liability as they respond to this pandemic.

Legislation being filed by Rep. Denise Garlick, D-Needham, states, "all physicians, physician assistants, specialist assistants, nurse practitioners, licensed registered nurses and licensed practical nurses shall be immune from civil liability for any injury or death alleged to have been sustained directly as a result of an act or omission by such medical professional in the course of providing medical services in support of the State's response to the COVID-19 outbreak, unless it is established that such injury or death was caused by the gross negligence of such medical professional."

Similar legislation was signed into law in New York on April 3.

Prepare Now for Ethical Decision Making. Most healthcare facilities in Massachusetts have yet to establish a committee to make ethical decisions during the COVID-19 surge when adequate care resources are not available.

From the MNA April 7 letter:

"We are already hearing stories of various institutions making decisions of who to intubate and place on vents, though currently vents and ICU beds remain available in the Commonwealth. Much like N95 masks, the concept of rationing care has already invaded the thinking and decision-making process, causing extreme strife among and between clinicians and families. In the coming week as we prepare for these issues to become more prevalent, it is important that institutions have in place decision making groups that include front line staff of various disciplines along with clergy and social services support."

Read the full April 7, 2020 MNA letter to Gov. Baker, the Secretary Sudders ICU letter and more information at www.massnurses.org/COVID-19.

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Founded in 1903, the Massachusetts Nurses Association is the largest union of registered nurses in the Commonwealth of Massachusetts. Its 23,000 members advance the nursing profession by fostering high standards of nursing practice, promoting the economic and general welfare of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Legislature and regulatory agencies on health care issues affecting nurses and the public.

SOURCE Massachusetts Nurses Association