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| How a Nurse With No Paid Sick Leave Sees the Coronavirus Crisis | |
| (about 3 hours later) | |
| TACOMA, Wash. — When the coronavirus was first detected in a nursing home an hour away in Kirkland on Feb. 29, Lasana Bridges, a licensed practical nurse here, thought little of it. | TACOMA, Wash. — When the coronavirus was first detected in a nursing home an hour away in Kirkland on Feb. 29, Lasana Bridges, a licensed practical nurse here, thought little of it. |
| As a “traveling nurse” employed by multiple agencies, she has spent the last decade working in nursing homes all over the country, from Florida to Maine and now Washington. She isn’t quick to alarm. Covid-19, like influenza, is an infectious respiratory illness, and Ms. Bridges is used to treating patients with the flu. “People just panic and act,” she told me. “You should just slow down and use your common sense. It’s something I’ve had to do for so long, I’m just like, shrug.” | As a “traveling nurse” employed by multiple agencies, she has spent the last decade working in nursing homes all over the country, from Florida to Maine and now Washington. She isn’t quick to alarm. Covid-19, like influenza, is an infectious respiratory illness, and Ms. Bridges is used to treating patients with the flu. “People just panic and act,” she told me. “You should just slow down and use your common sense. It’s something I’ve had to do for so long, I’m just like, shrug.” |
| The nursing home Ms. Bridges was assigned to in Tacoma had her on the night shift, 6 p.m. to 6 a.m. As a black woman in Washington, she said, she had found that a lot of facilities weren’t “always respectful” to her. But she was enjoying this new placement. Her duties include administering medication, documenting patients’ progress, and inserting the occasional catheter. | The nursing home Ms. Bridges was assigned to in Tacoma had her on the night shift, 6 p.m. to 6 a.m. As a black woman in Washington, she said, she had found that a lot of facilities weren’t “always respectful” to her. But she was enjoying this new placement. Her duties include administering medication, documenting patients’ progress, and inserting the occasional catheter. |
| In the first days after the news of the infections in Kirkland, Ms. Bridges said she didn’t receive any specific instructions about the coronavirus, despite its peculiarly lethal impact on older people. There was anxious gossip and a big box of paper masks set out on a counter, but otherwise, “nothing’s been implemented, because there really is nothing,” she said. “There’s no special precautionary measure that can be taken.” In Maine, the home where she worked had dealt with an outbreak of norovirus. She wondered, would Covid-19 be just another flu or something much more dangerous? | In the first days after the news of the infections in Kirkland, Ms. Bridges said she didn’t receive any specific instructions about the coronavirus, despite its peculiarly lethal impact on older people. There was anxious gossip and a big box of paper masks set out on a counter, but otherwise, “nothing’s been implemented, because there really is nothing,” she said. “There’s no special precautionary measure that can be taken.” In Maine, the home where she worked had dealt with an outbreak of norovirus. She wondered, would Covid-19 be just another flu or something much more dangerous? |
| Now, she says, everyone is on heightened alert. A manager armed with a thermometer sits in the lobby of the facility where she works, checking the temperature of everyone who comes through — employees along with contractors and delivery workers. Anyone with a temperature of 101.5 degrees Fahrenheit or higher will be sent home. For Ms. Bridges, who is technically self-employed, that would mean no paid sick leave; she only recently obtained health insurance. | Now, she says, everyone is on heightened alert. A manager armed with a thermometer sits in the lobby of the facility where she works, checking the temperature of everyone who comes through — employees along with contractors and delivery workers. Anyone with a temperature of 101.5 degrees Fahrenheit or higher will be sent home. For Ms. Bridges, who is technically self-employed, that would mean no paid sick leave; she only recently obtained health insurance. |
| Another care worker I interviewed, Shelly Hughes, a certified nurse’s aide at North Cascades Health and Rehabilitation Center, in Bellingham, near the Canadian border, was in a similar position. She had public health insurance but only a few hours of accrued sick leave. She hoped her union might be able to get its members some version of short-term disability coverage if they contract an infection at work. | Another care worker I interviewed, Shelly Hughes, a certified nurse’s aide at North Cascades Health and Rehabilitation Center, in Bellingham, near the Canadian border, was in a similar position. She had public health insurance but only a few hours of accrued sick leave. She hoped her union might be able to get its members some version of short-term disability coverage if they contract an infection at work. |
| Nurse’s aides and licensed practical nurses like Ms. Hughes and Ms. Bridges do exhausting, often tedious work for the four million people in residential long-term care, in return for low pay and meager benefits. America’s long-term care system is already fragile, because of staffing shortages and a growing population of elderly people. The addition of an epidemic makes the situation even more perilous — for nursing staff as well as for patients. | Nurse’s aides and licensed practical nurses like Ms. Hughes and Ms. Bridges do exhausting, often tedious work for the four million people in residential long-term care, in return for low pay and meager benefits. America’s long-term care system is already fragile, because of staffing shortages and a growing population of elderly people. The addition of an epidemic makes the situation even more perilous — for nursing staff as well as for patients. |
| Over the past few months, I’ve read many accounts of nurses in South Korea and China. Some have left their families and worked round-the-clock shifts to battle the virus. Covid-19 had spread so aggressively, through such populous areas, that health care workers had no time to prepare, physically or mentally. In South Korea, the government has, at least, responded with the speed and on the scale that an epidemic demands. The authorities there have tested nearly 200,000 people for the virus, free of charge, some via drive-through booths that produce results in less than 10 minutes. | Over the past few months, I’ve read many accounts of nurses in South Korea and China. Some have left their families and worked round-the-clock shifts to battle the virus. Covid-19 had spread so aggressively, through such populous areas, that health care workers had no time to prepare, physically or mentally. In South Korea, the government has, at least, responded with the speed and on the scale that an epidemic demands. The authorities there have tested nearly 200,000 people for the virus, free of charge, some via drive-through booths that produce results in less than 10 minutes. |
| The Centers for Disease Control and Prevention, despite having weeks to prepare for the virus’s spread, reports having tested only 1,583 people as of March 5; state and local health services are just beginning to offer their own tests, and not always free of charge. Vice President Mike Pence, who was appointed the nation’s coronavirus czar despite his abominable management of an H.I.V. outbreak as governor of Indiana, announced that the C.D.C. would lift the rationing of coronavirus testing materials. | The Centers for Disease Control and Prevention, despite having weeks to prepare for the virus’s spread, reports having tested only 1,583 people as of March 5; state and local health services are just beginning to offer their own tests, and not always free of charge. Vice President Mike Pence, who was appointed the nation’s coronavirus czar despite his abominable management of an H.I.V. outbreak as governor of Indiana, announced that the C.D.C. would lift the rationing of coronavirus testing materials. |
| It isn’t clear, though, where the needed test kits will come from or how they will be distributed. Susan Zeman, a registered nurse at Swedish Hospital in Seattle, told me that the coronavirus has revealed that “American health care doesn’t have surge capacity.” | It isn’t clear, though, where the needed test kits will come from or how they will be distributed. Susan Zeman, a registered nurse at Swedish Hospital in Seattle, told me that the coronavirus has revealed that “American health care doesn’t have surge capacity.” |
| In Washington State, where the virus has spread largely through “community transmission,” not through contact with travelers abroad, 22 people have died and 162 have tested positive. Matt Thompson, a family physician at the University of Washington who works with the Seattle Flu Study, told me that a key intervention would be to develop a Covid test that people can take at home, like a pregnancy test. On Sunday, the Gates Foundation pledged to fund mass-production of an existing swab-based test, available for home delivery, pickup and processing by a lab at the University of Washington. | In Washington State, where the virus has spread largely through “community transmission,” not through contact with travelers abroad, 22 people have died and 162 have tested positive. Matt Thompson, a family physician at the University of Washington who works with the Seattle Flu Study, told me that a key intervention would be to develop a Covid test that people can take at home, like a pregnancy test. On Sunday, the Gates Foundation pledged to fund mass-production of an existing swab-based test, available for home delivery, pickup and processing by a lab at the University of Washington. |
| Officials here are moving quickly, in the absence of a federal plan. Gov. Jay Inslee has declared a state of emergency, directed all insurers to cover coronavirus-related treatment without co-payments and deductibles, promised to offer free testing to the uninsured, and advised residents 60 years and older to avoid crowds. | Officials here are moving quickly, in the absence of a federal plan. Gov. Jay Inslee has declared a state of emergency, directed all insurers to cover coronavirus-related treatment without co-payments and deductibles, promised to offer free testing to the uninsured, and advised residents 60 years and older to avoid crowds. |
| Things feel tenser than usual on the streets of Tacoma, where I grew up, and other cities in the Puget Sound area. At the library, I heard a man complain loudly, on his cellphone, about “Chinese carriers” of the virus, while a librarian repeatedly wiped down her work station. On the bus, passengers seem unnerved by coughs and sniffles and general proximity. Ms. Bridges, the Tacoma nurse, told me that she was more uncomfortable with her brother-in-law taking the bus to Seattle than her being at work. | Things feel tenser than usual on the streets of Tacoma, where I grew up, and other cities in the Puget Sound area. At the library, I heard a man complain loudly, on his cellphone, about “Chinese carriers” of the virus, while a librarian repeatedly wiped down her work station. On the bus, passengers seem unnerved by coughs and sniffles and general proximity. Ms. Bridges, the Tacoma nurse, told me that she was more uncomfortable with her brother-in-law taking the bus to Seattle than her being at work. |
| When I visited Ms. Bridges at her home, in south Tacoma, she offered her elbow, the new standard greeting of the region. She was resting up before another week of 12-hour shifts, for her work will continue, as ever. She will commute by Lyft, wear safety equipment as needed, and keep tabs on the coronavirus the way we all do, through internet research and “all the stuff on TV,” she said. | When I visited Ms. Bridges at her home, in south Tacoma, she offered her elbow, the new standard greeting of the region. She was resting up before another week of 12-hour shifts, for her work will continue, as ever. She will commute by Lyft, wear safety equipment as needed, and keep tabs on the coronavirus the way we all do, through internet research and “all the stuff on TV,” she said. |
| Ms. Bridges is trying to stay focused on being “there for the residents,” and she has no choice but to trust her superiors to act prudently. | Ms. Bridges is trying to stay focused on being “there for the residents,” and she has no choice but to trust her superiors to act prudently. |
| One of the Covid-19 deaths in Kirkland was of someone who had been transferred, while asymptomatic, from Life Care Center of Kirkland to a nearby adult family home, possibly contaminating a new facility. | One of the Covid-19 deaths in Kirkland was of someone who had been transferred, while asymptomatic, from Life Care Center of Kirkland to a nearby adult family home, possibly contaminating a new facility. |
| “I’m sure they’re going to be more aware of bringing people in,” Ms. Bridges said of her supervisors. “If people have symptoms, they won’t be transferring them into the facility. If it’s possible for them to come up with a test or vaccine, that’s the next step, but it’s a virus. There’s no magic pill to take care of it. We’re just kind of stuck with this virus.” | “I’m sure they’re going to be more aware of bringing people in,” Ms. Bridges said of her supervisors. “If people have symptoms, they won’t be transferring them into the facility. If it’s possible for them to come up with a test or vaccine, that’s the next step, but it’s a virus. There’s no magic pill to take care of it. We’re just kind of stuck with this virus.” |
| At the end of last week, Ms. Bridges received a job offer, via text message, from one of her placement agencies. There was an “urgent” need for a licensed practical nurse at an unnamed “skilled nursing facility in Kirkland.” | At the end of last week, Ms. Bridges received a job offer, via text message, from one of her placement agencies. There was an “urgent” need for a licensed practical nurse at an unnamed “skilled nursing facility in Kirkland.” |
| “That’s the coronavirus facility, isn’t it?” Ms. Bridges wrote back. There was no immediate reply. | “That’s the coronavirus facility, isn’t it?” Ms. Bridges wrote back. There was no immediate reply. |
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