WORCESTER, MA — Saint Vincent Hospital nurse Marlena Pellegrino is seeing the new coronavirus on the inside, and she’s seeing it on the outside.
“This virus, this pandemic, is real,” she said Monday during a day off from work, admitting that at times she feels worn out. “I’ve never seen anything like it in my 33 years of nursing.”
Pellegrino represents more than 800 unionized nurses in Worcester, and she’s watched over the past few weeks as the new coronavirus has strained her hospital. Personal protective equipment — or PPE — is being rationed. Patients are isolated while they fight the deadly disease. Nurses and doctors are tired, beginning to crack under the stress of the pandemic.
And over the weekend, the outbreak hit home. Pellegrino’s uncle died Friday of complications from COVID-19 at UMass Memorial Medical Center in Worcester. Now the relative who cared for her uncle is hospitalized in serious condition with coronavirus symptoms.
Still, she’s doing her best as a nurse, a union leader and a citizen in the ongoing battle against the new disease.
The situation inside Saint Vincent Hospital is similar to that in hospitals across the country, she said. In Massachusetts, health care workers are preparing for a surge in coronavirus cases, which Gov. Charlie Baker said could come between April 7 and 17. There’s been a steady increase of coronavirus patients in recent weeks, Pellegrino said, and the hospital has devoted three units to COVID-19 patients.
“We expect within the next two weeks what’s happening in New York City and New Jersey will be here,” she said. “The surge is coming.”
The top concern for nurses at Saint Vincent right now is PPE. Nurses are getting one plastic gown and one N95 mask per shift, along with items such as gloves and face shields. The hospital has adequate supplies, she’s been told, but it’s unclear how long they will last. The Centers for Disease Control and Prevention has been lowering standards on PPE guidance, including reusing N95 masks, which some hospitals are doing.
In some parts of Saint Vincent, nurses and other staff wear only surgical masks, which don’t offer good protection against coronavirus. If a nurse is exposed, Pellegrino said, that person could be out of work for up to 14 days — not to mention the severe health risks.
Donna Kelly-Williams, president of the Massachusetts Nurses Association, has been urging Baker and Health and Human Services Secretary Marylou Sudders to strengthen PPE standards. Kelly-Williams said Tuesday that loose PPE guidance from the state could give hospitals cover to withhold supplies, putting health care workers at risk.
The shortage of N95 masks in the United States can be traced to China, where production of the masks has been concentrated. When China locked down due to the coronavirus, factories stopped making masks and other products. China is producing an N95 alternative called the KN95, but it’s not approved for use in the United States yet.
Massachusetts received nearly 900,000 pieces of medical equipment over the weekend from the federal government stockpile, including about 245,000 N95 masks, but that’s about one-third of what the state has requested, The Boston Globe reported.
Even if nurses get the right PPE, they are still being pushed to their limits by the pandemic.
More than half of the 840 nurses at Saint Vincent are scheduled on a flex basis, an arrangement where nurses can have their shifts canceled based on staffing needs. That’s happening to many nurses who would be assisting with procedures that have been canceled due to coronavirus, such as colonoscopies. Those nurses should be used in places such as the intensive care unit and the emergency room, or at least be trained to work there in case of a COVID-19 surge, Pellegrino said.
She wants Saint Vincent’s owner, Tenet Healthcare, to end flex staffing during the pandemic response. That way, nurses who are stressed while watching COVID-19 patients — many who need to be on ventilators — can have all the backup they need.
Saint Vincent CEO Carolyn Jackson said Tuesday that the hospital is working to double the capacity of the intensive care unit, including “flexing in” more nurses.
Working while wearing coronavirus-appropriate PPE is tough, she said. Tasks such as drinking water or going to the bathroom require nurses to undergo decontamination procedures as if they were heading into surgery.
She compared the situation right now to working in a MASH (Mobile Army Surgical Hospital) unit.
“There’s a mental fatigue and a mental worry and fear that I haven’t encountered,” she said.
There’s also some hope. Local residents have put signs up outside the hospital thanking the Saint Vincent doctors and nurses. The nurses bring each other jelly beans during the workday as a sign of support. Pellegrino and all the other nurses are driven to return to the hospital each shift because helping people is their calling.
“My job is to help people. My job is to care for people,” she said. “People need us.”
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