Perina Gaines, a registered nurse, asked twice to be tested for COVID-19. A colleague of hers at the Department of Behavioral Health’s Comprehensive Psychiatric Emergency Program tested positive for the coronavirus disease, and Gaines became concerned that she too might be infected. She worries not only for herself, but for family members who she comes in contact with that have compromised immune systems, like her elderly mother or her nephew with systemic lupus erythematosus.
“I didn’t meet the criteria for testing,” Gaines says. She did not have any of the three commonly cited symptoms that would force a test: a fever, cough, and shortness of breath. “I am really, really concerned about becoming infected, because I see what it’s done to the other nurses that have been on the frontlines. Some of them have been able to combat it. Some of them have not.”
To keep her family from getting infected, Debra Washington has sacrificed hugs from her grandchildren, who used to embrace her as soon as she got home from working a 12-hour shift. Now, the 30-year veteran nurse goes straight to the bathroom to shower because she runs the risk of carrying the coronavirus. Washington has been exposed to a colleague who tested positive for COVID-19 at United Medical Center, where she works in the telemetry unit. In a letter addressed to her the first week of April, Washington was notified that she had been exposed and should monitor herself for 14 days in case she started experiencing symptoms.
“It may well have not even been given to me, because the time I would have needed to self-monitor had already come and went,” she tells City Paper. Washington says she received the letter on the 14th day after she was exposed.
For more than a month, the District of Columbia Nurses Association, the union that represents Washington, Gaines, and 2,000 other nurses and health care professionals in D.C. medical facilities, has been demanding that union members be tested for COVID-19 regardless of whether or not they show symptoms. DCNA leaders say nurses they represent work with COVID-19 patients while having to reuse personal protective equipment like masks. On April 22, Mayor Muriel Bowser announced that DC Health would expand the criteria to allow some asymptomatic individuals who have a history of exposure to be prioritized for testing. This includes health care workers.
“Individuals who are over 65, who have underlying health conditions, who are health care workers—those are the groups that we really want to focus on for asymptomatic testing,” DC Health Director Dr. LaQuandra Nesbitt said during the April 22 press conference. “We are not at a position at this time where we are asking for all asymptomatic individuals in the community to push into our system and ask to be tested.”
DCNA was pleased with the change, though they were not informed. Like everyone else, the union learned of the news when it was shared publicly. This appears to be a pattern. While the union has asked to be consulted when it comes to matters related to their workers and the pandemic, DCNA has only met with government officials, including Deputy Mayor of Health and Human Services Wayne Turnage, once since the public health emergency was declared on March 11. DCNA was also not invited to be part of the ReOpen DC Advisory Group, an assembly of community leaders, medical degree holders, and CEO types personally selected by Bowser to provide guidance on when and how to lift social distancing restrictions. There is minimal labor representation on any of the 11 committees broken up by sector.
“We know that it’s a busy, busy time for everybody, but we think that certainly communicating with the nurses union that represents 2,000 health care workers in the District would be advisable,” says DCNA executive director Edward J. Smith.
Increased access to testing ultimately brings peace of mind. One DCNA member already died due to complications from COVID-19: Noel Sinkiat, a veteran nurse at Howard University Hospital. Countless more are infected—the union does not know the exact number of nurses who have tested positive. During an April 27 press conference, Bowser said she could not release the total number of health care workers infected with COVID-19, although Nesbitt added that between 5 and 6 percent of the confirmed cases that have undergone contact tracing are among health care workers.
Only a few states, including California, track and report the number of health care workers who test positive for COVID-19. D.C. only publishes the number of St. Elizabeths Hospital employees who test positive or are quarantined due to possible exposure, and the reason why this is the only public medical facility D.C. reports on its COVID-19 website is not exactly clear. The DCNA president for St. Elizabeths’ nurses, Susan Nelson-Pierre, told City Paper too many of her colleagues were out due to COVID-19 in mid-April, creating staffing issues at the city’s only public psychiatric hospital. As of April 28, the number is 80. Separately, a spokesperson for the mayor tells City Paper there have been four cases among health care workers at CPEP—one nurse, one manager, and two administrative staff—and seven cases among health care workers at United Medical Center. The spokesperson says the public hospital could not break up the cases by job title.
Beyond testing, unionized nurses are having to advocate for other life-saving necessities like personal protective equipment. There’s still the issue of nurses having to reuse the same N95 mask during a 12-hour shift, or needing to bring a homemade mask because there just aren’t enough at work for everyone, Smith hears from his nurses. At CPEP, PPE is hidden in an undisclosed location because it’s such a hot commodity. At Howard University Hospital and UMC, nurses have relied on donated N95 masks from a “Masks For America” GoFundMe page.
Over the course of the pandemic, DCNA has made several requests on behalf of their members to both the D.C. government and hospital administrations. In a letter addressed to Nesbitt on April 27, DCNA asked DC Health to rehire furloughed employees to help with contact tracing and to notify health care workers within 48 hours when a patient or employee tests positive. “The health care system in the District of Columbia cannot afford an overwhelming number of medical professionals to be lost to the virus. The amount of stress the health care system would face in such a situation is unimaginable,” reads a letter signed by labor groups including 1199SEIU United Healthcare Workers East and Metro Washington Council AFL-CIO.
Unionized nurses at UMC asked management for hazard pay on April 6. In an email the DCNA staff attorney wrote to the UMC general counsel, they requested regular full- and part-time employees receive a premium pay of 35 percent of the nurses’ base rate per hour when they are working on a unit with COVID-19 patients. “Appreciation is good and we appreciate them to say ‘you’re heroes, you’re this, you’re that’,” says Washington, who serves as the vice president for unionized nurses at UMC. “I just wish that my facility … could show appreciation in other ways as well. Monetarily? Yes, that would be great.”
The union’s request for hazard pay has so far been rejected. “When it comes to hazard pay, UMC is evaluating the possibilities on how to recognize and support our team during these times. To date no medical facility in the District is offering hazard pay,” says UMC spokesperson Toya Carmichael in an email to City Paper. “At UMC—we are all in this together—and looking out for one another. We are proud of the team working so hard to keep our community safe and healthy.”
According to Smith, the union’s input has either “fallen on deaf ears or we don’t even get access to the decision makers here.” A recent example of this came when DCNA pushed back against a decision at Children’s National Hospital to temporarily lay off school nurses who did not agree to participate in DC Health’s efforts to combat the coronavirus pandemic. DCNA wanted reassurances that nurses would not have to work at testing sites and would be provided the appropriate PPE if they agreed to anything. Many of these nurses are older and medically frail, which is why they didn’t work in medical facilities to begin with. Of the 150 school nurses asked to participate, nearly 40 refused the new work assignment. They were laid off and their health insurance transitioned to COBRA.
DCNA says at least one school nurse has tested positive for COVID-19. The union believes the nurse got infected during an April 2 training, where roughly 30 volunteers gathered at DC Health’s headquarters on North Capitol Street NE without masks and gloves. A few days later, the nurse started showing symptoms, the union alleges.
In a statement to City Paper, a DC Health spokesperson said the agency follows guidance from the Centers For Disease Control and Prevention regarding social distancing by having people remain six feet apart and providing hand sanitizer along with cleaning supplies to disinfect work spaces. “Unless a person only has been in a single place in the past 14 days, it is not possible to state that their infection is caused by a single exposure,” says the spokesperson, citing widespread community transmission in the city.
This has been the hardest time in many nurses’ careers. This is true for Gaines, who’s been a nurse for 18 years. Six of those have been spent at CPEP, where she works with patients in mental health crises. Screening patients for COVID-19 is difficult when patients, many of whom are experiencing homelessness, can’t provide definitive answers because they are struggling with severe mental illness. Constantly changing guidance just adds insult to injury. Missing any bit of information could result in infection or even death. Health care workers writ large are under immense pressure, having to turn to one another for support.
“It is still a fear everyday, but since I’m so committed and have a passion for health care, I overcome the fear every morning after prayer, meditation, and getting to work with my colleagues,” says Gaines. “It’s the collaboration among the nurses that kind of get us through each shift each day.”