TRANSCRIPT
The Inside Story: Pandemic Nursing Fatigue
Episode 16 – December 2, 2021
Show Opening Graphic:
Voice of CAROLYN PRESUTTI, VOA Correspondent:
Inside the front lines of the pandemic.
Overwhelmed by the unending number of the sickest -- and at times – the angriest of patients.
The world’s nurses find themselves running out of patience.
Mawata Kamara, National Nurses United Member:
If a nurse had to choose between you know, keeping her job and coming home, you know, with a broken jaw or coming home traumatized every day…
CAROLYN PRESUTTI:
With infections spiking …
and concerns about the Omicron variant …
Why are nurses burning out and checking out in record numbers?
We explore on The Inside Story: Pandemic Nursing Fatigue.
The Inside Story:
CAROLYN PRESUTTI:
Hi, I’m Carolyn Presutti reporting from Washington ---
I’m standing in the center here in the newsroom at Voice of America ---
For nearly two years, our office space has been mainly dark, as employees continue to work through a global pandemic, mainly from home.
In a few moments ---we’ll go inside a different group of workers --- the nurses who had to report to work on the pandemic’s frontlines.
But first --- a new coronavirus variant. It was initially identified in South Africa. The World Health Organization identifies it as a “variant of concern” and has named it Omicron, after the 15th letter of the Greek alphabet.
President Joe Biden has issued a travel ban for eight African nations. His top doctor, Anthony Fauci, says it will be two weeks before the U.S. can measure Omicron’s effect.
VOA’s Arash Arabasadi reports on efforts to contain this new variant.
ARASH ARABASADI, VOA Correspondent:
Days after South African health officials announced the discovery of the latest coronavirus mutation, now known as omicron, travelers in Johannesburg say this feels like deja vu.
Lizette Buys, Traveler:
After being stranded for two years because of COVID and not seeing your family – my parents were deathly ill, you know – so I had to come back when the borders were open to come and see them and now only realize, well, it’s happening all over again.
ARASH ARABASADI:
Many countries have already started barring or restricting travel from southern African nations.
Dr. Joe Phaahla, South African Health Minister:
The reaction of some of the countries in terms of imposing travel bans and such measures are completely against the norms and standards as guided by the World Health Organization.
ARASH ARABASADI:
Dr. Phaahla called the travel restrictions “draconian.”
US President Joe Biden’s chief medical adviser, Dr. Anthony Fauci, said travel restrictions won’t stop the virus’s spread as much as it will buy time to act.
Dr. Anthony Fauci, Chief Medical Adviser to President Biden:
Utilize the time that you’re buying to fill in the gaps. And by time-biding, you learn more about the virus, you learn what its relationship is to the antibodies induced by the vaccines, and above all, you use this time to really, really put your pedal to the floor and get people vaccinated and get people boosted. It’s going to give us a period of time to enhance our preparedness.
ARASH ARABASADI:
Dr. Fauci went on to praise South African officials for their quick transparency in identifying and sharing details of the omicron variant. Fauci says it’s too soon to talk of lockdowns but urged booster shots and wearing masks.
Meanwhile, South African health officials continue studying the mutations against the efficacy of current vaccines. More than a dozen countries report at least one case of the omicron variant.
Arash Arabasadi, VOA News.
CAROLYN PRESUTTI:
Overwhelmed with patients, limited staff, and exhaustion, the toll of the pandemic is hitting registered nurses the hardest, especially here in the United States.
As some are learning to cope with ongoing grief and mental health issues, others are leaving hospital bedsides - which is creating a work shortage.
I spoke with a few nurses about this crisis and their strategy to manage this problem.
When U.S. President Joe Biden stepped onto the tarmac in Scranton, Pennsylvania, he met Jen Partyka.
See the white note in her hand? She handed that to the president.
Jen Partyka, Registered Nurse:
I did feel like it was important that he understand that the nurses are not OK.
CAROLYN PRESUTTI:
Partyka has been a nurse for 30 years. During the pandemic, nurses have worked nonstop and are still stretched thin. Partyka lost a colleague to suicide and has seen extreme exhaustion.
Jen Partyka, Registered Nurse:
We have been absolutely tapped. We have been, you know, fighting this fight. We did not expect it to go on so long.
CAROLYN PRESUTTI:
That has led to a nursing shortage.
Jen Partyka, Registered Nurse:
I've had a 50% turnover in the past year.
CAROLYN PRESUTTI:
The official recommendation is a 1 to 2 ratio of nurse to patient in the intensive care unit. Partyka says a nursing shortage is making it 1 to 3.
Jen Partyka, Registered Nurse:
That's the only way you get to go to ICU (intensive care unit) now is if you're really, really like the sickest of the sick, because there's no bed for you. So tripling those patients is incredibly dangerous.
CAROLYN PRESUTTI:
And that has led to burnout in the hospital emergency room.
Gi, Registered Nurse:
I was just crying so uncontrollably, and I couldn’t stop. It was a full-body cry.
CAROLYN PRESUTTI:
Gi, who asks that we use only her first name, had a panic attack while on the job. It temporarily paralyzed her ability to speak and function.
Gi, Registered Nurse:
All of a sudden, I couldn’t fill out a simple form. My brain was not making connections in the same way.
CAROLYN PRESUTTI:
The nurse became the patient. She now sews scrub caps for health care workers as part of her recovery after spending a week at a psychiatric hospital for PTSD (post-traumatic stress disorder). Gi says she wasn’t the only nurse being treated there.
As if COVID isn’t enough, nurses here in Philadelphia and in several other U.S. cities face an onslaught of patients from another menace. The homicide rate is skyrocketing.
VOA spent several hours on the streets with Philadelphia police. This is a double shooting. Police regularly load victims into their cruisers instead of waiting for ambulances. Some weeks the slayings equal the number of COVID-19 deaths.
Alex Kaspin, Philadelphia Nurse:
Every single day is like combat levels of casualties coming through our doors.
CAROLYN PRESUTTI:
Alex Kaspin works as a nurse at a Philadelphia hospital. After she developed a panic disorder, she was moved from the ER (emergency room) to a pediatric floor, which she said saved her life.
Alex Kaspin, Philadelphia Nurse:
There was a point in time where I felt like I was not present for my family. I was giving my all to my patients, but I don’t think there was much left over for me.
CAROLYN PRESUTTI:
When medical work affects a nurse’s well-being, experts call it “compassion fatigue.” The U.S. health care system is fighting a nearly two-year battle with no ending in sight, as nurses leave hospital bedsides and emergency rooms for less stressful work. Many, carrying their guilt with them.
Alex Kaspin, Philadelphia Nurse:
One way or another, I would not be able to continue with this job. I loved being an emergency room nurse. I really loved being an emergency room nurse. I think it was my true calling.
CAROLYN PRESUTTI:
The American Nurses Foundation surveyed nearly 10-thousand nurses in August.
34-percent said they were not emotionally healthy.
42-percent said they experienced some sort of trauma as a result of COVID-19.
Those numbers are significantly higher for nurses who work in the emergency room or intensive care units.
Among the many reasons: an increase in attacks against healthcare workers.
VOA’s Veronica Balderas Iglesias has an inside look:
VERONICA BALDERAS IGLESIAS, VOA Correspondent:
Clipped to his ID badge, nurse Benjamin Coe has something extra, a panic button.
Benjamin Coe, University of Missouri Health Care Charge Nurse:
I’ve only been physically assaulted by a patient twice, but every single shift that I’ve ever worked as a nurse, at least one patient is going to use curse words at me, is going to make violent statements towards me.
VERONICA BALDERAS IGLESIAS:
Coe says the COVID-19 safety protocols aren’t always welcome.
Benjamin Coe, University of Missouri Health Care Charge Nurse:
They are taking out their frustration on visitor policies. And the vaccines and the treatments have just been so over-politicized that it is politics at this point that’s driving the problems.
VERONICA BALDERAS IGLESIAS:
A September survey from National Nurses United shows that 31 percent of hospital nurses experienced workplace violence, up more than a third since March.
ICU Nurse Mawata Kamara says a national nursing shortage is partly to blame.
Mawata Kamara, National Nurses United Member:
We have more people getting agitated for things like waiting long hours in the emergency room. Unfortunately, the reality is that there are other patients that are equally sick, and I can only dedicate a certain amount of time to this patient.
VERONICA BALDERAS IGLESIAS:
After being assaulted, nurses can report what happened to supervisors or the police,
but they don’t always do so. On social media, however, they are not so shy.
Sandra Risoldi, Nurses Against Violence Unite:
Nurses are afraid to report anything because of retaliation, because of feeling like they are going to be blacklisted. Or they’re told by the facility not to make a report because of patient satisfaction scores.
VERONICA BALDERAS IGLESIAS:
That’s where accountability breaks down. No reporting means attackers can get off scot-free, explains Richard Mereu, of the Emergency Nurses Association.
Richard Mereu/Emergency Nurses Association:
We’re up to approximately 31 states that have felony laws. So, if you violently assault an emergency nurse, if you are convicted and it’s a felony, it’s generally a year of jail time or even more.
VERONICA BALDERAS IGLESIAS:
A proposed law in the U.S. Senate would require employers to protect
nurses and others from reprisal for reporting abuse. It also mandates tailored prevention plans.
The Maryland Hospital Association represents 53 hospitals and seven health systems. In the last five years, its members have taken multiple steps to prevent workplace violence.
Bob Atlas, Maryland Hospital Association CEO:
More cameras, more actual security guards, sometimes with canine.
VERONICA BALDERAS IGLESIAS:
But with all the politics in this pandemic, security only goes so far.
Bob Atlas, Maryland Hospital Association President & CEO:
The nature of health care in hospitals is such that you can’t eliminate the opportunity for harm. I mean, you’ve got to have caregivers and patients face to face.
VERONICA BALDERAS IGLESIAS:
Nurses like Kamara want a seat at the table when hospitals plan for safety.
Mawata Kamara, National Nurses United Member:
Nurses don’t want to quit. But if a nurse had to choose between you know, keeping a job and coming home, you know, with a broken jaw or coming home traumatized every day, I think a lot of people would choose that peace of mind.
VERONICA BALDERAS IGLESIAS:
The more than four million registered nurses in the United States have shouldered a huge burden in the pandemic. A little help from their patients, they say, shouldn’t be too much to ask.
Veronica Balderas Iglesias, for VOA News, Washington.
CAROLYN PRESUTTI:
In the U.S., the vitriol and violent rhetoric is typically about wearing masks and getting vaccinated.
Debbie Moore-Black has worked as a registered nurse on the frontlines for three decades.
She says COVID-19 has been unlike any other health crisis in history, and not just for the sheer number of sick people.
Let Debbie tell you what she told us --- in her own words:
Debbie Moore-Black, Registered Nurse:
‘You stupid ((expletive)). You don't what you're talking about. You're nothing but a ((expletive)). You're the one giving the misinformation not me.’ It's like, ‘please I can't even
deal with you.’
Hi. My name is Debbie Moore-Black and I'm a registered nurse and I've been an ICU nurse
for 33 years and recently a behavioral health nurse at a local hospital in Charlotte North
Carolina.
When I graduated from high school in 1974, my mother pushed me out of the house and said I had to be a nurse.
And eventually I was pulled to the ICU one day and then I became dazzled by all of the
mechanisms involved in ICU and I was hooked. An ICU every day is totally different
and it's nonstop and there is no 15 or 30 minute break. It's 12 hours grueling.
When HIV came out we were scared to death. And in fact our E.R. usually admitted most HIV
patients to the intensive care unit. And we did gown and glove, and if you even got urine
on your forearm, you needed to be tested. We were that scared.
But you know, it took time to education that, you know, practice your washing your hands and
things like that. But it certainly wasn't nearly as devastating or scary as COVID has been.
When covid came, the hospital was flooded with just covid and then your same day surgeries were kicked to the curb planned surgeries even emergency surgeries. If Charlotte wasn't
open to those patients and they had to go to another city and some patients, if it were an
emergency surgery needed, did not make it to that next city.
And we were flooded in in every unit whether it's an intensive care unit or a coronary care unit, it was COVID, COVID, COVID wherever you went.
I also helped out at the front entrance of the hospital. And of course, they could not go
any further past our desk without a mask on, and we fortunately have public safety
there to really protect us because we had many patient family members who were very belligerent and they were saying, I'm not going to wear this ((expletive)) and ((expletive)).
And we had a lot of profanities coming our way, total disrespect to us, and and and they were
refusing but there was this incredible amount of ignorance.
‘This is my rights. You are infringing on my rights are not going to wear a mask of you're not
going to force me to get the vaccine’ even though these are the same people who have had
Smallpox vaccine and polio and and all of those other vaccines that their mama made
sure they got as a youngster.
‘You should trust in God. He's going to protect you’ and then go on and on and on. And I just
stare that at them look toward the public safety They stand up and escort them out. I'm
66 years old, and you know I say my prayers, too, that I don't get COVID, because I could
be a target.
I wish people would respect science more than they respect social media, more than respect
their spiritual feeling that it's never going to happen to me.
A virus does not discriminate. It doesn't care if you're a Republican or a Democrat. It cares if
you don't get a vaccination. It cares if you don't wear a mask.
CAROLYN PRESUTTI:
In that August survey by the American Nurses Foundation that we mentioned a bit earlier in the show, 50 percent said they are considering leaving the profession. Now that’s half the nearly 10-thousand nurses surveyed.
And it is putting patients at risk.
I spoke with several nurses who opened up about their difficult decisions to leave the hospital jobs they love – and where they think America’s healthcare industry is headed.
A veteran emergency room nurse we will call “Clara” is so worried about her profession that what she is about to say could get her fired. Many months into the COVID-19 pandemic, Clara says hospitals are so short staffed that patients are dying in the emergency room who might otherwise be saved -- including one of her female patients.
“Clara” Registered Nurse:
Ultimately, by the time someone was able to get to her, she was at a point of disrepair, that's the best way I can describe that we weren't able to fix her. Then ultimately, she died. So that's, that's hard to … to carry.
CAROLYN PRESUTTI:
Family members are sent to hospital parking lots for lack of space as the sick wait most of the day to be seen.
“Clara” Registered Nurse:
People are literally shoulder to shoulder, you could be sitting next to someone that is COVID positive and you're not. It could be 6, 8, 10, 12, 16 hours before you get that care that you need.
CAROLYN PRESUTTI:
You heard right. She said up to 16 hours before any treatment.
Abigail Donley, IMPACT in Healthcare Founder:
It definitely is a crisis.
CAROLYN PRESUTTI:
Abigail Donley left the hospital ICU earlier this year to create the advocacy group IMPACT in Healthcare to fight for policy change. She spoke on Skype.
Abigail Donley, IMPACT in Healthcare Founder:
Nursing ratios are terrible, the workload has become unbearable, they are getting hit, verbally abused.
CAROLYN PRESUTTI:
The American Nurses Foundation says the pandemic is causing 9 out of 10 of nurses to think about leaving their hospital jobs. Half say inadequate staffing is the main reason. So where are they going?
Jonny, Nurse:
Travel nurse.
Clara, Nurse:
Travel nursing.
Abby, Nurse:
Travel nurses.
Michelle, Nurse:
Travel Nursing.
CAROLYN PRESUTTI:
“Michelle” doesn’t want us to say her real name because she is in the minority of nurses who are unvaccinated. She left her hospital when a COVID vaccine mandate was introduced. An agency hired her as a travel nurse to fly wherever she is needed for short contracts.
Michelle” Traveling Nurse:
I’ll literally be making in one week what it typically takes me a month to earn.
CAROLYN PRESUTTI:
Nurse Jonny Sorber loves his New Jersey job and his colleagues. The nurse in the middle left for a travel nurse job in Alaska that pays $10-thousand dollars a week.
Jonny Sorber, Registered Nurse:
It’s just absurd.
CAROLYN PRESUTTI:
Yet tempting for Sorber and his young family. Sorber says hospitals need to find a way to retain and lessen the stress on veteran nurses.
Jonny Sorber, Registered Nurse:
I think just higher pay -- at least something like higher pay, and there's always a shortage of nurses if you could like get the right amount of nurses so you don't actually have to work harder.
CAROLYN PRESUTTI:
We asked the American Hospital Association about that idea -- higher pay and more nurses. They had no official comment but sent VOA a document asking Congress and the Biden administration to intervene -- to “use its authority to investigate anti-competitive pricing” from agencies hiring travel nurses.
But for now, some hospital nurses are at the point of complete exhaustion with “compassion fatigue” a lowered ability to empathize.
They were thrown into a pandemic war beyond their control and are still fighting … with ever-fewer staff.
Michelle, Travelling Nurse:
So just try to be kind. We want to do what's best for you. And where we're at right now in healthcare, is really scary.
CAROLYN PRESUTTI:
In our weekly spotlight on press freedom spotlight, we are concentrating on Mexico, where covering crime is dangerous for reporters.
Eight journalists have been killed in Mexico since March of 2020 according to the Committee to Protect Journalists.
Even with state protections available, many Mexican reporters say they do not feel safe doing their jobs.
Reporting from Mexico from the U.S. southern border, Victor Castillo brings us one local journalist’s harrowing story of survival.
VICTOR CASTILLO, VOA Correspondent:
It was a day that crime reporter Jesús Humberto Gonzalez thought would be his last.
Jesús Humberto Gonzalez, Journalist:
Everyone thought I was dead, that's what still haunts me every day.
VICTOR CASTILLO:
The veteran journalist was on assignment, covering the discovery of dismembered bodies in a parking lot near Rio Bravo in Tamaulipas state, when he was suddenly confronted.
Jesús Humberto González, Mexican Journalist:
At least four vehicles with armed people intercepted me. They kidnapped me, took me to a cliff, put a gun to my head and literally pulled the trigger.
VICTOR CASTILLO:
The gun didn’t fire and Humberto González was eventually released.
But the memory of the day he was “levantado” -- a Mexican term for being kidnapped and beaten by members of organized crime - is seared in his memory.
Jesús Humberto González, Mexican journalist:
I believe that Iraq, Afghanistan, or war zones, are as dangerous as covering public security issues here. I imagine that is true not only in Tamaulipas, but also in Coahuila and Nuevo León.
VICTOR CASTILLO:
Humberto Gonzalez reported his case to a federal entity charged with protecting journalists and human rights activists, called the Mechanism to Protect Human Rights Defenders and Journalists.
Created in 2012, the entity offers safe houses and panic buttons to help protect social activists and journalists in a country where drug-related crime is rampant.
Enrique Irazoque Palazuelos, Federal Mechanism for the Protection of Human Rights Defenders and Journalists:
We have more than 90 percent impunity, which evidently increases the desire of the perpetrators to continue committing offenses, to continue committing crimes and to continue committing human rights violations.
VICTOR CASTILLO:
On paper, the practical safety measures would seem to offer a solution. Some 495 journalists are enrolled in the system. But critics say the body is ineffective.
Heriberto Deandar, Hora Cero:
It is evident that they are not well designed, it is evident that they lack criteria, it is evident that they lack resources.
Itzia Miravete Veraza, Article 19:
From 2009 to 2021 we have documented 141 cases of journalists killed in probable connection with their journalistic work.
VICTOR CASTILLO:
Overall, Mexico is ranked as the sixth worst country in the world for successfully prosecuting journalist murders, says the Committee to Protect Journalists. But even with a protection mechanism in place, many working in the media don’t feel safe.
Heriberto Deandar, Hora Cero:
I believe that not even companies can provide that type of protection, much less governments. Neither governments nor companies.
VICTOR CASTILLO:
For Humberto González, who still receives threats and says he is being watched, the protections offered by the mechanism does not bring peace of mind.
Jesús Humberto González, Mexican journalist:
If they want to kill you, they’ll kill you; I don’t see that there is justice in Mexico.
VICTOR CASTILLO:
Victor Castillo, for VOA News, Reynosa, Mexico.
CAROLYN PRESUTTI:
That’s all for now—just so you know --- this was my pre-pandemic desk in the VOA newsroom. I miss it. Here’s hoping that we all will soon be able to return to our normal lives.
Meantime, follow me on Twitter at CarolynVOA for the latest on the pandemic and other news.
Connect with us on Instagram and Facebook at VOANews.
And stay up-to-date online at VOANews.com.
For all of those behind the scenes who brought you today’s show, thanks for joining us. I’m Carolyn Presutti. I’ll see you next week for The Inside Story.
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