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The DC Nurses Association picketed outside Howard University Hospital this morning as part of a National Day of Action to demand employers address the medical staffing crisis as cases of the omicron variant of COVID-19 surge in the U.S. The “new standards of care” and norms around staffing levels hospital employers are applying both endanger nurses and reduce the quality of care, according to a DCNA statement about the Day of Action. 

“We don’t see this as a nursing shortage, we see it as a shortage of nurses that are willing to basically put up with these kinds of poor working conditions,” DCNA Executive Director Edward Smith told City Paper after the demonstration. 

About 30 to 40 demonstrators picketed at any given time, as per social distancing guidelines, throughout the two-hour rally. At-Large Councilmember Robert White and Ward 1 Councilmember Brianne Nadeau attended to lend their support, along with Metro Washington Council AFL-CIO President Dyana Forester. Protesters’ signs carried their core messages: “Staff Up for Staff Care!” and “Every patient deserves a nurse!” 

“Far too often I have received complaints from nurses who are assigned too many patients for them to provide the proper amount of time and care to all their patients,” Eileen Shaw, a registered nurse and chairperson of DCNA’s Howard University Hospital unit, said in a statement. 

Nurse supervisors are also pushing their staff to go to work even when they’re sick, Shaw said. When some of these nurses go to work, they end up having to leave anyway because of illness, she added.

“We’re … seeing the staff of the hospitals being affected by COVID-19 in the same way that we’re seeing the community is,” Patrick Ashley, senior deputy director at DC Health, said during a press conference Monday. 

DCNA is calling for city officials to introduce legislation that requires minimum staffing ratios, Smith says. California is currently the only state with permanent mandated staffing ratios for nurses, but New York recently passed legislation requiring hospitals to form committees that set staffing standards. While the limited public health emergency order Mayor Muriel Bowser issued on Tuesday might help the staffing crisis in other ways, one of its components—allowing medical facilities to lower its staff-to-patient ratio—can exacerbate staffing shortages, Smith notes. 

“If you’re my patient … and I’ve got five of you, the D.C. Hospital Association wants to add to my load,” Smith explains. “And that’s the exact recipe for disaster. It’s the opposite of what we’re asking for and need, and it will cause me to leave, or cause me to quit my job because it’s just too stressful, and it’s jeopardizing my license, and does not allow me to do what I joined the profession to do, which is care for patients.” 

Bowser’s emergency order is aimed at helping D.C. hospitals, some of which are facing staffing shortages of up to 25 percent, grapple with the spike in patients and COVID-related hospitalizations. It allows hospitals, medical facilities, and staff to alter standard operations, using “crisis standards of care” to guide their decision-making while dealing with scarce resources. Under these standards, clinics are able to put elective procedures on hold, authorize liability protections, lower the staff-to-patient ratio, and allow other care facilities to accept patients who don’t require critical care. 

The DCNA supports two of the order’s additional provisions: Allowing hospitals to hire medical staff licensed out of state as well as recent grads with supervision. These measures could help hospitals rev up efforts to hire nurses full time. Employers should also properly cross-train current staff nurses so they’re competent to work in other departments, especially in critical care where they’re now most needed, according to a statement on DCNA demands. 

Bowser’s order was a response to pressure from the D.C. Hospital Association to declare the emergency after weeks of reports from city health officials about overwhelmed emergency rooms. While there are enough beds, scores of residents showing up in ERs for COVID testing or mild symptoms lead to long wait times and tax understaffed medical personnel, according to the order. Unlike at the start of the pandemic, the concern is mostly around staffing levels and staff health, not patient capacity, according to city health officials. 

“This is different from 2020,” Deputy Mayor for the Department of Health and Human Services Wayne Turnage told WTOP. “In 2020, hospitals had real capacity issues. They weren’t losing staff. But the influx of sick patients was so significant that we had to make plans to expand the footprint of the hospitals. And this time, the response was to the hospitals’ cry that they were losing staff.”

The last D.C. public health emergency was in place from the onset of the pandemic to July 25, 2021. This one is slated to last less than 2 weeks, ending, as of now, on Jan. 26. Maryland and Virginia issued 30-day states of public health emergency earlier this month. 

While the limited public health emergency is designed to be temporary, as its name suggests, advocates like Smith are concerned that hospitals might unofficially leverage the “crisis standards of care” to prioritize profits over patients in the future. 

“We worry about having these emergency crisis changes be permanent,” Smith says. “The more patients you require a nurse to see, the more money you’re going to make.”

Ambar Castillo (tips? acastillo@washingtoncitypaper.com)

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