COVID-19 in long-term care: A nurse’s witness statement
Nurses and other healthcare workers in the frontlines of Ontario’s COVID-19 pandemic – especially in long term care, but increasingly in other sectors – are experiencing trauma. This is the result of sheer exhaustion, insufficient and late government action leading to escalating spread of COVID-19, episodes of public disregard for the necessary rules to contain the virus, and the excruciating loss of lives. And there is more – the muzzling of healthcare workers’ voices. There are hundreds, if not thousands, of untold stories of devastation, which workers keep for themselves for fear of repercussions.
Nurses are more and more confiding on RNAO and we are hearing about what happened during the first wave of COVID-19, and what is happening now. These accounts of preventable illness and death take added gravity as we count with 1,855 new cases in Ontario today – many preventable.
RNAO is inviting nurses – RNs, RPNs and NPs – and other healthcare workers to speak anonymously through us. Please write in full confidence to dgrinspun at rnao.ca with copy to pgbatten at rnao.ca
Next we present with permission and unedited, the words of a registered nurse who has asked to remain anonymous. She was redeployed to a long-term care home in COVID-19 crisis in the spring. What she found is unbelievable and disturbing. The long-lasting personal impact on this nurse is palpable. Here is her account:
COVID-19 is once again surging and claiming the lives of residents in long-term care (LTC) homes, and the government is only offering weak or temporary solutions to a deeply flawed system.
Early on in the pandemic, my coworkers and I were redeployed to a COVID-19 unit at a LTC home in critical need of support. When we arrived, it was very quiet and there were no staff to be seen. It took some time to find the only healthcare worker on site, an agency nurse. She looked frantic and informed us she was in the middle of working a double shift.
None of us had been given training or any kind of orientation upon entering this LTC home. Looking around and assessing the situation – it was worse than we had anticipated. Residents were in their rooms, but many had not been assessed, changed, fed, or cared for in hours. We quickly decided to focus on basic necessities, but there was no infrastructure or support in place to help us meet this basic level of care. There was no access to information regarding residents’ dietary needs or social history, and we had no login passwords or access to medication records.
We tried to get in contact with the LTC home’s upper management, but had no luck, and it had already been some hours since arriving. Thankfully, in the middle of the day a personal support worker (PSW) arrived on her own merit, despite knowing that it was likely no one else would be coming in to help. She seemed genuinely worried about the residents’ well-being. This PSW guided us through the rest of the day, telling us the names of the residents and showing us where any limited supplies may be found.
Even with our combined efforts to provide basic care to the residents, we were failing. We found a resident on the floor and had to lift them back to bed. One resident was found lying in a different resident’s bed. Another was short of breath, at the end of their life, and dying with no one by their side. Our hearts were breaking, hopelessness set in and we were holding back tears. However, there was nothing more we could do but keep moving. We did not use the bathroom, eat, or sit for 12 hours and were afraid to remove our personal protective equipment.
As a nurse, I have frequently heard about the alarming and unique challenges the LTC sector faces. Now with the addition of COVID-19, this home was in a complete state of emergency. From my perception, they likely never had appropriate staffing levels and were hanging by a thread even prior to the pandemic. With the added stress of COVID-19, it seems that many LTC homes will not stand a chance.
Today, months have passed, and I still think about my experience and the residents often. I haven’t been able to openly discuss the details because as a nurse, we are discouraged from speaking out against the system in which we work. Nonetheless, our government was aware of the staffing shortages, among other complex challenges the LTC sector has faced for years. They have ignored many voices that have raised concerns regarding the state of the LTC sector. What will it take for our voices to finally be heard? How much more suffering needs to take place before more actionable changes are implemented?