nurse New York
New york state edition | april 2021
Tribute to the fallen pp. 8-9
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New York Nurse april 2021
Landmark bill provides a pathway for staffing ratios By Judy SheridanGonzalez, RN NYSNA President
Advocating for patients. Advancing the profession.SM Board of Directors President Judy Sheridan-Gonzalez, RN, MSN, FNP judy.sheridan-gonzalez@nysna.org First Vice President Anthony Ciampa, RN anthony.ciampa@nysna.org Second Vice President Karine M. Raymond, RN, MSN karine.raymond@nysna.org Secretary Tracey Kavanagh, RN, BSN tracey.kavanagh@nysna.org Treasurer Nancy Hagans, RN nancy.hagans@nysna.org Directors at Large Anne Bové, RN, MSN, BC, CCRN, ANP anne.bove@nysna.org Judith Cutchin, RN judith.cutchin@nysna.org Jacqueline Gilbert, RN jackie.gilbert@nysna.org Robin Krinsky, RN robin.krinsky@nysna.org Lilia V. Marquez, RN lilia.marquez@nysna.org Nella Pineda-Marcon, RN, BC nella.pineda-marcon@nysna.org Verginia Stewart, RN verginia.stewart@nysna.org Marva Wade, RN marva.wade@nysna.org Vacant Regional Directors Southeastern Yasmine Beausejour, RN yasmine.beausejour@nysna.org Southern Sean Petty, RN sean.petty@nysna.org Central Marion Enright, RN marion.enright@nysna.org Lower Hudson/NJ Jayne Cammisa, RN, BSN jayne.cammisa@nysna.org Western Chiqkena Collins, RN chiqkena.collins@nysna.org Eastern Vacant Executive Editor Pat Kane, RN, CNOR Executive Director Editorial offices located at: 131 W 33rd St., New York, NY 10001 Phone: 212-785-0157 Email: communications@nysna.org Website: www.nysna.org Subscription rate: $33 per year ISSN (Print) 1934-7588/ISSN (Online) 1934-7596 ©2020, All rights reserved
Eyes on the prize
Staffing legislation 2021
One of the most difficult situations we face as nurses, workers, students, and as individuals in our everyday lives, is managing what can best be described as “Victory Pathways.” Such pathways are not the ultimate solution to specific challenges we face. But they are most definitely building blocks toward a desired outcome. A negotiated contract is a perfect example of this, as is any compromise, or even passing one subject among many towards a degree. Such victories must be celebrated-they’re always the result of hard work and perseverance. But we can’t become complacent with such successes. This is what’s meant by “keeping our eyes on the prize.” Every victory provides a road to bigger successes — but it’s up to us to make those things materialize. The historic staffing legislation put forward in the State Legislature has provided us with a map.
Safe staffing is the most potent uniting issue among nurses and caregivers across the nation. NYSNA put forward staffing language over 17 years ago and members, leaders and staff have been struggling on every level imaginable to achieve minimum staffing ratios in law ever since. It’s important to understand that the bulk of donors to politicians come from large corporations and billionaires (often the senior staff of these very corporations!) via a series of loopholes in finance law. Among the biggest and most powerful corporations in the state of New York are — you guessed it — Large Hospital Systems, which are vehemently opposed to any staffing language at all, ever. This is the main reason we’ve not been successful in realizing the goal of establishing minimum nurse/patient ratios as outlined in our bill: “The Safe Staffing for Quality Care Act.” This is why candidates who run on a policy of refusing corporate donations are so important. And this is why Campaign Finance Reform is a premier issue for NYSNA members and for all
unions and community advocacy organizations.
Nysna member fightback yielded results In spite of the “power of the purse” that these hospital cartels leverage, the unrelenting actions of members, staff and leaders over the past year have resulted in a meaningful victory. Nurses have pushed the powerful forces of the state to do what our employers said would never happen: propose staffing legislation with specific metrics that will likely be signed into law. This is an extraordinary milestone, in spite of its complex provisions and the amount of work that will be required to give it more meaning and muscle. While the details of the legislation will be explored elsewhere, one thing is clear: our work is cut out for us. Town Halls, tutorials and workshops will be developed to arm us all with the necessary tools to utilize this language in the most effective ways. As we develop a statewide algorithm, each LBU will need to be activated to participate, engage and fight for the realization of the potential that is contained in every crevice of the language.
The traumas of the pandemic & its precursors Any nurse can tell you that due to the decimation, fragmentation and “robotification” of our practice over the decades, the cutbacks in health care, the dysfunctionality of a for-profit health care system, the absence of mandatory staffing ratios and an OSHA standard on PPE, the horrific outcomes of the COVID period were inevitable.
The way forward We still mourn our dead…and have yet to recover from our experiences and our own victimization — ongoing — of these utter failures of government, employer and regulatory agency alike. Protecting front line workers and the public requires all hands on deck. NYSNA is involved in such engagement on multiple levels.
The strength of our union lies with the involvement of our members. This is true no matter what the issue is. We can do a lot as individual leaders, but anything is possible when we are many and united.
NEW YORK NURSE april 2021
OSHA turns 50
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his month the Occupational Safety and Health Administration (OSHA) turns 50. It was created on April 28, 1971, but the battle against COVID-19 has made this anything but an occasion to celebrate. More than 3,600 healthcare workers are dead in the US, the majority under 60, disproportionately people of color. Roughly one in three were nurses. Workplace-related COVID illness and fatalities in healthcare and other industries are undercounted. According to the Wall Street Journal, “Infection sources have been publicly identified for just a small fraction of what Center for Disease Control and Prevention data show as 90,000 people of working age who have died of the disease.” OSHA’s role as the nation’s watchdog for workplace safety has never been more critical.
or suffered from injury or illness because of their job. It is observed annually on April 28 to coincide with the anniversary of OSHA’s formation. The number of worker deaths alone this year is unprecedented in the holiday’s history. In observance of Workers Memorial Day 2021, unions around the country are calling on OSHA to
Tip of the iceberg In 2020, worker complaints of COVID exposure in the workplace poured in from around the country — from UPS Worldport to Walmart, from Tesla to Tyson Foods, from nursing homes to e-commerce warehouses. Sick employees were pressured to work … Social distancing was not enforced … Or mask-wearing … Employees were never notified of co-workers’ infections. In January, using federal, state, and local government data and news accounts, Reuters identified 106 U.S. workplaces, “where employees complained of slipshod pandemic safety practices around the time of outbreaks. ... [OSHA] never inspected 70 of those workplaces, where at least 4,500 workers were infected by the coronavirus and 26 died after contracting COVID-19 ... As of midDecember, just 12 of the 106 facilities had been penalized.” The January report from Reuters on OSHA was anything but comprehensive: “most state and local governments do not track or publicize data on workplace outbreaks.”
Renew the promise Workers Memorial Day has been set aside each year since 1989 to commemorate those who have died
“Renew the Promise” — safety at work for all Americans. On his first full day in office, President Biden signed an Executive Order on Protecting Worker Health and Safety, which required OSHA to, “consider whether any emergency temporary standards on COVID-19, including with respect to masks in the workplace, are necessary.” An Emergency Temporary Standard (ETS) can be issued only if OSHA determines that employees are exposed to “grave danger” and that an emergency standard is “necessary” to protect them from that danger. Because OSHA has no infectious disease standard other than the Bloodborne Pathogens Standard, an ETS would allow for expedited action and the greater likelihood of employer citations and fines. The President’s Executive Order called for the ETS to be issued by March 15. That deadline came and went. While the fate of the ETS is at best uncertain, your complaints to OSHA are generating responses. OSHA has launched another effort, the National Emphasis Program (NEP), allowing OSHA inspections even when a complaint has not been
filed or when a workplace death occurs in industries where COVID exposure is high, including hospitals. This is a win for labor. The NEP mandates that 5% of each OSHA region’s total inspections be related to COVID-19. This is expected to amount to approximately 1,600 total inspections. OSHA has strongly encouraged the 28 states with their own state worker protection plans in place, such as NYS’ PESH and NJ’s PEOSH (both regulating public sector facilities), to adopt the NEP as well. States such as California, Michigan, Oregon and Washington already have their own COVID ETS in place. Virginia has made its ETS permanent. The NYS Senate and Assembly have just passed the NY HERO Act, championed by NYSNA’s own Assemblymember Karines Reyes. The HERO Act, if signed into law by the governor, would require the NYS Department of Labor to create an airborne infectious disease standard covering all private sector employers. NYSNA will continue to push for workplace protections for public sector workers as well. On March 26, OSHA launched yet another program aimed at fighting COVID-19: an updated Enforcement Response Plan (ERP) that calls for in-person worksite inspections of employers, targeting the healthcare industry, followed by meat processing and warehousing. Still, an ETS on COVID-19 conditions would pack a powerful punch. It could give workers and employers a baseline for safe working conditions and make it easier for OSHA to issue citations and fines against employers who do not comply.
Contact and airborne transmission standards needed The vast number of U.S. workers who have been, and continue to be, exposed to COVID-19 in the workplace is evidence of the need for a permanent OSHA standard on all infectious diseases. Yet there are no standards covering pathogens that are transmissible through contact or airborne exposure, saving employers millions of dollars at the expense of worker’s health and safety. As it stands now, the Bloodborne Pathogen Standard, adopted in 1991, is the only OSHA standard Continued on page 4
By Pat Kane, RN NYSNA Executive Director
Still, an Emergency Temporary Standard on COVID-19 conditions would pack a powerful punch.
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new york hero act
New York Nurse april 2021
A member weighs in The NY HERO Act, or the New York Health and Essential Rights Act, would require the Departments of Labor and Health to implement enforceable minimum standards for workplace safety. The regulations must include protocols on testing, PPE, social distancing, hand hygiene, disinfection, and engineering controls. Workers would also be given a direct role in monitoring and reporting violations through workplace health and safety committees and employees would be protected from retaliation for utilizing their rights under the law.
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y name is Flandersia Jones and I am a nurse at BronxCare Hospital. I am also a proud union member of the largest nurses union in New York State, the New York State Nurses Association. I stand here today to ask our elected officials in the New York State Assembly to pass the New York Hero Act. This bill will go a long way to taking care of New York’s essential workers, like myself. During this pandemic, we have honorably put our lives on the line so we can serve our communities. The most you can do for us and the least we are asking for, is to follow the science and keep us safe. We must put mandated protocols in place as soon as possible. This will save lives now and in the future. COVID-19 is still a threat and we have to be responsible in combatting it with the knowledge we have. To not do so is criminal.
OSHA turns 50 Continued from page 3
that covers infectious disease. It is estimated to have saved 9,000 workers from infection and 200 from death every single year. In lieu of its own standards, OSHA has traditionally followed CDC guidance on infectious diseases. Unfortunately, the CDC has not issued adequate guidance to protect healthcare workers and the public from COVID-19, particularly related to respiratory PPE and other controls to limit airborne exposure. Along with the CDC, the Food and Drug Administration (FDA) oversees standards for N95s and other medical devices. The FDA has moved away from “crisis standards” because of the glut of N95s and other respirators now available (on March 1 U.S. mask manufacturers wrote President Biden that nearly 300 million N95s or equivalents sit unused in warehouses).
Nurses have seen up close the havoc this disease has caused. Over 51,000 people have died from the coronavirus so far in New York. The deaths we experienced were largely due to essential workers not getting the protection they needed, despite demanding it. All we have been asking for is adequate PPE, social distancing, sanitizing supplies and sanitizing protocols.
Disproportionate impact Black and Brown communities have felt both the health and economic impacts of COVID-19 disproportionately. People of color are more likely to be punished for raising concerns at their workplace, increasing the risk of spread among workers and their communities. Undocumented workers are performing essential work yet remain inadequately protected, fearful The CDC is slowly heading in this same direction, stating that, “Once PPE supplies and availability return to normal, healthcare facilities should promptly resume conventional practices.” (See CDC’s “Strategies for Optimizing the Supply of N95 Respirators” updated April 9, 2021.) The CDC also states in this updated document that, “N95 respirators are intended to be used once and then properly disposed of and replaced with a new N95 respirator.”
The data keep coming It is time for healthcare facilities, which used earlier, weaker CDC guidelines governing healthcare worker protections, to follow the newer guidance and return to the standard of protection and care that healthcare workers and patients deserve. The fight to make OSHA and CDC more responsive to the needs of the people is our fight.
Flandersia Jones, RN
of seeking medical attention, and ineligible for any economic relief. This is unacceptable! We need to ensure that every worker has the right to voice their concerns without retaliation. We should encourage this, because it will ultimately make us all safer. All workers should be given the right to assemble and have a say in the health and safety within their places of work regardless of whether they have a union or not. New York can pass critical legislation right now that will protect essential workers and prevent more deaths. Let’s make sure our essential workers feel supported rather than expendable. We can’t waste any more time. Let’s pass this bill! Peer-reviewed research from Harvard University’s School of Public Health, published in November “found a correlation between a rise in OSHA complaints in a specific region and a rise in COVID-19 deaths within four weeks in the same area,” underscoring the need for rapid follow-up from OSHA on worker complaints. Hospitals are designated by OSHA as “high exposure risk” workplaces. In 2020, according to Reuters, OSHA “closed out complaints from about 1,800 hospitals and nursing homes.” Onsite inspections were conducted at about 15% of those facilities. Of that 15 percent, just one in five was fined. As nurses on the frontlines, we have lived daily with the staggering human cost of this pandemic. We are calling on OSHA, on the occasion of its 50th anniversary, to act now. Renew the promise: keep America’s workers safe and injury free.
around our union
NEW YORK NURSE april 2021
Ellis nurses speak out for patient safety
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n April, nurses from Ellis Hospital in Schenectady spoke out about how the COVID pandemic has strained essential service and staffing at the hospital. They are regularly understaffed in the ER, in the ICU, and on the Medical-Surgical floors — putting patient safety at risk. Nurses feel that the Administration used COVID as an excuse to reduce and eliminate some essential — but less profitable services — like inpatient mental health and pediatrics. Not only has healthcare access been reduced for patients who need these services, but extra strain has been put on the ER. “Our patients are holding for hours and sometimes days in the ER,” said Fred Durocher, RN, a 25-year veteran ER nurse at Ellis. “Patients deserve a higher level of care and enough nurses to care for them. Every hospital has its own staffing standards, but they always have an excuse for not meeting them. When companies won’t do the right thing, government should step in.”
Safe staffing is critical Nurses interviewed with local reporters, letting the public know about their concerns. They explained how understaffing in just one or two units of a hospital can have a major impact on the qual-
Cathy Dawson, RN
Denise D’Avella, RN
ity of patient care throughout the hospital. When hospitals fail to staff a safe number of nurses and caregivers in one unit, it has a ripple effect. It can create longer wait times for patients, delays in lifesaving care, or the delivery of care in units that are not adequately equipped or staffed with specialty-trained nurses. OR nurse Cathy Dawson explained: “I work in the Operating Room, where I only take care of one patient at a time — in accordance with New York State law. Staffing in the rest of the hospital is very uneven and should also have safety standards, because all the units function together. There’s no way one person can provide quality care to three or four critically ill patients at the same time. When there’s no room in the ICU
or on the Medical Surgical floors, patients are sometimes held in units not equipped to deal with them; for example, we recently had five patients on ventilators in the ER. New York must prioritize the safety of the patients and nurses in our hospitals by passing a safe staffing law.”
The evidence is on our side NYSNA released Protest of Assignment data, which documented nearly 300 official complaints filed by more than 1,000 nurses about understaffing at Ellis Hospital in the last two years. The data showed that the problem of understaffing did not begin with COVID, but it did hamper the healthcare system’s response to the pandemic and continues to be a problem. “We need safe staffing more than ever, especially in the critical care areas, where we’ve seen an exodus of experienced nurses as the COVID pandemic has worn on,” said Denise D’Avella, RN. “It’s so important to have experienced and well-trained nurses throughout a hospital but especially in critical care, because no one wants to be on the receiving end of learning by trial and error. Hospitals are increasingly being run like a business, and they’ll continue to cut corners on safe staffing unless the public and the legislature demand better.”
“Patients deserve a higher level of care and enough nurses to care for them. Every hospital has its own staffing standards, but they always have an excuse for not meeting them. When companies won’t do the right thing, government should step in.” –Fred Durocher, RN
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New York Nurse april 2021
Putnam nurses fight back against reduction of Putnam County health services
O “We hoped that once the COVID surge was over, our staffing levels would go back to normal, but the administration is still keeping the hospital short-staffed. Nurses want to provide the best quality care possible, but with short staffing and now the layoffs, it has been a challenge.” –Maura Rooney, RN
n April 7, nurses at Putnam Hospital got official notice of service reductions/ closures and job elimination affecting 11 staffers, including seven NYSNA nurses who helped save lives during the COVID pandemic. The notices came as a blow after nurses, inflicting with another COVID surge in December, beat back a similar threat late last year. The patient census in surgical services has not gone back to pre-COVID highs, and that’s the excuse that Putnam management is using to cut services and eliminate jobs. Of course, during COVID surges management had no problem moving these nurses out of their specialties with minimal training, extending their hours, and completely flipping their schedules, in order to handle the surge. “During the COVID surges, surgical services nurses went above and beyond and helped in every way that we could,” said Jeannie Carey, RN. “You can’t imagine how emotional it’s been to be treated like just a number and to see my colleagues targeted for layoffs.”
Rolling the dice with healthcare As COVID cases in the county remain stubbornly high, Putnam Administration is rolling the dice with the community’s health by reducing services and staff. As the only hospital in the county and a safety net, Putnam should be adequately staffed and prepared to deal with the ongoing pandemic. Unfortunately, that’s not the case. Nurses in critical care and the Medical-Surgical floors are reporting chronic understaffing that puts patient safety at risk. Using recent 2021 reports into the NYSNA text reporting system, nurses in Putnam’s Intensive Care Unit texted in staffing reports 56 times, 36 of which reported
Putnam Ambulatory Surgery nurses went above and beyond
unsafe staffing, where the nurses had more than two patients at a time — nearly 70% of reported times. In a Medical-Surgical unit, where NYSNA’s safe staffing legislation requires 1 nurse care for a maximum of 4 patients at a time, nurses made 54 staffing reports, and indicated unsafe staffing levels with ratios greater than 1 to 4, 45 times — more than 83% of the time. Instead of looking for cost savings elsewhere, Putnam Hospital is balancing its budget on the backs of its COVID nurse heroes and patients’ access to care. Although Putnam and Nuvance were awarded hundreds of millions of federal stimulus dollars to stabilize their operations due to the COVID pandemic, it’s impossible to know how they spent that money.
Profits over patients A few years ago, Putnam Hospital became part of the Nuvance Health System, headquartered in Connecticut. One of the smaller hospitals in Nuvance’s system, Putnam received little attention, until recently. New managers were brought in from Connecticut and “efficiency consultants” were hired. Now, nurses fear that the cuts that
are being made will affect the quality of care they’re able to provide. “I’ve always loved coming to work, but the layoffs and the stress of the pandemic have left nurses, including me, physically and mentally taxed,” said Maura Rooney, RN, local bargaining unit Vice President at Putnam Hospital. “We hoped that once the COVID surge was over, our staffing levels would go back to normal, but the administration is still keeping the hospital short-staffed. Nurses want to provide the best quality care possible, but with short staffing and now the layoffs, it has been a challenge.” Nurses are worried that this is the beginning of a “death by a thousand cuts” for their community hospital. There are rumors of more cuts coming down the line, including in telemetry and the ICU. The hospital only has 10 ICU beds, so any reduction would be potentially devastating. Nurses spoke out in the media, because the community deserves to know what’s happening at their hospital — before it’s too late to fight back. Nurses at Putnam plan to continue to fight for the safe staffing and essential services that their patients need and that their community deserves.
around our union
NEW YORK NURSE april 2021
“They play with our hearts” Tonia Bazel, RN, has been a registered nurse for 24 years. For the past 2 1/2 years she has worked at Albany Medical Center in an infectious disease unit. Nyn: What was your experience last year? TB: When it all began it was extremely nerve racking. Initially our unit and another were set aside for covid patients. Our ratios were 1:3 and we were issued papers. It worked out. We were handling things. Nyn: When did that change? TB: More patients started arriving and conditions changed radically. Our access to face masks was decreased and we started running out. The N95s were sent out for cleaning and reused six or seven times. We knew that the N95s in this condition did not provide the protection we needed. Nyn: How did you react? What made a difference? TB: We were united in our strong objection to the N95s and their very compromised condition. I was interviewed by osha twice, most recently in February. They wanted to know about our ppe. By that time policy had changed, but they were still recycled. With the osha citing finally change came about. Now we get an N95 when needed. Still, before covid we would have been written up for this use! Nyn: Can you explain the path that staffing followed? TB: It was 1:3 and it went to 1:4 and it kept going up, to 1:5 and 1:6. 1:6 was a breaking point for us. Nyn: Where does it stand today? What are the pressing issues? TB: There are two enormous issues. The largest issue is ratios: icu, MedSurg. It’s pervasive. We are trying to get New York State to recognize that no more, that ratios on MedSurg should never exceed 1:4. The second issue is wages and benefits, that is medical insurance. At amc, wages have been frozen for us. This happened during the pandemic year. Management is doing the very least necessary
to stop staff bleeding. They want senior nurses to leave. They want rns who signed for the union to leave. Even new nurses are leaving. There will come a point where patients will stop using the hospital.
stressful. They do their 13 weeks and move on or they float to another floor. Nyn: What trends have you identified? TB: The hospital’s priority is not to fund the bedside. Outpatient clinics that cover cardiology and same for gi — that’s their priority.
Nyn: What is the role of agency nurses?
Nyn: How do you feel when you get home after a shift?
TB: The hospital is loaded with agency nurses. Many of them are unskilled for the unit to which they are assigned. Two weeks ago I was working with another staff nurse and three agency nurses. They don’t know our blood infusion policy. They are not familiar with our pumps. Agency nurses float. So they change day to day!
TB: I feel that they are not taking acuity into consideration. They save money at the bedside. To them, nurses are replaceable. They play with our hearts.
Nyn: Have you gotten to know the agency nurses? TB: Agency nurses at amc have complained that amc work is too
NYN: What keeps you going through these difficult times? TB: This is when you need a union most — when we need more than anything support for each other. The union is based on that idea. The hospital needs to know that with our union we’ll fight back very hard.
Tonia Bazel, RN
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New York Nurse april 2021
TRIBUTE to the fallen “We cannot ensure safe, quality care without the staffing ratios for nurses reviewed by professionals in the nursing field and set out in peer-reviewed studies. Here in NYC at our public hospitals, virtually none of our units, including critical care, are staffed even at close to appropriate ratios. That short staffing can be measured in lost lives. Now is the time to make safe staffing the law in New York so that all hospitals in the state are ensured life-saving levels.” NYSNA Board Member Judith Cutchin, RN, President, NYSNA's NYCH+H/Mayoral Executive Council
NEW YORK NURSE
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n April 1, nurses and supporters gathered at Greeley Square in Manhattan in a solemn and emotional gathering to honor the fallen. NYSNA members who died from exposure to COVID-19 were remembered by their colleagues and NYSNA staff. “Nurses have been on the frontlines battling COVID for a year,” said NYSNA Executive Director Pat Kane, RN, “often lacking the resources they need to properly care for their patients and protect themselves. Many of them have been infected, some suffer from
april 2021
ongoing complications, and others were ultimately taken from us.” “I am an ICU nurse and have been caring for patients with COVID since the first surge," said Katie Paccione, RN, New York Presbyterian-Columbia University Medical Center. “When two patients need us at the same time we do our best to provide quality care to both. We should never have been in this situation to begin with.” Dedicated caregivers helped save more than 150,000 New Yorkers. But the nurses can be heard saying, “We could have saved more!”
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New York Nurse april 2021
When covid just won’t let go
If you have been infected with COVID-19 and continue to suffer symptoms 4-6 weeks after the initial infection... consider seeking care at a postCOVID clinic in your area.
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ome say it’s like the worst flu they ever had. Others have had little or no symptoms. And some end up desperately ill on a critical care unit. But for many survivors of COVID-19, the initial infection is just the start of a long, tortuous struggle. It is estimated that 10-20% (other studies show 1 in 3) of those who’ve been infected with COVID, even those who were asymptomatic, suffer from COVID symptoms 6 months or more after infection. This trend is sounding alarms among public health experts, infectious disease doctors and epidemiologists. A recent Swedish study of healthcare workers, reported by the Center for Infectious Disease Research and Policy (CIDRAP), found that 15% of those studied reported at least one moderate to severe COVID symptom from an infection that occurred at least 8 months before. The most common lingering symptoms include fatigue, breathlessness, pain, brain fog and
psychological problems. Symptoms can also include cardiac, vascular, neurological, gastrointestinal, renal and multiple respiratory conditions. Many suffer in silence or have their health issues dismissed by medical professionals.
Hoping symptoms don't last Cheryl Korzybski, RN, a NYSNA member work works in critical care at South Shore University Hospital/ Northwell Health System, became ill due to COVID a year ago. Along with COVID, she developed bilateral pneumonia and was very ill. She was out of work for several months and continues to have respiratory problems including severely aggravated asthma. Pat Monem, RN, a NYSNA member in the CCU at St. Catherine of Siena Medical Center, became ill with COVID just last month. She reports that returning to work has been very difficult due to lingering fatigue and periodic breathlessness. She hopes that her symptoms do not last much longer and wishes
that hospitals gave staff who are returning to work after a COVID infection the opportunity to ease back part time until fully recovered.
Long-covid Newly developed medical clinics that specialize in long-COVID, also known as post-COVID, are bringing much needed attention and scientific study to this problem. These clinics have multi-disciplinary teams studying the causes of, and effective treatments for, long-term COVID symptoms. The clinics have found that many long-term COVID symptoms appear grouped together, though it is not clear why. Some symptoms appear to be caused by an immune response that is dysregulated and won’t stop fighting a virus that is no longer there. For others it is possible that remnants of the virus, or pieces of virus, remain in their systems at too low a level to be picked up by tests. Whatever the cause or causes of post-COVID symptoms, these clinics are likely to be the first place where effective treatments are identified and administered.
Post-COVID clinics
Pat Monem, RN
Cheryl Korzybski, RN (above and inset)
If you have been infected with COVID-19 and continue to suffer symptoms 4-6 weeks after the initial infection, speak with your medical professional and consider seeking care at a post-COVID clinic in your area. If no such clinic is available, contact the clinics found in the links below to see if any of them offer telehealth services. If you believe your infection was caused by exposure in the workplace, remember to ask the clinic if the clinic, and the doctors they refer patients to, accept workers’ compensation. Post-COVID clinics continue to open throughout the country. Clinics in your area can be found at www.survivorcorps.com/pccc. Additional clinics in the NYC area can also be found at https://www1. nyc.gov/assets/doh/downloads/pdf/ covid/covid-19-care-clinics.pdf. If you have any questions regarding post-COVID care or would like to provide NYSNA with feedback regarding any post-COVID clinics, please send an email to healthandsafety@nysna.org.
Jacobi Medical Center
NEW YORK NURSE
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april 2021
Remembering Freda Ocran, RN
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reda Ocran, RN, passed away at age 51, the first NYSNA nurse to die from the COVID-19 virus. On March 28, family, friends and colleagues gathered at Jacobi Medical Center in the Bronx, where Freda worked in the psychiatric unit,
Assemblywoman Nathalia Fernandez
to recall this exceptional nurse, spouse, mother and friend. An immigrant from Ghana, she earned her nursing degree while caring for her three children. Her husband, Joseph Ocran, also a nurse, spoke in very emotional terms. “She was a good person, a very, very good person. She was a very vocal person. She was my everything,” said Joseph. Assemblywoman for the 80th Assembly District and Bronx Borough President candidate Nathalia Fernandez said, “Our nurses and doctors and our healthcare workers put everything on the line.”
Join the fight!
Our memories live on
Kelley Cabrera, RN
Flandersia Jones, RN, a friend and co-worker at BronxCare Health System, where Freda once worked, said, “A beautiful garden stands alone, missing the one who nurtured it because Freda nurtured everybody she came across. But now Freda is gone, her flowers still bloom.”
Kwame A. Ocran, Freda’s eldest son, told those who gathered, “Today, we’re here to remember our heroes. We’re here to salute those who have dedicated their lives to the service of others. Our memories of Freda live on in celebration and sorrow.”
As you can see, Freda Ocran was a deeply respected and admired mother, wife, nurse and friend. I want to extend my condolences to her lovely family who I now have had the pleasure of meeting. Though I did not know Freda personally, I will never forget how it felt, one year ago today, to learn of her passing. How it felt to lose one of our own. At the time, we were holding one of the first protests in the city demanding PPE and adequate protections from COVID. Back then, it was clear that our government was failing us. And sadly, Freda was one of the first of thousands that this city would lose. The story of Freda and her family, is the story of so many New Yorkers. Her husband Joseph was the first to come to America from their native Ghana. He worked hard to save up enough money to eventually bring his beloved wife. That story was especially meaningful to me, because it’s exactly what my father did for my mother when he immigrated here from Ecuador. It’s a story that resonates with so many children of immigrants whose parents come to America and work so hard to give their children a better life. Freda was here, at Jacobi, working, alongside her colleagues just days before she passed. She shared her fears of the virus with friends and family, yet she continued to show up. Her commitment to her patients and her community were truly unparalleled. I ask all of you who joined us today in remembering Nurse Ocran, to please join us in fighting to protect the system that meant so much to her. – Kelley Cabrera, RN, President, Local Bargaining Unit, Jacobi Medical Center
Joseph Ocran, RN, husband of the late Freda Ocran, RN (center)
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SIUH/ Northwell
New York Nurse april 2021
Stepping up The Staten Island Advance commenced a podcast coupled with print interviews of nurses and their experiences with COVID-19. These are excerpts from those interviews. These are excerpts from interviews with NYSNA nurses at Staten Island University Hospital/Northwell.
Michelle Pittman, RN
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ovid changed my role as a post-partum newborn baby nurse. Our new mothers, many experiencing parenthood for the first time, were left alone in the hospital without their support person. I often felt like I was a nurse and family member to these patients. On the other hand, during the worst of the pandemic Covid-stricken mothers were separated by a different unit from their newborn. These new mothers not only had to battle such an infectious disease, but also the added stress of being separated from their new baby and family. I very quickly learned how important face time has become in our society. I think we all played a heroic part in this pandemic, whether it was helping new mothers with Covid, or taking care of the seriously ill ICU patients. We reported to work every day in a Covid environment willing to help in any capacity. I’m still working on my post unit, wishing that I could see the end of this pandemic come in the near future. I have been a nurse for over 30 years and have been through so many changes. I am glad to say that I chose this profession to help and speak up for my patients, I am still here doing what I love. Never think it can’t happen to you.
Michelle Pittman, RN
Joanna Nelson, RN
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hen COVID hit us in March of 2020 it happened so fast, we really had no time to process it. We just had to make a decision: Were we going to stay, or quit? Before it hit, I loved helping patients and talking to them, getting to know their family members. With COVID, at first, all my patients were on ventilators. There was very little opportunity to connect with them on a personal level. During the summer, cases decreased until they were almost non-existent. Things started to get bad again in November. By then, we weren’t intubating people as fast as we were earlier in the year. I started to get to know the people that were coming in sick. I always ask my patients how they think they got COVID. A lot of times, but not always, they are 50 and above and I’ve often heard that they got it from a family member — a son, a daughter, a family gathering where several family members contracted it, but they were the unlucky one that ended up having to be hospitalized. COVID was not something that anyone expected or prepared for. It has been the biggest challenge that I’ve faced in my 14 years of nursing. My unit was the first unit to fill up with COVID patients and we’ve been caring for them ever since. I have seen more people die in one year than in all 14 years of my nursing career combined. I have had to look my patients in the eyes after they asked me if they were going to die and answer, “I don’t know” because I’ve seen what this virus can do to people, and I’ve seen it over and over. I’ve had lots of unforgettable patients. I’ve cried in their rooms when they weren’t looking because I know COVID and its pattern. I could see what was happening and knew what would happen next, and it broke my heart. It’s affected me. I’ve felt the pain of the families that couldn’t be there
Joanna Nelson, RN (above and inset)
to say goodbye. I’ve felt the loneliness and fear of the patient on the BiPAP machine [a type of ventilator] who just wants to survive. They don’t pay me for that, but it comes with the job. It’s what you feel when you are caring for a human being. I’ve been working COVID for over a year now, and I’m still trying to process it myself. It’s a lot to take in when you really see what’s happening on the other side. Sometimes I think I’ve seen too much. But not everything I’ve seen has been bad. I take comfort in knowing that through someone’s toughest battle we were there, ready to help in any way we could.
Learning from this experience I’ve also seen that life is not always fair, and it can be taken from you at any time. The world does not always have the answer for you, or the cure (even if you think that it does or should). I’ve learned that in this imperfect world we only have each other to depend on to try to make it better. From this experience, I can speak as a nurse at the patient’s bedside, and say, we should appreciate what’s really important in our lives. Before COVID we were so preoccupied with trivial things and now we’ve all been through this real life human awakening and we’ve been through it together. You don’t have to just go back to the way things were before. Instead, use this experience, learn from it and find your highest value. Be safe, protect yourself and your loved ones. We aren’t out of the woods just yet.
NEW YORK NURSE april 2021
Debt relief on the frontlines
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his month Congresswoman Carolyn B. Maloney (D-NY) introduced the Student Loan Forgiveness for Frontline Health Workers Act — a gesture of gratitude to nurses and other healthcare workers who have worked countless hours in life-threatening conditions and under devastating circumstances throughout the COVID-19 pandemic. “The bill will alleviate the burden of student loan debt resulting from medical/ professional healthcare training,” and will be the first loan forgiveness program that applies to private loans as well as public, if passed. “Being a frontline health worker during this pandemic meant that every day was life-or-death,” Maloney said. “These healthcare workers should not have to worry about their financial stability and be struggling to pay down their debt while fighting on the frontlines of the COVID-19 pandemic.” The proposed Student Loan for Frontline Health Workers Act comes in addition to two existing programs that provide student debt relief to healthcare workers — (1) the payment pause and interest waiver and (2) the Public Service Loan Forgiveness (PSLF) program. These programs apply to public loans only.
Dept. Education loans The payment pause and interest waiver is part of a COVID-19 relief measure passed before President Biden took office, but extended on the first day of his presidency. Only loans owned by the Department of Education are eligible, including Direct Loans (defaulted and nondefaulted), FFEL Loans (defaulted and nondefaulted), Federal Perkins Loans (defaulted and nondefaulted), and Heal Loans (defaulted). Eligible loans are automatically placed in administrative forbearance; loan payments, including auto-debits, are suspended and borrowers don’t have to make payments. Like the payment pause, the
NYSNA President Judy Sheridan-Gonzalez, RN, with Congresswoman Carolyn B. Maloney (right)
waived interest rate (0%) is automatic. This measure will expire as early as September 30, 2021. For more info: https://studentaid.gov/ announcements-events/coronavirus
Public interest workers The Public Student Loan Forgiveness (PSLF) applies to health workers and other professionals who do full-time public interest work. Eligibility for PSLF kicks in when the relief period ends, and after borrowers have made 120 qualifying loan repayments, including payments during the pause. Nurses must be working at a public service job when the 120 required payments are made and when loans are forgiven. A public service position is defined as work in federal, state, or local government, or for most nonprofit 501(c)(3)s. Thirty hours of work per week or more constitutes fulltime or whatever your employer defines as such. Those who work multiple part time jobs adding up to 30 hours may also qualify. Loans covered are the Federal Direct Stafford Loans, PLUS Loans and Department of Education Consolidation loans. The PSLF application is found here: https://
studentaid.gov/sites/default/files/ public-service-application-forforgiveness.pdf These existing relief measures have been critical to the financial health of nurses crippled by public student loan debt. But for nurses and nursing students struggling under the burden of private student loan repayments, passage of the Student Loan Forgiveness for Frontline Health Workers Act may determine whether essential financial relief is, in fact, in sight.
“After risking our lives without adequate PPE, working in the severely understaffed state, and suffering the trauma of making life and death decisions precisely because we did not have enough caregivers, functioning in an environment that even before COVID was severely underfunded, to then be faced with college debt and the conscionable interest that goes along with it is beyond acceptable. College debt has become an albatross around the necks of students and the workers they become. This bill is a start to address this egregious situation.” –Judy Sheridan-Gonzalez, RN, President New York State Nurses Association
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New York Nurse april 2021
A budget worth a loud cheer!
W The sum of $4.3 billion in new taxes on the wealthiest New Yorkers and corporations is a major breakthrough...
e are enthusiastic about this year’s budget that allocates funds for sustaining patient care in and access to hospitals and measures that strengthen the public’s health. These commitments are critical to the on-going battle to defeat the COVID-19 virus and return the state to a level of normalcy this year. The sum of $4.3 billion in new taxes on the wealthiest New Yorkers and corporations is a major breakthrough in filling the public coffers, helping healing the state at a time of crises across many sectors, including prominently healthcare.
Filling fiscal holes Federal money makes a big difference. From the recently enacted $1.9 trillion American Rescue Plan, New York is set to receive approximately $24 billion in direct unrestricted federal funding, including $12.7 billion for the state, $5.7 billion for New York City, and about $6 billion for cities and counties. This goes a long way to filling the enormous fiscal holes created by the pandemic and what it has left in its wake. With our allies in labor, public health and amongst community advocates, we fought successfully against cuts to vital healthcare programs, including the 1% Across-the-Board Medicaid reim-
bursement rate reduction totaling $217 million in state and federal matching funding; elimination of a $139 million Indigent Care Pool fund funding reserved for major public hospitals, including more than $100 million for NYC Health + Hospitals; and implementation of 340B Drug Program conversion from fee-for-service to managed care, which would have cost safetynet hospitals $200 million or more. A total of $700 million in cuts to hospitals was averted. The Essential Plan, which covers New Yorkers who are above the income threshold for Medicaid but not able to afford ACA private exchange plans, will now have no co-pays or premium contributions. This is a very important step towards our goal of universal healthcare to cover all New Yorkers. Nursing home reform includes legislative oversight of expenditures, an absolutely necessary measure in regaining confidence in that sector of the healthcare industry.
Left undone There are a number of laws that still need to be changed. One is a reduction in Medicaid reimbursement rates for hospital capital improvement costs. We and our allies were unsuccessful in our efforts to fully repeal the Medicaid global cap (which limits annual increases in Medicaid spending to around 2% per year, regardless of whether enrollments have surged
due to unemployment rate increases or other factors). The $311 billion infrastructure plan including providing affordable Internet to low-income households put NYS back on a track in building about which NYS is decades behind. The Budget directs $2.3 billion in federal child care resources.
Assisting undocumented workers The Budget also allocates $29 billion in public and private green economy investments to create 12,400 megawatts of green energy — enough to power 6 million homes. This helps to fulfill the goals of New York’s Climate Leadership and Community Protection Act and to spur the COVID economic recovery. Fair and safe housing and protection of renters with a $2.4 billion rent relief program falls under our definition of social determinants of health. We are cheering the allocation of over $2 billion to New York’s fund to assist undocumented workers — the excluded workers fund. Lifelines like unemployment insurance and federal stimulus checks were out of their reach because undocumented people are ineligible for most government aid. Now, New York has funds to offer one-time payments of up to $15,600 to undocumented immigrants who lost work during the pandemic. New York stands out for this effort, by far the biggest of its kind in the nation.
Rest in power! It is with a heavy heart that I write you about the loss of one of our own. Our dear colleague Charles Mighty, RN, has passed away. Charles was a long time NYSNA H+H member at Metropolitan Hospital. He served as the LBU chairperson there for many years and was known to many as “a champion fighter for nurses, a lion, a union leader and role model that made management uncomfortable.” In his words, “I became a nurse because I wanted to embrace people and prevent tragedies from happening. Nurses are totally committed. We give from the heart.” He was taken too soon, but he lived by these words and impacted so many people and will not be forgotten. Rest in Power, Charles! Your NYSNA family honors you. In solidarity, Judith Cutchin, RN
NEW YORK NURSE
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april 2021
Climate report
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e are unions representing hundreds of thousands of workers in health care, public transport, manufacturing, utilities, education, and the hospitality industries. We welcome President Biden’s Executive Order on Tackling the Climate Crisis at Home and Abroad issued on January 27, 2021. As progressive unions, we support the Order’s main proposals and commitments, alongside its recommitment to the Paris Climate Agreement. The purpose of this communication is to urge the Administration and the Department of State to submit a Nationally Determined Contribution (NDC) to the UNFCCC that is consistent with the latest science. We note the words of the administration’s Special Presidential Envoy for Climate, John Kerry, that the US would need to submit an “aggressive” NDC in order to make up for the time lost as a result of the actions, and inactions, of the previous Administration. We note further that the Executive Order of January 27 also states the following: “the United States will exercise its leadership to promote a significant increase in global climate ambition to meet the climate challenge.” In our view, the United States can show leadership in at least three ways:
1.
The goal of the Paris Agreement is to “limit global warming to well below 2 degrees Celsius, preferably to 1.5 degrees Celsius compared to pre-industrial levels.” Therefore the US should submit an NDC that is consistent with what is needed in order to be consistent with achieving these limits. The first NDC submitted by the US to the UNFCCC in 2015 was severely criticized for its lack of ambition. With the defeat of the Waxman-Markey climate bill in the Senate in 2010, president Obama’s administration was fully aware that a more ambitious commitment would have been difficult to achieve. But the NDC submitted by the US very likely resulted in other major economies submitting NDCs that also lacked sufficient ambition. This prompted the UNFCCC to appeal to the parties
to the Agreement to do better in the second round of NDCs. That time has now come.
2.
As part of the preparation for both the Leaders’ Climate Summit in late April, COP26 in Glasgow in November, and the reconvening of the Major Economies Forum on Energy and Climate, the Administration can draw attention to the fact that, while more ambitious NDCs are needed, most of the Group of 20 (G20) countries are not on track to meet even their current NDCs. The voluntary nature of the Paris Agreement is, in our view, partly responsible for this. We encourage the Administration to begin a discussion with the G20 countries with an eye on submitting a communication to the UNFCCC acknowledging that the current, non-binding approach to emissions reductions is not working, and a new architecture is needed to address the continued upward course of global GHGs. Anything less than this will result in only inadequate national targets, and even those will most likely not be met. Given the need for urgent action, the Paris Agreement’s weakness in terms of ensuring that parties to the agreement honor their NDCs must be addressed, and the Administration can show leadership in this respect.
3.
A more ambitious NDC submitted by the US makes clear the need to develop policies that can deliver the kind of emissions reductions which the science indicates are required. In its 2018 Special Report on Global Warming of 1.5 Degrees, the IPCC concluded that limiting overall warming to 1.5 degrees Celsius remains technically possible. But meeting this goal “would require rapid, far-reaching and unprecedented changes in all aspects of society,” including “transitions in land, energy, industry, buildings, transport, and cities.” In our view, the current policy framework, which accords a leading role to the private sector, and largely subjugates the power of public finance to “unlocking” private investment capital, cannot deliver the change the IPCC (and common sense) says are required at
the necessary speed and scale. The “sticks and carrots” approach to climate policy has had several decades to deliver results consistent with the science, but has produced only deeply inadequate investment, destructive deregulation and liberalization, and regressive social outcomes. We urge the Administration to work with progressive labor and its policy allies to develop a robust and realistic “public goods” approach to emissions reductions and the energy transition — one that embraces: public ownership of the power sector; adequate funding to expand modern public transport services; a public works program for energy conservation and efficiency; the restoration of carbon sinks; affordable utility services for low-income consumers; and more. If such an approach were pursued in the US, it could have a transformative impact on global policy, freeing up investment capital from development banks and governments, easing or removing intellectual property restrictions that hinder progress in countries of the global South, and creating the kind of jobs that the world currently needs to meet the climate challenge. Regarding point 3, we would like the opportunity to engage in an organized dialogue with the Special Presidential Envoy for Climate John Kerry and other Administration officials in order to present in detail how a public goods approach to decarbonization and job creation would produce the kind of outcomes the Administration desires.
Nella Pineda-Marcon, RN
NYSNA Board Member Nella Pineda-Marcon, RN, chairs NYSNA’s Committee on Climate and Disaster Relief. She shared this letter with New York Nurse (at left). She spoke on climate issues at a 2022 Budget and, was a panelist at the hearing of the NYC Council Committee for Environmental Protection, held jointly with the sub-committee on capital budget which passed the next day. NYSNA joined other environmental groups and advocates for a rally at Washington Square Park in NYC on April 7.
Climate Rally, Washington Square Park, NYC, April 7, 2021
NEW YORK NURSE
Non-Profit US Postage Paid NYSNA
april 2021
131 West 33rd Street, 4th Floor New York, NY 10001
INSIDE
When covid just won’t let go p. 11 Pathway to staffing ratios, p. 2
OSHA turns 50, p. 3