NEW HOPE, Minnesota – Pfc. Shina Vang and her fellow Minnesota National Guard have had an exceptionally busy year. They helped treat Afghan refugees fleeing Kabul for the United States, provided security for US military bases in the Horn of Africa, and remained sentries in Washington, DC, following the Jan.6 attacks on the Capitol. American.
Closer to home, they were deployed across Minnesota during civil unrest sparked by the police murders of George Floyd in Minneapolis and Daunte Wright in the nearby Brooklyn Center.
But none of these experiences prepared Private Vang and his fellow Guardsmen for their final deployment: picking up bed pans, trimming toenails, and feeding residents of North Ridge Health and Rehab, a nursing home. sprawling nurses in the suburb of Minneapolis, the state’s largest.
“Protesters threw apples and water bottles at me, but that doesn’t compare to the challenge of giving someone a bath in bed,” Private Vang said.
Over the past two weeks, 30 members of the Guard have worked as certified nursing assistants in North Ridge, which has been so severely hampered by an exodus of employees that administrators have been forced to put entire wings to sleep, severely limiting new admissions.
As a result, hospitals cannot send patients to long-term care facilities like North Ridge, creating a backup that erodes Minnesota’s ability to treat people with Covid-19 and other medical emergencies. Similar arrears – patients hospitalized well enough to get out but too fragile to return home – are choking health systems across the country.
“It’s beyond a crisis,” said Katie Smith Sloan, president of LeadingAge, a nonprofit association of long-term care facilities. “For many vendors across the country, it’s a meltdown.”
On Tuesday, President Biden announced that 1,000 military medical professionals would be sent to hospitals across the country this winter to help overwhelmed doctors and nurses.
Public health experts fear the worst is yet to come as the highly transmissible variant of Omicron spreads to communities where health workers are already struggling to manage Delta’s influx of sick patients. Maine, New Hampshire, Indiana and New York State have deployed the National Guard to overcrowded hospitals and nursing homes in recent weeks, but the Minnesota initiative may be the more ambitious, with 400 members of the Guard with no nursing experience having completed rapid fire training before being sent to long-term care facilities across the state.
Last week, CEOs of nine of the state’s largest hospital networks ran ads in Minnesota newspapers urging residents to get vaccinated and take other steps to limit the transmission of the coronavirus. “We are overwhelmed,” the ads said.
Gov. Tim Walz, a Democratic and National Guard veteran whose mother was a nursing assistant, said he was viewing the program as an interim measure.
“Our health workers are heartbroken and tired,” Governor Walz said in an interview on Tuesday, shortly after learning that him and his wife and his son had tested positive for coronavirus. “The fact that the Guard is providing a bit of a breather is a godsend, but just to be clear, looking towards the horizon, we don’t see the end of the soaring just yet.”
Staff shortages have long been a problem for nursing homes in the United States, but the coronavirus has pushed many to the brink as low-wage aides retire early or quit for higher-paying jobs and less demanding. “The pandemic has underscored the fragility of the system and the need for fundamental change,” said R. Tamara Konetzka, long-term care economics expert at the University of Chicago.
In Minnesota, that means 23,000 nursing home positions were vacant in October, up from 8,000 in March, according to a survey of providers.
North Ridge has been particularly hard hit by the pandemic, with more than 592 cases and 52 deaths of Covid among its residents since March 2020, according to the Centers for Medicare and Medicaid Services, although the vast majority of those cases, 472, are among patients already sickened by the Covid on their arrival. Over the past four years, North Ridge has been fined over $ 180,000 by federal inspectors and cited for a number of health and safety violations. He received two out of five stars for general care from CMS, a “below average” rating.
Austin Blilie, vice president of operations, said the two-star rating was based on 2018 surveys and that North Ridge had significantly improved the quality of care since then. He noted that the most recent rating at the start of the year gave the establishment five stars for the quality of the staff. The 8.5% death rate for Covid patients in North Ridge, he added, was less than half the state average for patients in collective care facilities.
“Every time I look at how many we have lost, I am struck again that each represents an individual person, with a life and a story, and connections to other people,” he said. -he declares. “Please know that we never lose sight of this here.”
A low-slung collection of brown and beige brick buildings, North Ridge has 320 beds, but 100 of them are empty at the moment due to understaffing. The employees who remain are in tatters as they work overtime, and on some days administrators, dieticians and physiotherapists are forced to help make beds and fill pitchers with water. “We’re doing what we can because the show has to go on,” said Liz Ellenz, 37, the restaurant manager, who often works weekends and stays until 9pm doing the dishes. “Some days are really dark.”
But on Thursday Ms Ellenz was genuinely stunned as five members of the Guard rushed into the kitchen with soldierly purpose and precision. They sprayed food carts, bagged trash cans, and helped make lunch for the day: ham and macaroni au gratin, sautéed snow peas and citrus gelatin cubes.
One of them, Staff Sgt. Nathan Madden, 47, whose civilian job is an assistant manager at a home improvement store, said the past two weeks had given him a new appreciation for those caring for the sick and the elderly. His past deployments have taken him to Kuwait, Croatia and, most recently, to the Minneapolis courthouse where Derek Chauvin was on trial for the murder of Mr. Floyd. “This kind of work is certainly a lesson in humility,” said Sergeant Madden, adjusting the hairnet on his head. “It’s great to help out in the community, but I have older parents so in a way it prepares me for what I might have to do someday. “
Certified practical nurses, the workhorses of long-term care facilities, normally take five weeks of training before taking final exams, but nursing school leaders have condensed the program to eight 10-hour days. “It’s like we are supporting a natural disaster,” said Traci Krause, director of nursing at Minneapolis Community & Technical College, as a group of students practice taking pulse and washing their faces. on bed-ridden mannequins.
Other than things like providing free pizza and ice cream, there’s little that North Ridge administrators can do to stem the exodus of staff; the number of nursing home employees has increased from 590 to 450 since the start of the pandemic. Although burnout and fears of infection have prompted some nursing assistants to quit, the root of the problem is money, according to employees and the administrator.
North Ridge and other long-term care facilities in Minnesota that primarily serve Medicaid patients pay about $ 16 an hour for newly hired practical nurses. This is comparable to what some fast food restaurants offer in and around New Hope. (North Ridge kitchen staff are paid even less: $ 11.25 an hour.)
These low wages are primarily tied to the state’s reimbursement rate for nursing home patients, which averages about $ 270 per day, according to the Minnesota Department of Human Services. Gov. Walz’s efforts to raise reimbursement rates have stalled in the state’s politically divided legislature, as have his efforts to use up some of the $ 1.2 billion in unspent Recovery Act funds. in bonuses and increases for nursing assistants.
Fatimate Massquoi, director of nursing at North Ridge, said the meager pay associated with the physical demands of the job, the anxieties of treating Covid patients and endless loss inevitably takes its toll. “People don’t know what it’s like to hold hands with someone who is dying alone because their family is not allowed to be here,” she said. “Sometimes after a patient dies, I have to go to the bathroom to cry so no one can see me because I have to be tough. “
With Omicron racing across the country, staff and administrators are worried for the weeks to come. Only 60% of residents received their booster shots, slightly above the national average, and a federal appeals court ruling last week means North Ridge may have to lay off the 10% of employees who are not vaccinated .
But last Thursday, Ms. Massquoi and her colleagues felt good after learning that the National Guard would stay an extra week, including 18 soldiers who had volunteered to work during the Christmas holidays. Having extra hands available doesn’t mean North Ridge can increase its admissions count, but it does allow exhausted workers to take a few days off.
“Care has really given us the opportunity to take a break and allow people to spend time with their families and try to cope with the emotional exhaustion of the past 18 months,” Mr. Blilie said, vice president of operations. “I hope they come back a bit rested and ready to start over.”