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Long term care facilities (LTCs) are facing numerous challenges, which are beginning to pile atop one another. Late last week Canal View’s Administrator, with the backing of the facilities board of directors, posted a letter to their facebook page, hoping to open up a conversation on how long term care facilities move forward, as the pandemic has begun to come to an end. Kim Salmi, Canal View’s administrator, identified issues with the current state of COVID regulations still on LTCs, the stress and untold story of the staff workers in a vital sector of healthcare, and a lack of open discussion on how these facilities move forward as the pandemic winds down.
Currently in the various healthcare sectors, LTCs have some of the highest requirements and restrictions still in place from the early days of the pandemic. In July last year, Michigan began to fully open back up, lowering mask requirements in public settings and other COVID protocols that were in place throughout 2020. And as the months progressed similar relaxations occurred in healthcare at places like hospitals, and prisons. Salmi’s letter calls action to begin discussing lifting some restrictions on LTCs, considering, many staff workers in the industry are returning to a sense of normalcy outside of work.
Salmi’s letter has certainly created a stir within the industry, stating in conversation, that it has made its rounds on internet healthcare forums. As well received a large amount engagement on the original facebook post. Salmi left her final thoughts during the interview, that it is time to start talking and following the data available on where the state of COVID is at in communities and begin to make informed decision on how long term care moves forward. Especially as the sector faces extreme staff shortages, and exhaustion from the stress of working in these facilities during the pandemic and are becoming a forgotten part of the front lines of the pandemic.
The conversation that Salmi has begun is very nuanced, and should be taken seriously, just as it was in March 2020. Salmi points to the success of vaccines for preventing illness, and treatments that have developed as the virus evolved, for the post. Read a copy of the full letter below. Follow this link to view the original facebook post.
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Posted with the full support of the Houghton DHHS Board.
A Heartfelt Letter from the Administrator.
We had yet another nurse resign today. Why this one hit me harder, I’m not sure. Maybe it is because I thought they were a lifer. They have been employed at the facility for over 12 years and I have never heard them complain or threaten to leave. Maybe it is because the nurse in question is leaving to work as a prison nurse. In the hierarchy of healthcare, Long term care (LTC) nursing has typically been a rung higher than the prison healthcare system which led me to ask, how did we get to this point? What happened? My husband, also in healthcare, helped me answer this question…
Not once has the LTC worker been seen as a hero during this entire pandemic. People made posters, had parades, went on TV stations everywhere and praised the hospital workers and EMTs. Compare that to the headlines that the Long Term Care sector garners, “Are Long-term Care Staffers Bringing COVID into Facilities” or “Alarming New Findings In 2020 COVID-19 Nursing Home Death Data” or the New York Times headline, “Nearly One-Third of U.S. Coronavirus Deaths Are Linked to Nursing Homes”. And yet, LTC employees works under more stringent regulations with more severe repercussions than any other healthcare entity. Very simply put, nursing homes are the villains and who wants to work for the bad guys? No professional athlete wants to play for a losing team, i.e., Matthew Stafford.
We have testing requirements not replicated in any other healthcare entity such as hospitals and clinics. My husband, who works in a hospital, has only been tested after a known exposure or when symptomatic. Most LTC facilities have to deploy an entire team to test staff twice a week, in addition to outbreak testing and testing for symptoms. We do this weekly despite already being short staffed. Masking…if you aren’t vaccinated in the LTC setting, I can almost guarantee you that your day will consist of labored breathing through a N95 mask while trying to complete your assignment…because completing resident showers in a warm and humid shower room isn’t bad enough without adding a N95 to the equation. Compare that scenario to the clinic nurse experience. Last week at my daughter’s doctor appointment, the large majority of the staff at the clinic was wearing their masks as a chin strap or under their nose. We would get cited for that. In the prison, the nurses are only required to wear a face mask when they are in the health care building. Again, all Long term care employees are required to wear a mask, regardless of where you work.
And agency staff…they don’t care about our residents. They only care about the money. It is demoralizing that we have come to rely upon them. Not all of the staffing agencies or their employees are bad, but a good portion of them are. Why isn’t there a national registry for them and why aren’t the shady agency operators held to the same standard that we are!?!
So why does all of this matter? or is this just me ranting again?
It matters because we now have treatments and vaccines available, not to mention that the current variants are not as deadly. It has been a long time since I have heard clinicians talk about “covid cement” when describing the secretions of a covid patient. It matters because we have decimated the healthcare industry, particularly in the rural setting. Workers are leaving in droves to work in non-healthcare related jobs and they are reporting back that they are happier outside of healthcare. It matters because our hospitals are backlogged with “nursing home residents”. Where do our sick go? Home health has been hit as bad as us. So where does that leave the infirmed? Home to die? Leaving the state for care? It matters because I have seen a tremendous increase in the number of nurses, CNAs and other healthcare workers who are seeking treatment because they have turned to drugs and alcohol to help them cope. They want to quit because of the unrelenting pressure of this industry, but feel too guilty to abandon their coworkers and residents.
And please, I implore whoever reads this, to not patronize LTC workers by saying it is bad everywhere not just in nursing homes. That is blatantly not true. With the exception of law enforcement, no other industry has been villainized like the LTC industry. No one has had our experiences over the last few years…the confusion revolving around conflicting guidance, the righteous indignation from both sides, the vaccine mandate, the STRICT enforcement of masks, testing and infection control mandates, the unrelenting stress with NO. End. Date. In. Sight! Things have happened to us and at our facilities that will forever be etched in our memories. Some of the things I will take to my grave include: being forced to deny visitations to dying residents (following the rules even when ethically disagreeing with them); my inability to prevent the mass exodus of employees that I know care, but just can’t anymore; and most notably, meeting that family of an employee who died after the employee determined that our facility was the safest place to commit suicide, and then dealing with the emotional aftermath of the staff who found him. Powerless, sadness and hopelessness, over and over and over for the last 2 -1/2 years. So please, don’t tell me that it is like this everywhere. Even soldiers have a return date when deployed to a warzone!
So why do I write this. My message is simple. It is time to roll back some of the COVID restrictions and treat COVID like we do any other virus. Our facility has clinically done very well during COVID. We have done a great job in preventing spread of illness and meeting residents’ medical needs with the most current treatments. Is there a reason, other than the fear that the word COVID incites, that we are treating today’s COVID any different that a flu outbreak? When we have the flu, we offer Tamiflu prophylactically and shut down the affected wing and gown/mask up. We have treatments and vaccines now for COVID. Let science work before the healthcare system completely collapses. This is an urgent matter! Action cannot come soon enough.
~Kim Salmi, Administrator
If you would like to see a change or have your opinion heard, please call the offices of Senator Stabenow at (906) 228-8756 and Senator Peters at (906) 226-4554. Changes can only come from the Federal level!
