The tsunami we call COVID-19 has threatened to overwhelm everything in its path, with devastating effects that can be hard to quantify or qualify. But the Nurses Organization of Veterans Affairs (NOVA) has taken on the fight. Earlier this year, NOVA surveyed its members to learn how nurses felt the US Department of Veterans Affairs (VA) was managing personal protective equipment (PPE), testing, communications, staffing needs, and other issues. Following the survey NOVA conducted in-depth interviews with nurses at the VA Boston Healthcare System to better understand how the pandemic was affecting nurses across the Veterans Health Administration (VHA).
The first survey, which was conducted in March and April 2020, included the following questions:
- Do you feel prepared for COVID-19?
- Do you feel your facility’s supply of PPE is adequate?
- Are you aware of the protocol for the distribution of equipment/supplies at your facility?
- Are staff being tested for the virus, and if so, when, and are there enough test kits available for staff and patients?
- Do you believe your facility is properly handling staff who have been exposed to COVID-19 but are asymptomatic?
With the May survey, NOVA aimed to get an update on how things were progressing. This survey asked how the pandemic was affecting members personally, including questions such as: Do you feel you are being supported—mentally and physically? Has VA offered to provide staff mental health counselors or others to help mitigate stress during the crisis?
Results revealed inconsistencies and some confusion . For example, c ommunication among leadership, staff, and veterans continued to change rapidly, causing some misunderstanding overall, respondents said. Some pointed to “e-mail overload” and weekly updates that didn’t work. Others felt communication was “reactive” and “bare minimum”—not “proactive and informative.”
Most (74%) respondents felt that access to PPE was inadequate, and many did not know the protocol for distribution or what supplies were on hand, while 47% felt ill prepared for any COVID-19 onslaught. Although things had improved somewhat by May, > 85% of the respondents said they were reusing what was provided daily and were still finding it difficult to get PPE when needed.
According to respondents, testing was pretty much nonexistent. When asked whether staff were being tested and whether tests for both staff and patients were available, the answer was a resounding No (80%). Nurses’ comments ranged from “staff are not being tested, even if they have been exposed,” to “there are not enough tests for patients, let alone for frontline staff.”
The lack of tests compounded stress. Helen Motroni, ADN, RN, spinal cord injury staff nurse, said, “I have been tested twice for direct exposure to the coronavirus in the past 3 weeks. Luckily, the results were negative, but waiting for the test results was extremely stressful because I have 2 little boys at home. While waiting for results, I self-quarantined and was terrified that I possibly brought the virus home to my children. I never left my room and would talk with my boys through the door and FaceTime. My 8-year-old asked me why I couldn’t stay home so I would not get sick. I explained to him that if every nurse did that, there would be nobody to help those that are sick and suffering.”