Front-line hits very close to home
National Guard steps in to provide help in public health crisis
NEW HOPE, Minn. — Pfc. Shina Vang and his fellow soldiers in the Minnesota National Guard have had an exceptionally busy year. They helped process Afghan refugees fleeing Kabul for the United States, provided security at U.S. military bases across the Horn of Africa and stood sentinel in Washington, D.C., following the Jan. 6 attacks on the U.S. Capitol.
Closer to home, they have been deployed across Minnesota during the civil unrest prompted by the police killings of George Floyd and Daunte Wright.
But none of those experiences prepared Vang and his fellow Guard members for their latest deployment: collecting bedpans, clipping toenails and feeding residents at North Ridge Health and Rehab, a sprawling nursing home in suburban Minneapolis that is the largest in the state.
“I’ve had protesters throw apples and water bottles at me, but that doesn’t compare to the challenge of giving someone a bed bath,” Vang said.
Over the past two weeks, 30 Guard members have been working as certified nursing assistants at North Ridge, which has been hobbled by an exodus of employees that administrators have been forced to mothball entire wings, limiting new admissions.
As a result, hospitals cannot send patients to long-term care centers such as North Ridge, creating a backup that is eroding Minnesota’s capacity to treat people with COVID-19 and other medical emergencies. Similar backlogs — hospital patients well enough to be discharged but too fragile to go home — are choking health systems across the country.
“For many providers across the country, it’s a collapse,” said Katie Smith Sloan, president of LeadingAge, an association of nonprofit long-term care facilities.
Last week, President Joe Biden announced that 1,000 military medical professionals would be dispatched to hospitals across the country to help overwhelmed doctors and nurses.
Public health experts fear the worst is yet to come as the highly transmissible omicron variant spreads to communities where health care workers are already straining to handle the surge of patients sickened by delta. Maine, New Hampshire, Indiana and New York have deployed the National
Guard to overburdened hospitals and nursing homes in recent weeks, but Minnesota’s initiative may be the most ambitious, with 400 guard members who have no previous nursing experience going through rapidfire training before being sent to long-term care facilities across the state.
North Ridge has been hit especially hard by the pandemic, with more than 592 cases and 52 COVID-19 deaths among its residents since March 2020, according to the Centers for Medicare and Medicaid Services. The vast majority of those cases — 472 — were among patients already sickened by COVID-19 when they arrived. Over the past four years, North Ridge has been fined more than $180,000 by federal inspectors and cited for a number of health and safety violations. It has received two out of five stars for overall care from CMS, a “below average” rating.
Austin Blilie, vice president of operations, said that the rating was based on surveys from 2018 and that North Ridge had greatly improved since then. He noted that the most recent rating this year gave the facility five stars for staffing quality. The 8.5% mortality rate for COVID-19 patients at North Ridge, he added, was less than half the state average for patients in congregate care settings.
“Every time I look at the numbers of those who we lost, I am struck anew by the fact that every one represents an individual person, with a life and a history and connections to other people,” he said. “Please know that we never lose sight of that here.”
North Ridge has 320 beds, but 100 of those are empty at the moment because of staff shortages. The employees who remain have been running ragged as they work overtime, and on some days, administrators, dietitians and physical therapists are forced to help with making beds and filling water pitchers. “We do what we can because the show must go on,” said Liz Ellenz, 37, director of dining, who often works weekends and stays until 9 p.m. washing dishes.
Fatimate Massquoi, a nursing manager at North Ridge, said meager pay coupled with the physical demands of the job, the anxieties of treating COVID-19 patients and the unending loss inevitably take a toll. “People don’t know what it’s like to hold the hand of someone dying alone because their family isn’t allowed to be here,” she said. “Sometimes after a patient dies, I have to go into the bathroom to cry.”
With omicron racing across the country, staff and administrators worry about the weeks ahead. Only 60% of residents have received booster shots, slightly higher than the national average, and a federal appeals court ruling means North Ridge may have to fire the 10% of employees who remain unvaccinated.
But on Dec. 16, Massquoi and her colleagues learned the National Guard would be staying an extra week, including 18 soldiers who had volunteered to work over the Christmas holiday. Having extra hands allows exhausted workers to take a few days off.