Nurses nervous over prep for second wave

Frontline nurses who worked around the clock at the pandemic’s height are now deeply concerned the state government isn’t doing enough to prepare for a second coronavirus wave as it begins to reopen.

The nurses say the criteria outlined by Gov. Cuomo for reopening is nowhere near specific enough given all they’ve learned during the crucible of the first wave — and they want answers.

“The bar needs to be raised the second time around,” said Pat Kane, executive director of the New York State Nurses Association. “We should be prepared. We should know what we need. We should put metrics in place that very clearly touch on all the things we need to truly protect the public’s health.”

Right now, she said, that isn’t happening.

According to the ground rules laid out by the state, there is no requirement to maintain low nurse-to-patient ratios, Kane said — even though ratios jumped to dangerous highs during the pandemic’s peak. She added that the criteria for personal protective gear are too vague and that stricter standards need to be implemented around training.

Under its reopening criteria, the state is requiring that hospitals keep 30% of their beds in reserve in the event of a patient surge, but Kane said there’s nothing mandating those beds have dedicated staff and at what nurse-to-patient ratio those beds should be covered.

“It just says 30% hospital capacity. It doesn’t stipulate that those will be staffed beds,” she said. “It should stipulate staffed beds at a ratio of — for regular patients — one to five, one to six. For ICU, one to two.”

Kane added that the state Health Department was supposed to release a report on hospital staff-to-patient ratios months ago, but still hasn’t.

That study, according to Health Department spokesman Jonah Bruno, remains under review.

“As our reopening progresses, we will continue to ensure that health care workers have the resources they need to advance this unprecedented public health emergency response,” he said.

During the peak of activity in city hospitals, ratios in ICUs ran as high as one to nine — a scenario that nurses say almost certainly cost patients their lives.

Jacobi Medical Center in the Bronx, where registered nurse Kelley Cabrera works, was one of those hospitals. She fears that without proper planning it will happen again — and she’s not confident the right kind of planning is taking place.

Management has given vague assurances to staff that the hospital will be prepared for a second or third wave, she said, but they’ve been short on specifics.

“What is the point of having increased bed capacity if you don’t have people who can work in those units?” she said. “We are still wearing one N95 mask a day, which is better than a mask every five days, but one mask a day is still wrong.”

Jacobi, a public hospital, is overseen by city Health and Hospitals. Stephanie Guzman, a spokeswoman, noted that the agency deployed more than 4,000 nurses to the hardest-hit hospitals during the pandemic and that its nurse-topatient ratios were aligned to industry standards.

“We heroically surged additional staff, resources, nearly tripled ICU capacity throughout the system at a moment’s notice and are prepared to do it once again as needed,” she said.

The N95 masks — a focal point among medical staff in March and April — were intended for one use per patient, but due to supply shortages, the federal Centers for Disease Control and Prevention altered its guidelines for their use, allowing that they be reused and drawing widespread criticism from frontline workers.