Nurses in the emergency room at DMC Sinai-Grace Hospital took a stand late Sunday night against what they said are dangerous working conditions that put them and their patients at risk.
Salah Hadwan, a registered nurse in the emergency department at Sinai-Grace, which is in the northwest section of Detroit, the city hardest hit by the coronavirus outbreak in Michigan, said the surge in extremely sick patients coupled with nurses who have quit or been sickened by the virus, led to a crisis in staffing.
The hospital's emergency room managers are requiring those who report to work to manage more than 100 critically ill patients, many of whom are on ventilators and need critical care, he said, adding that ideally, there would be 21 nurses on staff for every shift.
- The latest: Michigan coronavirus map, locations, updated COVID-19 news
- What Michigan’s coronavirus school closure means for you
- What jobs are exempt from Michigan coronavirus lockdown? You may be surprised.
"Tonight, it was the breaking point for us because we cannot take care of your loved ones out here with just six or seven nurses and multiple vents (ventilators), multiple people on drips," said Hadwan, adding that the patient load has been building for three weeks.
"There would have been nurses that had to watch up to 20 patients at a time, which is not safe," he said.
Stories from the front
Bridge Magazine and the Detroit Free Press are teaming up to report on Michigan hospitals during the coronavirus pandemic. We will be sharing accounts of the challenges doctors, nurses and other hospital personnel face as they work to treat patients and save lives.
The night nurses asked managers to call for extra help to handle the patient load. But when they saw no relief, they staged a protest late Sunday, said Hadwan, 30, who has worked at Sinai-Grace for three years and said he has never seen working conditions like this.
"We decided to sit in our break room until they could pull in more resources to help us out for the night," he said.
"After four hours, they basically told us there was not going to be any support coming in for the night. And they told us, 'What is your decision?' We told them we were taking a stand, so they basically told us, 'You can leave.' So that meant the day-shift workers had to work the whole night, for 24 hours."
Hadwan, who also is vice president of the Hamtramck Public Schools Board of Education, posted a Facebook Live video about midnight Monday, showing the group of nurses leaving Sinai-Grace. The nurses said they love their hospital and city, but they could not take those working conditions anymore.
Brian Taylor, a spokesman for the Detroit Medical Center, said high-patient volume is driving an increased need for staffing, especially nurses.
"The DMC is using a variety of resources to help to supplement nursing staff including contracting with staffing agencies to secure more nurses and reaching out to colleges and universities to recruit nursing students who are close to graduation to assist in providing care to our patients, in accordance with state guidance," Taylor said.
“We know this is a very challenging time for caregivers. Our doctors and nurses continue to demonstrate their commitment and dedication to our patients.
"We are disappointed that last night a very small number of nurses at Sinai-Grace Hospital staged a work stoppage in the hospital refusing to care for patients. Despite this, our patients continued to receive the care they needed as other dedicated nurses stepped in to provide care.”
‘You have to give us the weapons’
Nurses throughout the state are reporting increased anxiety from a continued shortage of personal protective equipment, providing intimate care to highly contagious COVID-19 patients, while trying to keep loved ones safe at home, nurses have told the Detroit Free Press and Bridge in recent days.
“When there aren’t enough troops to fight this fight, what do you do? You retreat.” said Nina Bugbee, president of the Teamsters Local 332, which represents radiologists and respiratory therapists at McLaren Flint Hospital.
“These workers who appear to be walking away, aren’t really,” Bugbee said. “This is not something they want to do, but they are saying, ‘This is bigger than what we can handle. You have to give us the weapons to fight this, or we will lose this war.’”
Bugbee represents tens of thousands of health care workers in her role in the International Brotherhood of Teamsters, where she serves as director of the health care division.
She said the tension, building for weeks, is near a snapping point at hospitals throughout Michigan and the country.
“In Week 1, we were in shock. In Week 2, we didn’t have [personal protective equipment]. In Week 3, we realized the hazards and warnings, and now here in Week 4, the [staffing] ratios are not manageable and they are not safe.”
"Until hospitals start taking the concerns of nurses seriously, it’s only a matter of time before more actions like these [at Sinai-Grace] occur," she said. "It is absolutely essential that hospitals start working with nurses and stop silencing our voices."
Hospitals as well as nurses are in impossible situations, said Jeff Morawski, a long-time nurse and president of the OPEIU Local 40, which represents nurses at McLaren Macomb Hospital in Mount Clemens.
Hospitals and patients need nurses. And for many nurses, caring for others is threaded through their DNA.
Still, Morawski said, among the ranks of nurses are parents of young children and caregivers to elderly loved ones and spouses to people with underlying conditions that make them more susceptible to the virus.
Those loved ones, too, count on the nurses.
"There is a point in your life and you have to decide that your own life is worth something, and whether it's worth working without protection and putting the people you care for, the patients, in danger and your families in danger," Morawski said.
He said McLaren's nurses haven’t been pushed yet to the point reported by Sinai-Grace's night shift.
A breaking point
Kenisa Barkai, 38, of Woodhaven said she was fired March 27 from her nursing job at Sinai-Grace after speaking out about staffing and poor conditions at the hospital.
She said she was trying to form a union for the nurses before Michigan marked its first known coronavirus case, but the pandemic brought underlying problems that were simmering at the hospital to a full boil.
On March 16-17, Barkai said she was caring for seven patients, including two who had tested positive for COVID-19.
Then, she said, more patients were admitted, increasing her workload.
“I voiced my concern loud and clear that day, like this is ridiculous,” she said.
“I can't be in 100 places at one time. I was already overwhelmed and overworked. You know, we don't get to take breaks. We don't get to go to the bathroom. And with COVID patients, it's not just like, you're able to go in and out of the room — you have to take a lot of steps to protect yourself, right?”
Barkai said she repeatedly raised concerns about conditions and indicated plans to contact authorities. She posted a Facebook video showing her gown and mask, which was then featured by WDIV-TV (Channel 4). The local news station interviewed her about conditions at Sinai-Grace.
Soon after, she lost her job. The hospital system cited a violation of its social media policy, according to a document Barkai provided to the Free Press.
Taylor, the spokesman for Sinai-Grace, said he could not discuss the personnel matter.
Hadwan said the pressure for the night nurses got to be too much on Sunday.
Hadwan described an emergency department with patients filling the hallways, and nurses who wear the same mask over multiple 12-hour shifts. "The patients deserve to be in a room. They deserve to be monitored correctly," he said.
"We've had a lot of great nurses resign. We've had a few people call in because they are mentally exhausted. ... they want to be there, but it's unsafe."
Hadwan is scheduled to report to work again Monday night.
"They didn't take our badges," he said. "We all are scheduled to go back in tonight. We all plan to go in tonight, and see what happens from there. We don't quit."
He hopes people who hear about the situation will understand that COVID-19 is not a hoax or a scam, and that it is killing people.
"People are dying in large amounts. Please stay home, please. If everybody stayed home for two weeks, you know we could be saving each other just by doing that. We have to take it seriously," Hadwan said.
"If only they could see what we see. There's no words to describe it."
- Hey, Michigan, here’s how to make a face mask to fight coronavirus
- Michigan coronavirus dashboard: cases, deaths and maps
- Michigan families can get food, cash, internet during coronavirus crisis
- How to give blood in Michigan during the coronavirus crisis
- 10 ways you can help Michigan hospital workers right now
- Michigan coronavirus Q&A: Reader questions answered
- How to apply for Michigan unemployment benefits amid coronavirus crisis
Michigan Health Watch is made possible by generous financial support from the Michigan Health Endowment Fund, the Michigan Association of Health Plans, and the Michigan Health and Hospital Association. The monthly mental health special report is made possible by generous financial support of the Ethel & James Flinn Foundation. Please visit the Michigan Health Watch 'About' page for more information.