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A&E walkout

Doctors and nurses who work in the Accident and Emergency (A&E) Department at Princess Margaret Hospital (PMH) refused to work in that area yesterday, and instead sounded the alarm over what they described as a critical lack of adequate safety protocols to prevent themselves and patients from being exposed to COVID-19, as individuals suspected of being infected were being kept in A&E.

“Our staff is concerned about being compromised because we have those patients under investigation on the floor,” Bahamas Doctors Union (BDU) President Dr. Melisande Bassett said.

“So, today they have removed themselves because of the risk to themselves and their families if they contract COVID-19.

“Not only that, but they are also speaking for the patients who have been waiting without proper assessment because there is no place to assess them.”

Bassett indicated yesterday morning that doctors from her union will not return to A&E until the matter is addressed.

“We are waiting for the situation to be rectified,” she said.

“And until that happens, you can’t ask anyone to put themselves in harm’s way without the necessary protocols and safety measures in place. We’re not leaving work. We just need it rectified.”

Consultant Physicians Staff Association (CPSA) President Dr. Sabriquet Pinder-Butler confirmed yesterday evening that consultant physicians were still not working in A&E as their concerns had not yet been addressed.

She said no official from the government or the Public Hospitals Authority (PHA) had yet spoken to the CPSA about the safety concerns.

Bahamas Nurses Union (BNU) President Amancha Williams also said yesterday evening that her union had not heard from any official on the matters.

Williams said a majority of nurses who work in the A&E Department called in sick yesterday. She did not say why they called in sick but noted that they had grave concerns over the current situation.

Williams said some nurses were working in A&E yesterday.

The healthcare professionals said the situation at the hospital is dire.

“…With the onslaught and increased numbers that we’re seeing, we knew that we needed a plan ASAP to deal with that (suspected COVID patients in A&E) and that if we didn’t have such a plan, we would get to a tipping point,” Bassett said.

“This morning, we are at a tipping point where our staff members have become compromised because of the overwhelming number of patients with suspected COVID symptoms presenting to A&E.

“As it stands, all of our isolation rooms are occupied. And as you know, with the COVID-19 case, they should be in negative pressure rooms even under investigation until that can be ruled out.

“With the hurricane, we would have lost four standalone rooms in the Legacy unit. They have yet to be opened. We need those opened up. And we need additional rooms, additional spaces to account for the number of patients that we are seeing on a daily basis.”

Noting that teams of doctors are already out of the system due to exposure, Bassett said a meeting with the relevant officials on the matter would be a big first step in solving the problems at the hospital.

Bassett insisted that the move was not a walkout or sickout, but said the doctors cannot put themselves in harm’s way.

“We’re still here,” she said.

“We’re not leaving our jobs. This is not a walkout. This is not a sickout. We want to help the Bahamian people, but we have to do it safely and sensibly.”

In a national address on Monday night, during which he announced a nationwide two-week lockdown, Prime Minister Dr. Hubert Minnis said ICU beds were at capacity and non-critical beds were nearing capacity.

Last week, it was estimated that roughly 50 patients had been exposed to COVID-19 across three PMH wards, which were subsequently closed.

Pinder-Butler said the incident has had a significant impact on operations at the hospital, impeding the function of some departments.

She said the issues currently facing PMH were foreseeable, and more action should have been taken earlier to prevent the current crisis.

“We know that we will potentially have more numbers,” she said.

“We’ve known this for a while. So, I think the challenge is that we saw a lot of these things coming, but the preparation for making sure things were in place did not happen the way it should have. So, now we end up with this unfortunate situation today.”

Butler-Pinder said they reached out to the managing director of the PHA and Minister of Health Renward Wells, and were hoping for quick intervention.

“We are hoping to have a meeting with them shortly,” she said.

“…We would have liked that meeting to happen last week and weeks before that, and especially with the events of today, we would have liked that meeting to even happen now.

“I think we could avoid a lot of these things which are detrimental to patient care, detrimental potentially to the staff that work in these environments who also have to now go home and care for their families.

“…This is a matter of urgency. I think that the response from all areas is just too slow. And I think that we need to really see this for the crisis situation that it is. And if you don’t see an emergency department coming to a halt as a crisis situation, then I think we’re in big problems.”

Up to press time yesterday, neither Wells nor a PHA representative was available for comment on the matter.

Williams said the situation at the hospital is exacerbated by the underwhelming health insurance provided for staff.

“We [are] already stressed because we have the worst insurance ever,” she said.

“The nurse doesn’t have insurance for her family, only for herself. But she’s taking back everything that she picks up from the hospital to her family.

“…The institution should not bring the nurses or the doctors or the healthcare workers to this point. You shouldn’t have to choose.”

Williams said that on Grand Bahama as of a week ago, 16 nurses were in quarantine, and six had tested positive for COVID-19. She said the numbers for New Providence were still not confirmed, but “several” were quarantined.

She said insufficient testing of nurses who don’t have COVID symptoms has also been an issue.

“We have not been testing. The nurses here are saying, ‘You’re putting me in harm’s way. And you still don’t want to test me. You only want to test the patient. I work with the patient, so test all of us.’

“Don’t say it’s because you aren’t seeing symptoms in the nurses, because you aren’t seeing symptoms in the patients either.”

There are 715 confirmed cases of COVID-19 in The Bahamas. Thirty-six were reported yesterday — 20 cases on New Providence, 11 on Grand Bahama, three on Bimini and two on the Berry Islands.

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Rachel Knowles

Rachel joined The Nassau Guardian in January 2019. Rachel covers national issues. Education: University of Virginia in Charlottesville, BA in Foreign Affairs and Spanish

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