By Jacob Nakamura
(NOTE: This is part 1 of a two-part report on nurses working at Guam Regional Medical City)
(Tumon, Guam) GovGuam has sent eight Department of Education nurses to work at Guam Regional Medical City to help the overburdened nursing staff deal with the influx of medical demand. Guam Memorial Hospital is the designated COVID-19 hospital; thus, other types of hospital-related care (aside from maternity) are routed to GRMC.
GRMC nurses who spoke to Kandit on condition of anonymity and out of fear of retaliation confirm that the nurse to bed ratio has been as high as one nurse with responsibilities over 12 patient beds. The safety standard has been a 1:3 ratio, making the nursing situation at GRMC untenable.
"GDOE nurses have been directed to report to [Department of Public Health and Social Services] during the public emergency," superintendent of education Jon Fernandez said. "They are assigned to various places and recently about eight are assigned to GRMC."
GRMC, however, is not absorbing the personnel cost. The funding is coming out of DOE's budget.
"At this point we are paying their salaries but have received assurance that the amounts paid will be reimbursed by the governor via [Department of Administration]," Mr. Fernandez said.
Guam Federation of Teachers union vice president Sanjay Sharma said the GFT is watching the situation closely. GFT, which represents school nurses, also represents many GMH nurses and other professionals throughout the government of Guam. The recent strain on GMH nurses has been a concern for the GFT, as is the long term effects of revenue bleeding from the already-underfunded school system to pay operational costs of a private hospital.
"One hundred percent of cost for this assignment of DOE nurses is being dumped on DOE," Mr. Sharma said. "DOE managers are not happy about this and have many questions and concerns that remain unanswered. Since DOE is financing this, I believe it has more say than they realize. This is a free ride for GRMC."
Mr. Sharma also is concerned over the treatment and safety conditions of DOE nurses and of GRMC nurses, especially during this crisis.
An intensive care unit nurse manager at GRMC recently was fired for challenging a decision by higher ups to allow a visitor to enter the ICU to visit a patient related to a hospital executive. The nurse, who was fired, reportedly fought the decision because he alleges it violated GRMC policy and placed his nurses and patients at further risk of COVID-19 exposure and other contamination.
GRMC, however, responded to the allegations, saying the visitor was the primary care physician for that patient. These statements cannot be verified without breaking medical privacy laws.
GRMC nurses are refuting their hospital management's assertions, but refuse to go on the record for fear that what happened to the fired nurse, whom GRMC is labeling as a disgruntled former employee, will happen to them. Kandit is not the only organization these nurses have reached out to; they apparently have been speaking with the GFT as well.
"We want GRMC to know we are organizing their nurses," Mr. Sharma said. "There is a culture of fear over there and we plan on fixing it for them."
The GFT is in the starting phase of recruitment of GRMC nurses, according to Mr. Sharma. "We have their staffing pattern and [we are] reaching out."
In the meantime, GFT is working to protect its members from unsafe working conditions. Mr. Sharma said GFT President Tim Fedenko participated in a meeting with GMH, GRMC, and DOE officials Saturday, when the working conditions of GRMC and DOE nurses was discussed.
"GRMC nurse managers will be working with DOE nurses to address concerns," Mr. Sharma said of the results of their meeting. "Currently the nurses are working four 12-hour shifts per week. After the meeting today, DOE nurses at GRMC will work three 12-hours shifts. We will continue to address this matter."
"Nurses are not comfortable with [the GRMC} assignment," Mr. Sharma said. The assignment does not seem to be a choice, though. When Gov. Lou Leon Guerrero invoked her powers under the Emergency Health Powers Act, she exercised her authority to direct GovGuam personnel to undertake duties her public health director, Linda DeNorcey, commanded under the guise of the emergency.
"Our nurses asked for the ability to opt out," Mr. Sharma said. "GMH Administrator Lillian Perez-Posadas would not grant it, but said it is under consideration."
A legal issue that emerged at the table is the classification of DOE nurses as nine-month employees, who are legally entitled to a summer break. Ms. Perez-Posadas, according to Mr. Sharma, said at the meeting that the public health emergency likely will be extended at least to the end of May, and GRMC officials would like the DOE nurses to remain until September.
But perhaps the most contentious issue is about the pay these DOE nurses should receive. Kandit will follow up this report with the details of those discussions, and what Mr. Fernandez tells us about pay for GovGuam employees who work during this public health emergency.