While working at Michigan Medicine, Katie Scott, an intensive care unit nurse, said she can see University of Michigan students lining up outside residence halls waiting to get into the dining halls.

She said she and the other nurses wonder, “How long can they keep this up?”

“It makes me concerned for how long we can keep up the vigilance of people doing all the protective things they need to do in order to not have a resurgence (of COVID-19),” Scott said. “Coupled with reopening things like gyms and movie theaters, I feel like I have extra trepidation for our community.”

In the first wave of COVID-19 in March, many patients came to Michigan Medicine from overwhelmed Detroit-area hospitals. Now that students have settled back on campus, Scott said she worries about what this population influx will mean for the Ann Arbor community and immunocompromised patients in the hospital.

In June, more than 700 employees were laid off from Michigan Medicine as the hospital system continued its front-line battle against the coronavirus. Michigan Medicine spokeswoman Mary Masson said at the time that the layoffs “will help Michigan Medicine continue to provide hope and healing to our patients and allow us to continue to support our clinical, educational and research missions.”

The job cuts included 38 emergency technicians employed by the hospital system. Anne Jackson, an ambulatory care nurse, said she’s worried nurses won’t be able to handle another rise in cases.

“The techs help get a lot of the procedures done in the ER,” Jackson said. “If we get another surge, having the nurses have to care of it alone without techs to support them is going to be crazy.”

Jackson, who is also a union steward at the hospital, said she believes Michigan Medicine leadership was concerned primarily with saving money over the past months. She said the new staffing model requires nurses to work harder and work more, ultimately making them less safe.

“They’re taking the opportunity of a pandemic to make the institution more lean, which takes away from what (the) University of Michigan is, which is a very unique institution that takes care of the sickest of the sick and the most unique patients,” Jackson said.

Jackson cited a May 8 Michigan Medicine town hall, during which hospital leadership talked about the prospect of bringing the cost per case down from the 90th percentile to the 75th percentile. 

At the town hall, Chief Financial Officer Paul Castillo said the changes were “operational leadership asking certain departments to probe a little bit deeper into what the opportunities are to cut costs.”

But Jackson said these cuts came at the expense of cutting down on support services and staff. For example, according to Masson, 23 unit hosts — responsible for providing support to nursing staff, patients and families — were laid off in June.

“We are continuing to provide similar services to patients and families (as the unit host provided) and will continue to reassess their needs,” Masson said. 

Karen Rappaport, a registered nurse on Pediatric Hematology-Oncology and Pediatric Bone Marrow Transplant floor, described the unit host role as the “heart and soul of our floor.” She said in targeting budget cuts toward the role, Michigan Medicine lost people who provide extra care and emotional investment to families in need, which she said was especially needed during the pandemic.

“If we do have a resurgence, that means that the patients will have fewer visitors, and then (the unit host) role is even more missing at the current time,” Rappaport said.

According to emails from Michigan Medicine to employees obtained by The Michigan Daily, as of July 28, any health care worker who provides direct patient care to patients with confirmed COVID-19 or persons under investigation needs to wear a gown, gloves, N95 respirators and eye protection.

Prior to this, the emails said this protective gear was only required for aerosol-generating procedures, or any procedures performed on patients that are likely to result in higher concentrations of infectious aerosols than coughing, sneezing, talking or breathing. 

“Everybody’s exhausted and traumatized and worried,” Jackson said. “It’s frightening to work there when you know you don’t have enough protection.”

Scott said that as of last week, healthcare workers are still not allowed to bring personal protective equipment from home. According to Scott, this is because masks such as N95s must be fit-tested to ensure they are effective. However, she found it frustrating because she has an elastomeric mask at home, which she said was “definitely reusable.”

When asked about the impact of students returning to Ann Arbor on the hospital system, Masson said the system is always prepared for increases in patient volume.

“At Michigan Medicine, we are in a constant state of preparedness and have been planning for potential patient surges since early this year,” Masson said. “Michigan Medicine leaders are in constant contact with campus leaders and all are closely monitoring COVID-19 data. We remain prepared to serve our community, including students, as this pandemic continues.”

Scott said the weeks following Labor Day would be the “next hurdle” for the community.

“I think we'll see what happens after this weekend — at least at the two-week mark after Labor Day weekend,” Scott said. “If we can remain safe after that, I’ll have a little bit more confidence. But right now, I just have a high degree of anxiety for what this will mean for my colleagues and for patients and the health system.”

Daily staff reporter Iulia Dobrin can be reached at idobrin@umich.edu.

 

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