New York's health care workforce braces for influx of retirees, inexperienced staffers

Ambulances face the NYU Langone Health emergency. | Getty Images

NEW YORK – As the Coronavirus infests New York City and the largest U.S. city becomes the epicenter of the national crisis, government officials are trying to expand a healthcare workforce that is already overworked and falling victim to the virus itself.

New York is reaching for reinforcements in every corner of its medical industry, but a new push for retirees is raising the alarm as older populations are among the most vulnerable to the disease. And since the state rules are relaxed, medical and nursing students with little experience are employed. Specialists and nurses are asked to realign their virus-fighting skills, while many others have been relegated to the fringes of the fight.


While the war situation that hospitals are now in requires a loosening of the protocols, some fear that the rush may worsen the crisis.

“My main concern is that you involve the high-risk group [of retirees]”Said Joyce Lemon, a 67-year-old retired nurse.” Anyone who has retired has aged or retired. Both [are] Groups that you should not ask to return to a hospital at this time. When they get sick, they consume valuable medical care for the people you bring with them. “

To meet demand that could rise to 140,000 hospital beds at the head of the pandemic, Governor Andrew Cuomo, in a few weeks has used new executive powers To loosen medical admission and practice standards, to protect healthcare workers from civil liability and, among other things, to oblige hospitals to increase their capacity by at least half. He has increasingly called for doctors in New York and across the country to “enroll” the state’s reserve workforce This will occupy the expected influx of Covid 19 beds and relieve front workers who have contracted the virus.

More than 50,000 people have responded to the governor’s call for help, suggested by Cuomo could eventually turn into an involuntary design. These include 16,300 registered nurses, 4,000 licensed practical nurses, 2,300 doctors, 2,400 nurses, 900 medical assistants, 300 anesthetists, 160 respiratory therapists and 8,600 psychiatric professionals.

However, no one had been deployed until Wednesday, and it remains unclear when and how this will happen. From Thursday morning more than 37,000 people were infected and 385 died all over New York, according to Cuomo’s office. The death toll increased by 100 within 24 hours.

Art Fougner, president of the New York State Medical Society, said the reserve workforce should send international medical graduates and newly-formed doctors who have not been compared to medical facilities before contacting retirees.

“It has nothing to do with medical rules now, it has to do with the fact that many retirees in this age group are at high risk,” he said in an interview.

However, introducing inexperienced workers to the field carries its own risks.

Fougner said the relaxed rules raised “a number of concerns about the scope of the practice,” potential liability issues and other changes to Cuomo’s rules of procedure, especially if the measures become permanent.

But he said, “This is a situation where all hands are on deck. It is not as usual. “

“We understand that this is an emergency … but we have to be vigilant and make sure that someone looks after the store so that crazy things don’t happen unnecessarily,” warned Fougner.

Medical schools such as the Albert Einstein College of Medicine and New York University are turning to class 2020 to strengthen the workforce. Einstein, a Bronx-based medical school, asked students to “resume clinical work as a sub-intern” or to work in an adjunct area where patient care is not required. This comes from an email sent to the 2020 class.

“We know that this news is likely to be baffling and potentially frightening, but we are working with Montefiore’s leadership to protect the health and safety of those who choose to work in a hospital,” said the email from POLITICO.

The NYU announced this week that it will give medical students who have met all the necessary requirements the opportunity Complete early if you volunteer work in the internal or emergency medical department of the NYU hospital system.

Most of the reserve – especially medical students – is unlikely to be sent to the frontline to treat coronavirus patients, Fougner said.

“I don’t think they’re going to send an early graduate medical student to do an emergency cardiac bypass, it clearly doesn’t happen,” he said.

Randall Moore, CEO of the American Association of Nurse Anesthetists, said the regulatory changes in New York will allow advanced practice providers such as the state’s 1,700 anesthesiologists to “care for patients as effectively as possible” – and essentially reuse their treatment skills multiple breathing problems caused by the corona virus without mandatory direct monitoring.

“Nurse anesthesiologists are advanced respiratory experts,” said Moore. “You can imagine that in a crisis where a shockingly high percentage of people need intubation and mechanical stimulation, nurse anesthetists will be a big part of it.”

Given the fact that anesthesiologists are among those who are at greatest risk of contracting coronavirus due to their intubation work, Moore said using a reserve workforce, including 270 state anesthesiologists for nurses, could help alleviate bottlenecks to avoid with the airway supply.

“I think that now more than ever, it is imperative that we have providers, whether doctors or nurses, in a clinical setting that does the care,” he said. “I support the concept of including medical students in the workforce, and I also support the transfer of nursing students who are in the same boat … to the clinical setting as well.” This is not the right time to give bureaucracy the opportunity to take care of patients. ”

Many hospitals have employees who are not directly involved in the fight against the corona virus. The Hospital for Special Surgery, a medical center for musculoskeletal health in Manhattan, has canceled all elective operations and procedures and has asked its staff to stay at home. Lenox Hill Hospital, owned by Northwell Health, has also taken some employees on leave but continues to pay their salaries.

Other hospitals are shifting their specialist staff to other roles.

NYU Langone Health uses its orthopedic hospital to discharge coronavirus patients. However, staff said they were concerned that if they prepared patients for departure, they would become infected with the virus. According to Lemon, a NYU Langone Orthopedic Hospital employee asked the contract administrator, “I didn’t sign up for it. Can I withdraw and come back afterwards?”

The health care system has not returned a request for comment.

According to Lemon, the use of personnel from other fields also has its pitfalls.

“Your specialty can be orthopedic, or it can be neuro, or it can be the mother-baby unit,” said Lemon. “Now you are [put] on a medical unit that you are not familiar with. The [nurses] I’m not going to say no, but it has to be a unit that feels like it’s coming out on the other side. “

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