Testimony of Barbara Rosen, RN First Vice-President of the Health Professionals and Allied Employees Before the New Jersey Assembly Committee on Health

Thursday, 11 June 2020

Good morning Chairman Conaway, Vice-Chair(woman) Jimenez, and committee members. Thank you for the opportunity to provide insight and recommendations regarding the mental health needs of frontline healthcare workers in light of the Covid-19 pandemic. My name is Barbara Rosen, RN and First Vice-President of HPAE, NJ’s largest union of healthcare professionals representing 14,000 nurses and healthcare workers in hospitals, nursing homes, behavioral and mental health, blood collection, and substance abuse facilities.

I appreciate the opportunity to shine light on the horror our healthcare workers have endured over the past several months, and will continue to experience for months, possibly years, to come. Our healthcare workers have been stretched beyond any reasonable expectation in this pandemic, regardless of job duties. We in turn must make it a priority to provide behavioral health care, intervention, and support to these workers. The well-being of our frontline workers is crucial to the State’s ability to re-open and for handling a resurgence of COVID-19 cases.

We can all agree that New Jersey and the entire country were completely unprepared to handle any type of pandemic. The lack of planning – nationally, within the State, within healthcare facilities – thrust healthcare workers into a nightmare they could not escape.

Healthcare workers by nature are compassionate caring people, with a core mission to comfort and rescue those in need. They give of themselves unselfishly and place themselves in harm’s way if it means saving a life. And yet, during this pandemic those that should have been caring about the safety and health of healthcare workers abandoned them in the time of their greatest need.

The Centers for Disease Control (CDC) guidance has changed almost daily, down-grading minimum standards of personal protective equipment (PPE) for healthcare workers. The CDC even went so far as to say a bandana or scarf was acceptable PPE given the shortage of masks and N95 respirators. The American Hospital Association (AHA), with every state chapter on board including New Jersey, lobbied for the defeat of implementation of an emergency temporary standard that would have protected healthcare workers during the pandemic. Despite the knowledge that Covid-19 was and is transmissible through the aerosolized particles of human breath, AHA was promoting paper surgical masks as “adequate” protection while N95s were in short supply. A surgical mask offers almost no protection and a bandana even less, and yet these are what our hospitals and Federal agency experts were recommending. It is no wonder healthcare workers felt as though their lives were considered disposable.

What healthcare workers have experienced every day is unimaginable to the general population. They have endured unbearable workloads, been exposed daily to a life threatening illness, lived with the constant fear of bringing Covid-19 home to family members, worked without proper PPE almost from the beginning, had their jobs and livelihood threatened by their employers when they have advocated for safe conditions for patients and workers, and had to make life or death decisions nearly every day. Their experiences will cause them to suffer the conflicts and pain of moral injury. All while most of us have been safe at home.

Recently, one of our members burst into tears as she described how her hospital had run out of body bags. Staff were forced to put the bodies of deceased Covid-19 patients into garbage bags, which were then stacked in refrigerated trucks outside the facility. The likelihood of post-traumatic stress disorder (PTSD) is assured, and New Jersey healthcare facilities must prepare to make assistance available sooner rather than later.

A 2016 study on police officers responding to 9/11 showed that 12.9% reported PTSD symptoms over a decade after the incident. In addition, 72.4% of those that reported PTSD also suffered from depression and anxiety. A study of survivors who had been in both World Trade Towers when the planes hit found that more than 14 years later, 13% of survivors experienced PTSD and 68% with PTSD suffered from depression.

Already, early studies are showing soaring rates of anxiety, depression, and insomnia in medical workers around the globe. Healthcare workers have faced the loss of life in staggering proportions, and in turn have had to deal with loss of their own colleagues. They have substituted for family members for the dying when family was not allowed to be at the bedside of loved ones. They have lived with the daily stress of engaging in a battle without the proper equipment that put their lives, patients’ lives, and family members at risk. The strain of that toll is truly incalculable.

We must commit to having accessible mental health care in place for all our frontline workers. A recent article in JAMA Network stated that much distress could be headed off if hospital leadership created a proactive, supportive culture that included ways for workers to express concerns and feel heard. Rather than firing them for advocating for co-workers health and safety, like one of our members experienced in April, healthcare employers must begin to take actual steps toward caring for their employees’ mental and physical health. It is critical not only to the workers, but also to the lives of patients and to the continued operation of each facility. Employers must stop behaving as though workers are expendable – the ability of facilities to care for patients rests in the hands of the workers.

Mental health care should be viewed as a survivor benefit for life. The State needs to make this assistance a top priority and must monitor access and delivery, with minimal to no cost to the workers. As our state legislators, you are uniquely positioned to create an enforceable plan that will see to the care of our frontline workers and ancillary staff. They at least deserve a plan for that. We cannot call them heroes only to treat them as disposable as the paper masks on their faces.