From left to right: TTRNA President Mr. Idi Stuart, NWRHA Disaster Preparedness Coordinator, GM HR Mr. Christopher Auguste, GM IR Mr. Deryck Cyrus, CEO Mr. Terron Gilchrist, GM Nursing and Patient Services Ms. Sherma Alexander, TTRNA OSH Chairperson Mrs. Sharon Lakhan-King, NWRHA IROs, TTRNA 2nd Vice President Ms. Letitia Cox and NWRHA OSH Registrar Dr. Khea Clement-Marshall (not in picture).
Trinidad and Tobago Registered Nurses' Association (TTRNA) met with a team from the North West Regional Health Authority (NWRHA) led by its Chief Executive Officer (CEO) Mr. Terron Gilchrist on Monday 16th March 2020 regarding the Region’s response to Covid-19 outbreak.
The following points emanated:
1. Maintaining Staffing Compliment
Ministry of Health is charged with the responsibility of ensuring capacity in response to this crisis. There is expected to be a redeployment of staff from across regions and importation of foreign nurses to assist with shortfalls in affected areas. Clinics would be closed and staff deployed elsewhere. TTRNA urged that Nursing and Midwifery personnel who are immuno-compromised, over 60 years, pregnant nurses and mothers of young children, be excluded in the first instance from being deployed to the front-line. This was affirmed by the GM IR and the OSH Registrar. The GM Nursing was instructed to intervene in any issues arising in this regard. Ms. Letitia Cox requested that correspondence itemizing considerations for deployment of nursing personnel to screening areas be forwarded to the Supervisors for guidance.
2. Sensitization and Training
The GM HR gave assurances of an education drive to allay fears of both staff and public to reduce panic and misuse of resources. Multi-sectoral sensitization exercises have commenced with the first being conducted at St. Anns Psychiatric Hospital (SAPH) on Monday 16th March 2020, then St. James Medical Complex (SJMC) on Tuesday 17th March 2020 at 10:00am.
Screening tents have been set-up and protocols issued at all institutions in association with Infection Prevention and Control (IPC). A doctor, using a basic form, would screen patients accessing the facilities. TTRNA maintains appropriate PPE’s must be donned during the screening process to reduce health professionals' exposure. Suspected cases must be treated as if they were confirmed cases according to the Adverse Events Policy, and the recommended length of time one should wear the suit especially in humid weather.
Transfer of suspected and positive cases would be done by the Emergency Management Service (EMS) Ambulance service and not the nursing personnel or vehicles of the NWRHA.
Ms. Letitia Cox enquired about availability of recommended negative pressure rooms for managing highly infectious cases. It was revealed that SJMC has two fit for purpose ICU rooms (one male and one female) that is fully equipped with hepa-filters and a number of private rooms which can be utilized and that a request was submitted to the Ministry of Health to upgrade those rooms with hepa-filters to achieve negative pressure.
Ms. Letitia Cox raised the issue of infestation of rodents and serpents at the St. Ann’s Psychiatric Hospital (SAPH) stock area which is a health concern amid this COVID-19 health concern. The CEO gave assurance that it is engaging his attention and that stocks were supplied to SAPH today. Mrs. Sharon Lakhan-King reiterated the need for cleaning of all wards twice daily at SAPH.
Doubt surrounds Nursing and Midwifery Personnel being entitled to Pandemic Leave.
Consistent with what was stated by the Chief Personnel Officer and the Minister of Labour on Sunday 15th March 2020 at the press conference, NWRHA has reiterated that RHAs’ employees do not fall under this leave for the most part.
However, NWRHA says detailed information is still coming in from the CPO’s office and the situation is fluid and subject to change. In the interim, NWRHA will be guided by the Manual of Terms and Conditions for monthly paid employees in treating with leave request and have developed a Frequently Asked Questions (FAQ) sheet for staff. The following provisions will apply:
a) employees whose contract of employment provides for paid Sick Leave (SL), and are
i. exhibiting flu-like symptoms and are advised to refrain from the workplace
ii. advised to self quarantine
iii. who are tested positive for COVID-19
iv. ill due to other medical conditions
These persons would utilize their SL eligibility. When the SL is exhausted and further leave is required then Extended Sick Leave (ESL) would apply.
b) Children away from school
parents should seek to utilize their support system. Where there is inadequate support systems then ‘Compassionate leave’ would be applied at the fair discretion of the Supervisor or Head of Department.
Documentation is of critical importance for both the affected staff (medical certificate, justification letter, travel ticket stub etc.) and for the Supervisor (approval letter) for accounting and clarification purposes.
Nursing personnel were reminded that children are not allowed in the workplace and urged to follow the guidelines of the Ministry of Labour and utilize the appropriate leave facility responsibly and only as needed. However, TTRNA reiterated the call for DAYCARE services at the workplace should be consider going forward. Especially since the very Ministry of Labour, houses a daycare in their offices for their employees.
TTRNA commends the NWRHA for being proactive in maintaining a mutually respectable relationship with the Association. TTRNA remains committed to working with the RHAs to represent nursing personnel and to improve healthcare from within. TTRNA will update our members next on SWRHA readiness as we are set to meet with them next week.