Early in the pandemic, nurses were celebrated as heroes, with nightly symphonies of clapping or banging pots and pans. Now, many are being asked to go into work despite positive Covid tests — or they say they are being told they must use their vacation and sick days to stay home when they contract the coronavirus.
“You’re talking about a group of people who sat at bedsides — not one a night, multiple, because we were consistently losing people. We were holding the iPads as people said their last goodbyes,” said Ana Bergeron, a registered nurse who is the president of a local union affiliate. “I can’t tell you how sick it makes me now being called a hero, because that’s not how we’re being treated by our employers.”
As the omicron variant continues to spread rapidly across the country, nurses at numerous hospitals have had to use their own sick days and vacation days if they test positive for Covid-19, according to conversations with 10 nurses at five hospitals, two unions representing thousands of nurses at many more and an internal memo reviewed by NBC News. In some instances, nurses who test positive have also been instructed to return to work if they are asymptomatic, according to another internal memo, also reviewed by NBC News.
“Healthcare providers (HCP) who test positive for Covid-19 and are asymptomatic may return to work immediately without isolation and without testing,” reads a memo sent Tuesday to the staff of St. Francis Medical Center in Lynwood, California. “These healthcare providers must wear an N95 respirator for source control. The HCP may be assigned to Covid-19 positive patients if possible.”
As St. Francis Medical Center said in a statement, its memo uses guidance from the California Department of Public Health that is in effect from Jan. 8 until Feb. 1.
“At St. Francis Medical Center, employees who fall under this criteria may choose to return to work or follow the guidelines for sick leave as set forth in their collective bargaining agreement,” spokesperson Chris Yarnovich said. “St. Francis continues to institute all safety standards and measures to mitigate staffing shortages as we continue to care for patients during this surge.”
The health department said it revised its guidance in response to “the critical staffing shortages currently being experienced across the health care continuum because of the rise in the Omicron variant.” It also says on its website that “everyone, regardless of vaccination status, previous infection or lack of symptoms,” should “stay home for at least five days.” However, “this guidance does NOT apply to healthcare personnel in any setting,” it says.
In a statement, the health department said that while it is “extremely grateful” to all of the state’s health care workers, it has given hospitals and emergency services providers “temporary flexibility” because hospitals are reaching capacity and staffing shortages continue. It said, however, that “hospitals have to exhaust all other options before resorting to this temporary tool.”
The St. Francis memo also provides guidance for boosted workers who test positive and who have mild symptoms but are improving. They may isolate for fewer than five days and are supposed to treat only Covid-19 patients. However, it says, “this may not be possible in all settings and circumstances due to extreme staffing shortages.” The same caveat is also given to workers who are eligible to be vaccinated but are not and those who have been vaccinated but have yet to receive booster shots.
For people who need to check their status, the memo says, “in-house Covid testing is limited to employees who have approved vaccine exemptions.” Several nurses said they have had to find testing for themselves, as it can take several days to get appointments as test shortages continue across the country. (The Supreme Court on Thursday upheld a mandate that requires health care workers at hospitals that receive federal funding to be vaccinated.)
Policies about when someone can go back to work after having tested positive vary from hospital to hospital. Policies also vary about how or whether employees will be compensated for the time they are not able to work for coronavirus-related reasons. Nurses at hospitals in Maine, Florida, Missouri and California all said they were required to use personal paid time off if they tested positive. They shared frustration that they did not have the option of paid administrative leave.
For Laura Gosselin, a nurse in Maine, the issue came to a head late last year when she found herself isolating at home with her family, unable to go to work, after they all tested positive for the virus. Her brother works for the city of Augusta, her husband works for the state, and her son-in-law works for a farm. All of them got special Covid pay from their employers, while Gosselin had to use up her vacation days.
“It was like a slap in the face,” said Gosselin, who has been a nurse at her hospital for 30 years and is vaccinated but not yet eligible for a booster shot. “We are just working our hardest and doing our best. I always felt like nurses were so respected and held in such high esteem. I feel like that has been pulled away. We still take care of our patients and want to take care of our community. But we deserve better. Our government and employer has let us down.”
She’s not alone.
“I got sick with Covid for the third time. It hit me really hard,” said Candice Cordero, a registered nurse in Florida who is vaccinated but not yet boosted. “I let work know I was positive, and they told me to take the seven days that were recommended at the time. I called after a week and said I still had symptoms. They said, ‘You’re supposed to be better after five days.’ But that’s not really how Covid works.”
Cordero was told that if she was going to be out for longer than a week, she would need to apply for short-term disability benefits through the Family Medical Leave Act. She was also told that she would have to use personal time off for half of the time she was out.
“I feel like they’re pushing people back into the workforce to minimize shortage,” she said.
Nurses at Cedars-Sinai, one of the largest hospitals in Los Angeles, are also being required to use their paid time off for Covid-related absences, according to a memo sent Friday to employees and reviewed by NBC News.
“If you are off work while awaiting Covid-19 test results or while recovering from Covid-19 before cleared to return, please use your available paid time off,” the memo reads.
The policy is a change from the previous year and a half, when those who tested positive were placed on paid administrative leave and did not have to use their earned paid time off.
“Since the pandemic began, Cedars-Sinai has adapted our employment policies to meet the unique challenges presented by Covid-19,” Sally Stewart, a spokesperson, said in an email. “It is likely that our employment policies will continue to adapt as the pandemic creates new challenges.”
She also said Cedars-Sinai offered “employees paid administrative leave from the start of the pandemic through last fall” if they experienced symptoms or tested positive.
In California, a pandemic-era law required companies with more than 25 employees to provide up to 80 hours of paid leave for Covid-related reasons. The law expired in September, leaving employers to set their own policies. California Gov. Gavin Newsom included Covid sick leave in his proposed budget for this year, but it is unfunded and has not been adopted by the Legislature.
The American Rescue Plan, which President Joe Biden signed early last year, extended the Trump-era Families First Coronavirus Response Act, which gave companies with fewer than 500 employees incentives to provide Covid-related paid family leave. The incentives ended when the law expired in September.
The United Nurses Associations of California/Union of Health Care Professionals, a trade union that represents 32,000 registered nurses and other health care professionals in the state, is calling on employers to reinstate or implement Covid leave and to stop requiring asymptomatic staff members who have tested positive to go back to work.
“Whether you have separate banks of vacation and sick leave or a combined bank, utilizing hours over and over again for this Covid pandemic is very disconcerting,” said Denise Duncan, the union’s president. “Some of our workers’ banks have been depleted, meaning less time off for other things. There needs to be work-life balance.”
Duncan said lawmakers and hospital administrations could have negotiated Covid time off last year.
“They could’ve been working on some of these solutions, and they weren’t. That’s created a lot of anger and mistrust,” she said. “People are saying this will not be our last pandemic. That creates a lot of angst and fear among our workforce.”