An­na-Lisa Paul

The Min­istry of Health has as­sured that al­though the con­tracts of doc­tors and nurs­es hired to staff the COVID Sur­veil­lance Con­tact Trac­ing Team will ex­pire on Mon­day, they will be re­tained for an ex­tend­ed pe­ri­od.

Re­spond­ing to con­cerns by anx­ious em­ploy­ees, se­nior of­fi­cials of the Min­istry of Health sought to al­lay fears that con­tact trac­ing of COVID-19 pa­tients at state quar­an­tine fa­cil­i­ties in­clud­ing step-downs, ho­tels and those in home iso­la­tion was in jeop­ardy.

Un­der­scor­ing the need for the con­tin­ued ser­vices as eco­nom­ic ac­tiv­i­ty con­tin­ues to re­sume and as cit­i­zens con­tin­ue to be repa­tri­at­ed, one nurse claimed that if the unit is dis­man­tled "it could lead to an ex­plo­sion in cas­es if there is no clear mon­i­tor­ing poli­cies or mech­a­nisms in place."

She said, "All that in­for­ma­tion the min­is­ter pro­vides on tele­vi­sion, the sta­tis­tics, it is based on the back­ground work we do dur­ing the con­tact-trac­ing process."

The con­tracts of med­ical pro­fes­sion­als in­clud­ing doc­tors and reg­is­tered nurs­es hired by the Min­istry of Health (MOH) in Au­gust to staff the unit, will end on No­vem­ber 23. Up to Fri­day, the nurse said no ros­ters had been pre­pared for them this week.

How­ev­er, the se­nior of­fi­cial said on Sat­ur­day that the cur­rent staff com­ple­ment would be main­tained go­ing for­ward.

Em­ploy­ees of the unit are al­so con­cernd about when they will be ful­ly com­pen­sat­ed for the work they have con­duct­ed over the past three months.

Ap­prox­i­mate­ly 50 RNs and 50 doc­tors were giv­en three-month con­tracts when they were hired to staff the unit and com­menced work­ing on Au­gust 24.

How­ev­er, sev­er­al peo­ple last week com­plained of re­ceiv­ing their Sep­tem­ber salary in late Oc­to­ber. They al­so claimed that they are still await­ing their Oc­to­ber salary with just a week to go be­fore No­vem­ber ends. They are won­der­ing if they will be paid for the full three months be­fore Christ­mas.

The MOH of­fi­cial, how­ev­er, claimed to be un­aware that per­son­nel had been ex­pe­ri­enc­ing prob­lems re­ceiv­ing their salaries. In re­sponse to claims that there were not enough cell­phones for use by the unit’s em­ploy­ees, he said once this is­sue is re­port­ed to them, they would take cor­rec­tive ac­tion to en­sure ad­di­tion­al de­vices are pur­chased for the work­ers who need it to stay con­nect­ed to those be­ing mon­i­tored.

Health Min­is­ter Ter­rence Deyals­ingh has said elec­tron­ic tag­ging was one way to keep clos­er tabs on peo­ple in quar­an­tine, but ad­mit­ted it could on­ly be done on a vol­un­tary ba­sis as T&T’s Con­sti­tu­tion does not al­low for this.

While there has been no word yet on if and how soon these track­ers could be in­tro­duced, the nurse spec­u­lat­ed it would al­low the po­lice to re­duce the num­ber of dai­ly checks they of­ten have to do to en­sure peo­ple in home-iso­la­tion do not breach reg­u­la­tions.

Ac­cord­ing to the MOH’s 4 pm up­date yes­ter­day, 27 peo­ple were in step down fa­cil­i­ties, 112 peo­ple were in state quar­an­tine fa­cil­i­ties, and 480 were in home-iso­la­tion.

Scope of work

|The 100 short-term em­ploy­ees were spread across the eight coun­ties ac­cord­ing to their res­i­den­tial lo­ca­tions.

The job scope of the unit’s per­son­nel in­cludes gath­er­ing and analysing the da­ta and in­for­ma­tion that is nor­mal­ly pro­vid­ed by the MOH dur­ing the thrice-week­ly pub­lic brief­in­gs.

One nurse said, "We are the ones, to­geth­er with the doc­tors, that do the con­tract trac­ing. We go to ho­tels to as­sist the doc­tors with swab­bing clients that have re­turned and are quar­an­tined.

"Some of us are as­signed at dif­fer­ent health cen­tres in the var­i­ous coun­ties, where we as­sist with screen­ing clients be­fore they can en­ter the health fa­cil­i­ty, as well as as­sist the doc­tor who is as­signed to swab clients that present with flu-like symp­toms."

Oth­er ag­griev­ed nurs­es claimed that "when clients test pos­i­tive and an on-call doc­tor con­tacts them, we do the back­ground work get­ting their in­fo and their fam­i­ly’s in­fo to en­ter in the sys­tem.

"We al­so have to keep in touch with all the quar­an­tined clients whether at the ho­tels or those at home to mon­i­tor their sta­tus…like if they are im­prov­ing or not im­prov­ing, or what fur­ther med­ical as­sis­tance they may need to re­cov­er."

The MOH stat­ed that the unit’s ob­jec­tive was to pro­vide ad­di­tion­al doc­tors to in­crease na­tion­al ca­pac­i­ty to re­spond to COVID-19, whilst the reg­is­tered nurs­es would form part of a cross-func­tion­al clin­i­cal team.

The nurs­es were man­dat­ed to work with the nurse in charge to per­form gen­er­al nurs­ing ac­tiv­i­ties in­clud­ing ad­min­is­ter­ing med­i­cines, and as­sist­ing at op­er­a­tions and oth­er sim­i­lar du­ties in the care and treat­ment of pa­tients.

In the area of clin­i­cal care, the RN’s were as­sured the MOH would pro­vide the nec­es­sary Per­son­al Pro­tec­tive Equip­ment (PPE) as they were ex­pect­ed to per­form a host of gen­er­al nurs­ing du­ties.

Re­port­ing re­quire­ments in­clude month­ly re­ports to be pre­pared for the Chief Med­ical Of­fi­cer Dr Roshan Paras­ram.

The list of du­ties to be per­formed by the nurs­es in­cludes but is not lim­it­ed to:

· Per­form gen­er­al nurs­ing du­ties such as tak­ing tem­per­a­tures, pulse and res­pi­ra­tion, blood pres­sure; ob­tain spu­tum, urine, blood and oth­er spec­i­mens for lab­o­ra­to­ry ex­am­i­na­tion;

· Ac­com­pa­ny doc­tors dur­ing ward rounds and doc­u­ment com­ments, treat­ment, and find­ings, and up­date doc­tors on client sta­tus (gen­er­al con­di­tion of clients);

· Or­der stores (gen­er­al stores, med­ical stores, phar­ma­cy drugs, di­etary needs of clients) as re­quired;

· Ad­mit and as­sess emer­gency pa­tients and ini­ti­ate nurs­ing in­ter­ven­tion in emer­gency cas­es;

· Ad­min­is­ter med­ica­tion as pre­scribed; ac­com­pa­ny pa­tients in am­bu­lance for var­i­ous di­ag­nos­tic in­ves­ti­ga­tions and trans­fer to oth­er hos­pi­tals;

· Make con­tin­u­ous as­sess­ment, eval­u­ate client sta­tus and ad­min­is­ter ther­a­py/coun­sel as or­dered;

· At­tend to pa­tients’ psy­cho­log­i­cal and spir­i­tu­al needs;

· Keep watch over pa­tients with spe­cial em­pha­sis on their be­hav­iour and ob­serve pa­tients to de­tect any changes from nor­mal con­di­tions and pre­pare re­ports;

· Su­per­vise pa­tients en­gaged in oc­cu­pa­tion­al and recre­ation­al ther­a­pies;

· Per­form dai­ly dress­ings as or­dered, su­per­vise and serve di­ets and en­sure in­tra­venous (IV) flu­ids are giv­en as or­dered;

· En­sure crit­i­cal pa­tients are reg­u­lar­ly mon­i­tored e.g. vi­tal signs tak­en every 15 min­utes;

· Clean and ster­ilise in­stru­ments and dress­ings;

· Per­form rou­tine pa­tient care ac­tiv­i­ties such as mak­ing beds, serv­ing food and giv­ing baths;

· Ad­min­is­ter holis­tic care to client, that is, phys­i­cal­ly, men­tal­ly, spir­i­tu­al­ly and so­cial­ly;

· Be an ad­vo­cate for pa­tient rights in­clu­sive of ed­u­cat­ing and coun­selling pa­tients and rel­a­tives about ill­ness and treat­ment and about re­ha­bil­i­ta­tion pro­grammes;

· In­sert na­so­gas­tric (NG) tubes and ad­min­is­ter blood and to­tal par­enter­al nu­tri­tion (TPN);

· Keep in­ven­to­ry of equip­ment de­liv­ered to ward/unit; and

· Use con­flict man­age­ment skills to re­solve con­flicts with staff/clients.