Workers at a psychiatric facility in eastern Connecticut have filed a federal workplace safety complaint alleging administrators at Natchaug Hospital are “putting the lives of patients and staff at risk” by failing to adequately distribute personal protective equipment to nurses and failing to properly isolate a patient suspected of having COVID-19.
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Natchaug is a congregate psychiatric facility, providing group-setting services to children, adolescents and adults, with a focus on mental health problems and substance use disorder.
What it’s not, said John Brady, a registered nurse and vice president of AFT Connecticut, is an acute-care hospital properly equipped to handle COVID-19 patients.
“When we asked, ‘Is this going to be an issue? We’re not set up for this,’ they said, ‘No, we won’t have them here,’” Brady said. “Unfortunately, that has not been completely the case. They have received some COVID patients. And, in some cases, those patients have stayed there.”
AFT recently filed a complaint with the Occupational Safety and Health Administration, alleging unsafe working conditions at the hospital.
Natchaug is a partner in Hartford HealthCare’s behavioral health network.
After AFT filed its complaint, OSHA wrote back on May 12, after an initial investigation conducted by Hartford HealthCare. The agency said it believed the case could be closed “on the grounds that the hazardous conditions have been corrected (or no longer exist).”
But days later, AFT appealed the findings of the hospital’s internal investigation, arguing PPE for staff was still not adequate and that “multiple nurses have already tested positive” for COVID-19.
OSHA officials decided to keep the case open. Brady said since then, they’ve spoken to at least 10 members of his union about conditions at Natchaug.
A spokesperson for Hartford HealthCare cited the pending investigation and declined an interview. The network did not answer questions about COVID-positive patients being kept at Natchaug.
But OSHA documents provide a look at how the psychiatric hospital has managed COVID-19.
In an internal investigation letter sent to OSHA on May 8, Hartford HealthCare’s Thomas Mulhearn wrote that in late March the hospital began “providing face masks to all employees providing patient care.”
Mulhearn said staff treating patients got masks “whether or not care was being provided to patients with suspected or confirmed COVID-19.”
“Additionally, all patients are asked to wear masks,” Mulhearn wrote.
“As Natchaug Hospital is a psychiatric facility, some patients present a challenge in strictly adhering to this policy,” he wrote.
According to AFT, inadequate PPE is one reason nurses at the hospital tested positive for COVID-19.
Brady said if union workers are treating patients whose COVID status is unknown, they should be properly fitted with N95 respirators, especially if some of those patients aren’t wearing face coverings.
“When a psychiatric patient comes into the hospital, typically, they will go into a room, sit down with a nurse, and the nurse will do an in-depth interview with them,” Brady said, “... so you’re in a small room, for privacy, with this patient.”
“If the patient doesn’t wear a mask, and if you don’t have an N95 on, and then that patient later is found to be positive for COVID, then you’ve been exposed,” Brady said.
According to documents, on April 13 an adult patient was admitted to Natchaug for reasons unrelated to COVID-19.
Cases in Connecticut were surging at that time, with over 700 people hospitalized in Fairfield County alone. But in Tolland County, where Natchaug is located, hospitalizations were comparatively light: just 13 people.
On April 25, when that patient began to display symptoms consistent with COVID-19, the hospitalizations in Tolland County had dropped to only six patients, according to state data.
Brady said the patient should have been immediately sent to a nearby acute-care hospital that was equipped to isolate and properly treat the patient.
But that’s not what happened, according to Hartford HealthCare’s internal investigation.
“Patient A was placed into isolation as a patient under investigation (a “PUI”), and was tested for COVID-19,” wrote Mulhearn in the internal investigation letter. “When any patient is placed into isolation, a sign is placed on the outside of the patient room providing conspicuous notice to the employees and indicating the precautions required to enter the room.”
Mulhearn said the patient tested negative for COVID-19 on April 26.
“Based on the symptomology, and the fact that Patient A tested negative for COVID-19, an N95 respirator and face shield were not required,” Mulhearn wrote. “Accordingly, the investigation revealed that appropriate infection control procedures were in place.”
But Brady said that’s the wrong approach. He said that all patients coming into the facility should be assumed to have COVID-19 and that all staff should be adequately protected.
“That’s what we’re doing in acute-care hospitals,” Brady said. “When you visit an acute-care hospital as a patient … you’re expected to answer some questions, have your temperature taken, and wear a mask.”