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Roshan Parasram

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 sterilize 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.