Antigua and Barbuda’s main hospital, the Sir Lester Bird Medical Center (SLBMC) has responded to claims by several nurses employed there, that they are burnt out, demotivated, underpaid, and not getting their concerns addressed by the management.

Nurses, about a dozen of them, said that they have been working long hours without compensation, they are exposed to Covid-19 patients without proper medical gear and they are just about ready to migrate for greener pastures.

These women are accusing the government, more or less, the Ministry of Health of turning a blind eye and a deaf ear towards their plights, saying that their marriages are under pressure because they have no time for family after spending long hours at work.

In a statement on Friday afternoon, the SLBMC acknowledged that indeed, within the last week they were subjected to several reports both on the functioning of the Sir Lester Bird Medical Centre (SLBMC) and the staff, more specifically Nurses.

However, the management of the hospital said “doctors, ancillary staff and patients are all wrapped up in the criticism as it relates to the care at SLBMC. Our intention at this moment is to point out to you; the people we serve, and how and why some decisions are made as it relates to caring for patients.

According to the very detailed response, the management of the hospital said “we recognize the vital role that all of our employees play in delivering compassionate, high-quality care. Every day doctors, nurses, and all other support staff risk all to keep all of us safe by caring for our loved ones with dignity and distinction. That is why our commitment to doctors, nurses and other staff means, doing everything we can to provide them with the best working environment,”.

They claimed that for the last three years residents have been experiencing the seriousness of the Covid-19 pandemic and all of the changes and additional limitations that we had to endure.

“As a result of the aforementioned, lots of the expected norms have not returned fully. Supply of goods and services continues to be somewhat of a problem not only here in Antigua and Barbuda but globally. As a result, there remains a lag in some of the items necessary to take care of patients on the island. We are therefore forced to use the resources in such a way as to treat lifesaving procedures as a preference to urgent or elective procedures. To patients that have been waiting for specific surgical care we ask for your understanding and pledge that we are doing everything possible to arrive at the point where we can offer the required service safely,” the statement said.

They claimed that one of the holdovers from the Covid-19 pandemic is the use of masks and at the beginning of the outbreak the hospital introduced many restrictions which were seen as uncomfortable and at times rather intrusive.

“However, all of the said measures were to protect staff, visitors and patients from spreading or contracting the disease. Today the infection is less severe but still present, and we continue to be diligent and hold on to protocols developed during the pandemic that include mandatory mask wearing when in the hospital and strict testing for admitted patients,” the statement added.

When it comes to the ER and its patients, the hospital said patients in the ER who will be admitted to the hospital will receive a Rapid Antigen test and if the test is positive, a PCR test is done to confirm the antigen results.

“There is a lag time between the Antigen test and PCR result, thus depending on the severity of the illness and length of stay, confirmation by PCR can return after discharge from the hospital. This delay is most disconcerting particularly if the patient died before confirmation by PCR. Standard precautions continue to be required for all patient care activities. Thus, the proper use of personal protective equipment (PPE) by our staff is required to reduce the risk of infection as well as to minimize the spread to patients,” they explained.

Furthermore, the hospital explained that following the outbreak of the pandemic in 2020, SLBMC formed a new Employee Health and Infectious Disease Department.

“This department was charged with caring for all employees who were sick secondary to Covid-19 and any associated health-related issues. Along with caring for the employees, they were also charged with who should be quarantined or return to work based on the protocols mandated by the CMO, Ministry of Health and The Government of Antigua and Barbuda. It must be said, our decisions received strict oversite by the Covid-19 working group headed by the CMO on behalf of the Ministry of Health,” the statement added.

Referring to a decision that was made in April 2020, by the government to offer an honorarium of $1000 monthly, to nurses on the frontline caring for COVID-19 patients, the statement said the decision was later changed to include all front-line workers.

“The duration of this incentive was for one year commencing on March 01, 2020. It is no secret that this has been and remains a serious concern for our staff—and we acknowledge this and respect their right to voice these concerns. However, the scale of this challenge is quite substantial (a total of approximately $ 1 million has been paid to date) and we are taking every possible action to help us get closer to settling these outstanding payments,” the statement further explained.

The SLBMC said the management and the government continue to support a healthier working environment for the staff at the hospital.

“This is evident by the recent reintroduction of our Employee Wellness Group, a weekly Zumba class as well as yoga, other fitness and social activities of which the staff is encouraged to bring their families along. Any employee who is stressed or has a feeling of being burnt out can seek help by going to the Employee Health unit and a referral will be made to an appropriate counselor in an attempt to shepherd them through their difficult moment,” the press release continued.

And concerning certification and specialization, the statement said the organization has been fully supportive of continuing educational opportunities for our staff.

“This is further demonstrated by the number of employees supported by the granting of duty-leave studies to all levels of staff who qualify. Our basic qualification benchmarks are acceptance and enrollment into an accredited program or course (where applicable). Of course, the area of study being pursued must be in alignment with the hospital’s mission, vision, and values and the employee must be able to commit to work for a specified period at the hospital. As part of our longer-term plans, we will continue to support continuing education and certification as this no doubt will remain the driver of nurses’ job satisfaction and has been identified as an essential element for recruiting and retaining not only nurses but all levels of staff. Regardless of our financial challenges, it’s our hospital’s policy to appropriately remunerate staff based on upgraded certification,” the statement confirmed.

The nurses also raised concerns about the dress code at the hospital, saying that some staff members are allowed to wear their hair and nails as they please where others are told it is prohibited.

But the management of the hospital said all employees of the hospital are required to follow our dress code and no preference is awarded to anyone.

“Not unlike any other organization, there can be a few who will test the limits of the regulation. Be assured that several warnings, both verbal and written, are often issued.  Of note, an annual allowance of $1050.00 is awarded to all nursing personnel as an annual uniform allowance. This is a negotiated sum between their union and the Government.

Another bone of contention brought forward by the nurses was bereavement time. They claimed that they are allowed only three days for immediate family and no time for cousins, aunts and other extended families.

Here’s how the hospital is responding: “As a hospital, we are acutely aware of how death can impact a family, which is why when a death occurs in an employee’s immediate family, that employee is allowed necessary time off with three (3) days as bereavement consistent with the laws of the country. If additional time is needed, the employee may request vacation time. For those who are not immediate family members (aunts, uncles, nephews, very close friends etc.) necessary time off will be granted on the day of the funeral”.

Addressing the issue of migration, the hospital said in its statement that for the last two years, the Caribbean has seen an exodus of nurses to the UK and USA and Antigua and Barbuda is no different than any other island.

“We simply cannot compete with the offers being made. We will therefore continue to experience shortages in the future. Once again, it’s important to emphasize that when the COVID-19 pandemic hit, it didn’t affect any one country or hospital, but the entire healthcare system of the world was affected. It froze supply chains, and, to this day there continue to be challenged in adequately procuring the required supplies to function. They are lengthy delays and disruptions to get supplies as simple as sutures and other everyday hospital items. This has caused us to temporarily suspend some services. These decisions are not taken lightly as we know and understand the possible consequences when care is delayed. We continue to work with our stakeholders to find new and innovative ways to manage supplies and strike a balance between efficiency and resilience so we can better meet the needs of our patients and families,” the statement said.

The SLBMC ended the detailed communique by stating “we value all of the staff, both medical and ancillary, that make up the SLBMC family. We appreciate the hard work done daily as we all care for patients which grants us the privilege to care for them. All members of the organization at the SLBMC work very hard to live up to our motto and for that the Board and management say thanks”.