As COVID-19 accelerates, Tennessee will send the National Guard to hospitals


Brett Kelman

| Nashville Tennessean

As the rapid coronavirus epidemic threatens to flood Tennessee’s health infrastructure, Governor Bill Lee turned to an emergency authority to allow members of the National Guard to be sent to hospitals as nurses, COVID-19 testers or ambulances.

According to Implementing Decree 68, issued on Friday, guard members will only be given these duties if they have “appropriate qualifications or skills,” and the assignment has been approved by Admiral Jeff Holmes and Health Commissioner Lisa Piercey.

Dr. Morgan McDonald, deputy health commissioner, said the state does not appoint guard members who currently work in civilian medical positions, which would effectively “deprive Peter of paying Paul”. Instead, the enforcement order is used only to designate a “relatively small number” of “trained physicians” who are actively on duty at the guard. Some currently work in public test centers.

McDonald said some hospitals had already expressed interest in the guard’s help, but declined to identify them. He said the hospital needs more manpower across the country.

“The lack of staff is becoming an increasing problem in terms of capacity,” McDonald said. “So our top priority is to make hospital hospitals aware, knowing they have a place in facilities, but their bed capacity is really limited by staff.”

The members of the guard wear military uniforms but do not carry firearms, said Laine Arnold, a spokesman for the governor’s office.

While the number of guards sent to hospitals may be small, this order is considered by the Tennessee government to be one of the most aggressive steps to prevent the virus from sweeping the hospitals. In addition to activating the National Guard, the decree suspends certain laws governing health care to give health care institutions more flexibility in dealing with the coming wave.

The opportunity to reinforce the guard is welcome news in northeast Tennessee, where several Ballad Health hospitals have struggled to keep up with the influx of patients. Johnson City Medical Center recently made the news when it acquired a morgue truck to supplement the capacity of its morgue.

Alan Levine, CEO of the ballad, said a group of guards began performing the COVID-19 test at a company hospital about a week ago.

“With the help of the National Guard, we were able to free up a portion of our clinical team to return to the hospital,” Levine said. – It was already useful.

Nashville’s largest hospital, the Vanderbilt University Medical Center, also praised the governor’s action. C. Wright Pinson, Vanderbilt’s deputy general manager, said in an email that the guard’s help and staff flexibility “could significantly help state hospitals, including ours”.

The Trump administration first raised the idea in July that governors would use COVID-19 to deploy the National Guard in hospitals, and the strategy has since been used to some degree in some states. While Lee has now accepted this recommendation, he rejects more widespread defenses, such as a nationwide mask mandate, or requires businesses to take precautions. Lee as has repeatedly refused to fight COVID-19 by restricting individuals, businesses, or gatherings, despite increasingly desperate requests from physicians and the general public.

“Our national guard must not be published in such a way that Governor Lee could have jumped the surge if he had prevented him from resigning from his own office and responsibility earlier.” said Dr. Amy Gordon Bono, a doctor in Nashville. in the statement responding to the enforcement order.

“Since then, we’ve seen that global epidemics of patchwork,‘ defend yourself ’approaches don’t work. So we have a simple question: now what?

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Medical assistants can now perform nursing duties

While Lee rejects their request for a mask mandate, the governor has given doctors more flexibility in treating the coronavirus.

An implementing ordinance signed on Friday suspends certain state laws “to alleviate the workload of hospital staff and emergency services.”

For example, the regulation allows hospitals to delegate nursing responsibilities to certified medical assistants – who have a lower level of training – if they are supervised by a nurse.

Levine, the CEO of the Ballad, said he had recently urged the governor’s office to lift these restrictions and was “grateful that they had acted against it”.

“We intend to take advantage of that. I hope and pray that we minimize its use, but if we have to take advantage of it, we will. The goal is to make it easier for our nurses, ”Levine said.

The order allows healthcare professionals handling COVID-19 to perform tasks outside of the normal licensed assignments anywhere in the hospital. Previously, under another implementing instruction, this flexibility was only allowed in emergency rooms or “acute care conditions”.

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In addition to hospitals, the order will remove regulations that limit the expansion of nursing homes and home health agencies. Normally, before these businesses can be allowed to expand, they must prove to the government body that their expansion is necessary to meet public needs. This is no longer necessary if their extension is related to the treatment of COVID-19. (Lee had already suspended this requirement for hospitals in May.)

Ambulances can also operate with lower personnel.

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The new order comes when Tennessee once again sets new records for COVID-19 infections, hospital care and test positivity. The average number of new infections a day has exceeded 5,000 for the first time in a week, and that statistic is expected to rise further next week in widespread fear of Thanksgiving.

Tennessee reporter Natalie Allison contributed to this story.

Brett Kelman is a health reporter for The Tennessean. Available at 615-259-8287 or [email protected] Follow him on Twitter at @brettkelman.