Caregivers positive for Covid but asymptomatic: at the front despite everything

Some health and medico-social establishments employ their caregivers who test positive for Covid-19, if they are asymptomatic. If this decision is accepted institutionally, it is nevertheless considered unethical by health professionals.

Note from the Ministry of Solidarity and Health (dated 01/11/2020), relating to visits and protective measures in nursing homes for the elderly and in USLDs (Extract).

A note from the ministry on protective measures in medico-social establishments welcoming the elderly as well that an opinion issued by the HCSP in May, aimed at all health establishments, make people cringe.

And for good reason: the two writings recommend considering retention with ” strengthening of precautionary and hygiene measures »Staff tested positive for Covid, if they are asymptomatic and not replaceable, « so that the risk / benefit balance is not unfavorable ”States the HCSP opinion.

In practice, ” this decision does not come under the regional health agencies (ARS), but is specific to each establishment, says Céline Laville, president of the National Nursing Coordination (CNI). However, there is nothing in law that obliges a caregiver to come to work if they test positive. »

Ethics undermined

Example of the center for the fight against cancer, Gustave Roussy (94). A management note dated August 20, 2020 mentions that “irreplaceable” PCR + and asymptomatic caregivers can continue their work “with preventive measures”.

In the two texts cited above, making positive caregivers work is the last resort. This does not prevent this from posing significant ethical questions.

« I hear and understand this choice of managers who do not know how to manage the lack of personnel, continues Céline Laville. On the other hand, I do not endorse it in any case, because in terms of safety vis-à-vis patients and other caregivers, this decision is intolerable.. »

« A certain number of CHUs and many small establishments and nursing homes apply this type of operation », Laments Thierry Amouroux, spokesperson for the National Union of Nursing Professionals (SNPI).

Faced with such decisions, two levels of reaction are possible. ” Registered nurses generally appeal to unions to ensure that patients’ rights are respected, he explains. Because that’s what it is! This measure taken by the management is an ethical violation. It is asking asymptomatic but contagious caregivers to turn into agents of contamination and endanger the lives of their already fragile hospitalized patients who are therefore more at risk of developing the severe form of the disease. »

For their part, trainees awaiting tenure or contract workers, have greater pressure because they are in a situation of social fragility. ” The impression of job blackmail is real », Adds Thierry Amouroux.

One of the protections may be to request a work stoppage from your attending physician, ” but it is easier to assert it when you are a holder », He insists.

Take no risk

Lucie, a nursing home nurse, reports that the management of her establishment encouraged caregivers to take a screening test, which she did. ” But while waiting for the results, I was still asked to continue my work, trying to touch the patients as little as possible! What then is the point of taking the test? »

Lucie is not surprised by such directives from her management because there are five nurses to practice for 120 residents. ” But I do not admit that we can be asked to continue working if we have doubts, she admits. In any case, if I had tested positive, I would have gone to my GP to be arrested. I work with elderly, fragile people, and I don’t want to take any risks. With my colleagues, we all agree. »

Laure martin

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