ORDERLIES! And Other Help the Federal Government Could Be Providing

The Quarantine Zone
1

I’m using specifics about the USA here, but this idea could be used in many nations:

To put it lightly, health care workers are massively overworked, now. The exhaustion can only be contributing to doctors, nurses, and other medical personnel getting sick (whether with COVID-19 or other ailments).

A huge problem at the moment is the lack of personal protective equipment (PPE). But even when that issue is solved, there will still be the problem of overwork and exhaustion.

It’s also the case that millions of people with good employment histories are currently not working, due to lock-downs and other stay-at-home measures. This includes restaurant and bar workers, factory workers, drivers, hotel workers, and a wide variety of other semi-skilled (or even unskilled) people.

Why not put people with good records who are otherwise unemployed–and who may remain so for months to come, due to closures–into training programs as orderlies?

https://study.com/articles/orderly_courses_training_certification.html

The US Army, among other entities, trains soldiers as orderlies to staff their field hospitals and other medical units. Take that training program (or one used by the VA or any other relevant source) and expand it to millions of the currently-unemployed (with good records). Promise the recruits that they will have guaranteed employment for a year. After a year, they will have experience as a working orderly on their resumes. Even if the government doesn’t need them, some hospital or nursing home will.

Put the program under the auspices of FEMA. Set it up, physically, in now-unused hotels, in every major city. Get X-many dozen likely recruits and test them for COVID-19. While awaiting the test results, have them watch relevant videos in their rooms. When their tests come back clean, put them into hands-on training with the medical equipment they’ll be using. Get them ready to walk into any hospital and be able to take the burden off the backs of the LPNs, RNs, and probably-limited number of orderlies now working.

So every hospital can be told: 'On Monday we will send you 30 trained, healthy orderlies to take up some of the workload. We will house them in [wherever–possibly FEMA trailers parked in the lots of now-closed businesses, if nothing better is available]. We will pay them. We will supply them with PPE. You will carry no legal or pension liability, and no other responsibility. Two weeks after that, we can send you Y many more orderlies, if needed.’

This requires that PPE become readily and widely available in every medical facility, of course. But we need to do that anyway.

The psychological effect on working doctors and nurses of knowing that they will have extra hands to do some of the work that is now contributing to their exhaustion, will be enormously beneficial.
Long-term, we need expanded education that will increase the numbers of both doctors and nurses. But orderlies can be trained quickly. They can be trained now. They could make a difference.

2

As soon as this problem emerged, my mind immediately went to the Civilian Conservation Corps. We need a medical version of that.

3

Yes, good point. When I was thinking about this, I considered proposing it be a Peace Corps sort of thing (and Civilian Conservation Corps could be another appropriate model). But in the end I didn’t want to emphasis this as a ‘commit two years to public service’ concept, but more of an ‘earn a living while helping your community (or country)’ idea.

In re CCC, this is certainly a time in which modern parallels of many of FDR’s public works programs are, again, relevant.

4

Is this something that individual states could do? I can’t imagine the federal government, such as it currently is, doing this.

5

I would think so. If it’s states, they might do it under the auspices of the state’s National Guard, rather than FEMA, given that the National Guard is directed by each state’s Governor.

National Guard organizations for each state may have their own programs for training orderlies, too. So that could be a good fit.

The essence is that whatever orderlies are sent to each hospital should not be a burden in any way on the hospital (financial or legal or any other way). They would be trained and paid and housed by the entity (National Guard or FEMA or whatever makes most sense, logistically) that is providing them. Accepting them would be a win-win for the hospitals—helping hands that cost them nothing.

6

why is this a good idea? From the viewpoint of one of the people that you would target with this idea:
Your quote mentions median annual salaries in the low to mid $20k range. The stimulus gives $30k via unemployment insurance minimum. I expect that to be extended past mid summer if this continues. I also plan to go back to my previous job or one like it when this is over. And there would be no risk to me of increasing my odds of getting sick or dying. And this would cut into my gaming or face time.

What you can do for your country / fellow citizens is a historical footnote now.

7

Along those lines, I work for the post office and they sent out an email today asking if anyone has medical training (ex. RN, LPN, EMT) they can get immediate leave to go work in healthcare.

8

Interesting.

Because there are risks involved, this could work ONLY after a full supply of PPE for every health care worker is available. That would make the risk of working in a hospital closer to that of working in a post office (for example), where most workers may be using masks and gloves, but probably not full gowns, probably not changing out the PPE often during the shift, etc.

The orderlies program would need to provide incentives of safety (ample supply of full PPE), pay, and some degree of social reward—the support of a grateful nation being part of the resume each participant would be able to show to prospective employers, once the emergency is over.

(Assuming here that it will be “over” in at least the sense that the economy and society will adjust to the new reality of highly-infectious viruses being a part of life.)

9

I was at the post office on Friday, and they had something like Saran Wrap as a drape between the customers and the clerks. You could pass your packages, money, etc. in between the panels. I thought that was a good idea, FWIW.

I got an e-mail from one of the state boards of pharmacy where I am licensed stating that anyone who let their license lapse or put it on inactive status in the past 5 years can go ahead and practice in that state without going through all the red tape of renewing it. This does not, of course, apply to people whose licenses were suspended or revoked. So far, that has not been necessary in this area, and I hope it stays that way.

I also have a Facebook friend who is an ICU nurse in Winnipeg. So far, it hasn’t really struck there either, and her hospital census is probably the lowest she’s ever seen it, due to the cancellation of elective surgeries.

10

Yes, there are places where health-care workers aren’t yet having to work long shifts.

We may not be able to count on that remaining the case for long, though. The long incubation period for this thing is fiendishly calculated* to let people hold on to a false sense of security.
Interesting about the pharmacy boards making that decision–seems very sensible to me.

*not actually mindfully calculated, of course. ‘Evolved’ is more literally true.

11

Not to be insensitive, but is it true they over overworked everywhere? I look at state / county statistics, and in a state like IL, outside of the collar counties and Cook county in Illinois, there are not a huge case load.

While I am sure NYC is overwhelmed, it appears other cities are using their times to prepare.

12

Yes, great idea.

13

In some jurisdictions, all those with ANY medical training are being recruited to help. I was a military medic (with a field hospital unit) and civilian EMT (with a rural ambulance service) over 40 years ago, when I was under 30. I’ve gone through other careers since then and I’m in an at-risk grouping. Could I be of use now? Possibly. Should I risk myself to apply long-unused training? MrsRico, coughing, doesn’t want me to leave the house. I can’t argue.

I’ll argue that the nation needs a reserve medical-backup corps. Everyone needs bedpan training.

14

New York City is the epicenter of the crisis. Trump sent up a naval hospital ship with 1,000 beds and 1,200 staff last week. It now has 20 patients.

Other places there are lots of healthcare layoffs:

https://www.crainsdetroit.com/health-care/trinity-health-michigan-furlough-2500-cut-executive-pay-it-deals-coronavirus-financial

The healthcare system should be making use of its existing capabilities.

15

Thing is, these hospital ships are supposed to take the non-COVID patient load off area hospitals. Gov. Cuomo says there aren’t any.

16

I agree.

Calling up retired health-care workers has been touted as one part of the solution, but as you say, those people tend to be in at-risk groups by virtue of age alone. So asking them to come back when there isn’t enough personal protective equipment is ludicrously unfair. No one should be asked to take such enormous risks. (Ordinary risk: sure. High-likelihood-of-infection-and-death risk: no.)

All solutions to the overworked-health-care-workers problem require, as a precondition, that the USA solve its (artificially-created) PPE shortage problem.

17

I haven’t heard that here is an overwork issue with the people who don’t actually provide medical care. I don’t think the term “orderly” is often used any more and that article seems to mix together three jobs which in my experience are separate. There are nursing assistants/patient care technicians who provide care that doesn’t need a license - taking vitals, collecting specimens, assisting with personal hygiene. There are “patient transporters” who wheel you to X-ray etc. There are the janitorial/custodial staff who do the cleaning and floor-mopping. Whether it’s a single job or three, these people are not licensed and therefore can’t perform any tasks that require a license. Hiring a people to do these jobs won’t help f the problem is overworked/exhausted doctors and nurses.

18

Orderlies are still part of medical-care. Look at the link in the opening post.

Part of the exhaustion of nurses and other licensed medical professionals is the increased need for cleaning—surfaces, equipment, and so on. The novel coronavirus is notorious for both living for days outside human bodies, and for being highly infectious. More orderlies equals less time that the licensed healthcare workers have to spend on this task.

Here’s an example of a role orderlies are playing in the current crisis:

If there were a choice between “10,000 new doctors and nurse, ready to work in one month” or “10,000 new orderlies, ready to work in one month,” of course the doctors-and-nurses would be more useful. But we don’t have the option of training either doctors or nurses, start to finish, in one month.

We do have such an option with orderlies.

19

I’m not saying this can’t be true, but I haven’t heard that licensed medical professionals are overwhelmed with cleaning tasks. My understanding is they are overwhelmed taking care of patients because so many of their licensed co-workers are sick.

 I'm not sure exactly what the website you linked to is - it seems to be some sort of online school but the Wiki on "orderly" says

Both from being in hospitals and knowing people who work in these positions, in my area ( yours may be different) there are three different jobs. The person who takes my temperature is not the same one who wheels me to X-ray and an entirely different person is mopping the floors. And of those three positions, only the PCA/CNA might have formal classroom training - the transporters and cleaning staff are trained on the job.

20

Part of taking care of patients is the cleaning tasks. We’re not just talking about mopping the floors.

This represents a misunderstanding of the purpose of the thread. I’m suggesting that the federal government could provide help to the exhausted and overworked people now laboring in hospitals, nursing homes, and other medical settings, by (relatively) quickly training people who could do the work* that doesn’t need to be done by doctors and nurses*.

The name given to the trainees certainly doesn’t have to be “orderlies.” The name isn’t really the point. I used it in the thread because it is a generally-understood concept that conveys the basic idea of ‘help that doesn’t rely on years of college and post-graduate study.’

As mentioned, the military currently has in place training programs for such workers–programs that could fairly easily be put into action by FEMA or other appropriate agency.

And the name on the program isn’t the point.