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- Every day I have to deal with the feeling of fear shared by the caregivers and our residents alike. Doctors and nurses do not want to visit us - says the director of one of the private nursing homes in Silesia.

According to the Ministry’s instructions sent to local governments, the nursing homes should isotate residents with symptoms of SARS-CoV-2 infection in their rooms. In case of suspicion of infection among members of staff, the suspected member should "self-isolate" and "contact the health officer without delay". In addition, Minister Maląg recommends to "promote the principles of hand and respiratory hygiene", "emphasize to the employees the need for personal protective equipment", and "provide cleaning products". New residents are not allowed, unless the situation is exceptional and the nursing home has to admit a person after hospital treatment. "I recommend the isolation of such a resident from other healthy residents and staff," writes Minister Marlena Maląg.

- How is the staff supposed to leave such a resident alone? After all, this person needs care like others - says the head of another facility.

Nursing homes do not treat patients

However, most directors were outraged by another recommendation of Minister Maląg: "Due to the high epidemiological threat, it is necessary to ensure continuity of medical and nursing care in nursing homes".

- It's outrageous. After all, we do not treat patients and the National Health Fund does not pay us for it. How are we to ensure continuity of care if doctors do not even want to come to us now? They are limited to advice over the phone - says Rafał Marek, vice president of the Polish Association of Social Assistance Organizers and Health Care Managers.

Nurses are still visiting some nursing homes. They earn additional salaries for circling between institutions. - But what should we do to convince a nurse to work for us on a daily basis and resign from work in other places? It's impossible! - says Jarosław Mencwel, head of the Nursing Home in Sośnicowice.

Theoretically, nursing homes are not obliged to employ nurses at all. Everyone has a contract with a primary health care facility. Residents should be treated by members of the staff of such facility. This does not happen. Rafał Marek: - One nurse has 2,500 registered patients, but if 122 of them are residents of nursing homes, she won't find time for anyone else besides them. I have a resident who has just returned from hospital after amputation. It is the health service visitor who should change his bandages, but it has always been difficult, and in the times of epidemics you cannot count for this type of help. On Saturday, the doctor refused to come to declare the death of a resident. According to him such a visit would be too risky.

- The problems that are now coming to light? We have been warning about them for the past twenty years. - says Ewa Bombała, vice president of the association and director of a nursing home in Żyrardów

The ministry instructs

The directors of nursing homes are also nervous for other reasons: - The Minister does not have to instruct me to provide personnel with protective equipment. She should make it possible for us to buy it at a fair price. We should also have access to tests for staff - says Małek.

In the Czech Republic, which copes with the epidemic much better than Poland, such tests are conducted on every nursing home employee at least once every two weeks. In Poland - according to information provided to "Wyborcza" by the spokesman of the Ministry of Health Wojciech Andrusiewicz - the nursing homes are to get antigenic tests, but their larger batches will be available only in a few weeks from now. 

- The National Health Fund called us about ten days ago asking if we have nurses. That's all. They didn't say they would send someone. It just made us angry- says another director. And he adds: - The system is paralysed. We are getting more personal protective equipment, but it is mostly the local government that helps us in buying them. Prices are rising, mainly the food prices. Near the end of the year, we may run out of money. Meanwhile, ZUS (Social Insurance Fund) does not send a decision on indexation of retirement pensions, even though the old ones expired on February 1. That also has a large impact on our finances.

ZUS spokesman claims that decisions are already being sent out. On the other hand, the Ministry did not answer why it demanded that the Nursing Home provide medical care to the residents.

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