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As the spread of covid-19 increased, the chief of operations at one of Vardagas’ private nursing homes wrote an urgent email on how residents with fever and respiratory symptoms should be managed. The email was sent to the night nurses who pick up at four o’clock when the day staff go home.
“New directives come from the doctors today Thursday, March 26”.
The email ends with the sentences:
No patient (resident) should be sent to hospital for these symptoms.
Patients (residents) who have the symptoms mentioned above should be treated with cohort care or barrier care, as it is also called, until the sample is verified. “
– He even called me and told me that there have been new directives and that he is emailing them to all of us so that we know what we have to deal with, says Latifa Löfvenberg.
She has no doubt what the email means.
– It says that I should not send anyone, it cannot be read otherwise.
She and her colleagues worked part-time as night nurses at Klara Team, employed by Klara T AB, which is owned by the healthcare giant Ambea and is part of the same group as Vardaga.
They worked alone from home, made planned efforts during the day, and withdrew when necessary.
Just during his night shift, he says that ten residents have died from suspected or proven covid-19. They have been treated palliatively with morphine and midazolam, a sedative.
– I have not been with anyone sent.
Before the pandemic sounded the nurses themselves 112 if the transfer of a patient to the hospital was urgent, something that the new directive does not allow, as interpreted by Latifa Löfvenberg and several of his colleagues. When it is considered that patients cannot benefit from life support care, doctors, in consultation with a nurse, decide to switch to palliative care, palliative care at the end of life. The decision is recorded in the medical record and means that a nurse can begin palliative care without further contact with a doctor.
Latifa Lövfenberg believes that these decisions were made too quickly and easily when the infection increased this spring.
By law, everyone has the right to receive an individual assessment and care. It is set out in a series of directives and decision support that expired during the pandemic.
– We have never said that people who need care should not be sent to hospitals, says public health advisor Iréne Nilsson Carlsson of the National Board of Health and Welfare.
The individual physician must assess what level of care is most appropriate. In exceptional circumstances, care may be forced to prioritize patients who are more likely to undergo treatment over patients with many underlying diseases and a high biological age.
But don’t exclude people based on chronological age.
“It is not compatible with the regulations to classify a group in general for any kind of care, such as hospital care,” writes Anna Karin Nyqvist, unit manager at the Ivo Health and Care Institute, in an email.
Photo: Fredrik Sandberg / TT
Still, there are many indications that happened in various places in Sweden. In the initial stages of the pandemic, various regions had rules that nursing home patients should not go to the hospital but should stay at home. It shows a review Ivo did of the 1,700 special nursing homes in the country, which DN wrote about previously. In 91 households, the doubts were so great that the patients received an individual assessment, that Ivo does an in-depth review that should be completed when October turns into November.
An accommodation being inspected has been serviced overnight by Latifa Löfvenberg and her colleagues, who received the email from Vardaga’s operations manager.
Latifa Löfvenberg is a health policy of the Swedish Democrats in the Gävleborg region. She reacted from the beginning to the fact that oxygen was not given to the sick in nursing homes. His criticisms quickly spread on social media and also in the media abroad. Among other things, she has been interviewed by the British BBC.
He claims that his participation in the Sweden Democrats is not relevant.
– If people think I say this for political reasons, it’s scary. I am, above all, a nurse and my intention is not political, but humanitarian, she says.
Almost at the same time As his criticism spread on social media, he had outraged discussions via text message with supervisors about working conditions and extra shifts.
At 3:13 p.m. from Walpurgis, you receive a text message in which your business manager writes:
Hello Latifa. We at Klara understand that you want your employment to end with immediate effect as of 4/27. I want you to confirm your wish by replying to this text message. “
Latifa doesn’t want to give up and doesn’t reply to the text message. At 20.12 he receives a new text message:
“Hello again Latifa. I would like you to confirm my previous text message.”
“I have not witnessed the sending of anyone,” says Latifa Löfvenberg about the effect of the directive not to send older people with suspected covid symptoms to hospitals that were sent to nurses.
Photo: Nicklas Thegerström
Latifa Löfvenberg has now sued your employer for unlawful dismissal without objective reasons. According to the lawsuit, she received a phone call from Klara T’s operations manager and business unit manager on May 4-5, where she was told that she was not allowed to return to work, that she was fired, and that she defamed the manager of operations of Vardaga, who is part of the same group, and private. caregivers in the media.
Eva Domanders, CEO of Klara T, tells DN that she does not want to comment on the matter.
– It is a matter of labor law and we do not comment on it. So all of our employees have freedom of information, he says.
Dagens Nyheter has been in contact with former co-workers who criticize how his colleague has been treated, but do not want to appear by name, among other things with reference to his handling.
The nurses who before the incident were permanently employed together with Latifa Löfvenberg at Klara T in Gävle have resigned.
– It was, among other things, this with Latifa, but also that it is difficult to have a collaboration with the staff when you never meet, says one of them.
Photo: Fredrik Sandberg / TT
Be on duty in three houses it worked fine, but no more. She thinks there should be night nurses directly in nursing homes.
– This arrangement with consulting nurses is not good for anyone. Not for us, the accommodation staff, or for the residents. This is only done for financial reasons.
The email from the operations manager was interpreted as an interruption of hospital care for residents who had fever and respiratory symptoms.
– Yes absolutely! Did. But I thought when I read it that he still would have called our ER doctor. I could never have stood there and said no, we have received new directives so you should not go to the hospital.
Care in private nursing homes acquired by various health centers. The accommodation where the email was written has an agreement with the Eira health center in Gävle, which belongs to Praktikertjänst.
Health Center operations manager Alexander Wirdby says that he, along with the accommodation doctor, was responsible for the new medical directives on patients with fever and respiratory symptoms.
– But it has never been decided that no one should be sent to the hospital. Everyone should get an individual evaluation.
Even though it says so in the email?
– Email means that nurses should not call an ambulance. They should call a doctor who can look up the medical record and plan how we should do it. But they should not decide for themselves that this is so serious that we should not call an ambulance.
The email has been interpreted to mean that it should not be sent to anyone.
– If it is the case that an individual employee interprets it that way, then I think it is a bit unprofessional not to question whether it really is true that they should not call emergency services, says Alexander Wirdby.
