Board of Health examines nursing positions

ELLSWORTH – As Covid cases spike in Pierce County, Public Health Officer AZ Snyder told the Board of Health at its Sept. 8 meeting that her department is overwhelmed.

As of Sept. 8, Pierce County and 90 percent of Wisconsin counties were well into the Centers for Disease Control highest disease category, Snyder said. Last week, the PCPH logged 121 new confirmed Covid cases, a significant increase from 88 the week prior and 32 the week before that.

Last year, during the first week of September, 22 cases were confirmed. That’s almost 100 higher cases in the same week in 2021.

“This is not a good place to be starting the school year,” Snyder said.

The department has officially shifted into “crisis mode” as far as contact tracing goes. Snyder said. With the number of confirmed and possible cases overwhelming staff, shortened interviews are being conducted. PCPH will make two attempts to call someone; if they don’t reach them, a letter will be sent. PCPH is documenting household close contacts, but not social contacts, Snyder said. However, staff is asking people to reach out to their social contacts themselves.

If case numbers continue to increase, staff will not be able to reach out to people within 24 hours, Snyder explained. They simply don’t have enough time with the number of cases. Volunteers have been helping with contact tracing and notifications.

Ellsworth Elementary has had one outbreak in a fourth-grade classroom which resulted in the classroom’s closure. Students learned virtually Sept. 1-3.

“I cannot emphasize enough what a dangerous time this is for schools,” Snyder said.

She said many area school districts are not following CDC and PCPH guidance as far as masking, social distancing and proper mitigation efforts.

According to a letter sent to parents by Ellsworth Superintendent Barry Cain on Friday, Sept. 10, the district at that time had had 36 confirmed Covid cases among students (total student population is 1,633) since the beginning of the interim session days Aug. 24. As of Sept. 10, 14 Covid cases, or .08 percent of the overall student population, are active.

“It is important to note that a number of cases happened in the earliest days of our school year and likely came from outside of our schools,” Cain wrote. “We did identify spread within one classroom at the elementary level that likely occurred during the three interim school session days.”

Four cases were identified in that classroom the day before school started officially Sept. 1; three other cases were identified later.

“Our school board approved school start up plan provided for face coverings to be optional for all students and staff,” Cain wrote. “This is still in place. We have worked with our students and staff to highlight the need for all to respect the individual choice that any individual makes in regards to wearing face coverings.”

Ellsworth is also contacting all families in which a student has been defined as a close contact by being within 3 feet of a known case for longer than 15 minutes. These students are not being quarantined, but notified. Parents are being asked to keep children home who are ill or exhibiting symptoms. Cain noted in his letter that children have been coming to school with various symptoms and should not.

Snyder said an outbreak has occurred in one assisted living facility, while suspected outbreaks are being investigated in two skilled nursing facilities. The outbreak has been traced to unvaccinated staff member(s), Snyder confirmed. A large outbreak was identified in a residential complex as well, she said.

As far as vaccine distribution, almost half of vaccinations distributed recently have been to Minnesota residents jumping the border, Snyder said. PCPH and other health departments are having trouble receiving Johnson & Johnson vaccines due to a shortage. And concerning booster shots, those are not yet available in Pierce County.

“If incidents of disease keep increasing, we may have to choose between distributing booster shots or notifying residents and contact tracing,” Snyder said. “The vast majority of outbreaks were unvaccinated individuals. No one in Pierce County has died of Covid who’s been vaccinated.”

Public health positions

The board voted to forward registered nurse and public health nursing manager job descriptions to the Finance & Personnel Committee for review.

Recruiting for open public health nursing positions is tough, Snyder said. Public health nursing positions are outlined in state statutes and administrative rule. A public health nurse must have a four-year Bachelor of Science in Nursing (BSN) degree. Simply put, the county doesn’t pay public health nurses enough to recruit them, Snyder said.

“Everyone is desperate for nurses right now,” Snyder said. “We just can’t compete with the Twin Cities market.”

Some places are even offering $25,000 signon bonuses for nurses, Snyder explained.

“I think we have a lot to offer at the county,” Snyder said. “But our salary is just not competitive.”

A county public health nurse receives about $24 to $25 per hour. The trade-off is set hours, no weekends, and a relatively low-stress environment compared to an intensive care unit or emergency room, Snyder outlined.

Pierce County has four full-time public health nurses: Manager Dianne H-Robinson, two in River Falls at reproductive health, and one in Ellsworth, who is the lead for all clinical services in Ellsworth and surrounding areas, as well as the county’s epidemiologist.

Last week, one of the River Falls Public Health Nurse Courtney Seipel submitted her resignation; her last day was Sept. 13. She has been with the county for nine months.

In light of the nurse shortage, Snyder proposed recruiting for a BSN candidate, but also opening up the position to two-year registered nurse degree recipients. Ideally, the county wants a someone with a BSN, but if that’s impossible to recruit, having a two-year RN is better than having none at all, Snyder said.

“In this specific position the scope is very clinical rather than focusing on policy planning, community outreach, etc.,” Snyder said. “We are unlikely to have a BSN drop in our laps and accept this salary.”

Both existing public health nurses have young children and appreciate the sane schedule, Snyder said. Hopefully by creating another type of job classification and having two scales in one recruitment, a candidate will come forth.

“Public health nursing has certainly not been a low-stress environment the last 18 months,” Snyder said. “We cannot provide reproductive health services without this position.”

The nursing manager position, currently held by H-Robinson, will likely be filled by an internal candidate when she retires in a couple of months, Snyder said.

The next Board of Health meeting will be held at 4 p.m. Oct. 13.