NASHVILLE, Tenn. (WTVF) — All across Tennessee, hospitals have been ordered to postpone elective surgeries to save on critical protective equipment.
But a lack of clarity over the definition of "elective" has left medical professionals inside one downtown surgical hospital worried that their bosses might be violating Gov. Bill Lee's order.
Hospital officials insisted they are only conducting "essential surgeries based on medical judgment."
"I do think it's a recipe for disaster," Franklin surgeon Dr. Ysela Carrillo told NewsChannel 5 Investigates.
"I really do think all these elective surgeries should stop."
Inside a six-story medical building in Nashville's Midtown, the Saint Thomas Hospital for Specialty Surgery bills itself as "the only hospital in Tennessee dedicated to spinal and joint replacement surgery."
After Lee issued his executive order Monday calling for an end to elective surgeries, NewsChannel 5 Investigates heard from staff inside the Saint Thomas facility, concerned that surgeries were continuing.
NewsChannel 5 pulled out hidden cameras to watch as patients checked in Tuesday morning for their procedures.
At 5:30 a.m., more than five hours after the governor's order took effect, we spotted what appeared to be the first patient arriving.
Then, at 6:15 a.m., we saw what appeared to be another patient heading inside.
An operating room schedule, obtained from inside from the facility, shows seven different orthopedic-spinal surgeries throughout the day.
Dr. Carrillo, who practices at Williamson Medical Center, said the concern is preserving badly needed personal protective equipment, or PPEs, and protecting patients and staff.
Her practice suspended elective surgeries last week.
"There's a lot of gray areas still going on, but I do think that surgeries that are elective should stop," Carrillo said.
"I mean, chronic conditions -- those people have had this condition many times for years -- there's no reason for this being pursued right now."
In a statement, an Ascension Saint Thomas spokesperson said, "We began curtailing our number of elective surgeries prior to the Governor's order."
The statement added, "Some essential surgeries based on expert medical judgment are continuing ... and do not meet the definition of elective."
More than a week ago, in response to the coronavirus pandemic, health authorities began to urge hospitals to postpone elective surgeries.
At the Saint Thomas facility, while managers began to work from home, an email to medical staff just this past Friday informed them, "At this time all St. Thomas hospitals are still performing elective cases."
"The bottom line," Carrillo said, "is anything that is a chronic disease really shouldn't be operated on at this point. They are actually really putting that patient in jeopardy, as well as the people in the facility such as nurses and physicians."
The Tennessee Nurses Association encouraged all nurses "to stand up for their rights and safety" and report any potential violations.
"Nurses are reminded daily of their social contract with their patients and community to care for them at their time of vulnerability and use scientific and evidence-based criteria for determining their own risk and their ability to safely care for their patients," said Tina Gerardi, the association's executive director.
Saint Thomas said it is doing everything it can to comply with the governor's order - and it is continuing to review upcoming surgeries to see which ones can be cancelled.
The full statement is below:
"The safety of our caregivers and patients is our utmost priority as we all work to slow the transmission of COVID-19 and care for all those in need. Ascension Saint Thomas Hospital for Specialty Surgery is following the updated CDC guidelines regarding the use of personal protective equipment (PPE). For aerosol generating procedures, Ascension Saint Thomas Hospital for Specialty Surgery clinical staff are donning N95 masks. In high risk areas, Ascension Saint Thomas Hospital for Specialty Surgery associates are donning universal masks which may be worn for a shift unless they become wet, grossly contaminated or used in aerosolized procedures. Healthcare systems across the country are being asked to implement aggressive PPE conservation measures during this national crisis. While this is not standard practice during normal times, it is critical for mask conservation and protection of our associates over the next weeks to months as the COVID-19 pandemic escalates. Also, please keep in mind that these guidelines are changing almost daily.
"Protocols are in place and monitored in regard to an associate's ability to return to work with a mask based upon their level of exposure. High risk exposures require a 14 day from last exposure quarantine before associates are allowed to return to work. There have been no confirmed patient or associate COVID-19 cases at Ascension Saint Thomas Hospital for Specialty Surgery.
"Ascension Saint Thomas Hospital for Specialty Surgery is making all efforts to comply with the Governor's orders, as we have done with every other order at the state and federal level. In fact, we began curtailing our number of elective surgeries prior to the Governor's order. Some essential surgeries based on expert medical judgment are continuing at Ascension Saint Thomas Hospital for Specialty Surgery, and do not meet the definition of elective. Delay of these surgeries would be detrimental to the health and safety of these patients. Since the COVID-19 outbreak, 215 surgical procedures have been cancelled or postponed at Ascension Saint Thomas Hospital for Specialty Surgery. Those cases not yet cancelled are being reviewed for appropriateness and compliance with the Governor’s order and all other applicable federal and state mandates. "
The Tennessee Nurses Association released the following statement:
"During this time when nurses are needed most and are working tirelessly on the front lines, we strongly encourage all nurses to stand up for their rights and safety. Nurses are reminded daily of their social contract with their patients and community to care for them at their time of vulnerability and use scientific and evidence-based criteria for determining their own risk and their ability to safely care for their patients. If any are ordered to practice against government mandates they should contact the Division of Health Care Facilities to file a complaint. If the facility is run by a healthcare professional, a complaint should additionally be filed with the specific professional board. The nurse should also report the issue to us so that we may expedite the report.
"In this time of crisis, it is important we all work together, ensure that nurses are supported with the proper personal protective equipment, and heed the warnings and recommendations of public health experts."