By Jayne O'Donnell & Adrianna Rodriguez

Cadence Washington, 6, wants to run up and hug her grandmother when she gets home after her shifts at a hospital in nearby Washington. That can't happen for at least a half-hour.

Debra Washington, 64, keeps Lysol spray, a robe and a bag by the front door, and her family knows she needs privacy. She sprays herself with the disinfectant, puts her uniform in the bag, dons the robe and slips upstairs to shower and shampoo her now-natural hair style every day.

Only then can she greet her grandchildren and husband whose hypertension and age, 68, puts him at high risk.

Since the coronavirus pandemic started, Washington can have up to six patients who are either COVID-19-positive or need to be treated that way until test results come back. Like beleaguered nurses across the USA, she has to change gowns and gloves between rooms, disinfect her goggles and face shield and wear the same hospital-grade N-95 mask covered with two blue surgical masks all day.

Washington, vice president of the District of Columbia Nurses Association, said she didn't sign up for all that or the constant risk she puts her family in when she became a registered nurse almost 40 years ago. As cases soar in new parts of the country and nurses treat a steady stream of infected people, many fight to get the kind of "hazard pay" many in the military get during war.

Many nurses in Illinois and at several New York City hospitals got some form of bonus pay during the pandemic, but that's ended, and hospitals and government officials in the nation's capital and elsewhere resist pressure to pay nurses more.

"The bottom line for hospitals is often more important than the quality of care and safe working conditions," said Wala Blegay, staff attorney for the D.C. Nurses Association. "A lot of that was illustrated in the pandemic."

Hundreds of nurses at Howard University hospital and United Medical Center, where Washington works, signed petitions demanding hazardous pay. Blegay said the conditions nurses in her group have had to work under, with insufficient personal protective equipment, are bad, "but what our patients have to go through since the beginning of this is even worse."

In a statement, United Medical Center said it "is evaluating the possibilities on how to recognize and support our team during these times." The hospital noted no other hospital that is only in D.C. is offering hazard pay.

"UMC truly appreciates all the work our entire team has done as we stay committed to providing quality healthcare to our patient community during this pandemic," said the statement. "We will continue to acknowledge, show appreciation, and honor our staff as we have been doing over the last few months."

The American Hospital Association asked Congress to give hospital workers $5,000 bonus pay tax credits in addition to any money from the Coronavirus Aid, Relief and Economic Security (CARES) Act.

"The front-line caregivers in the COVID-19 crisis, including nurses, physicians, facilities management personnel, technicians and other health care providers, are working around the clock to provide the care that our patients and communities need," the AHA told House Speaker Nancy Pelosi, D-Calif., in a letter in March. "These essential workers need, and deserve, additional resources to both continue their work and support themselves and their families after this crisis."

The House passed a bill including bonuses, but it hasn't been taken up by the Senate.

Does the pandemic merit hazard pay for nurses?

The U.S. Department of Labor defines hazardous pay as additional money for work that causes extreme physical discomfort and distress not adequately alleviated by protective devices and deemed to impose a physical hardship.

Kathleen Bartholomew, a nurse, author and patient safety advocate, posted a question last week for members of the online group Show Me Your Stethoscope about hazard pay. Within a day, she got nearly 4,000 responses, more than 3,100 in favor.

Some argued the job itself is a hazard, and the majority said the unprecedented pandemic conditions merit extra compensation. One anonymous respondent said those in the military know what they signed up for, too, and still get hazard pay in "active fighting areas."

Though many nurses favor hazard pay, some said it’s a temporary fix for what nurses – and patients – really need in the pandemic and beyond: more protective equipment and adequate staffing. Bartholomew is among those opposed, saying "hazard pay is not the answer" because nurses need the support necessary for them to do their jobs.

"Just asking the question, I discovered that the vast majority of nurses are hungry for respect," Bartholomew said. "They want a country that values them enough to provide the right equipment, adequate staffing and compensation when they are out of work for two weeks due to COVID, and for organizations to care enough to provide hotels so that nurses do not infect their families, and mental health days if needed during a crisis."

Cokie Giles, a registered nurse and vice president at the union National Nurses United, said, "Having additional compensation during extreme working conditions would be welcomed, but it should not replace the ethical, moral responsibility for the employer to protect us."

As of July 8, 149 nurses and nine other health care workers have died from COVID-19, according to NNU data. The union said it's an undercount because many deaths aren't publicly reported.

Nurses who said they are overworked and underprotected have left hospitals to protest. In Illinois, more than 720 nurses of AMITA St. Joseph’s Medical Center are on strike, alleging management intimidation and demanding more pay. At least 78 nurses left UChicago Medicine Ingalls Memorial Hospital in the past six months, citing a high RN coronavirus infection rate of 6% and poor hospital protocols, the National Nurses Organization Committee said.

In a statement, the hospital said, "It is unfortunate that National Nurses Organizing Committee seeks to exploit the pandemic for gains in a labor dispute." The statement noted the hospital remains committed to providing a safe work environment for nurses and health care workers by ensuring they're equipped with PPE "despite widely reported national and local shortages of medical supplies through the COVID-19 pandemic."

Giles said, "There’s not enough money in the world" to risk catching COVID-19 and bringing it home, but Washington said more money would help.

Her son and Cadence's father, Jermaine Washington, also works at the hospital, transporting patients, so there's an even greater risk of exposure at home.

There is also the difficulty of simply doing her job. Wearing all that protective gear, she often has to fight to breathe through her nose, sweats heavily and struggles to see through cloudy glasses and goggles.

It's a balancing act between limiting time in rooms for safety, as she's told to do, and doing the job for which she was trained.

"We take the time to be a nurse with the hope of helping them get back to a healthier state," Washington said. "Their families can't be with them, and they feel isolated, so we spend that extra two to three to five minutes because we want to give comfort."