Advertisement

SKIP ADVERTISEMENT

Nurses Battling Coronavirus Beg for Protective Gear and Better Planning

Health care workers are among the most at risk of contracting the virus, but many say they lack protective gear and protocols to keep themselves and their patients safe.

Robin Addison, a nurse at Providence Regional Medical Center in Everett, Wash., demonstrated how she wears a respirator helmet with a face shield. It is similar to the one she used when she helped treat a man, currently in isolation at the hospital.Credit...Ted S. Warren/Associated Press

In the fight against the coronavirus, nurses play a critical role, but some on the front lines in the hardest-hit areas in the United States say they fear that their health is not being made a priority.

Nurses in Washington State and California said they have had to beg for N95 masks, which are thicker than surgical masks and block out much smaller particles, and have faced ridicule from colleagues when expressing concerns about catching the highly contagious virus. Some have complained about being pulled out of quarantine early to treat patients because of staff shortages.

“If nurses aren’t safe, then really our community isn’t safe,” said Jenny Managhebi, a clinical nurse at the University of California, Davis, Medical Center, where 24 nurses were asked to self-quarantine after a patient tested positive for the virus. “If I’m not safe at the bedside, when I come home to my husband and my children, then they’re not safe.”

Concerns from nurses in Washington State and California echo those of nurses nationwide. National Nurses United, a union that represents about 150,000 nurses across the country, announced on Thursday the sobering results of an online survey it recently conducted.

Of the 6,500 nurses who participated, 29 percent said their hospitals had a plan in place to isolate potential coronavirus patients, and 44 percent said they had received guidance from their employers about how to handle the virus.

Sixty-three percent had access to N95 face masks, and a quarter of the respondents had access to an even more protective mask recommended by the union, known as a PAPR, or a powered air purifying respirator.

One California nurse, who is in a 14-day self-quarantine after caring for a coronavirus patient, complained that the Centers for Disease Control and Prevention was not testing her for the virus quickly enough. “This is not the ticket dispenser at the deli counter; it’s a public health emergency!” she wrote in a statement shared by National Nurses United.

At a news conference on Thursday afternoon, the union demanded, among other things, that the federal government ensure all health care workers receive the highest levels of protective equipment, that any vaccine that is developed be offered to the public for free, and that Congress immediately pass an emergency spending package in response to the virus.

“The C.D.C. has been behind the ball at almost every step of the way,” said Jane Thomason, a union official who focuses on workplace health and safety.

Medical professionals have died in Wuhan, China, where the new coronavirus first surfaced late last year.

Health care workers are among the groups most at risk of contracting the virus, as sick people report to emergency rooms and are treated before their condition is known. At least eight people who work in U.S. health care facilities have received a coronavirus diagnosis, including three employees of a hospital in Vacaville, Calif., and five people who worked at the Life Care long-term care facility in Kirkland, Wash.

And health care workers who are exposed to it can also unwittingly transmit the virus.

At EvergreenHealth, a hospital in Kirkland where at least 11 deaths have occurred, nurses who were told to self-quarantine were later asked to return to work, according to the Washington State Nurses Association, raising fears that they could further spread the virus if they had contracted it.

The association, which represents more than 16,000 registered nurses in the state, surveyed its members and reported that 40 percent of the Evergreen nurses who responded said they lacked access to adequate protective equipment. More than half said they did not feel prepared to provide care for a patient with a known or suspected case of the virus, which causes a disease known as Covid-19.

The union said nurses at other hospitals around the state have also reported concerns about lack of equipment. “Some have expressed concern that they themselves or colleagues have been in close contact with Covid-19 patients and yet are being told to continue working,” the union said.

Mary Shepler, the chief nursing officer at EvergreenHealth, which includes the hospital in Kirkland, defended the facility’s preparedness and protocols. The hospital, she said, has adequate supplies, including single-use masks and face shields that are sterilized and reused.

The hospital, too, has conducted drills and training for such situations, Ms. Shepler said, adding that she understands the stress that people are under while dealing with a new virus.

“It’s uncomfortable to all of us in this new zone,” she said.

Ms. Shepler said that after quarantining some workers who were exposed to coronavirus patients, the hospital determined that the extent of the quarantine was unrealistic because it left shortages in a needed work force. They brought nurses back who were asymptomatic — an approach deemed reasonable by the C.D.C., she said — and are testing them twice a shift. They are also required to wear masks while treating patients.

The California Nurses Association, a statewide union that has grown into the largest organization of nurses in the country, with representation of 155,000 nurses, is scheduled to hold a news conference on Thursday afternoon to demand access to “the highest level of protection” for nurses on the front lines. It also plans to demand training and clear plans for how to handle patients suspected of having the virus.

“Employers shall plan for a surge of patients with possible or confirmed Covid-19, including plans to isolate, cohort, and to provide safe staffing,” the union said in a statement. “Any nurse/health care worker who is exposed to Covid-19 will be placed on precautionary leave for at least 14 days and will maintain pay and other benefits during the full length of that leave.”

Some nurses at other hospitals have reported being asked to take their personal paid leave to cover periods of mandatory quarantine. California has one of the strictest nurse-to-patient ratios in the country, with one nurse for every two sick patients in intensive care units. Some nurses said they were concerned that hospitals would struggle to meet that quotient if too many were forced into quarantine.

Image
Dr. Nicole McCullough, a global health and safety expert at 3M, demonstrating the correct way to put on an N95 respiratory mask.Credit...Nicholas Pfosi/Reuters

Training for how to use protective gear, nurses said, is almost as important as the gear itself, because taking it off incorrectly can result in spreading dangerous fluids from a sick patient.

“It used to be that you’d get a full day training,” said Gerard Brogan, the director of nursing practice at the California Nurses Association. “Now, they will send a nurse and doctor to the internet to learn how to don and doff a hazmat suit.”

A nurse at a hospital run by Tenet Healthcare in Orange County who spoke on the condition of anonymity, fearing reprisals, said staff members have not been told what to do if a possible coronavirus patient walks into the emergency room. The nurse said some doctors have ridiculed staff members who have raised concerns.

“It’s been pretty disturbing what is happening,” said the nurse, who is among the most experienced nurses at the hospital. “Some doctors have been walking through the hospital for weeks with respirator masks. Others have been brushing it off like, ‘If you think this is a big deal, you are a conspiracy theorist and you are weak.’”

A spokeswoman for the hospital network said the hospitals were prepared to care for coronavirus patients and were working to protect the health and safety of staff members.

Ms. Managhebi, the clinical nurse in California, said nurses have asked that N95 masks be made available on the supply carts in their units, rather than having to ask a manager or an assistant manager for one, as is the current practice.

She also said nurses wanted the UC Davis hospital to adopt a detailed set of protocols about how they should handle suspected coronavirus cases, similar to a plan for Ebola that stipulated everything from the elevator that would be used to transport a patient to the specific staff members who would treat the patient.

But, Ms. Managhebi said, “They responded to our request and said it wasn’t necessary at this time.”

Dana Goldstein and Mitch Smith contributed reporting.

A version of this article appears in print on  , Section A, Page 10 of the New York edition with the headline: Nurses Say They Lack Proper Training and Protective Gear, Increasing Risk. Order Reprints | Today’s Paper | Subscribe

Advertisement

SKIP ADVERTISEMENT