Nurses’ Concerns with COVID19 Update: March 22, 2020


I know for many people at this point a day might feel like a decade. We are worried and stressed. I myself have some concerning symptoms (headache, fatigue, weakness, sore throat, nasal congestion; no fever), but I will ride it out at home for now as we all know it could be a cold, the flu, or even adenovirus.

Cloth Facemasks, Update from the CDC: “In settings where facemasks are not available, HCP might use homemade masks (e.g., bandana, scarf) for care of patients with COVID-19 as a last resort. However, homemade masks are not considered PPE, since their capability to protect HCP is unknown. Caution should be exercised when considering this option. Homemade masks should ideally be used in combination with a face shield that covers the entire front (that extends to the chin or below) and sides of the face.” https://www.cdc.gov/…/hcp/ppe-strategy/face-masks.html

In other words, the CDC is recognizing that an adequate barrier is still needed. I have heard from nurses that face shields are also in low supply; they are being shared, cleaned, and reused. I would assume this may be a safe practice for some face shields, and not for others.

From the nurses: One of my nurse colleague friends stated the hardest part of working in an ER is the changing circumstances; she told me that the recommendations for how they can safely care for patients literally shifts every 12 hours. In order to keep herself and her colleagues safe, she was able to purchase PPE, spending her own money, and they were allowed to bring it into the facility.

Some facilities are not allowing nurses and other providers to bring in their own PPE.

Some nurses on social media platforms state that they are buying, and some facilities are investigating the use of, what one might call industrial-grade respirators that have filters, which can be changed. Nurses have posted pictures of themselves in these types of respirators on social media pages. I have no data on whether these we will work and if this is the right move to make to be protected. I don’t know if a face shield works with them.

 

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Lastly, nurses on social media platforms are concerned that they are being told that they cannot wear PPE unless absolutely called for, and hospitals are establishing those guidelines of when PPE is appropriate. They are being told that it’s an optics issue and that the administrators are concerned if everybody is wearing PPE in a setting like the ER, it gives patients and families the wrong image. And in this time of PPE shortage, there is the need to conserve PPE. This means that many nurses feel like they are taking unknown risks every time they work. Many have stated that they generally don’t feel safe, and they have anxiety about being in these settings.

I reached out to my federal representatives and received canned responses. I do suggest everybody do the same and consider manning the phone on Monday and calling their elected congressional representatives and senators to express concerns and ask for clarity around how the federal government plans to address the lack of PPE.

Ask them how the Defense Production Act is being used to ensure that those on the frontlines are being protected: it’s enacted, but it needs to be implemented. According to CNN, there is little evidence that it is being used to actively enhance the production of PPE and medical equipment like ventilators.

https://www.cnn.com/2020/03/20/politics/defense-production-act-trump/

Ask them for a clear plan for your state in procuring PPE.

 

 

3 thoughts on “Nurses’ Concerns with COVID19 Update: March 22, 2020

  1. Carey, take good care, do what you know but may feel too anxious to do, lots of fluids, rest, maybe less news and yacking on the phone or FaceTime and STAY IN TOUCH! Your voice is so important to us.

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  2. Feel better Carey.

    As I have been saying, cloth masks are better than nothing, but they clearly are not going to work as well as N95s and face shields.

    The problem being that our hospitals haven’t been adequately stocked for routine demand for supplies for decades due to budget cuts and efforts to maximize profits.

    People who are going to be using cloth masks are going to be using them because nothing else is available to them.

    To be clear this is a relatively simple issue of basic materials science. Any material barrier at all is superior to no barrier at all.

    The best thing would be full hazmat suits for all nurses with decontamination between patients, the worst thing is no protection at all.

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  3. It is a little like closing the barn door after the horses have left, but this is a good time for nurses to bone up on the National Incident Management System (NIMS).

    https://training.fema.gov/nims/

    For those unfamiliar with it, there is a very well developed structure for responding to “incidents” at the Local, City, State, and Federal level. ICS-100 is a very basic level course, available online, that will allow you to see what is happening at the Federal level vs what is supposed to be happening, and to understand what to look for, and how to help when local officials start implementing itin your area .

    https://training.fema.gov/is/courseoverview.aspx?code=IS-100.c

    I took these courses years ago in anticipation of this moment.

    Understanding how this is supposed to work, and where it is, and is not working, will help in processing, and deconstructing what you are seeing on TV. Trump, of course, is clueless. He shouldn’t be at the podium at all, it should be the heads of CDC, FEMA, DoD, Homeland Security. But we all know he can’t stand not being the center of attention.

    But the governors are stepping up, albeit hampered by the lack of Federal backup, as are mayors and other people involved in the local, city, state, and Federal Incident Management System infrastructure. For what should be obvious reasons the Democratic governors are way out ahead of the republican governors. Hopefully, people will REMEMBER IN NOVEMBER.

    Hopefully, eventually, someone will just escort trump out of the white house so that we can actually get this done but one good anxiety reduction mechanism is to learn about what is happening.

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