In light of the COVID-19, or the novel coronavirus, pandemic, hospital nurses’ jobs have changed, especially surrounding personal protective equipment, or PPE, and testing procedures.
Rosa Villarroel, a registered nurse at UCSF Medical Center, and Robin Leffert, a registered nurse at UCSF Benioff Children’s Hospital in Oakland, both said they have to reuse PPE at their hospitals.
“We take that mask and we use it for our entire shift. Now, what that entails is that we may take that mask and, after we are done caring for one patient, we have to carefully remove it from our face without contaminating ourselves — our skin — and place into a paper bag, which has been graciously given to us and write our name on it just like a little lunch bag,” Villarroel said. “When the next patient comes in, we need to use it again. We carefully retrieve that mask and put it back on.”
The reason for this reuse, according to Villarroel, is the nationwide shortage of PPE and preparation for a potential surge in COVID-19 cases.
According to Villarroel, her hospital previously adhered to a high standard endorsed by the Centers for Disease Control and Prevention, the California Division of Occupational Safety and Health and PPE manufacturers, which considered PPE single-use only. This is to protect patients from the spread of disease or infection, Villarroel said.
Matthai Chakko, spokesperson for the city of Berkeley, said the city implemented its shelter-in-place order to help prevent such PPE shortages.
Leffert said her hospital has seen its PPE supply reduced, which has led to the reusing of PPE and created practical challenges.
“It’s very common practice that if a patient needs something, if the call light is on, and the nurse is busy then another nurse will go and help out. It is a team approach to nursing,” Leffert said. “Now if a call light goes off and it is a rule-out COVID-19 patient, I don’t necessarily want to go and help out because that means I am going to have to use those disposable gowns and it could be just for two minutes to find out that the patient wants apple juice and I just wasted a gown.”
Both Leffert and Villarroel said there is a nationwide shortage of ventilators. According to Villarroel, before the pandemic, hospitals had just enough ventilators, but with the increase in patients who need ventilators because of COVID-19, this supply has been insufficient.
According to Villarroel, there has not been a surge in COVID-19 cases at her hospital, but she said if there were a surge, hospital resources and staff would be “stretched.” Villarroel said this could lead to a “burnout of nurses” and increased rates of infection for nurses. Villarroel also said she has concerns that due to job loss, people will lose their insurance and not seek treatment for COVID-19 and other health issues.
“It is a nationwide problem that nurses overall at all hospitals don’t have the kinds of equipment that they need. … Patients aren’t being isolated properly, according to basic safety standards,” Leffert alleged. “There is so much we don’t know and aren’t being filled in on, which creates a sense of being sent into battle without proper armor or an action plan.”
According to Leffert, nurses follow a precautionary protocol when patients are awaiting the results of a test by treating them as if they have the condition.
Without this protocol being followed in the case of COVID-19, patients are not properly isolated, Leffert alleged, and nurses could be exposed to the disease.
“If the patient isn’t being properly isolated and nurses aren’t given the necessary equipment while we are waiting for the test results and it turns out that the patient is positive, then that means the entire time we are waiting for those test results then those nurses were exposed,” Leffert said.
According to Leffert, nurses have to advocate for more resources and better working conditions because of the pandemic. Villarroel said she also has concerns around nurse and health care worker safety.
There have been more than 120 complaints filed with the federal Occupational Safety and Health Administration in about 16 states regarding alleged unsafe working conditions, the lack of PPE and alleged inadequate isolation of patients, Leffert said.
“When we finally see those numbers of workers infected due to lack of resources, and by resources I mean PPEs, I hope that the CEOs can look at those numbers and say that they are happy with those numbers and say that they did as much as they could and that they gave as much support as they could to the nurses,” Villarroel said.