Under the watchful eye of Mission Hospital security, several nurses involved with the push to unionize their colleagues demonstrated during the 6 p.m. shift change on April 9. Their signs and conversations with other staff members questioned the availability of personal protective equipment and training to deal with the COVID-19 threat — and how a union might increase their safety.
“The biggest thing we’re pushing right now is that we want the highest level of PPE,” including N95 masks (which filter out most particles) and PAPRs (powered air-purifying respirators, used by staff with beards or those who have difficulty getting a good fit in an N95 mask), said Sybil McCrorey, a registered nurse who works in the cardiac step-down unit. Hospital administrators, she continued, are following current Centers for Disease Control and Prevention guidelines regarding masks and other gear, but those recommendations are based on the availability of supplies, not the highest level of safety.
“There’s just so much that’s not known about COVID yet and its transmission, and we just want to make sure we’re safe,” McCrorey said. “If nurses are safe, the patients are safe, and the community is safe. We don’t want to be a vector for this.”
McCrorey acknowledged that Mission leaders had responded to many of the issues raised in a recent petition signed by about 700 nurses. “You do have access to N95s for certain cases, so it’s not that they’re not out there; it’s just not as available as we would like to see,” she said. She claimed not to have been issued her own N95 mask, despite working with vulnerable patients with multiple health problems.
In an April 3 press release, Mission leaders announced that they would mandate the wearing of masks throughout all patient care facilities. However, N95 masks remain reserved for personnel directly interacting with confirmed or suspected COVID-19 patients during “aerosolizing procedures” such as intubation; staff not deemed to require “higher levels of protection” are being issued basic surgical procedure masks.
The hospital has also provided training in safe methods for putting on and taking off protective gear, McCrorey said. But Robyn Sadle, a registered nurse who works as a case manager in Mission’s cardiac unit, argued more training is still needed. “They did provide clinics; they have handouts,” she said. “But especially for those folks that might get redeployed from one jobsite to another role, being able to have that in-person demonstration, effective training, it’s very necessary and could always be done better.”
Both nurses agreed that the hospital feels unusually quiet right now, with elective procedures postponed and fewer patients arriving due to traffic accidents and other mishaps. “It’s the calm before the storm, if you will. All the more reason that we should be taking advantage and making sure that we’re having the education and training while we can,” Sadle said.
Reusing protective equipment is another concern the nurses share. Staff members are being given a “special brown bag” for storing N95 masks and are asked to reuse them for multiple shifts, Sadle said.
“There’s been no evidence that that’s safe. The N95s are designed to be single-use. The CDC is allowing for these things because of supply chain issues. That’s concerning, that that’s your only reasoning, so that’s why we would like single-use N95s or PAPRs,” added McCrorey.
Asked to comment on the nurses’ requests, Mission Health spokesperson Nancy Lindell provided the following response:
“Mission Health is doing everything it can to equip its patient care teams to provide safe, effective care to the people we serve, unwavering in our dedication despite the unique challenges presented by COVID-19. The National Nurses United is trying to use this crisis to advance its own interest — organizing more members.
“Since the onset of the COVID-19 pandemic, Mission Health’s goal has been to protect our frontline clinicians and caregivers so they are able to continue to care for our patients and community. The pandemic has strained the worldwide supply of personal protective equipment (PPE), including masks, face shields and gowns, a challenge that is not unique to Mission Health or any other hospital or health system in the United States. While Mission Health is doing everything in our power to secure additional supplies, and we are following CDC protocols for using and conserving PPE, the worldwide shortage is a reality that we are addressing with realistic, workable solutions. The steps we have taken include:
- Enacted universal masking for all of our employees.
- Appointing a PPE Steward to oversee priority deployment of PPE effective for COVID-19 where and when it is needed most.
- Creating strategically located PPE distribution centers across our campus to quickly deliver equipment.
“We also have taken steps to help protect the financial security of our front-line caregivers and their support colleagues, including a ‘pandemic pay continuation’ policy even as other health care systems have announced layoffs.
“In addition, we will provide cleaned hospital scrubs each shift for colleagues who care for COVID-19 patients to help prevent potentially carrying the virus home on clothing. Mission is also working with major hotel chains to provide housing for caregivers who provide care to COVID-19 patients and prefer not to go home to their loved ones after their shift.
“The COVID-19 pandemic is unique, and our colleagues’ concerns are real. In this unparalleled crisis, everyone should stand together to support our nurses and not spread misinformation and fear to advance other agendas.”
Editor’s note: This article was updated at 12:54 p.m. on April 10 to include Mission Hospital’s statement.