By Megan Chao Smith, RN
As a nurse, I am in fear for my life, and feel like I am the only one taking my safety into account. I am less frightened about contracting the virus as I am shaken by the prospect of entrusting my safety to the current, irresponsible thinking and policies of my employer. In the face of a callous disregard for nurse safety, I am forced to weigh self-preservation with the real needs of patients in a time of national crisis. I have to choose between serving my oath, which risks my life and family’s health, and leaving my job and co-workers. Only a nurse knows this wrenching dilemma, and it’s one of many dilemmas front line workers are shouldering alone as our country faces this national crisis.
Nurses are taught very strict protocols, reinforced again and again, to reduce risk and keep patients safe from easily transmittable disease. In January 2020, for example, when our hospital was under customary inspection by federal accreditation auditors, if they had witnessed us going in and out of a patient’s room reusing one mask over and over, we would have been written up and deemed not to be practicing safely.
However, as of March 2020, the CDC has made an arbitrary announcement that those precautions don’t apply. Now, nurses have no choice but to routinely use and re-use one mask for a full 12 hours on the floor. In the face of this pandemic, we are being asked to ignore the long-standing, optimal standards of care, without science, without support, and without acknowledgment of the risk posed to our patients, families, and coworkers. It is no surprise that hospitals find themselves short of the necessary supplies in a pandemic, even with the forewarning of countries battling this virus before us. Still, I was surprised by the callous way this national crisis is being handled in my hospital.
On the weekend of March 14, 2020, when rule-out cases first started to show up on our floors, only select doctors were allowed masks. There were situations already that day, where we were in the position of not knowing whether we were safe or not in our patients’ rooms. On my unit, there were only two N95 masks on our crash cart, reserved strictly for physicians. Our charge nurse was told to announce that no one was to touch those masks in the event of a patient coding/crashing/dying from COVID-19, except the doctors whom had been fitted for those masks. We felt under these conditions, we nurses were inevitably fated to contract the virus.
It has also been the policy on my unit not to inform nurses of drastic changes to our assignments. I was not informed prior to my next shift that in fact my unit had become a designated Covid-19 rule-out unit. I was quickly told to come in to be fitted for an N95 mask in an email on March 17. On March 19, we were told none of us would get masks, because the CDC deemed them unnecessary. Doctors were permitted to wear masks, but nurses were told not to bring in or wear their own masks. Many nurses reported they were told not to wear their own mask because it would “frighten the patients.” In addition to the mask issues, nurses and workers continue to be denied testing at my workplace for the virus. If we have symptoms, we are ordered to stay at home until we are recovered, and can report back to work.
Further realization of the lack of regard for employees crystalized when nurses had to resort to finding our own masks. The Minnesota Nurses Association began a massive drive to collect N95 masks from the public, to give to the state for distribution. The machinists union dropped cases of masks off, and public citizens drove up, car by car, to drop off single masks in this highly publicized effort. Weeks later, nurses on our unit were finally allowed to be fitted for N95 masks. In our morning team meeting, our manager insinuated that we were getting masks because nurses “had made a big stink,” and they were doing it to “ease our fears.”
Not only are nurses being denied critical equipment, we are also being silenced. As established, my hospital hid behind the modified and inaccurate CDC guidelines to justify lack of protective equipment for nurses and patients. In the absence of this proper guidance, nurses joined social media pages, one with over 30,000 nurse members across the U.S., in an effort to compare notes and form treatment protocols based on each other’s experiences with the virus. The site was soon made private by the site administrator, as hospital managers, in the time of this national health crisis, were found to be scanning social media and disciplining staff for ‘negative comments’ about lack of equipment or inadequate hospital response. My contract with my institution included a vital clause disallowing us from posting on social media to protect the privacy rights of patients. The hospital is now trying to silence nurses by grossly misrepresenting the spirit of the HIPAA laws, asserting inaccurately that nurses are forbidden even to say how many COVID patients there are in their hospital.
It is unacceptable to be silenced by hospitals seeking to protect their reputation, as we scramble to find our own protective equipment, identify real safety protocols, and provide one another crucial support to serve our patients. Such callous hospital policies and actions during this pandemic clearly outline hospitals’ valuation of reputation over the provision of cohesive, optimum employee safety measures.
My biggest worry is that nurses and our front line coworkers with whom we work shoulder to shoulder, will catch the virus, not be permitted to take the test to confirm the diagnosis, go home as ordered, to recover, and, like nurse Lisa Ewald in Michigan, age 54, go home and die a terrible, painful, tortuous death alone. I fear those nurses deaths will be hushed, hidden and glossed over, the irresponsible thinking and policies in our healthcare system will pick right up where they left off, and workers will not be treated for stress and harm. I am afraid masses of nurses will quit instead of stay to receive appropriate recompense for the duty they will have served, and for the sacrifices they will have made. I am worried for our healthcare system and for the care of patients not only in the wake of this crisis, but for the years to follow.