As the calendar turns to April and, as Dr. Amy Acton has said, we exist in the “calm before the storm” of impending surges of coronavirus cases, Ohio’s hospital systems are struggling with shortages of personal protective equipment, including N95 masks.
That’s factoring in what was already on hand, what’s been donated, and this week’s shipment from the Strategic National Stockpile (271,450 N95 masks, 672,100 surgical masks, 131,808 face shields, 107,670 gowns, 483,575 pairs of gloves, 552 coveralls), which Dr. Acton called insufficient on Tuesday night.
“The supplies we received, and the state’s reserve will not meet the immediate or future needs of Ohio’s healthcare providers and first responders,” she said.
Different models put Ohio’s peak at different levels and at different times, but they generally range from a minimum of 6,000 new cases a day up to 10,000 with a peak in late April or early May. The storm is not only coming, but it’s going to be unlike anyone’s ever seen.
So, yes, there is fear among healthcare workers — who make up almost 20% of confirmed coronavirus patients in Ohio thus far — for their patients, for themselves, for their families. And there’s fear of talking about that fear.
Bloomberg this week rounded up the long list of hospital systems across the country that have threatened, and in some cases gone through with threats to fire any staff members who talk to the media. The guiding principle, at least before the coronavirus pandemic, was that all requests are best handled and approved by a hospital’s communications department, both to protect the image and reputation of said hospital but also to create and operate by a codified process to protect patient confidentiality. As Bloomberg noted, it’s a different world now, and those processes, and threats, are not in the interest of preserving patient confidentiality but in making sure that nurses and doctors don’t give honest evaluations of their workplace safety to the public.
And they’re asking anyone who can help get the information out. Via Bloomberg’s story:
Nisha Mehta is a 38-year radiologist from Charlotte, North Carolina, who runs two Facebook groups for physicians with around 70,000 members. She’s fielded numerous requests from health-care workers hoping to get their stories into the public arena.“I’m hearing widespread stories from physicians across the country and they are all saying: ‘We have these stories that we think are important to get out, but we are being told by our hospital systems that we are not allowed to speak to the press, and if we do so there will be extreme consequences,” she said.
Which is why when you read a story about PPE and precautions in Ohio hospital systems, you’ll rarely see a nurse quoted by name. You might see nurse’s unions, where they exist, advocating for their members — like Rick Lucas of the Ohio State University Nurses Organization did in this Columbus Dispatch article where he said critically low supplies of protection equipment mean nurses are “going to work every day in fear” — but you’ll see nurses themselves having to resort to anonymous quotes, like the two interviewed for that very same Dispatch report, out of fear of repercussions.
The same problem exists here.
“I have to remain anonymous. I am risking my career,” said one Cleveland Clinic nurse who spoke to Scene about the hospital system’s current policies and supplies, information that they thought the public should know.
“Nurses were initially eager and proud to do their part in fighting the pandemic and caring for patients and we were reassured we would be provided with adequate protection,” the person said. “But days later leadership announced we would no longer get N95 masks, just surgical masks. N95 masks would only be supplied while conducting aerosolizing procedures, which is only a tiny fraction of what caring for a COVID-19 involves. When a person infected with COVID-19 coughs, a terrifying amount of aerosolized viral particles are hurled into the air for bystanders to inhale and become infected. Health care personnel are inches from these patients’ faces providing them with around-the-clock care. A simple face mask will not protect health care personnel from inhaling viral particulate. Many will soon become infected and thereby spread the infection to otherwise healthy individuals.”
When some nurses have complained, this person said, leadership has replied, “This is what you signed up for.”
“Nurses and other health care personnel did not sign up for caring for patients in unsafe working conditions,” the person said. “As nurses, we love our jobs and our patients. Our patients deserve the best possible care that we can provide. The Clinic has always provided us with the resources necessary to meet that goal. These policy changes, however, are uncharacteristic of the values and mission. We are not unionized and have little power to influence leadership. Health care workers are dying trying to care for patients across the globe. We will be next if the Cleveland Clinic does not provide their employees adequate equipment. We will continue to infect ourselves, patients, and our families. The Clinic should be creating the standard of care—not lowering it.”
This article appears in Mar 25-31, 2020.
Oh so the masks that dint work bafore are now going to be mandatory cuz they werk so gud.
Makes sense to me.
the mask flip flop just goes to show bureaucrats lie about everything. you have to sift through the feces that is the mainstream media to find the few corn kernels of truth
This is nothing new. I work in healthcare and can confidently say that our local leadership was deliberately misled by government bureaucracy. Front line empty should be smart enough to expect this. Sometimes the worst times bring out the worst.
Mushroom Management.
This is fear mongering at its best. I am a caregiver at the clinic, and can say with pride that I truly believe the administration is doing everything in its power to protect employees. I have never seen such exceptional leadership as I have from Dr. Mihaljevic and his colleagues. Do you think the clinic would withhold necessary PPE if it had the resources? As “Dog” said, this is a problem with supply and government, NOT local hospitals. In addition, I have many friends working at UH and Metro and can confidently say that we are in a much better position than them, so be grateful for what you have. If you don’t want to care for patients in this time of need, then you can join the unemployment pool like 20% of Ohio. And Scene, the responsible thing would have been to investigate these claims rather than irresponsibly report based on one disgruntled nurses claims.
What the nurse in this article said is completely true. Cleveland Clinic’s policy on PPE for the care of COVID patients is to wear a regular surgical mask. The only time you are to wear an N95 is during aerosol generating procedures. It is clearly spelled out in their policy. Any employee who says that isn’t true, needs to reread their policy, including the commenter above “CCFDOC.” That commenter obviously isn’t even working with covid patients. And anyone who tells a nurse to quit their job at a time like this obviously does not care about their fellow caregiver’s health and safety and should not be working in healthcare. Or maybe he/she is one of the doctors demanding N95 when seeing COVID patients even when not doing an aerosol generating procedure leaving the bedside nurses and other staff with even less N95’s. Unfortunately for the USA, the CDC changed their guidelines to align with the amount of equipment we have available not what is really required to protect healthcare workers. So technically Cleveland Clinic is following CDC guidelines. It’s scary. And it goes to prove that the government is not here to protect and help us. You have to protect yourselves!!
@nurseratchet – I am completely aware of the PPE guidelines at the clinic for COVID patients and in fact, am an active caregiver. To take it a step further, I perform aerosolized procedures on patients. My point with the comment was that this article lies the blame on the clinic, when in fact the clinic has taken more steps than most other healthcare organizations to prevent a PPE shortage. I have colleagues out west in Washington state and California who are wearing plastic sheeting and trash bags for PPE. Have you had to resort to these extreme measures? This situation is not ideal for anyone, including those who are unemployed, sick, or have sick family members. Irresponsible journalism only contributes to the problem – all we can do is continue to care for patients as we always have.
So, did you bother to contact the clinic for comment, or did you decide not to out of fear that their comments won’t fit your narrative?
CCFDOC, what is CCF’s policy regarding screening of health care workers and other employees after a coworker tests positive?
@ccfdoc. I encourage you to better empathize with the nurses and doctors who are consistently at the bedside caring for this patient population. A simple face mask is not adequate protection. As a provider who partakes in aerosolized procedures you would know that. Your comments are insensitive and insulting.
I am an RN at CCF. This information is completely accurate. CCF has taken extraordinary measures to combat COVID-19 and I applaud them for their achievements. However, simple face masks are not safe. CCFDOC, would you feel comfortable spending 12+ hours in a room with a COVID-19 patient wearing a simple face mask? Doubt it. @JUSTCURIOUS, my coworker went to Europe three weeks ago and returned to work without restrictions since she was not exhibiting symptoms. She is now positive for COVID-19. However, unclear if she become infected abroad or in the local community. Employees were not notified until a week later.
How often are those that interact with covid patients are being tested? With the shortage in tests I can’t imagine the high risk providers are being tested as frequently as they should. And if the providers do account for 20% and aren’t being tested unless they exhibit symptoms, which can take up to 2 weeks, shouldn’t they be wearing masks all the time?
Cleveland Clinic is following CDC guidelines. In guidelines for emergency management, it is already appreciated that resources may not be available in the same way that they are outside of the crisis. The author of this article posted an emotional response from a nurse who has likely never had to deal with a pandemic of this size before. Very few of us have. While I appreciate the emotion, it does not provide enough of an argument to attack the Cleveland Clinic, or any healthcare organization struggling to help a growing population of critically ill patients.
Take it down a notch, Cleveland Scene. The whole world is trying to partner through this. Maybe you could join.