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Do hospitals allow nurses to wear their own respirators of choice?

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Do hospitals allow nurses to wear their own respirators of choice to prevent from getting COVID? Can nurses purchase any respirator and wear it at work at any hospital, or are there certain respirators that you cannot wear at work?

Basically, I would like to know if nurses are restricted to the PPE they can wear at work in any way, or if they are free to purchase any outside PPE to wear at work in hospitals.

We must wear hospital supplied and fit-rested respirators. 

Just now, Wuzzie said:

We must wear hospital supplied and fit-rested respirators. 

Okay, if you think the hospital-supplied respirators are not sufficient, can you purchase better respirators to wear at work? I am just wondering if this is allowed at hospitals for nurses. 

Why would you think they are insufficient and how would you know the difference? Again, we wear hospital supplied and fit-tested respirators. We are not allowed any other kind but your facility may be different. 

15 minutes ago, Wuzzie said:

Why would you think they are insufficient and how would you know the difference? Again, we wear hospital supplied and fit-tested respirators. We are not allowed any other kind but your facility may be different. 

Well, according to the CDC website, there are 4 types of PPE respirators that healthcare workers can wear:

1. Filtering Facepiece Respirator (FFR) aka n95 masks

2. Elastomeric Half Facepiece Respirator (P100 masks)

3. Elastomeric Full Facepiece Respirator (Full-face P100 masks)

4. Powered Air-Purifying Respirator (PAPR)

I am wondering if nurses can choose to wear a "better-level" PPE at work in hospitals if they think it is better for them. For example, if the hospital only supplies P100 Elastomeric Half Facepiece Respirators, can you choose to wear P100 Elastomeric Full Facepiece Respirators instead? Also, can nurses wear Powered Air-Purifying Respirator (PAPR) if they purchase it themselves or no? 

https://www.CDC.gov/coronavirus/2019-ncov/hcp/PPE-strategy/powered-air-purifying-respirators-strategy.html

Edited by Kara638

I’m pretty sure I have answered this question but I’ll try again. Most hospitals only allow you to wear hospital-supplied and fit-tested respirators. The type will depend on the circumstances of your actual/potential exposure. On my unit we are supplied surgical and N95 masks. We cannot ask for a higher level nor supply our own. Routine  patient care (not on a dedicated COVID unit) does not require any more protection than what you would need in any other closed environment with potentially un-vaccinated people. 

1 hour ago, Wuzzie said:

I’m pretty sure I have answered this question but I’ll try again. Most hospitals only allow you to wear hospital-supplied and fit-tested respirators. The type will depend on the circumstances of your actual/potential exposure. On my unit we are supplied surgical and N95 masks. We cannot ask for a higher level nor supply our own. Routine  patient care (not on a dedicated COVID unit) does not require any more protection than what you would need in any other closed environment with potentially un-vaccinated people. 

Okay got it. Why do they not let you use your own respirator? Can you ask your manager if you can use your own respirator and have them approve it? Basically, I would like to use my own P100 respirator when working as a nurse and I would like to know if it would be possible for me to do so. I do not feel comfortable wearing n95 masks. I know other hospitals that have their nurses wear P100 respirators instead of n95 masks.

Edited by Kara638

Rose_Queen, BSN, MSN, RN

Specializes in OR, education. Has 16 years experience.

4 minutes ago, Kara638 said:

Why do they not let you use your own respirator?

Because there is no way for the employer to verify its authenticity and NIOSH approval. There have been a lot of counterfeit PPE items out there. Your employer is required by OSHA to provide the PPE you need. Yes, there were emergency use authorizations for the reprocessing of N95s that has since ended, but those were drastic measures that we hope to not see repeated. What your facility offers has been validated for use. 

Check out this article regarding N95 vs P100 and leakage (quick Google search, did not deep dive into the source)

https://academic.oup.com/annweh/article/64/2/202/5648932

Quote

Conclusions

With the presence of artificial leakage, a P100 FFR with high-flow-resistance may not be as protective as a low-flow-resistance N95 FFR. This finding suggests that future efforts should be directed to reducing the breathing resistance when designing P100 FFRs.

 

klone, MSN, RN

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership. Has 15 years experience.

7 hours ago, Kara638 said:

Okay got it. Why do they not let you use your own respirator? 

In a nutshell - because if you used your own, non-hospital approved PPE, and later had a workplace exposure in which you got infected, it would open up the hospital to all kinds of fines and liability.

Your manager does not have the expertise or authority to approve PPE. It would need to go through all kinds of vetting and committees, and frankly, it's not worth their time.

Use the hospital-provided PPE, get your vaccine, use good hand hygiene. You will be fine. I feel like this is an "18 months ago" question.

7 hours ago, Kara638 said:

Can you ask your manager if you can use your own respirator and have them approve it?

No, no you can't. Not sure how much clearer we can be. 

Why do you not think an N-95 is an appropriate mask?  Are you planning to work in a strictly covid unit?  
 

As others have stated you have to be fit tested every year for a mask.  But truly the N-95 is the gold standard.  Some places ended up using respirators due to the N-95 shortage.  Our RTs used them because we couldn’t get more N-95s at the time.  We are all back to the N-95/PAPR gear.  
 

You personally can’t determine from Amazon reviews what constitutes adequate PPE.  The hospital employees people that determine that and get you fitted for it.

Closed Account 12345

Has 14 years experience.

You can always ask since your hospital's policy may vary greatly from some of the posters here. As a general rule, you must use the provided PPE for the liability reasons outlined above.

Then again, a year ago nurses were being told to cover their faces with the same used, makeup coated, stretchy elastic, "cleaned" n95 masks that other nurses had previously worn for multiple shifts, or regular surgical masks, or pieces of cloth on their faces while caring for known covid patients... In situations like that, more power to the nurses who say absolutely not and provide their own real PPE. 

7 minutes ago, Closed Account 12345 said:

Then again, a year ago nurses were being told to cover their faces with the same used, makeup coated, stretchy elastic, "cleaned" n95 masks that other nurses had previously worn for multiple shifts, or regular surgical masks, or pieces of cloth on their faces while caring for known covid patients... In situations like that, more power to the nurses who say absolutely not and provide their own real PPE. 

While sort of true, although a bit heavy on the hyperbole, this was early in the pandemic during the PPE shortage  which no longer exists. 

adventure_rn, BSN

Specializes in NICU, PICU.

Even with the elastrometrics, there'd be no way to prove that you're replacing the filters at regular intervals, and I also wonder about the ability to thoroughly clean them between patients/rooms/days.

Also want to add that it's wildly impractical to get your own PAPR. They are crazy expensive, the filters are crazy expensive, servicing them is crazy expensive. If you're caring for a COVID patient, you can definitely ask your manager if you can use the PAPR if it's available. However, highest priority would go to people who have failed their fit tests.

Closed Account 12345

Has 14 years experience.

9 minutes ago, Wuzzie said:

While sort of true, although a bit heavy on the hyperbole, this was early in the pandemic during the PPE shortage  which no longer exists. 

Why would you consider this any degree of hyperbole, much less heavy on the hyperbole?

It is a literal, factual statement about the specific timeline provided- a year ago.  It is not in any way exaggerated or expanded upon for interest. 

Point of literal, not hyperbolic original post:

When an employer doesn't provide adequate PPE at the expense of a nurse's safety, the nurse should feel free to wear their own appropriate PPE regardless of policy.  I, personally, wouldn't intentionally expose myself to a deadly virus just to follow policy if I had a safe alternative available.

As a side note, there may not be a nationwide PPE shortage now, but that doesn't mean hospitals have purchased the available PPE or made it available to staff.  A hospital in my area continues to have very gross PPE sharing and reusing policies. Available for purchase is not synonymous with accessible to staff.

nursej22, MSN, RN

Specializes in Public Health, TB. Has 36 years experience.

My health department cannot find an N95 mask that fits me well enough to pass the fit test. I use a CAPR when needed. They are quite comfortable, but I think they cost about $300 each, plus replacement face shields and inner liners. They do make it a little hard to hear. 

adventure_rn, BSN

Specializes in NICU, PICU.

1 minute ago, Closed Account 12345 said:

When an employer doesn't provide adequate PPE at the expense of a nurse's safety, the nurse should feel free to wear their own appropriate PPE regardless of policy.  I, personally, wouldn't intentionally expose myself to a deadly virus just to follow policy if I had a safe alternative available.

I mean, there's no harm in asking your manager. However, there's a real possibility that you'll get an answer that you don't like. Even if you disagree with the rules, you have to follow them regardless unless you want to get fired. This whole argument seems like a moot point.

Closed Account 12345

Has 14 years experience.

45 minutes ago, adventure_rn said:

I mean, there's no harm in asking your manager. However, there's a real possibility that you'll get an answer that you don't like. Even if you disagree with the rules, you have to follow them regardless unless you want to get fired. This whole argument seems like a moot point.

You think in the peak of the pandemic last year that any ER in the country would have fired a nurse for bringing her own fresh n95 instead of wearing the provided simple face mask that had already been worn for 3 days? Please.

I am a big rule follower, not the rebellious type. I love policies and procedures. I wouldn't follow any policy that said I couldn't protect my own health if the employer failed to do so. At what point will nurses stand up for themselves and realize we deserve better? 

If a hospital has unused N95s available for airborne transmission conditions, yes! By all means, wear theirs. It's their responsibility, and it helps with liability. However, if they aren't making *appropriate* PPE available, nurses should be free to provide their own protection.

This is why hospitals are able to treat nurses so badly. We're willing to risk our lives for a job, even when that doesn't have to be the case. It's. Just. A. Job. We matter. Our health matters. 

Edited by Closed Account 12345