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

Wuzzie · Jul 22, 2021

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, MSN, NP · Jul 22, 2021

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 · Jul 22, 2021

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 · Jul 22, 2021

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, MSN, NP · Jul 22, 2021

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 · Jul 22, 2021

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.

Wuzzie · Jul 22, 2021

42 minutes ago, Closed Account 12345 said:

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

Sorry, I based it on my experience. We weren't allowed to wear makeup so that wasn't an issue but the use of quotation marks around the word clean was a bit provacative in my opinion. Apparently you see it differently and that's okay with me.

MunoRN, RN · Jul 22, 2021

21 hours ago, Kara638 said:

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.

Are you referring to respiratory protection when caring for known or suspected covid patients, or to masks which are for source control when caring for non-Covid patients in the hospital?

Kara638 · Jul 22, 2021

34 minutes ago, MunoRN said:

Are you referring to respiratory protection when caring for known or suspected covid patients, or to masks which are for source control when caring for non-Covid patients in the hospital?

Basically, when I become a nurse I would like to wear an Elastomeric Half Facepiece Respirator (P100 masks) or better (and not a fitted n95 mask) when I am anywhere in the hospital. This is because I do not trust fitted n95 masks to protect me as well as P100 respirators or CAPR/PAPR respirators. I believe P100 respirators and CAPR/PAPR respirators protect better than fitted n95 masks based on the research.

Based on news articles I have read, I have seen that some hospitals supply nurses with Elastomeric Half Facepiece Respirator (P100 masks) while other hospitals supply nurses with fitted n95 masks.

Some posters are saying it is not possible for me to wear an Elastomeric Half Facepiece Respirator (P100 mask) if the hospital only supplies fitted n95 masks and others are saying that it may be possible depending on management.

MunoRN, RN · Jul 22, 2021

8 minutes ago, Kara638 said:

Basically, when I become a nurse I would like to wear an Elastomeric Half Facepiece Respirator (P100 masks) or better (and not a fitted n95 mask) when I am anywhere in the hospital. Some posters are saying this is not possible if the hospital only supplies fitted n95 masks and others are saying that it may be possible depending on management.

You wouldn't be allowed to wear an elastomeric respirator or a PAPR for that matter "anywhere in the hospital" since when caring for patients who are not confirmed or suspected to by Covid positive, the purpose of staff wearing masks is "source control" protection, elastomeric respirators and PAPRs provide absolutely no source control protection.

"Source control" refers to preventing someone's exhaled breath from transmitted a pathogen (Covid) to someone else. Elastomeric respirators and PAPR's do not filter exhaled air at all.

Non-exhalation-valve N95 and N100 masks are made with a fabric that filters air primarily in one direction, but there is evidence they can catch exhaled droplets and particles similar to that of a procedure / surgical mask.

Kara638 · Jul 22, 2021

26 minutes ago, MunoRN said:

You wouldn't be allowed to wear an elastomeric respirator or a PAPR for that matter "anywhere in the hospital" since when caring for patients who are not confirmed or suspected to by Covid positive, the purpose of staff wearing masks is "source control" protection, elastomeric respirators and PAPRs provide absolutely no source control protection.

"Source control" refers to preventing someone's exhaled breath from transmitted a pathogen (Covid) to someone else. Elastomeric respirators and PAPR's do not filter exhaled air at all.

Non-exhalation-valve N95 and N100 masks are made with a fabric that filters air primarily in one direction, but there is evidence they can catch exhaled droplets and particles similar to that of a procedure / surgical mask.

Okay, got it. Also, there is no PPE shortage anymore in hospitals right? Do hospitals now have an oversupply of PPE for nurses and healthcare workers? Will they have an oversupply of PPE for nurses and healthcare workers in the future as well? I am just concerned about PPE for nurses, especially since I am planning to work in the ICU and become a CRNA in the future as well.

MunoRN, RN · Jul 22, 2021

2 minutes ago, Kara638 said:

Okay, got it. Also, there is no PPE shortage anymore in hospitals right? Do hospitals now have an oversupply of PPE for nurses and healthcare workers? Will they have an oversupply of PPE for nurses and healthcare workers in the future as well? I am just concerned about PPE for nurses, especially since I am planning to work in the ICU and become a CRNA in the future as well.

The supply chain is better, but still somewhat sporadic, and still susceptible to shortages with spikes in cases.

In the Covid-ICU at my facility we were wearing janky procedure masks up until just recently, this was when caring for confirmed Covid patients. The masks were being imported under an EUA and had no ASTM certification of any level.

And while the facility was pretty clearly violating both OSHA and State regulations, although nobody seemed interested in enforcing those regulations. At least now you would have the protection of a vaccine when using inadequate masks.

The Joint Commission issued a position statement that hospitals should allow staff to provide their own respirators when caring for confirmed or suspected Covid patients, but they don't set regulations (they are a third party surveyor that evaluates for regulatory compliance) so hospitals aren't actually obligated to abide by their positions that are their own.