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Refusing Care of a COVID-19 Patient Due to Inappropriate PPE

Disasters   (14,225 Views | 218 Replies)

EDboundSN has 5 years experience as a EMT-B and specializes in the Emergency Department.

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I have worked since I was ten years old. I was a RN for 30 years. I retired at 65 years of age. I was due for renewal six months ago. I did not renew. I am done. My wife is a nurse. She has a long way to go, but she is home with me. I have compromised health issues (STEMI). Think about it, do I need to be exposed at this point in my life? Tough call.....

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CaffeinePOQ4HPRN has 10 years experience as a BSN, LPN, RN.

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11 hours ago, caliotter3 said:

No wonder more and more nurses, and most likely other HCWs, are questioning whether they should be working during this time. 

I don't blame them at all... I'm working bedside during this, and our system/professional bodies/regulatory colleges have failed and abandoned us. I wouldn't even think less of anyone who walked away from the bedside or the profession at this point. After a while of being treated worse than a dog, people burn out, compassion fatigue sets in, people physically start to fall apart, the human spirit breaks... Nurses are not slaves. We are willing to help, all we ask is for safety measures and consideration.

Edited by CaffeinePOQ4HPRN

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CaffeinePOQ4HPRN has 10 years experience as a BSN, LPN, RN.

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3 minutes ago, Ned Pepper said:

I have worked since I was ten years old. I was a RN for 30 years. I retired at 65 years of age. I was due for renewal six months ago. I did not renew. I am done. My wife is a nurse. She has a long way to go, but she is home with me. I have compromised health issues (STEMI). Think about it, do I need to be exposed at this point in my life? Tough call.....

You've served society with 30 solid years. That is remarkable! IMO, stay home.

Edited by CaffeinePOQ4HPRN

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51 Posts; 964 Profile Views

My hospital has N95s but is trying to conserve them and wouldn't give me one for COVID patients. I threw a fit and insisted on one and they finally gave it to me. My wife has asthma and I'm not taking my chances.

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You don’t need an N95 unless you will do something that will generate aerosolized COVID like a breathing treatment. I’ve been using surgical masks Face/eye shield and gowns because it’s droplet and contact precautions. Washing my hands “, leaving shoes In garage, taking off scrubs and washing immediately after work and taking a shower immediately after work. And I’ve had positive patients and didn’t get sick. Plus, if you are young you are less at risk of getting any serious symptoms and eventually all of us will get sick with it. So, don’t worry, use your surgical mask and take care of your patients. All the nurses I know did it the way I did and none have gotten sick even though it’s been past the incubation period.

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On 3/19/2020 at 3:41 PM, LovingLife123 said:

No, you don’t refuse care.  These people didn’t ask for this and they are entitled to care.  I will end up at some point with COVID.  I’m healthy enough to handle it.

LOL....sigh...I assume you think its another flu and dont use social distancing

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Nurse19 specializes in Cardiac.

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I understand we as Nurses are to care for the sick, ill, and injured but that is why there are precautions in place to handle different disease process and situations. We should not have to put ourself at risk because this crisis due to lack of N95 mask and I am not. 

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I’m so tired of y’all “do gooder” nurses. Everyone is always throwing around how hard you worked for your license and don’t want to put that in jeopardy but you’re ready to place your life in jeopardy? This is an infectious disease that healthcare workers are catching, could potentially pass to other patients, co workers, and family. That would result in more hospitalized in an already overwhelmed healthcare system and possibly higher mortality rates. I’m so tired of hearing that BS. The military, police officers, firefighters all have adequate equipment. They have no control over the actions of others or a house falling on them. The hospitals are not providing us with the tools we need to safely perform our jobs and we are no wrong for thinking about our lives! You all should be the first to volunteer to quarantine at the hospital with no PPE and be the designated Covid Nurses since you’re willing to die. Smh

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MunoRN has 10 years experience as a RN and specializes in Critical Care.

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The debate we should be having is whether an N95 is sufficient, it's a failure of Nursing leadership in the US that we're debating whether procedure / surgical masks are sufficient.

As an example, from a journal article during the 2002-2004 SARS Coronvirus outbreak:

Quote

The transmission of the virus causing severe acute respiratory syndrome (SARS) appears to be by aerosol droplet and possibly through other routes.1 Therefore, it is recommended that health care workers and others who may be exposed1 employ respiratory and other personal protective equipment.2,3 The type of respirator that has typically been used by health care workers is the N95 half-mask.2,3 As correctly stated by Richard Schabas,2 the “N95-rated mask” is 95% filtration efficient,4 but does this level of efficiency provide the best protection for those at risk of exposure? The effectiveness of the N95 respirator has been supported by a small study on prevention of occupational transmission of infection.1 However, for work with bacterial bioaerosols and chemical and biological warfare agents, some have suggested that N95 masks are inappropriate5,6 because these respirators do not provide “absorbent capability” and because of the amount of mask leakage, which can be about 5% through the filter and 10% around the mask,7 even if properly fitted. For biological diseases like SARS, for which just a few particles may be sufficient for infection, the N95 mask may indeed be inadequate, and some health care workers may therefore become infected even if they use the respirator properly.

A better selection for respiratory protection would be an N100 respirator with an ultra-low penetrating air filter (ULPA), which would cost only slightly more than an N95 respirator. N100 respirators have an efficiency of 99.977%,8 and ULPA filters are 99.999% efficient for monodispersed particles 0.12 μm in diameter or larger.9 HEPA (high-efficiency particulate air) filters would not be the best selection for use with a respirator because their efficiency is 99.97% for monodispersed particles 0.3 μm in diameter or larger, and coronaviruses are smaller than this (at about 60 to 200 nm). For effective operation of an N100 respirator with ULPA, the user must be fit-tested. The United States and many other countries have numerous requirements for using a negative-pressure air-purifying respirator, including medical evaluation and training, as well as yearly fit-testing.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC156669/

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Nurse19 specializes in Cardiac.

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30 minutes ago, brittnie89 said:

I’m so tired of y’all “do gooder” nurses. Everyone is always throwing around how hard you worked for your license and don’t want to put that in jeopardy but you’re ready to place your life in jeopardy? This is an infectious disease that healthcare workers are catching, could potentially pass to other patients, co workers, and family. That would result in more hospitalized in an already overwhelmed healthcare system and possibly higher mortality rates. I’m so tired of hearing that BS. The military, police officers, firefighters all have adequate equipment. They have no control over the actions of others or a house falling on them. The hospitals are not providing us with the tools we need to safely perform our jobs and we are no wrong for thinking about our lives! You all should be the first to volunteer to quarantine at the hospital with no PPE and be the designated Covid Nurses since you’re willing to die. Smh

SMH too! This is my opinion! Put yourself and family at risk!!

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On 3/23/2020 at 9:20 AM, Jory said:

So what is your plan if the equipment runs out before it is replenished?  Allow people to lay there and die?  

That's like telling a fireman wearing nothing but casual clothes to battle a forest fire, or a policeman without equipment to face a gang with firearms; you expect them to jump out? No, they need to be smart and equipped. The same principle when it comes to healthcare.

Personally, if I was a patient with covid-19 and nurse refused to enter my room due to a shortage of ppe, guess what.........I wouldn't get mad at the nurse, instead, I'd get mad at the hospital. Why? Because it is NOT the nurses fault that there's a shortage of supplies, it is the hospital's fault for not being prepared for a pandemic such as this one. In my last moments, I wouldn't want blood in my hands....

It's not like the nurses are say "Nah, I don't feel like taking that patient" and lounge in their station, the nurses are being smart and protective- because if they don't wear their ppe, guess what, now the next 2 patients they have that didn't have covid-19........BOOM! Now there is 3 patients with covid, all thanks to the nurse who didn't wear the proper ppe, bravo!! SMH

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