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

Nurses COVID

Updated:   Published

I'm a senior nursing student and this debate arose with a couple of my classmates and me. I work as an ER tech and they work as patient care techs on the floor. As of right now, CDC guidelines state for PPE:

Quote

Updated PPE recommendations for the care of patients with known or suspected COVID-19:

Based on local and regional situational analysis of PPE supplies, facemasks are an acceptable alternative when the supply chain of respirators cannot meet the demand. During this time, available respirators should be prioritized for procedures that are likely to generate respiratory aerosols, which would pose the highest exposure risk to HCP.

Facemasks protect the wearer from splashes and sprays.

Respirators, which filter inspired air, offer respiratory protection.

When the supply chain is restored, facilities with a respiratory protection program should return to use of respirators for patients with known or suspected COVID-19. Facilities that do not currently have a respiratory protection program, but care for patients infected with pathogens for which a respirator is recommended, should implement a respiratory protection program.

Eye protection, gown, and gloves continue to be recommended

So basically CDC is saying wear an N95 if you have it, but if you don't, wear a surgical mask until you can get an N95.

So if you have a suspected or confirmed COVID-19 patient, and all you have is a surgical mask and no N95, can you refuse to take care of that patient? Do you face any legal repercussions or potential fallout from your employer if you do refuse? Asking not only about tech positions, but RN positions as well.

n95-mask.jpg.948ffc9ddec77bfd24a6a81472029d5d.jpg

Specializes in OR.
On 3/29/2020 at 11:02 AM, Katie82 said:

First of all, everyone is a suspected positive these days. Many of those who test positive have mild symptoms resembling cold or flu, yet are still contagious. I think what the CDC is saying is N-95 is ideal, but if you don't have them, use a surgical mask. In most states, you are free to refuse if you want to lose your license. Certainly your choice. Many are saying they would abandon then hope that their BON will excuse them retroactively. I wouldn't count on it. By next year at this time, most of the powers-that-be will have forgotten how hard we worked, or didn't as the case may be.

Heck YES. This whole wasted effort on testing herds of people pos/neg is such a waste of resources and TIME. It reminds me of the early days of HIV, when everyone thought every gay man was positive, and treated them that way. It took years for the rest of America to get the memo they, too, could be positive and NOT know.

We should be focusing on doing serology tests to find out who has been exposed and has presumed immunity based on serology. Those people could get back to work and lessen the economic depression we are going into.

On 3/29/2020 at 12:02 PM, Katie82 said:

First of all, everyone is a suspected positive these days. Many of those who test positive have mild symptoms resembling cold or flu, yet are still contagious. I think what the CDC is saying is N-95 is ideal, but if you don't have them, use a surgical mask. In most states, you are free to refuse if you want to lose your license. Certainly your choice. Many are saying they would abandon then hope that their BON will excuse them retroactively. I wouldn't count on it. By next year at this time, most of the powers-that-be will have forgotten how hard we worked, or didn't as the case may be.

There are only 2 boards that I saw were threatening revocation of licenses for refusing pts and how is this any different from what we’ve always done? Nurses refuse patients all the time

1 Votes
On 3/31/2020 at 11:07 AM, JennBSN918 said:

Refusing care is neglect which is licensure loss and possible criminal charges

No. Pt abandonment is negligent. Nurses refuse patients all the time. Y’all are being ridiculous and if you take a COVID patient with no PPE, u stupid cause you gone be a dead nurse

22 hours ago, brandy1017 said:

Now over 700 nurses and doctors are infected in Boston and NYC because of the unsafe PPE put thru by the CDC! How many need to be infected or die before they take this seriously and supply TB masks and even better PAPRs! And who is going to replace all these health care workers at the front lines!

Exactly but you have too many idiots willing to become martyrs to prove to everyone how dedicated they are to their jobs. Can’t take cate of anyone when you’re sick or dead

1 Votes
Specializes in Tele, OB, public health.

Dang, this is all terrible. I know I sound like a broken record on all of these discussions related to this issue, but for god's sake everyone organize your workplaces if they're not already union. And if they are union and not doing anything, raise **** with the leadership.

1 Votes
Specializes in ER.

From what I've read, some states are responding to nurses who refuse to work like this by saying the only way they can refuse is to permanently surrender their license.

Union should be national, it should be in every hospital, and ideally it should extend across professions, to include CNAs, pharmacists, physical therapists, radiographers, etc.

Then it could make a difference.

1 Votes
Specializes in Tele, OB, public health.
11 minutes ago, skylark said:

From what I've read, some states are responding to nurses who refuse to work like this by saying the only way they can refuse is to permanently surrender their license.

Union should be national, it should be in every hospital, and ideally it should extend across professions, to include CNAs, pharmacists, physical therapists, radiographers, etc.

Then it could make a difference.

It’s bad enough that there are still non union hospitals anywhere, but the fact that some nurses choose them over union jobs is just....smh

People are taught to use PPE properly otherwise. Where is this logic now? If the COVID-19 patient is contagious, therefore, a person who is directly taking care of the patient is mobilizing the virus, right? So, how do the COVID-19 caregivers protecting their community without proper protection? Are they isolated with the COVID-19 patients in order to control the viruses from spreading?

I need some help to understand how exactly the hospitals control the transmission of this pandemic?

Something is inconsistent. I find something is not right, or it's just me has a wild imagination.

1 Votes
Specializes in Telemetry.
On 3/19/2020 at 3:30 PM, MunoRN said:

My state has addressed the issue of whether nurses can refuse to care for these patients, the response was that you're free to permanently surrender your license, but that's the only option.

I would argue that older and immunocompromised nurses should be more of a last choice for caring for COVID patients, although we might already be to that point.

It is required to be cleared by HR at my hospital if you want refuse care to these patients. I have a coworker who was cleared because her son is immunocompromised, she is not, yet she never had a problem caring for patients with the flu or CDiff of any other infections. Yet I suppose healthcare facilities are afraid of repercussions and more nurses are quitting if they don’t honor nurses requests based on their fears.

Right now I’m taking care of my 4 Covid patients changing in and out of gowns double masked with my N95 under my surgical and I don’t care who says what about it as the orders keep trickling in and I snuck the time to read this post. You are not alone!! Nurses stand together! Hang in there! Gotta go

3 Votes
17 hours ago, skylark said:

From what I've read, some states are responding to nurses who refuse to work like this by saying the only way they can refuse is to permanently surrender their license.

Union should be national, it should be in every hospital, and ideally it should extend across professions, to include CNAs, pharmacists, physical therapists, radiographers, etc.

Then it could make a difference.

What states?

2 Votes
Specializes in Neurology/Oncology.

Out of curiosity, how many Magnet hospitals are union?

Specializes in Neurology/Oncology.
17 hours ago, dinah77 said:

It’s bad enough that there are still non union hospitals anywhere, but the fact that some nurses choose them over union jobs is just....smh

I work for a non-union hospital. Compared to the other hospitals in the area, I am not seeing any difference. What are you seeing in your area?

1 Votes
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