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

[BiscuitStripes]

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.

[BeenThereGoingThere, BSN, RN]

Has anyone here ever heard of laminar flow? I worked on a burn unit that used this years ago. I never became ill with anything while working at that hospital. (Michigan)

Later, I found that other burn units and ICU's didn't use this type of technology. Maybe they should. Seeing as the hospitals/corporations, or whatever you want to call health care facilities today, had thought about such a thing; they would be able to say safely, don't use a mask when you're not taking care of a confirmed diagnosis of COVID (forget the fact that we know that a good number of people out there have this virus without any diagnosis having been made.)

I learned 10 years ago, that corporate medicine cares about numbers, dollars, and profit. Staff are interchangeable part, and only good if they can profit from them. Anything that costs money that would prevent infection is not their priority. Profit is.

[subee, MSN, CRNA]

On 3/27/2020 at 3:47 AM, Blujai said:

I don’t think anyone should be caring for a patient with out an N 95. At this point two of my RN friends at home for quarantine because they were exposed to COVID 19. They are not old and one of them has lost more than 80 % of her lung function. She will never be the same again. So refuse to treat the patient..... It is a suicide mission and it is legal....

The CDC should treat the patient without an N 95 and sees what happens to them.

How does someone simply sitting quarentine at home know that they have lost 80% of lung function?

[mjjg]

Someone I know works for a company that has a huge supply of PPE that they can't sell to any large healthcare system. Nobody will buy it, and they haven't even marked prices up. It's absolutely outrageous. I don't know all the details but this company switched to making PPE a few months ago, I believe because they are based in China and were forced to, and now they have a huge supply that's literally just sitting. I tried to get this information into the hands of the right people, and I was given a generic reply about how to donate PPE. I wonder how common this is, and if there is really a shortage problem or a greed problem.

[dinah77, ADN]

On 4/2/2020 at 10:24 PM, Jory said:

So you actually believe there is an endless supply of everything medical in our country? Seriously? Do you really believe that?

Break out my scrubs? Honey, I wear scrubs every day. Get out of the profession if you are that self centered.

Then we are cowards. Thanks for that clarification and yes, supplies frequently ran out on soldiers when they were at war in very hard hit areas. They are also taught to do what it takes to help when called regardless if the situation is ideal or not.

I'm really sorry if you have made your profession your entire identity. Many of us have not

I am a wife, mother, sister, aunt daughter and friend. I am somebody. I have an amazing life, family, and friends, and I have a lot to live for.

How DARE you tell any of us we're supposed to sacrifice all for our freaking jobs. That's all it is at the end of the day. A JOB

[anonymous-phn-rn, BSN]

Imagine if everyone refused to care for Covid patients! Where would we be then? Imagine if everyone refused to care for SARS1, H1n1, patients, HIV patients, HepA, HEPB, or any pandemic patients; our country would collapse. You Should have N95 or N100 respirators; but somebody has to care for those patients. imagine if it was you or your family that was ill.

[rzyzzy]

9 hours ago, Jeffrey James Keely said:

Imagine if everyone refused to care for Covid patients! Where would we be then? Imagine if everyone refused to care for SARS1, H1n1, patients, HIV patients, HepA, HEPB, or any pandemic patients; our country would collapse. You Should have N95 or N100 respirators; but somebody has to care for those patients. imagine if it was you or your family that was ill.

You really don’t need to “imagine” being ill if you don’t have ppe, infectious disease being what it is, you will be ill.

[brittnie89]

10 hours ago, Jeffrey James Keely said:

Imagine if everyone refused to care for Covid patients! Where would we be then? Imagine if everyone refused to care for SARS1, H1n1, patients, HIV patients, HepA, HEPB, or any pandemic patients; our country would collapse. You Should have N95 or N100 respirators; but somebody has to care for those patients. imagine if it was you or your family that was ill.

And within 2 weeks those caring for patients will either become extremely ill or even die. That stupid ***. It’s not our responsibility to martyr ourselves for an ill prepared healthcare system

[maji2002]

I find it ironic, that in times of plenty we could be dismissed for not wearing correct PPE, or denied workers comp for the same if we were harmed, but how quickly its suddenly OK to work with inadequate PPE because it is convenient. This is all a result of greed, incompetence and disregard for workers. After this is over, nurses and other workers need to rise up and demand our rights. Time to rage against the machine......

[brittnie89]

16 minutes ago, maji2002 said:

I find it ironic, that in times of plenty we could be dismissed for not wearing correct PPE, or denied workers comp for the same if we were harmed, but how quickly its suddenly OK to work with inadequate PPE because it is convenient. This is all a result of greed, incompetence and disregard for workers. After this is over, nurses and other workers need to rise up and demand our rights. Time to rage against the machine......

Exactly! We would get denied help if we did anything wrong and were exposed, now we’re supposed to wear bandanas? Freakin no

[dinah77, ADN]

16 hours ago, Jeffrey James Keely said:

Imagine if everyone refused to care for Covid patients! Where would we be then? Imagine if everyone refused to care for SARS1, H1n1, patients, HIV patients, HepA, HEPB, or any pandemic patients; our country would collapse. You Should have N95 or N100 respirators; but somebody has to care for those patients. imagine if it was you or your family that was ill.

hmm, you know what would happen if we all refused to work without protection? I bet theyd figure out a way to get some for us very quickly

[eakirlin]

More to the point, might we consider some thoughtful criteria by which we might screen caregivers in their roles as potentially being in the middle of a covid ward? my facility just gave a nod to remove pregnant women from this scenario.... whereas for the past 5 weeks many have worked without N95's. The "what if everyone did this argument" reminds me that this line of logic ignores other problem solving dialogues. Quite a few years ago, when equal numbers of males and females were considered to be the criteria for managing disparity in gender, a choir famously did not move forward when they could not find enough female bass singers.

There also might be some consideration for hazard pay.

[anonymous-phn-rn, BSN]

Dinah 77; its unfortunate you think of your profession as just a job! You are suppose to be a Healer; not just another joker taking a paycheck. You obviously have gotten into the wrong profession. I am glad I am not your patient or my family members for that matter, because you don't seem to have the heart for this type of endeavor. this isn't just a job, This is a life, a profession, where we continue to learn for the remainder of our lives to provide the best care possible and maintain our License. if it was just a Job, you wouldn't have to have a license, and you wouldn't have to continue you education until you decide you no longer want to practice. You have the privilege of caring for peoples lives. Maybe you and everyone else that is thinking of walking out should just go ahead and give up your license. You don't have the temperament for nursing. Nursing-the profession or practice of providing care for the sick and infirm. When was the last time you took care of someone and actually gave the patient a cool wash cloth or a Back rub just to make them feel better?