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.

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Specializes in Critical Care.

I will refuse to take care of these patients without proper protection. If nurses stick together administration will listen. Remember guys, this is not a war you don’t have to risk your life for complete stranger.

Specializes in PeriOp, ICU, PICU, NICU.
1 hour ago, HGRN said:

I will refuse to take care of these patients without proper protection. If nurses stick together administration will listen. Remember guys, this is not a war you don’t have to risk your life for complete stranger.

Fun times.........

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Specializes in ICU/ER mostley ER 25 years.

Didn't I just hear Pence saying that the CDC will be releasing new rules for PPE. From what I got out of it they'll be relaxing them. So relax. (said with sarcasm)

Specializes in CRNA, Finally retired.
16 hours ago, Walti said:

Just wondering, what does a nurse anesthetist make per hour sitting in an OR. Not to say that they shouldn't be well compensated but shouldn't those risking there lives and their families be well compensated also?

I am reading that a lot of nurse anesthetists are now making nothing because elective surgeries have been cancelled. The AANA is not encouraging them to accept the legal risks of working as ICU nurses, but, of course, many will do so.

My suggestion is if you cannot do this, then make your own cloth mask for an emergency, or leave healthcare. It's better than nothing.

This is when the true call of duty arises. When I took this job, I made a pledge to take care of everyone that I was called to take care of...that means, regardless of what they have. I am not going to refuse care to someone because of it and I do support the sanctioning of licenses to those that do.

I have a plan in place to send my children to a relatives home if things get bad at my hospital. So far, no cases. But I have a plan.

There is a difference...between a hospital not providing equipment and THERE NOT BEING ENOUGH PPE TO SUPPLY THE HOSPITALS.

If you can't take care of the patient in front of you...then you went into healthcare for the wrong reasons. This is truly, what nursing is all about.

On 3/23/2020 at 12:02 PM, subee said:

I am reading that a lot of nurse anesthetists are now making nothing because elective surgeries have been cancelled. The AANA is not encouraging them to accept the legal risks of working as ICU nurses, but, of course, many will do so.

There are no legal risks. They are still RNs with a valid license. They can run a code or give medication just like anybody else.

16 hours ago, ReflectiveRN said:

Any RN's that actually accept that it is OK to work without proper protective equipment are not thinking wisely. Healthcare workers have died from the virus. Don't be one of them and if you do not get the right high level PAPRs, you have every right to protect yourself and walk out. Do it for your kids, family, and for all nurses...because it is not smart as profession to accept unsafe work environments ever...If you do you should be getting paid a lot more an hour, in my opinion.

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

Specializes in CRNA, Finally retired.
4 minutes ago, Jory said:

My suggestion is if you cannot do this, then make your own cloth mask for an emergency, or leave healthcare. It's better than nothing.

This is when the true call of duty arises. When I took this job, I made a pledge to take care of everyone that I was called to take care of...that means, regardless of what they have. I am not going to refuse care to someone because of it and I do support the sanctioning of licenses to those that do.

I have a plan in place to send my children to a relatives home if things get bad at my hospital. So far, no cases. But I have a plan.

There is a difference...between a hospital not providing equipment and THERE NOT BEING ENOUGH PPE TO SUPPLY THE HOSPITALS.

If you can't take care of the patient in front of you...then you went into healthcare for the wrong reasons. This is truly, what nursing is all about.

There are no legal risks. They are still RNs with a valid license. They can run a code or give medication just like anybody else.

We are not hospital employees. And many critical care skills are lost in the OR. Doesn't mean we can't make contributions but not being a hospital employee is a barrier.

2 minutes ago, subee said:

We are not hospital employees. And many critical care skills are lost in the OR. Doesn't mean we can't make contributions but not being a hospital employee is a barrier.

It shouldn't matter where the patient is located. If they can orient a new grad out of nursing school, they should be able to re-orient very quickly a seasoned CRNA.

Specializes in ICU/ER mostley ER 25 years.

Your patient has Covid-19, He has just stopped breathing. There is no cart or bag available. You are a 70 year old retired nurse that has answered the call of the BRN to come back. You had lung surgery and a lobe removed a few years ago. Should you do mouth to mouth respiration? Yeah I know it is no longer recommended but there is going to be a prolonged time for code equipment to get to you. You are working a SNF and the one cart is in use at the other end of the facility. Nobody gets paid enough to die for the patient.

Specializes in FNP- Urgent Care.
On 3/21/2020 at 2:24 PM, Gampopa said:

We are told to adhere to the CDC recommendation of N95 for aerosolizing procedures covered by a procedure mask and just a procedure mask for all other pt interactions with r/o COVID pts. I hear repeatedly from my manager that is all you need and since CNAs do not do these procedures they shouldn't even get N95s. Coughing does not qualify as aerosolizing since the CDC doesn't include it in their list. I fail to comprehend how coughing is not aerosolizing and I disagree with hospital policy. I understand that we're rationing the remaining stock of N95s for when we get hit with pts but we're already taking care of r/o pts who may or may not be positive. I ask myself would I go into a r/o COVID pt room w/o an N95 and my answer is no way so how can I insist that other staff do so? Perhaps it's time to resign from my position.

I agree, I'm bringing my own n95 to work with covid patients because I just don't trust it. coughing in my face is aerosolizing IMO!

1 hour ago, Walti said:

Your patient has Covid-19, He has just stopped breathing. There is no cart or bag available. You are a 70 year old retired nurse that has answered the call of the BRN to come back. You had lung surgery and a lobe removed a few years ago. Should you do mouth to mouth respiration? Yeah I know it is no longer recommended but there is going to be a prolonged time for code equipment to get to you. You are working a SNF and the one cart is in use at the other end of the facility. Nobody gets paid enough to die for the patient.

Absolutely not, NOPE NOPE NOPE.

Specializes in FNP- Urgent Care.
On 3/23/2020 at 12:20 PM, Jory said:

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

What good are you as a nurse if you knowingly contract covid19 and possibly die?

Specializes in Tele, ICU, Staff Development.
5 hours ago, HGRN said:

I will refuse to take care of these patients without proper protection. If nurses stick together administration will listen. Remember guys, this is not a war you don’t have to risk your life for complete stranger.

By proper protection, do you mean an N95 respirator or a surgical mask?

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