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Should every healthcare worker in the hospital wear full PPE if working with patients regardless of the unit

Posted

Plus should every hospital worker be tested for Covid-19 every week if more, regardless of symptoms?

Oh yeah this is not a homework question. Let me repeat THIS IS NOT A HOMEWORK QUESTION. 😉

No to full PPE, regular surgical masks yes. I'm on the fence about weekly testing, but lean toward no. Maybe in hot spots.

I'm trying to get my live in landlord to understand that it is not practical, but he thinks it is a huge conspiracy and that hospitals are just greedy (they are but not in that way). I tried to explain to him that much testing would cause a backlog and labs hardly have the resources and capacity to do that much testing every week or every few days.

I mean am I wrong

Why full PPE?

It's pretty well established and accepted now that covid is a droplet transmitted disease (except with aerosolizing procedures), so aside from a providing a false sense of security, it would be just a waste to be wearing it in every room.

Surgical masks, sure. Also N95 and negative pressure with aerosolizing procedures and treatments. Otherwise it's just a wasteful way to make you feel a little better.

If we had the means to efficiently test all medical staff, then maybe, but otherwise it seems that it would unnecessarily clog up the testing system to be sending in thousands of new tests every week. Not to mentions costs. Again though, it's droplet transmitted, so wear your mask and practice good hand hygiene and even if you're carrying you should bring the transmission risk next to zero.

pixierose, BSN, RN

Specializes in ED, psych. Has 4 years experience.

It’s difficult enough getting those rapid testing for my patients ... uh, rapid. There is a serious backlog, and believe me, it’s better than it was.

I can’t imagine unnecessary tests on top of that.

And I just have to laugh at the PPE. We still don’t have enough. I had a cdiff patient I ran out for the other day. A patient you absolutely need to change each time for... had to scramble to other units, which had the same story. On my COVID unit, you maintain the same PPE if they’re on the same level. We’d run out so much faster wasting all that PPE on people you don’t need it for.

What exactly does he think is a conspiracy?

Tait, MSN, RN

Specializes in Acute Care Cardiac, Education, Prof Practice. Has 14 years experience.

We don't have the PPE to support that kind of increase (we are already in cohort reuse of isolation gowns and gloves). In general the more PPE you put on people, the greater the sense of false security. People will self infect with poor donning and doffing practices and walk around with inappropriate and possibly infected gear in public spaces. Testing is a double edged sword.

http://netnebraska.org/node/1221415

May 26, 2020 - 8:38am

When President Trump took office in 2017, his team stopped work on new federal regulations that would have forced the healthcare industry to prepare for an airborne infectious disease pandemic like COVID-19. That decision is documented in federal records reviewed by NPR.

"If that rule had gone into effect, then every hospital, every nursing home would essentially have to have a plan where they made sure they had enough respirators and they were prepared for this sort of pandemic," said David Michaels, who at the time served as head of the Occupational Safety and Health Administration.

NurseB.MN

Specializes in Registered nurse on a surgical specialties unit. Has 3 years experience.

I will say that many times I wish we would be able to be tested as nurses or even antibody tested for piece of mind and reassurance we aren't bringing anything home or out to the public. However, I agree it is very unrealistic to test everyone weekly. We just don't have enough resources, lab technicians or phlebotomist. Also it seems like a waste to have hospital workers in an N95, face shield gown and gloves that don't even come into contact with patients or nurses.

7 hours ago, pixierose said:

It’s difficult enough getting those rapid testing for my patients ... uh, rapid. There is a serious backlog, and believe me, it’s better than it was.

I can’t imagine unnecessary tests on top of that.

And I just have to laugh at the PPE. We still don’t have enough. I had a cdiff patient I ran out for the other day. A patient you absolutely need to change each time for... had to scramble to other units, which had the same story. On my COVID unit, you maintain the same PPE if they’re on the same level. We’d run out so much faster wasting all that PPE on people you don’t need it for.

What exactly does he think is a conspiracy?

That hospitals are only out to save themselves money.

JadedCPN, BSN, RN

Specializes in Pediatrics, Pediatric Float, PICU, NICU. Has 15 years experience.

1 minute ago, DesiDani said:

That hospitals are only out to save themselves money.

Well they absolutely are, so he isn't wrong in that sense. But for this particular situation, I think it is a combo and not just solely the greed.

I say the more we test, the better off we are.

Tait, MSN, RN

Specializes in Acute Care Cardiac, Education, Prof Practice. Has 14 years experience.

While the cost of healthcare is a mess, it is not solely on the hospitals where the current prices are at. This being said, we are hemorrhaging money due to the just the short shut down on elective surgeries and outpatient clinics we went though in March and April. While federal funding will help us recoup some of the lost revenue (I work for a not-for-profit system) it will barely bring back 1/6th of what we will lose. Hence the furloughs, and the FTE reductions, and system C-Suite taking a 60% pay cut through the end of the year. I would love to pin everything we are seeing on pure hospital greed, but it isn't nearly as simple as that. These systems are large and complex and are reliant on even more complex government and insurance industry steam trains that cannot be stopped on a dime, if people even wanted to try. This crisis is cracking open, even further, the absolutely startling gaps in our social systems, yet people are spitting in retail workers faces for being asked to wear a mask.

An Infectious Disease doctor once told me "Never get swabbed for MRSA because you will be out of work for a year." We know some of us are carriers. Many of us maybe, but without us working people will die for sure. If the infection rate is 20%, as some studies have suggested, that means risking sending home 20 of every 100 employees on a shift for two weeks.

Testing will only be effective when it becomes systemic, and that can't just be on a hospital level. That has to be you, me, my DoorDash driver, my safe-at-home mom, and our children going back to school in the fall.