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  1. BY DOLORES HUERTA As a registered nurse and executive director of National Nurses United and the California Nurses Association, Bonnie Castillo is a visionary and a leader. She was among the first to call attention to the lack of personal protective equipment (PPE) available to nurses across the U.S. during the COVID-19 pandemic, and fought layoffs and pay cuts that nurses faced despite their vital frontline work. Bonnie’s commitment to the labor movement and unions is unwavering; she states that unions are the foundation of a democratic society. Bonnie does not just work to heal patients; she works to heal society. As a mother and grandmother of nurses, I thank Bonnie, and all nurses—including those who have died while serving—for their heroic work in this critical time. Huerta is a civil rights activist who co-founded what is now the United Farm Workers of America https://time.com/collection/100-most-influential-people-2020/5888341/bonnie-castillo/
  2. CABGpatch_RN

    Ethical Dilemma with Vaccine PPE?

    I am currently on a temporary contract vaccinating for a retail pharmacy. It's awesome! Most of the pharmacists and all the contract nurses are awesome! The other's involved in greeting and organizing the butt-load of patients are usually young with such a bright future. I love them all!! Here's my thing....... The retail pharmacies receive their vaccine PPE supply and all the other stuff needed to administer vaccines from the CDC (our taxes - more on this in a minute). They get boxes shipped regularly with face shields, alcohol pads, syringes, needles, surgical masks, vaccine cards. Sharps containers and gloves are also shipped regularly. When the store pharmacies were vaccinating the LTC's, the stores that held vaccine clinics in the LTC's also received gowns, N95's, surgical masks. CDC also pays for the bandaids from the store stock. These retail places pay nothing for any of these supplies. This is in my area, don't know about other areas. But I think it's all the same with the retail pharmacy part of the vaccine effort. Today, I found out something when unpacking and organizing the supplies from a bunch of boxes that have been sitting around for at least 3 weeks. There were tons of syringes and needles.. Tons of face shields, alcohol pads and surgical masks. All of these items in my estimation will go unused because they keep shipping them and the boxes continue to stack up! It's too much. And OMG the plastic bags that will go into a landfill drives me crazy (that's for another post). I had an idea today. I am willing to go around to the retail pharmacies and collect the excess (and I mean e.x.c.e.s.s) supplies and find a way to donate these badly needed supplies to underserved areas, like homeless shelters and hospitals that are known to still NOT provide the proper PPE to frontline workers. Even grocery store workers, childcare centers. But mostly underserved areas. When I asked the store manager today if I could take a box full of face shields and surgical masks to the county clinic for the homeless, I was told that the store's district managers are planning to create barcodes so that item's can be SOLD at the store! This means that this huge corporation is trying to plan a way to sell these leftover items that are paid for with OUR TAX DOLLARS for their own corporate benefit. I am p*ssed off about this. It's completely unethical. It bothers me even if these retail places plan to buy these leftover supplies and then sell them. I want to report this to someone. I am not sure who will listen. The CDC? My Senators? HHS? MY State? This is our money that's being played with. Maybe the stores should be shipping back excess supplies. But they are not! After writing this post, It's become cleat that it's not really a dilemma for me. I know what I want to do. But dang. Who will listen? Thanks for reading.
  3. MeganMN

    New PPE Recommendations

    Our policy just recently changed for our PPE: "N95’s mask ONLY required for confirmed COVID-19 patients (not suspect). An N95 will remain in effect for ANY person regardless of COVID-19 suspicion or not that is receiving an AGP. N95’s will now be single day use- Staff will now be able to discard their N95 at the end of their shift. Reprocessing of N95’s are no longer required." I contacted the infection Control nurse to question her about the ED. She informed me that we did NOT need to wear N95 masks to triage or room suspected Covid patients, but switch to an N95 when they are confirmed positive. That just seems completely bizarre to me. I cannot find anything on the CDC site that supports this change.
  4. TheMoonisMyLantern

    COVID Faces

    Okay, so this has the potential to sound very strange. I have noticed that at work the past couple months when a co-worker slips their mask down for a moment to take a drink, eat, readjust the mask, etc. That from the nose they just look strange almost deformed and it seems to be with all of them even the folks I knew before the pandemic their faces just look off. I figures it's just becoming so ingrained to see the masks that seeing a full face is disarming. Is anyone else experiencing this? I really hope someone is that I'm not having a COVID psychotic break 😂
  5. Dear, dear friends. We all hate being "under the man". I get it. But goodness. Let's face it. Protective gear is a rule because it is so very necessary. If you are ever fearing a back spray, please, wear the gear to protect your ever-absorbing skin and EYES. We touch some of the most unruly things in our profession. In the longest run on sentence I would love to share with you some of my icky-stickiest: maggots in the feet, wounds to the bone, explosive clostridium difficile, excessive lice that took over a week to treat (HEAD TO TOE), tunneling wounds in the peri-area that exceeded 8 inches in depth, infected boils bigger than golf balls, dehisced abdominal surgical sites (staples flew across the room), goopy tracheostomies that hadn't been cleaned in so long they were almost cemented in place, shingles galore, meningitis with fevers of 104, tuberculosis with projectile sputum that was yellow/green, anything sputum (makes me cringe), explosive bloody diarrhea, Mount Vesuvius-like blood spurts when inserting an airway while in a code, removing feeding devices thus spurting bile, etc, etc, etc. Did you turn a little green yet? If you're a nurse, I am sure the answer is no. For me, sputum always makes me a bit (more like a LOT) nauseated, and sometimes uncontrollably gaggy. Funny and so not funny all at the same time. It's kind of embarrassing. I'm always afraid it will make my patient feel bad (in any way shape or form). Moral of the story above is that PPE is not just a GREAT choice when dealing with our usual: MRSA, VRE, Cdiff, Meningitis, Tuberculosis, Shingles, etc. Any time you are coming into contact with flaking skin, excessive wound drainage, foot care, you name it, WEAR SOMETHING TO COVER YOURSELF. We all know that Cdiff has legs. The spores have legs people. It attaches to things and it clings on for dear life. Do you not realize that this advanced bug has the ability to live on surfaces for extended periods of time unless it's given a proper clean? Seriously. If you can't imagine anything else, imagine these microscopic critters sticking to you, your hands, your clothes and shoes. Now think of what you touch. Your face, phone, private parts (you gotta pee at some point), say you pick your nose for that stubborn boogey, or capture a stray eyelash, or even chew a nail.. Yum yum, nom nom, right? Wrong. Disgusting. Hospitals are cesspools. May I remind you that everyone is sick? (That or asking for Aunt Dilaula, but that's a different issue). It is OVERLY tedious to gown up, remove, gown up, remove, and go from room to room. I guarantee that your neutropenic patient who is crazy sick (or may even have cancer) greatly appreciates your attention to detail when washing your hands in between patients. It's easy to get cavalier when moving fast, rushing or just thinking that hand sanitizer will do the job. If I could give you a sad face/awkward frown, I totally would right now. The thing is that we all know this is necessary, an issue, and a PIA, but we have to do it. Personally, when I get home and hug my love, I don't want to pass someone else's poo to his lovely person. It's rude. And it's just down-right gross. What do we do then? Comply comply comply. Wash your hands. Comply some more. We are a profession that washes our hands before and after using the bathroom. It's just the way we need to conduct ourselves. I personally don't want to go to the bathroom and take care of MY business after putting a suppository up someone else's end. Just saying. Your poo-poo platter doesn't need to be on my platter. Okay okay. Enough puns. Things are becoming more and more resistant to antibiotics. When in doubt, don the yellow gown (or whatever color your hospital PPE is). When there are creepy crawling things that are jumping, break out the hazmat and have no shame. I've worn hazmat and I felt so so SOOOOOO blessed. I did NOT want to bring that ju-ju home with me. I love my job, but I don't have to love the bugs involved. What can be a controlled infection can turn to sepsis quickly. Be aware and seriously, just wash your stinking hands! I will never forget how horrified I was when palpating an abdomen that I didn't know had a tunneled wound down to the patient's infected stomach appliance from bariatric surgery. Let's just say that warm puss from someone's insides on your bare hands is enough to make you want to autoclave your body for the rest of the shift. Believe me when I say that I love wounds and wound care. I find it fascinating. But when I'm assisting on an Unna boot and physical therapy is blasting off dead skin with their crazy machine, I'm covered with PPE head to toe. Because as rewarding as it is to heal wounds and assist in curing the sick, I'd rather not have your skin flakes in my hair (thank you very much). There have been times when a culture has come back and I wasn't sure if the patient needed contact precautions or not. The navigator for that is literally a phone call away. If night shift can't get ahold of someone who knows for sure then a 'cheat sheet' needs to be made. For you and your safety, always err on the side of caution. Two last things to keep germs at bay... REMOVE your shoes before getting in the car. If I had a dollar for every time I stepped in poop, pee, vomit, spit, blood, or found those things clinging happily to my shoes, I would have paid for all of your school loans and probably paid off your mortgage (you're welcome). Leave those nasty buggers in the TRUNK of your car in a box. It is NOT necessary for those shoes to see the light of day besides fluorescent lights at your job, and then the brief walk to your car. You don't wear shoes in the house? Good for you. I don't either, but! Wearing work shoes home with first driving, then leaving them wherever you do and then driving the next day while (you're off) in your awesome civilian kicks, heading to a friends house and walking into their door... You're welcome. Whatever grime was on your work shoes, can make a lovely imprint on your car's pedals and excitedly await another shoe to make close friends with. It's truly that simple. Lastly, my dear dear germ-ED family, our scrubs. Our scrubs. They need their own planet. If there was a laundromat in space, we'd need it for frequent use. Since that is not (yet) a possibility (let's go NASA!) we have to wash our scary things at home. Rule number one. I don't care how much you paid for those super cute/stylish/comfy Grey's Anatomy scrubs (they are my favorite too), if you get excessive bodily fluids on it. Trash it. End of story. Buh-bye! I had Cdiff pooped down my leg once. I bought the scrubs the DAY BEFORE. Guess where they went? BIOHAZARD. OR scrubs the rest of my shift, for the win! Rule number two. Scrubs need to be cleaned on HIGH heat and washed separately from the rest of your gear. Think about it.. Wash your washcloths with your scrubs. Later on, wash your face, bum, etc with that washcloth... I don't think I need to elaborate more. I make my own detergent and use essential oils for their antimicrobial properties in my fabric softener. Then I do an empty cycle behind my scrub laundry to clean out the machine. Do what you need to do friends, the bugs we deal with daily are serious. Unfortunately, the germs we work with, deal with, fight with, all deserve respect beyond what we've been giving them. I'm sure we are all walking around carrying something or with some antibodies of some sort... But for me, I'd rather win than have to deal with MRSA boils, or Cdiff diarrhea.. Personally, I'd also like to refrain from nursing my own tuberculosis. We need to have compassion for our patients. Not the germs.
  6. PLEASE give me a cooling vest, I burn up every night under all this garb. https://nursingnotes.co.uk/news/research/cooling-vests-could-alleviate-heat-strain-caused-by-PPE/
  7. MeganMN

    Check out PPE App

    Our facility recently switched to an App that we log into every work day. We use it to self report any potential exposure of Covid symptoms, and we also use it to check out at the end of the day and report any breaks in our PPE. It concerns me for several reasons. We are asked to report it we had a mask and face shield on with every patient interaction. The second part asks about PPE with other coworkers. We are expected to self report if we sit in the break room without a mask on and another employee is within six feet of us also without a mask on. If we state that we had a break in PPE, we are asked to list the employees name . We are then given a flag at the end that states that we should never have a break in PPE and that we may need to be tested for Covid or quarantined if any of the reported employees come down with symptoms. My struggle with this is that our provided break room has two tables that are not six feet apart. So if two of us are eating without masks on at separate tables, we are closer than six feet, so technically, we are breaking PPE protocol, and should report it. My concern is that this app is going to be used to penalize us. Either we will be disciplined for not following PPE guidelines, or we will be lying if we report that we used all our PPE at all times. We do not have a big enough break room to eat and be six feet apart. Is anyone else using this type of app? It concerns me. Some days I am lucky to get a chance to sit down and eat. I do not Want to have to worry about not getting to eat it someone else is already in the break room.
  8. Newgurl17

    COVID-19: LTC Advice!

    Hey all... First of all, I am hoping everyone is staying safe and healthy during this nasty pandemic. My questions for today are for all the floor nurses working in LTC.... How are you coping with the workload amonst the pandemic? Have any policy changes been made at your facility to help prevent the spread of the virus? Recently, my facility got hit with COVID on one of the units, and so we've been asked to wear PPE whenever we enter a resident's room...even if it's something as quick as giving some medications. So here I am, looking after 17-24 residents in the special care unit, wearing PPE for the residents who are cognitive enough to stay in their rooms, sometimes doing assessments as necessary ( fall follow ups, for example) washing my hands before leaving the room, and dealing with any other distractions that may come along the way. My med passes that would have normally taken 45 mintues to an hour on average are now taking me an hour and a half to two hours to complete. A morning nurse told me her 0800 round sometimes takes her until 10 because she is helping out with feeds. This is only the second week of this new change and my brain is feeling like scrambled eggs! I've forgotten to chart things and I feel like I am rushing throughout my shift. Not to mention we're wiping down everything after shift and changing out of our scrubs. My shift is only 5 hours long. How has everyone's experience been dealing with COVID at your facility? Stay safe!
  9. Anonymous666

    Has anyone seen this?

    I'm sure this has been posted here before. I'm too computer illiterate to figure out how to post an article let alone search for one. I'm just wondering if anyone has any input on this systematic review and how you think it affects PPE policy in the hospital. (Don't worry, I'm not a conspiracy theorist. I'm just a little rusty with my meta-analysis versus everything else kinda stuff). Nonpharmaceutical Measures for Pandemic Influenza in Nonhealthcare Settings-Personal Protective and Environmental Measures
  10. DesiDani

    Is PPE really helping?

    Many of the nurses who work on the COVID units came down with it. They all were provided with full PPE and even those who had to take care of positive patients were supplied with the headgear that had the pack (forgot the name). Yet, they still came down with COVID. Was it human error or the PPE?
  11. imintrouble

    Tell me I'm being too literal

    Haven't been here in a while, but I need some advice. Covid has come to my little rural corner of the world. We're taking care of covid positive patients. I'm not afraid to take care of them. I've always figured I'd contract it eventually. However, my place of employment has issued a memo full of instructions and requirements to enter the Covid rooms. They've directed us what kind of masks to wear, and where to wear them. Eye protection the same. Detailed instructions on what to do and how to do it. The problem is they haven't supplied the PPE as directed in the memo. The way I interpret it is, they've covered their butts with the proper procedure, then I get to decide how I protect myself and those I care for. The last day I worked I didn't have an N95 mask, and threw a fit until I got "one" even though I'm supposed to have a different one for each covid room I enter. I've been burned several times in my long nursing career, improvising when I found I simply couldn't do what I was told to do. Management can and does leave you hanging when you try to do your best with what you have. I've read the horror stories about nurses in NY, and other hot spots, who weren't properly protected and what they had to do. I feel small complaining about my little problem, that's why I'm asking for advice. When they tell me I have to have a new N95 mask for each Covid room, and only supply me with one, what do I do?
  12. Infection prevention and control is a cornerstone of safe treatment in all practice settings. In this new era of patient care amidst COVID-19, the healthcare industry is faced with having to balance the new risks posed to providers by the pandemic with existing risks for patient infection due to age, gender, or co-morbidities. Safe, efficient use of personal protective equipment (PPE) is essential for patients, providers, and the professional community in mitigating the new risks to providers and to supporting patient care. We know what must be done to safeguard providers and patients, but we face great challenges as COVID-19 cases continue to surge in waves across the country. PPE Shortages: Many PPE items are now available in only limited supply according to the FDA’s list of medical device shortages and facilities are facing increased demand, especially as physicians in ambulatory surgical centers seek to provide non-emergent care to those requiring screening, surveillance, or therapeutic procedures. Increased Expenses: It is estimated that hospitals’ PPE cost has been $3.8 billion in the second half of 2020 (Richard Pollack, American Hospital Association [AHA], CEO). Such an unprecedented cost raises questions of how to best prioritize and distribute the necessary equipment, share the burden of cost, ensure integrity and management of supplies, and maintain education standards and training on the appropriate use of PPE. Time-Consuming Fit Testing: PPE fit testing is expensive not only from a dollar perspective but from the time required. In the case of unique procedures where outside experts are needed to attend, there may be limited room or time for proper PPE fit testing to take place. Inappropriate Use of PPE: Add to this burden the fact that some facilities are fighting back against the inappropriate use of PPE, such as N95 mask re-use, and you have a perfect storm. Having moved from a long career as a nurse practitioner and educator to a new role in infection prevention with a medical technology company, I am now using my training and education to help ensure that our company supports practitioners in the safe and effective use of our products. We are all deeply concerned by the struggles of healthcare providers in accessing the PPE needed to safely do their jobs, and out of this concern, we have looked critically at our own practice. Part of the calculus we have been forced to make as a medtech company is how to facilitate correct management of our medical devices and instruments being used during diagnostic and therapeutic procedures while trying to conserve critical PPE for healthcare providers involved in patient care. We have determined that one of the best routes to reducing PPE misuse is to avoid having to use it in the first place. And we have made this determination based on the potential we see in the use of virtual telepresence platforms to save PPE supplies by allowing support and training from outside experts to be provided remotely. Facilities can use a virtual telepresence platform to: Bring medtech representatives into procedure rooms to support physicians during diagnostic and therapeutic procedures in real-time. Enable health care students to observe cases as they learn to care for patients in unique circumstances. Invite experts into procedure spaces virtually to assist physicians without having to don additional sets of PPE for quick consults. Infection prevention was already a challenging endeavor, and COVID-19 has further pressurized the situation. With a “Communicate, Enforce and Preserve” mindset, the healthcare community will adjust, as we have adjusted to the many challenges we have faced before this one. My hope is that we will not only adjust but also adapt by making investments in technologies that can help us all better support patient care. Resources 1 Medical Device Shortages During the COVID-19 Public Health Emergency | FDA.gov Updated 9/24/20. Accessed September 19, 2020.
  13. nurse2bguy555

    Senior Center Job

    Hi. I am thinking of applying for a job at the senior center retirement community. Would there be a high risk of getting COVID? I'll wear the required PPE, but I'd just like some insight. Thank you.
  14. Brian S.

    Five Months Later, Where is the PPE?

    Earlier this month, The National Nurses United held a day of action to demand that hospitals and elected officials better protect them with Personal Protection Equipment (PPE) and a safe number of patients during the COVID-19 pandemic. Nurses in sixteen states including California, Florida, Georgia, Illinois, North Carolina, New York, Texas, and Washington, D.C. were involved. For a virus which has been within the borders of the United States since January, how is PPE availability even an issue in August? After over seven months, any rational person would expect that the companies who routinely produce these items – gowns, N95 masks, goggles, safety shields, and more – would have had plenty of time to ramp up production both in the United States and globally to provide the life-saving equipment for healthcare workers. The sad reality, though, is that this is just one piece of the response to this pandemic that has been severely botched. With each state and sometimes each healthcare company or even each facility being left to fend for themselves early on, procurement of PPE became a money game. With states bidding against each other to obtain oftentimes scarce PPE, it became a case of the haves versus have-nots. In a country where profits reign supreme, the COVID-19 pandemic became just another way for companies to profit on the suffering and death of others. It’s shameful but sadly all too real. While many will recall images of nurses in New York City from March and April donning garbage bags in lieu of proper disposable gowns, maybe things have changed. Maybe. What about the Defense Production Act? The very act to be used during times of national crisis which was supposed to spur companies to ramp up emergency production of the very equipment necessary to protect nurses in COVID wards appears to have yielded mixed results, at best. According to a July 10th press release from the Department of Defense, $84.4 million was appropriated for COVID-19 but appears to have gone for basically anything but PPE for healthcare workers. What is the Defense Production Act? The Defense Production Act is the primary source of presidential authorities to expedite and expand the supply of materials and services from the U.S. industrial base needed to promote the national defense. DPA authorities are available to support: emergency preparedness activities conducted pursuant to title VI of the Stafford Act; protection or restoration of critical infrastructure; and efforts to prevent, reduce vulnerability to, minimize damage from, and recover from acts of terrorism within the United States. DPA authorities may be used to: Require acceptance and preferential performance of contracts and orders under DPA Title I. (See Federal Priorities and Allocations System (FPAS).) Provide financial incentives and assistance (under DPA Title III) for U.S. industry to expand productive capacity and supply needed for national defense purposes; Provide antitrust protection (through DPA voluntary agreements in DPA Title VII) for businesses to cooperate in planning and operations for national defense purposes, including homeland security. AirMap, located in Santa Monica, California, received $3.3M to aid product development and engineering support for integration of sUAS mission planning, post-mission analysis, and unmanned traffic management software. ModalAI, located in San Diego, California, received $3M to develop their next generation U.S.-made flight controller that will enable advanced autonomy including GPS-denied navigation, and all-environment obstacle avoidance. Skydio, located in Redwood City, California, received $4M to improve the flight controller hardware/software and data link for their sUAS so that highly capable components can be purchased and used across U.S. Government unmanned systems. Graffiti Enterprises, located in Somerset, New Jersey, received $1.5M to modify their commercial data link for DoD’s sUAS use including operation in restricted frequency bands, reduction in the size, weight, and power of the hardware, and software developments to improve security and resiliency of their data link. Obsidian Sensors, located in San Diego, California, received $1.6M to build a low-cost, dual thermal sUAS camera that can be mounted onto a stabilization gimbal and then integrated and flown on small, packable, ISR systems. (source) It doesn’t end there, though. An additional $15 million was awarded to LeoLabs to strengthen the country’s Domestic Space Industrial Base. $56 million more went to ArcelorMittal, Inc. to “sustain critical domestic industrial base shipbuilding capability and capacity”. While this example of where $84.4 million of Title III COVID-19 funds went is only a portion of Defense Production Act spending somehow tied to the pandemic response, it is part of the puzzle of why nurses are still protesting over a lack of PPE. Want more details? Download allnurses Magazine What has been approved so far? While the above example portrays an excellent example of rather questionable spending tied to the Defense Production Act under the guise of COVID-19 response, hundreds of millions of dollars have been handed out in the name of COVID-19 PPE production. Or has it? N95 Masks On April 13th it was announced that a $15 million contract for 60 N95 Critical Care Decontamination Units was awarded. These units are touted as having the capacity to decontaminate 80,000 N95 masks per day. These reportedly allow N95 masks to be reused up to 20 times. This would allow for decontamination of up to 34 million N95 masks per week. Only weeks later, the Battelle Critical Care Decontamination System came under fire. “After 20 cycles, the company’s testing showed, the masks’ straps fragmented during stretching, which “may potentially impact the fit or comfort of the respirator exposed to the (vaporized hydrogen peroxide) cycles. While NBC News questioned the size of this particular federal contract, they found “That contract ballooned from a total of $60 million for 60 systems on April 3 to up to $413 million a few days later, according to the network.” To their credit, Battelle had deployed 50 of the 60 promised units by early June. On April 21, $133 million was awarded to 3M, O&M Halyard, and Honeywell to increase N95 production by over 39 million units over the course of 90 days. That 90 day window would end on or around August 21. (via) May 6th saw a second contract awarded to 3M for production of N95 masks – this time for $126 million. The contract stated that 3M would manufacture an additional 26 million N95 masks per month beginning in October. This new contract was expected to increase N95 respirator production by at least 312 million units annually within the next twelve months. (via) Testing Swabs April 29th saw the announcement that $75.5 million would be invested to increase swab production to 20 million per month starting in May. Puritan Medical Products in Maine stated that they would establish a new manufacturing facility to produce the swabs used for Coronavirus testing. The company also stated that they would add 150 employees in May to meet the stated production capacity which would soon ramp up to 40 million swabs per month. This ramping-up phase in May, though, is claimed by many to have been too late. For a virus that was already spreading in February, a two-plus month delay in something as seemingly basic as swab production is just one in a long list of items that contributed to the spread of COVID-19. According to many of the nation’s governors, the federal government’s delay caused a shortage of tests early on which hampered initial phases of the pandemic response. (via) Prefilled Syringes On May 12th, ApiJect Systems America was awarded a $138 million contract to produce over 100 million Blow-Fill-Seal aseptic plastic injection devices. These would be produced for use with the yet-to-be-developed COVID-19 vaccine. An ultimate production goal of over 500 million profiled syringes was expected in 2021. For a company whose CEO says “The fact of this matter is, it would be crazy for people to just rely on us. I would be the first to say it, we should be America’s backup at this point, but probably not its primary,” (via) that should certainly raise some questions about the award of this no-bid contract. Add in the fact that the contract could grow by an additional $456 million to bring several new factories online, that is a substantial sum for a company who has, to date, only produced 1,000 prototypes. Oh, and there’s the small detail that ApiJect doesn’t have a manufacturing facility yet. PPE for Nursing Homes Good news for nursing homes across the country arrived on May 13th as Federal Resources Supply Company was awarded a $134 million contract. Federal Resources Supply Company would be supplying PPE kits including 1.2 million goggles, 64.4 million pairs of gloves, 12.8 million gowns, and 13.8 million masks. (via) There were almost immediately problems with the PPE distributed by Federal Resources Supply Company. Many of the masks which were delivered appeared to have been made of an underwear material – even arriving sometimes in packaging donning the Hanes brand name. Other surgical masks were outfitted with flimsy paper loops, leaving caregivers at risk due to the ill fit. Many gowns that arrived were compared with trash bags and routinely lacked arm holes. Many of the gloves which did arrive in the first wave of distributions were essentially useless – size extra-small – entirely too small for even the smallest healthcare workers. When complaints were made, the responses from FEMA officials ranged from “It was one of those things, I’ll be honest, that just slipped through the cracks” to “[you] just don’t know how to use them.” The examples of both good and bad outcomes from the Defense Production Act keep coming and are too numerous to detail. Some of the most angering and wasteful are the examples of money being explained away as for the nation’s COVID-19 response being handed out to companies for defense and military projects – specifically those detailed to benefit the Navy, Coast Guard, various aerospace systems, ship manufacturing and more. For a federal government whose national response to what rapidly became a global pandemic was massively delayed, some of these expenditures are simply disappointing. The amount of money being spent on items and given to companies who lack experience in anything remotely related to what is clearly a medical crisis is appalling. This, however, is what happens when a nation’s priorities move from caring about its citizens to profits for companies. For a complete rundown of Defense Production Act contracts, download the Fall 2020 issue of allnurses Magazine for FREE!
  15. Joe V

    COVID-19: The War

    By now, every single solitary person on the face of the earth knows what is happening. Covid-19 is on the news hour after hour, day after day. We keep up with alerts constantly. We practice social-distancing. We work under adverse conditions, pleading and demanding adequate PPEs … and, we worry. One thing first and foremost on our minds is our family and friends. We strive to ensure that they are not infected. What about you as a Nurse? Other than the CDC recommendations, what additional precautions do you personally take to ensure your family members are safe?
  16. allnurses

    Spring 2020

    Version Spring 2020

    The Spring 2020 Issue of the allnurses magazine focuses on the Coronavirus Pandemic, it’s effects on communities around the world, as well as the healthcare teams on the frontline battling Covid-19. In this issue, you can read about the challenges our doctors and nurses are facing in treating the Covid-19 patients that are rapidly overwhelming our hospitals. We have added quotes that our members have shared about the daily challenges they are facing on the frontline. We hope you will read the stories that give a glimpse at the real struggles that are occurring around the world. Our nurses are indeed the heroes continuing to show up, risking their lives as they provide compassionate care to patients in the midst of this fight against a deadly opponent. It is you we are honoring with this special edition of our magazine. A COVID-19 Dilemma: Where are all the PPEs? Summary: While the rapidly spreading Coronavirus is frightening, healthcare workers across the United States are terrified by the lack of adequate supplies of appropriate PPE to protect them while th… "Warm Weather Will Slow the Virus" and Other Bad Advice There's a lot of bad information out there. This article discusses some of the top false claims being spread on the internet. As nurses, it is crucial that we have the most accurate, up-to-date inform… The COVID 19 Battle Cry for Retired Nurses COVID 19 epidemic brought me back to work after 20 years retired. The Real War Against COVID-19 in America A look what has come to light in hospitals across the country during the pandemic, and why we have to use this time as a catalyst for change.

    Free

  17. 42pines

    Discussion about use of Valved Masks

    Valved masks work very well at reducing moisture and heat inside the mask and does help to reduce glass fogging. However, they are essentially a 3/4" HOLE where exhalation occurs. This, in effect concentrates the outflow of breath without any filtration/capture at all. Worse it can increase the velocity of exhaled air, especially if the wearer should sneeze or cough. Here’s some articles on why one (especially a nurse) should NOT be wearing a valved mask: Heuvelmans, 4/29/2020. Sure, wear a mask. Just not one with a valve Skwarecki, 4/30/2020. If Your Mask Has a Valve, It's Half Useless Moffitt, 5/4//2020. Why your N95 mask could endanger others Kekatos, 4/28/2019. Bay Area says masks with valves are not acceptable face protection amid the coronavirus pandemic because they allow your breath to escape and endanger those around you
  18. 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: 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.
  19. j1m2f3

    This is Bull

    To Whom it may concern, My wife and I are both nurses. This week she brought up her concern for not having the proper equipment to take care of COVID-19 patients. One of the managers actually said, “Everyone is going to get this anyway.” They currently are implementing a plan to wear HOMEMADE CLOTH MASKS. I am not kidding. This is their plan for the surgical mask shortage. Forget about getting an N95 mask. NURSES SHOULD BE PISSED! We took the so called “oath” in the U.S.A., the richest country in the world and the one with the best health care systems. Right? We thought protective gear would be available to us at all times. Upper management and CEOs should be held negligent for not being prepared. Instead they are sending their staff threatening emails while they hide in their billion dollar office buildings with rivers and waterfalls built right inside of them! Nurses are sent into dangerous conditions with in some cases now NO protective gear at all! We are risking the health of ourselves, our patients and our families. Don't tell me that they didn't know this was coming! As far as I'm concerned, every hospital that runs out of masks and vents should be held criminally accountable for their greed and lack of preparation! Check out this simple time-line: 2002 SARS outbreak; 2005 Bird Flu; 2009 H1N1; 2014 Ebola; 2015 Milton Johnson HIGHEST PAID CEO IN HEALTH CARE! Hospital Corporation of America gets a 20% bonus bringing his total compensation up from $14.6 million in 2014 to $17.8 million; 2015 Toby Cosgrove CEO Cleveland Clinic Base Pay: $4.5 million RANKED #2 hospital in the world; 2019 Gianrico Farrugia CEO Mayo Clinic Base Pay: $1.91 million Ranked #1 hospital in the world; Average cost of an N95 mask: $0.75-$1.50 Average cost of a top of the line ventilator: $20,000-$40,000 I'll let you do the math...and these wonderful individuals had no idea something like this could ever happen. Right? I will leave you with this telling quote in light of the COVID-19 pandemic right off of the highest paid health care CEO's website https://hcahealthcare.com/care-like-no-other/stories/resilience.dot ...“In the face of a threat, we don’t panic, we prepare.” You sure as HELL have NOT prepared. They have all been getting filthy rich off the backs of nursing and now they threaten our jobs. Some of us WILL die because of this! Many people are saying that not many will die from COVID-19 but what about next time. To them you are expendable as long as they get their bonuses at the end of the year. What a sad state of the health care system and humanity we have become.
  20. Thanksforthedonuts

    Facial coverings effective?

    I’m sure I have an unpopular opinion but does anyone else feel like the mass push for facial coverings and masks has very little benefit? Think about it (I know this is immature, so forgive me) if a fart can go through underwear and a pair of jeans... can’t good ol’ Rona go through a piece of cotton? Not only that, the general public is not educated in how to wear PPE and are not wearing the masks or gloves correctly. Frankly... mask and gloves provide them with a false sense of security. As nurses, we are keenly of what’s clean or sterile so we can do a pretty good job navigating ourselves in public during this pandemic. However, not trying to be disrespectful or anything, watching the public on with their masks and gloves on is quite entertaining to say the least. I was in Whole Foods recently and you can see who’s a medical professional from a mile away as it’s obvious to see which hand they’ve designated as their “dirty hand” and how they hold they hand in resting position while grocery shopping! If I can smell my coffee through my mask as I pick up a new bag from the shelf and toss it into the cart, then Rona ain’t going to be fooled by my mask. I’m not willing to waste an N95 for grocery shopping. I just don’t see the need for a mask out in public unless you have a new or sudden change in cough or are immune compromised. We will always have rouge individuals who will defy advice and not wear a mask when sick, but I’m talking about the general public. I do see the benefit when you have a cough as it will stop the droplets from traveling further. But just breathing in and out can transfer this virus... I don’t know how a mask will provide protection from this. I live in a fairly wealthy area where almost EVERYONE is wearing a mask in public. For those who are not wearing a mask, is it because of a conscious decision, typically unrelated to financial reasons. My case is: I don’t see the efficacy of surgical/homemade masks against coronavirus for healthy individuals. Thoughts?
  21. 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. 😉
  22. girlwithnoname

    Exposed to COVID+ no PPE, only surgical mask

    I recently got exposed to a patient who got admitted for a diagnosis not related to COVID, or so we thought. I had a surgical mask and only in the patients room for maybe 30 minutes giving medications. Later on, we found out she was COVID+. The patient was not coughing and she was also not getting breathing treatment. I have so much anxiety about this. I think I am at a low risk for getting it? I know a handful of other nurses that have COVID already and I can't stop worrying. Please give me comforting words. Btw, my hospital said not to isolate only if I have symptoms. I think thats a load of crap.
  23. Hello- I work as an ED nurse in an inner city trauma center. The PPE situation recently improved (thank God) however our gowns are crap. They suck and rip as you doff. Anyways - does anyone else get extremely frustrated when providers keep piling on orders like 10-20 mins apart or the care plan drastically changes and they fail to communicate to that. disclaimer- donning/doffing for ongoing pt assessments, re-assessments and answering call-lights is necessary and NOT the problem I am venting about. Example: the provider sees the patient makes their assessment - writes their orders - I go in ready to do it ALL at the same time in the interest of clustering care -- I usually pop by provider desk and say "Hey I am going in to the room is there ANYTHING else you would like"... I also usually offer my suggestions at this time -- despite my efforts to keep open lines of communication this does not work----5-10 mins after I complete the tasks and leave the pt's room and completely doff they think of something else - now I have to don again, go through yet another gown and re-risk exposure as I doff again. unfortunatelt it happens quite consistently with certain providers... it is incredibly frustrating!! with our shortage of PPE it INFURIATES me. These providers go in the room ONCE, MAYBE twice. The techs arent going in the rooms at all - (I dont mind doing all my own VS/EKGs and toileting - not my point) but WHY does the nurse take ALL the risk and ALL the exposure - some providers DONT EVEN go in the room they call the patient then proceed to bark orders at the nurses - oh I didn't know you could assess a pt via telephone - or listen to lungs/heart via the phone. Pre-COVID I dont mind going into the patients room 20x/hour no big deal!! I am many things but lazy isn't one of them ... I understand COVID is HARD for ALL of us, all disciplines not just nursing - just doesn't seem fair? thoughts? thank you. sincerely, a frustrated ED RN.
  24. Hi, everyone -- I work in elective surgery (not a frontline nurse) and I was laid off d/t COVID-19 in mid-March, with the promise of being hired back. I've been in contact with my manager recently and it is expected that I return to work next week (great, right?!) However, I'm hesitant... I was told we are going to be testing patients. It seems that there is no solid plan as to where they will be testing patients (indoors? outdoors? in the waiting room?), when they will be testing patients (patients typically come to the office numerous times before surgery, but they're only being tested a few days prior to procedure), the building has poor ventilation, and I made the mistake about asking about PPE... sounds like we're expected to be OK with just surgical masks and a face shield when testing patients. It seems like I received a bit of pushback when I asked about N95's or something that filters a bit better than your typical surgical mask. I did a bit of research on the OSHA website and here's what I found: Source: https://www.osha.gov/SLTC/covid-19/healthcare-workers.html Basically, I want to know if any other nurses are in this situation. Are your jobs not supplying proper PPE? Are you expected to just be happy you have a job to return to, grin and bear it? I love my job and I want to return, but I'm super cautious about this... I have some underlying conditions that could cause greater-than-average health risks to me if infected, and of course I'm not trying to hurt my husband, parents, in-laws, etc. Help!
  25. signet

    Printing advertising on PPE

    This is kind of a wild idea, but I wonder if it would work? Hospitals and LTC's need all the PPE they can get, but it's very expensive and hard to find. What if companies paid to have masks and gowns made with their logo printed on them. They could then donate these and get free advertising. If you had many companies doing this, the stocks of supplies would go up considerably. Of course, the gear would have to be made to CDC guidelines. What do you think?