What can I do if hospital does not allow protection against COVID-19?

by Nurse Beth Nurse Beth, MSN (Columnist) Educator Columnist Innovator Expert Nurse

Specializes in Med Surg, Tele, ICU, Ortho. Has 30 years experience.

Dear Sister Beth,

I am a nurse. Kindly inform WHO recent recommendations for wearing masks in hospital settings. In this pandemic outbreak of covid-19 and while caring a patient having respiratory infections also? If hospital policy does not allows what can we do to protect ourselves??

Dear Sister Nurse,

Greetings, my friend.

Here in the United States, we are following current CDC guidelines, which are droplet precautions and airborne precautions for the duration of aerosolizing procedures (bronchoscopy, intubation).

The guidelines have changed and may change again as the pandemic evolves.

Many hospitals are disallowing the use of surgical masks outside of patient rooms and limiting them for use when caring for a patient with a confirmed or suspected infection transmitted by droplets only, including COVID-19. This is to conserve and ration protective gear in a time of shortages and uncertainty.

Other hospitals are allowing nurses to wear surgical masks at their discretion while outside of patient rooms, or caring for patients who are coughing. The rational includes that staff cannot socially distance themselves 6 feet from each other.

An example of hospitals changing the rules is lifting the requirement for nurses who decline the flu vaccine to wear masks during flu season. They are now being instructed not to wear masks. Unfortunately, nurses don't necessarily see these decisions as created to protect them and it results in mistrust.

So you see, we have mixed practice decided at the facility level here in the States. Even within facilities, we have varying practices. At some hospitals, nurses are not wearing PPE (personal protective equipment) while doctors are wearing N95 respirators.

A lot of nurses are asking "if hospital policy does not allow, what can we do to protect ourselves?" the same as you. You have to protect yourself while not panicking.

If I were a hospital administrator, I would allow nurses to wear surgical masks all day long. Not because they are shown to be effective, but because I think it is unwise to force nurses into a situation where they feel vulnerable and unprotected. Wearing a mask reduces anxiety and allows the nurse to focus on practicing nursing.

To disregard the fear of frontline employees who are putting themselves in danger by coming to work is a surefire way to create more anxiety and anger. These times call for wise, compassionate leadership and not hasty, fear-based decisions.

Let's keep reminding ourselves and each other to hand wash and not touch our faces. Be aware of high-touch surfaces, such as elevator buttons and door handles.

Be well, my friend

Nurse Beth