Before the coronavirus outbreak began, health care workers used N-95 masks and gloves once, then disposing of them to prevent cross-contamination. All that changed with COVID-19.
In March, the federal Centers for Disease Control and Prevention issued emergency guidelines to allow the reuse of personal protective equipment, or PPE. Health care workers have since been allowed to put on and take off the same N-95 respirator mask up to five times during a shift because there’s still a worldwide shortage.
But nurses have complained that the repeated use of protective equipment puts their own health at greater risk for the virus, said Cynthia Lewis, a nurse with Ascension Seton in Austin.
And the relaxed emergency guidelines allowing repeated mask use are stretched even further by hospitals. Until May, Lewis said her hospital was asking nurses to use their N-95 respirator masks for 20 straight shifts.
A mask’s seal can break, or the material can tear more easily after repeated use.
Ascension Seton said in a statement it is “taking proactive steps with distributors and suppliers to ensure access to supplies.” It declined to answer specific questions about PPE protocols.
Late last month, the hospital changed its policy and began instructing nurses to use their N-95 masks for one shift only. But by that time, Lewis said she had become one of nearly 75,000 U.S. health care workers infected with COVID-19.
Cindy Zolnierek, chief executive officer of the Texas Nurses Association says nurses fear they will lose their jobs if they speak up. But, as the leader of the organization, she feels like it’s her responsibility to speak on their behalf.
The relaxed federal guidelines “have made nurses uncomfortable and uncertain in the work environment” because some hospitals can’t meet them, she said.
Hospital officials say it’s not for lack of trying.
Carrie Kroll with the Texas Hospital Association says hospitals in West Texas, for example, have not been able to get any disposable gowns.
“So, they’re using gowns that need to be laundered,” said Kroll. “And, [there are] delays that come with that.”
Zolnierek said the pandemic and its aftermath will change PPE procedures forever, just as they were changed during the AIDS epidemic in the 1980s.
Zolnierek said back then, masks and gloves were not commonly used by nurses.
“We never wore gloves,” she said. “You cleaned patients, you bathed patients, you were exposed to blood all the time.”
But then the AIDS crisis changed everything after health care workers learned it could be transmitted through bodily fluids.
“We wore white uniforms back then,” Zolnierek said “I remember having to toss uniforms because they got blood stains on them.”
Nurses began wearing scrubs, gloves and gowns. Even needles were designed differently to prevent infections.
“It was a whole other practice. And certainly, supply chain had to rev up for that.” Zolnierek said.