Nurses demand proper protective gear, not scarves — it's science

Nurses demand proper protective gear, not scarves — it's science
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Imagine visiting a hospital for a broken ankle and leaving with COVID-19. This is a reality we may face if nurses and other health care workers don’t have the necessary protections to keep ourselves safe, let alone keep our patients safe. But corporate hospital employers and government agencies don’t seem to care.

Take the Centers for Disease Control (CDC), which purports to be in charge of the nation’s health. The CDC recently weakened its guidelines on infectious disease protections for health care workers to allow loose-fitting surgical masks instead of N-95 respirators. Last week, the CDC added that in a pinch, health care workers can make their own masks out of scarves or bandanas.

Let that sink in. In the midst of a pandemic the likes of which the world hasn’t seen since the 1918 influenza pandemic, the protections for those in charge of caring for COVID-19 patients were rolled back.

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Since there is no scientific evidence behind these weakened guidelines, the CDC is apparently basing its decision on protective equipment shortages. But nurses know it’s wrong to base best practices on whether or not hospitals have equipment in stock. That only lets our corporate hospital employers, who surely lobbied for this decision, off the hook.

Add the CDC’s protection rollback to the Trump administration’s bungled testing process and messaging around COVID-19, and it’s clear that when it comes to saving lives, we should not rely on guidance based on corporate profit or election favorability polls.  

It’s time to listen to the experts guided by science: nurses.

When we are studying to earn our license, registered nurses spend countless hours poring over coursework in biology, chemistry, physics, statistics, microbiology, pathophysiology, and pharmacology. That education is how we assess which systems in the body are or are not working. Nurses collect data, synthesize the information based on our expertise and knowledge, and make decisions about the treatment plan we're implementing, and the resources required to deliver the right level of care. 

In other words, nurses respect science because we practice science.

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The CDC claims that “airborne transmission [of the virus] from person-to-person over long distances is unlikely,” but the science is still uncertain. Some studies are showing that the virus may be more airborne than the CDC is taking into consideration.

Scientists from the National Institute of Allergy and Infectious Diseases (NIAID), part of the U.S. National Institutes of Health, recently conducted a study showing that when the virus causing COVID-19 is carried by the droplets released during coughs or sneezes, it can remain infectious in aerosols for at least three hours. The study also showed that it can survive on various surfaces for up to two or three days,

The bottom line is that we are still learning about this virus. Because it’s still so new, nurses follow “the precautionary principle"— a strategy to minimize risks when scientific understanding isn’t yet complete. This principle says that we don’t wait until we know for sure that something is harmful before we act to protect people. So, unlike the CDC, nurses demand the strongest protections from our employers, not the weakest.

We demand our employers follow the precautionary principle, rather than the inadequate, unscientific CDC guidelines. We demand they clearly communicate with us and our fellow health care workers, including when there is a possible COVID-19 case in our facilities—in which case, they need to identify and notify any workers who were exposed and place us on at least a 14-day, paid quarantine. We demand they provide us with the education and training to keep us safe, including how to put on and take off protective gear.

In the event there’s a surge of patients like we are seeing in Italy right now, nurses know our employers must have a plan, including how to isolate patients. The CDC’s recently rolled back guidelines also say negative pressure isolation rooms, which ensure air flows back into the room, rather than out, are only necessary for certain procedures. We demand our employers to have these rooms and keep them functioning at all times, not just sometimes.

And rather than loose-fitting, inadequate surgical masks or scarves, nurses demand that our employers give us the highest level of personal protective equipment (PPE). That includes powered air-purifying respirators (PAPRs), coveralls meeting the ASTM (American Standard for Testing and Materials) standard, gloves, temporary scrubs, and other protections.

Nurses have been demanding that the United States ramp up production of necessary equipment, including N-95 respirators and other protective equipment, as we have historically done in times of war. 

The Trump administration finally announced a plan to invoke the Defense Supply Act to increase production, and nurses urge that production to begin immediately. States and the federal government should also coordinate the release and distribution of all stockpiles of personal protective equipment. When it comes to saving lives, we must boost the supply to match the protections, not decrease protections to match supply.

At this critical moment, we need nurses to be on the frontlines, caring for patients, not sidelined, recovering from COVID-19. We need hospitals to be places of healing, not vectors for disease. As a country, we need to practice science, like a nurse, before it’s too late. 

Bonnie Castillo, RN, is the executive director of National Nurses United, the largest union of registered nurses in the United States.