Rob Schulte, a registered nurse at Research Medical Center, was taking care of a patient with COVID-19 symptoms and wearing a surgical mask but thought he needed the additional protection of an N95 medical mask.
So he asked his supervisor for permission to don one. Her response, according to Schulte: If she let him wear one to treat a patient who had not been confirmed with the disease, everyone at the hospital would be asking for one.
“Well, that patient came back positive the next day,” Schulte says. “And they did not notify me. She ended up going to the ICU for respiratory distress.”
The patient recovered and was expected to be discharged on Wednesday, Schulte says. But he’s still upset by the hospital’s seeming unwillingness to take measures to protect his health and safety.
“I live with my brother and I have a sister who’s pregnant and I have a nephew, and I haven’t seen them in three weeks because I’m isolating as much as possible when I’m not at work. I feel I could expose people to it.”
Research is one of eight Kansas City area hospitals run by HCA Midwest Health, a division of HCA Healthcare, the biggest for-profit hospital corporation in the United States. The nurses at three of those hospitals – Research Medical Center, Research Psychiatric Center and Menorah Medical Center – are represented by National Nurses United, and the union says HCA has been ill-prepared for the COVID-19 pandemic, putting the hospitals’ patients and front-line workers at risk.
In a statement, HCA lashed out at the union, saying now isn’t the time for conflict and dissension, and defending its policies, which it says follow Centers for Disease Control guidelines.
“The truth is that we've continued to follow and many times EXCEED the Centers for Disease Control (CDC) guidelines for PPE as the preemptive and global authority,” the statement said, referring to personal protective equipment.
“While we are aware that external organizations — including the NNU — are speaking out on issues of PPE, it is our firm belief that they are adding to the confusion, misinformation and fear spreading across the industry and public in the United States. This is – simply put – irresponsible. Across the globe, this pandemic has strained the worldwide supply of PPE as COVID-19 cases and utilization of PPE exceed the ability of suppliers to manufacture PPE. This is not a challenge that is unique to our region, or any other hospital or health system in the United States.”
NNU represents 1,000 nurses at Research, Menorah and Research Psychiatric Hospital, as well as another 9,000 nurses at HCA hospitals in California, Florida, Texas, Nevada and North Carolina. The union was staging protests Wednesday and Thursday at 15 HCA hospitals in those states, demanding that the company provide health care workers more personal protective equipment, including N95 respirators, gowns and masks.
“We’ve told the hospitals to get ready since January,” says Julie Perry, a registered nurse and an NNU national labor representative based in Kansas City. “They’ve been through Ebola before. These types of things should be old hat to them. They should be ready to go. … And in January they told us they had an action plan. That’s not proved to be true.”
Effective this week, HCA said in a statement, it’s requiring universal masking of all staff and N95 masks where appropriate.
“Since COVID-19 is spread by droplets, in most instances standard face masks offer adequate protection,” it said. “These decisions are based on known and proven evidence and guidance from the CDC, and are being implemented to protect our colleagues and our patients.”
The Nashville-based company said on Tuesday that it will pay 100% of the base pay of staffers who need to be quarantined under CDC guidelines. And it said it would try to redeploy full- and part-time staff who are seeing reduced hours. Those who can't be redeployed will be eligible to receive 70% of their base pay for up to seven weeks.
But NNU says HCA is not doing enough. It says a survey it conducted of 10,000 registered nurses in all 50 states and U.S. territories found that:
- 35% of HCA nurses reported having access to N95 respirators, compared to 52% at other hospitals.
- 16% reported having access to PAPRs, or powered air purifying respirators, compared to 23% at other facilities.
- 7% reported having enough personal protective equipment to protect staff and patients in the event of a surge in patients, versus 19% at other hospitals.
Angela Davis, who’s a Research nurse in the same unit as Schulte, says that as the number of COVID-19 patients at the hospital rises, she and her fellow nurses have been forced to reuse masks and sometimes haven’t had access to personal protective equipment altogether.
After a patient went into cardiac arrest recently, Davis says there wasn’t enough protective equipment to go around.
“I took my own hood and gave it to a co-worker,” she says. “And meanwhile, a lot of us, not having any way to protect ourselves, couldn’t go in the room and help and we just sort of felt helpless.”
The patient didn’t make it. And while nurses are accustomed to patients dying, Davis says what’s different now is that they’re needlessly dying alone.
“We are there to protect and hold your hand in the end,” she says. “And these people are dying with no family around and not enough nurses that can be caring at their side.”
As early as Jan. 24, a union committee had recommended that Research and Menorah provide personal protection equipment, including N95 masks, gloves and gowns, to health care workers providing care to patients infected with the coronavirus, according to emails obtained by KCUR.
Research’s chief nursing officer responded that the hospital had created an action plan and was following CDC recommendations at the time, which included using eye shields when caring for coronavirus patients.
“We’ve been reaching out to HCA since January to start alerting them to this pandemic that was approaching, that they needed to get more protective equipment ready,” Davis says. “But it’s only been in the last week that they’ve started to scramble and actually take it seriously.”
Schulte is still shaking his head over his supervisor’s refusal to let him wear an N95 mask.
“They’re trying to ration our supplies, which I understand,” he says. “But if I were to get sick, I’d be one less person working in health care. I would be quarantined. I could infect my brother, who lives with me, and it would take a lot out me. But it’s happening to all of us.”
Dan Margolies is a senior reporter and editor at KCUR. You can reach him on Twitter @DanMargolies.
