Death Of Nurse Raises Fear Of Health Care Worker Safety As More COVID-19 Patients Are Sent To Research Medical Center
As nurses at one Kansas City hospital mourn their coworker, the Missouri State Hospital Association reports a shortage of protective equipment in 27 hospitals.
About 80 nurses and health care workers held a candlelight vigil outside of Research Medical Center in Kansas City on Thursday night to honor a coworker who died of COVID-19.
Celia Yap-Banago, a registered nurse who had worked at Research for nearly 40 years, died at home on Tuesday evening. She was 69 and scheduled to retire next week.
Hospital workers said the loss might have been prevented if Yap-Banago had adequate personal protective equipment.
Nurses at Research also said they now feel even more at risk since HCA Midwest Health, which operates Research, started sending COVID-19 patients from other HCA facilities to be treated there.
HCA Midwest Health denied that the nurses lack adequate protective equipment. In a statement, HCA Midwest Health spokesperson Christine Hamele criticized the National Nurses United union, which organized the vigil, for "seeking to exploit Celia’s death as an opportunity to criticize the hospital for a PPE shortage.”
Yet many hospital workers say that the nurse's experience had made them concerned about their own safety.
In mid-March, Yap-Banago cared for a patient who was later found to have COVID-19, said Charlene Carter, a registered nurse who also cared for the patient.
Because the patient was not a confirmed or suspected COVID-19 patient, Carter said she and Yap-Banago were not provided with any of the masks or other equipment used by staff who treated COVID-19 patients.
“We didn’t have access to any personal protective equipment, outside of just gloves,” Carter said.
Yap-Banago went into quarantine on March 25 and tested positive for COVID-19, according to a statement issued by HCA Midwest Health.
Shortly after Yap-Banago went into quarantine, HCA Midwest Health implemented a new policy to require masks in all patient areas. The March 30 change was a shift from policies that required masks for medical staff working with COVID-19 patients and patients suspected of having the illness.
However, many nurses as Research say they have felt even less safe in recent weeks.
Research has been designated as a hub for COVID-19 care by HCA because the Level 1 Trauma Center has a high capacity for treating critically ill patients and to reduce strain on other facilities.
“This conserves supplies of vital PPE, consolidates resources, and further enhances our ability to manage the potential overflow of COVID-19 under investigation (PUI) patients,” wrote Hamele.
Angela Davis, a nurse and union representative who treats COVID-19 patients in a Research intensive care unit, said she was taken aback when she found out that her facility would be receiving the additional patients and worried how it would add further strain to the hospital.
“When they started sending them from other hospitals, I was like, ‘If you’re going to be sending your patients to us, you need to send a case of (personal protective equipment) with each of them,” said Davis.
For weeks, hospitals across the Kansas City and throughout the country have been experiencing low supplies of personal protective equipment, including masks, gowns and face shields, due to high demand during the pandemic.
Like many hospitals, HCA Midwest Health, which operates eight hospitals in the Kansas City area (including Lee’s Summit Medical Center, Menorah Medical Center and Overland Park Regional Medical Center) has been taking unusual steps to conserve or reuse protective equipment that is designed to be disposable.
HCA Midwest Health insisted that its hospital workers have been protected through adherence to guidelines from the Centers for Disease Control and Prevention.
“Our preparedness and planning started months ago and since the outset of the pandemic we have followed CDC guidelines for PPE,” Hamele wrote.
But the CDC acknowledges its current guidelines may put health care workers at additional risk.
A memo sent to workers at an HCA hospital in early April outlined procedures for reusing specialized N95 masks, which are designed to be disposable. They are recommended for health care professionals who are working in close contact with COVID-19 patients.
The CDC has issued special guidelines to reuse and decontaminate masks and other personal protective equipment during the COVID-19 pandemic.
However, the guidelines state that the extended use and reuse of N95 masks could increase risks of transmission and the performance of these masks under these conditions is not fully understood.
HCA Midwest said its hospitals do not have any shortages of equipment, but they are taking steps to extend the use of these supplies to prepare for the possibility of a surge.
Many hospitals have been dealing with low levels of protective equipment for weeks, and some now say they are reaching the end of their supplies.
Twenty-seven Missouri hospitals have shortages of N95 and surgical masks, and many are also short on surgical gowns, face shield and coveralls, according to a Missouri Hospital Association report issued on Thursday.
In addition, a handful of hospitals in Missouri have less than a three-day’s supply of many safety supplies.
The hospital association doesn’t disclose which hospitals are reporting shortages, and the actual numbers experiencing shortages may be higher because some hospitals have not submitted recent reports.
State leaders, however, have struggled to obtain additional equipment on behalf of hospitals.
In March, the state requested more than a million N95 or equivalent masks and 750,000 isolation gowns from the federal government, but only received a fraction of those supplies.
The Missouri Department of Health and Senior Services says it received only 163,000 N95 masks and 68,856 gowns from the Strategic National Stockpile, and those supplies have all been distributed to health care and long-term care facilities throughout the state.
This week, Missouri Governor Mike Parson said that the state health department had obtained a Battelle Critical Care Decontamination System, which would be able to decontaminate up to 80,000 N95 masks per day for reuse.
The system will help hospitals facing shortages, according to Missouri Hospital Association spokesperson Dave Dillon, but he wrote in an email that it wasn’t a long-term fix for the problem.
“The goal is to extend the life of N95 masks through decontamination, but this isn’t a one-for-one substitute for increased access to new supplies,” Dillon wrote.
Meanwhile, the numbers of COVID-19 patients have continued to grow.
The Kansas City health department reported the number of cases in the city had reached 461 on Thursday with 14 deaths.
The highest concentration of cases is in the central part of city, where Research Medical Center is located.
Research nurses and other workers have been speaking out about lack of supplies in recent weeks, but nurse and union representative, Pascaline Muhindura, who also treats COVID-19 patients, said she had seen no improvements in access to protective equipment since HCA began shifting more patients to Research.
“We have not seen any difference in the way they were being rationed – N95s, respirators, surgical masks or gowns,” Muhindura said.
At the vigil on Thursday evening, Yap-Banago’s eldest son, Jhulan Banago, held a picture of his mother and spoke to the health care workers who had gathered to pay respects to her.
“She’s become a mother figure to a lot of her co-workers and she has worked almost 40 years as a nurse," he said. "You’re either not smart to be in this field for 40 years or you are so compassionate and selfless that you would dedicate your entire life to helping others.”
Yap-Banago’s family members said she spent her final weeks fighting the illness in isolation to prevent others from contracting the virus.
The Research nurses said the emotional toll of treating COVID-19 patients for weeks has been overwhelming at times, though the raw emotions are increasingly giving way to numbness as they work to help victims of the pandemic.
“I have panic attacks, anxiety attacks. You cry like crazy,” Muhindura said. “But I feel like we’re just running out of tears, lately. We’re kind of getting used to it, unfortunately.”