Registered nurses at HCA hospitals in Florida, Kansas, Missouri, and Nevada will hold public actions Tuesday to highlight ongoing practices they say put nurses and other caregivers in jeopardy and increase the spread of COVID-19 to others.
 
At all the hospitals, HCA is requiring RNs to reuse single-use N95 respiratory masks after “decontamination,” a policy that is not proven to be safe or effective for protection against COVID-19, says National Nurses United (NNU).
 
“It is shameful for HCA to put our lives, and the lives of our patients, our co-workers, and our families at risk due to their failure and unwillingness to make workplace safety the highest priority, not a budget item to be constantly squeezed and cut,” said Leslie Rogers, an RN at Research Medical Center in Kansas City, Mo., where the nurses will be joined by RNs from Menorah Medical Center in Overland Park, Kan.
 
Additionally, RNs at Blake Medical Center in Bradenton, Fla., Fawcett Memorial Hospital in Port Charlotte, Fla., and Mountainview Hospital in Las Vegas are also alarmed at what they call dangerous short staffing, and in some cases cuts in additional staff. 

(Locations and times of the actions below)
 
“When we are with fewer nurses, and the loss of other staff, we are running between patients and have far less time to give each patient the timely, individualized care they need,” said Blake Medical Center RN Yulanda Bakare. 
 
“Short staffing is a prescription for missing subtle changes in a patient’s condition, and increasing the potential for mistakes, becoming infected, and passing the virus to other patients and other staff,” said Mountainview RN Nicole Koester.
 
“HCA has had six months to fully prepare, to be a model for how to safely care for patients, and to ensure that our dedicated frontline caregivers have every protection we need so we can be here taking care of our patients, not at home sick with this deadly virus, or worse,” said Meghan Jacobsen, also a Mountainview RN.
 
“With at least 180,000 lives now lost to COVID-19, among them 1,500 health care workers and nearly 200 RNs, including HCA nurses, we need HCA to commit to the highest standard of safety measures, and not disregard our voices and concerns,” said Research RN Angels Davis.
 
At Research, nurses have been given two choices. They are told to turn in their N95 masks daily for decontamination and reuse, or be given five masks and five paper bags and cycle through them wearing each mask 25 times, with the dubious theory that a five-day break will allow the virus to no longer be a threat so the mask can be reused.
 
Neither alternative offers proper protection, says NNU. “Decontamination must effectively inactivate the pathogen, not degrade the performance of the respirator, including filtration, structural integrity, and face seal, and not introduce an additional hazard to the worker wearing the respirator,” notes NNU’s Lead Industrial Hygienist Jane Thomason. “We have not seen any decontamination method meet these three criteria. Several methods currently in use may be harmful by one or more criteria.”
 
“Our nurses report that the reprocessed masks they've encountered have horrible odors, are deformed in critical areas like the face piece and the nose bridge, and that the straps have lost their elasticity,” says NNU President Zenei Cortez, RN. “There's no way a reprocessed mask will perform like a new one.”
 
NNU has also studied the scientific literature on the five day-five mask approach. It has found that putting an N95 in a paper bag for five days does not reliably “decontaminate” the N95. Research has shown that the virus that causes COVID-19 can survive for extremely long periods outside the human body, including for at least 21 days on N95 respirators.
 
And, to add further alarm at Research, where nurses are still mourning the loss of a long-time RN colleague Celia Yap Banago, who died of COVID-19 in April, the RNs are also struggling with broken down powered air-purifying respirator (PAPR) face shields that they have to share and are increasingly filthy through re-use, and defective negative pressure isolation rooms for infected patients with doors that no longer latch, increasing the risk of exposure to others.
 
Disposable parts of PAPRs should also not be reused, says NNU, as repeated donning and doffing (putting them on and taking them off) risks damaging the PAPR, which would render it no longer effective. With the isolation room, the seal is necessary to maintain the negative pressure. If it doesn’t close properly, viral aerosols can circulate into hallways and other patient rooms.
 
Actions scheduled for Tuesday, September 1 (local times)
 
Bradenton, Fla.—Blake Medical Center 
2020 59th Street W, 7:30 to 8:30 a.m.
 
Port Charlotte, Fla.—Fawcett Memorial Hospital 
21298 Olean Blvd, 8 a.m. to 9 a.m.
 
Kansas City, Mo.—Research Medical Center 
2316 E. Meyer Blvd., 5:45 p.m.
 
Las Vegas, Nev.—Mountainview Hospital
3100 N. Tenaya Way, 7:15 a.m. to 9 a.m.