Registered nurses at Berkshire Medical Center represented by the Massachusetts Nurses Association are calling for stronger personal protective equipment (PPE) standards for frontline nurses and healthcare workers and a triage area outside the hospital to limit the exposure of coronavirus (COVID-19) to patients, staff and the community.
BMC instituted an expanded personal protective equipment (PPE) policy on March 26, requiring all staff in contact with patients to wear surgical masks, eye protection and gloves. However, only BMC staff who are in contact with COVID-19 positive patients or patients being ruled out for COVID-19 are provided the N95 masks that offer the highest level of protection from infection when used in combination with eye protection, a gown and gloves. In fact, BMC is not even giving N95 masks to every nurse in the emergency department.
"We all know that coronavirus is a highly infectious and stealthy virus that can be spread by asymptomatic people, leaving frontline healthcare workers and hospital patients at risk unless we have the highest standard of protective equipment," said Alex Neary, an ICU RN and Co-Chair of the BMC MNA Bargaining Committee.
"Every nurse and healthcare worker on the front lines at Berkshire Medical Center must be able to use personal protective equipment that can effectively guard against the widespread risk of exposure to COVID-19," Neary said. "At this point, to be safe and limit the spread among staff and our community, we must assume any patient could have the virus and act accordingly."
- 97 BMC nurses had been furloughed and instructed to self-quarantine after potential exposure to COVID-19 as of March 28. All were exposed without PPE. Of those, 75 nurses DO NOT work on units designated for COVID-19 positive or COVID-19 rule-out patients.
- According to BMC's PPE supply numbers provided to the MNA, if the hospital changed its policy to reflect universal N95 masking for those in contact with any patient, the hospital would still have a 28-day supply of N95 masks.
- Acknowledging a looming shortage of PPE and committing to universal N95 masks for frontline staff would prompt additional donations of equipment. A local company is already preparing to manufacture N95 masks.
- BMC nurses requested the enhanced PPE policy in a meeting with management on March 27. Management did not agree.
- BMC nurses also called again on March 27 for a triage area to be set up outside the emergency department. Management had said it was discussing the topic after a previous MNA BMC meeting on March 20 but the hospital has yet to take action. Patients with respiratory problems should not be entering the main ED lobby. Instead there should be a designated area outside of the entrance to the ED to screen and triage patients with respiratory symptoms, so they do not comingle with other ED patients.
Areas of Progress/Appreciation
BMC nurses acknowledge and appreciate areas in which the hospital has made progress and/or has supported frontline staff during this outbreak:
- The hospital has ensured staff on furlough for potential exposure to COVID-19 receive their full pay by supplementing workers' comp.
- The hospital has agreed to supplement the essential personnel childcare the state has provided and make sure staff have no-charge childcare during this crisis.
- The hospital has worked to create a significant number of negative pressure rooms for COVID-19 patients that help limit infection exposure.
Background on Asymptomatic COVID-19
Infectious disease experts studying COVID-19 have detailed how infected people can be asymptomatic for periods of time and be able to spread the virus to others:
- A study in the journal Emerging Infectious Diseases shows more than 10% of patients become infected from somebody who has the virus but does not yet have symptoms.
- Japanese researchers looked at 634 passengers who tested positive for COVID-19 on the Diamond Princess cruise ship. They found that 17.9% of these passengers were asymptomatic.
- Dr. William Hillmann, associate inpatient physician director at Massachusetts General Hospital, told the Guardian, "A si...
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