For those of you who are unfamiliar to how medical training works in the US, residents have _no_ power. If they quit, they cannot become board certified, and effectively cannot practice in any capacity. 4 years of college, 4 years of medical school, and 4-7 years of resident training.
I was disciplined for bringing in a reusable respirator. The reason given was that it made other staff believe the health system wasn't doing enough to protect employees and creating extra fear. And yes, I was threatened with termination in the middle of this crisis.
It needs to be addressed or it will repeat in some other context. Right thing to do is get cool heads in mgmt to handle the hot heads in mgmt. Small changes in comms can prevents such distracting/harmful escalations. And experienced managers/admins will know how to make it happen.
I think I remember someone who was a new-ish doctor mentioning that part of the reason some doctors' salaries were so high was they had to basically pour money into malpractice insurance.
1. Regulations against using non-approved medical equipment of unknown provenance. 2. A worry about health care workers who don't have stuff they can bring from home. It's not as if you can go about and buy an N95 mask right now. If some of the healthcare workers have respirators that they have lying around at home and some don't then it could cause friction on the unit.
1. All regulations are pretty far out the window at this point, nurses are already reusing single-use items all over the place.
2. Oh so since we can't protect everyone we can't protect anyone?
On the second point I would actually be more sympathetic to their position (though probably not enough to actually ban employees from doing it). Humans are funny and if some people on a unit have better equipment than others it can certainly cause some interpersonal tension that over-stressed hospitals can't deal with right now.
They should be protecting the people who can actually help save other people even if they can't protect everyone. Should nurses in KY stop wearing masks because nurses in NY are out? I understand you point on "interpersonal tension" but people need to get over it right now and protect themselves in whatever way possible even if that means I walk into a hospital and see a nurse with a bandana over their face (already happening in some hospitals AND part of the CDC "Strategies for Optimizing the Supply of Facemasks" [0] -- Read the "HCP use of homemade masks" section)
[0] https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/f...
I'll also speculate that it could create friction between staff - How come you get protect and I don't? It could be a problem.
Actually failing to protect staff seems a worse litigation risk.
It's not just that they'll be fired if they speak out...
The hospitals are also threatening to withhold worker's compensation payouts if a staff member is caught using anything brought from home, even if it's real, name brand equipment. Got some N95s leftover from that home improvement project? Leave them at home and use this surgical mask instead (still better than nothing, to be fair). They are asking staff members to inform on other staff. To be clear: these policies were in effect for an area with coughing COVID patients. They do put surgical masks on the patients, which is very helpful, but I'm livid that they then ask the nurses to NOT use N95s in this scenario.
They are also undertaking dubious re-use and cleaning procedures that are not scientifically proven. For example, masks (both surgical and N95s, which are only for workers doing things like intubation) are being used for an entire day (also not correct usage) and then placed in paper folders for a week. At the end of the week, the masks are deemed 'clean' and reused by the same staff member. Kind of like a mask for each day of the week. There is not strong scientific evidence this is an effective or safe procedure. These procedures might work, but there isn't testing proving that fact.
I understand hospitals are in a bind here. There are simply not enough masks available (both surgical and N95) in the world. If the hospitals admit their ad-hoc procedures are ineffective they risk short term mutiny in their staff ranks. They also risk long term litigation by admitting they can't protect staff. Unfortunately their approach of 'clamp down hard on dissent' is preventing the real message from being broadcast loudly enough: It should be blindingly clear we need a crash program to ramp domestic PPE manufacturing by an order of magnitude (or two).
As an aside, please call your senators and representatives and ask them to force the Trump administration to use the DPA to bring more PPE capacity online. It's really too late now, but better late than never. We'll need to establish permanent manufacturing capacity for this anyways so we never get caught out like again.