"Voices From The Frontline" is a series of letters from the frontline medical staff that document their experiences fighting COVID-19 in Indiana. These are first-person accounts that give you transparency into the challenges and successes taking place on the frontline of this pandemic.
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INDIANAPOLIS (WTHR) — Nurses have contacted Eyewitness News to explain the challenging conditions they are facing as they treat an increasing number of patients diagnosed with COVID-19. The letter below comes from a nurse at Community North Hospital, describing the challenges facing the nursing staff at that facility on March 30, 2020. The nurse has requested anonymity at this time because the employee says the hospital does not encourage its staff members to discuss working conditions with the media.
I currently work on a unit for COVID-19. This unit sees patients who are positive and are awaiting results. So even if they are negative, they have the potential to become positive during their stay because of our lack of PPE.
One month ago, we'd use a different mask for each patient encounter, each time we'd go into their room. In 17 days our PPE procedures have taken a drastic turn. Originally we were to use surgical hair and shoe covers, isolation gowns, gloves, goggles and a N95 mask. We don't have anterooms (special rooms where health care workers can remove their personal protective equipment, remove their shoe covers and work clothing so they don't contaminate other areas) on our unit to decontaminate before stepping back into the hall, so at that time we were to dispose of the gown and gloves in the room, remove the goggles and N95 mask, call for our charge nurse to take those and place them in plastic bags to be reused for the same patient for the entire shift, then we could wash our hands for 20+ seconds and come out of the patient room.
Within those 17 days we have now been told we do not get a N95 mask unless the patient is on 6 liters or higher of oxygen or if they are receiving aerosolized medication. We get 1 surgical mask for the entire week, unless that one becomes wet by wearing it for 12+ hours straight per shift. That same mask is to be worn into every patient room and while at the nurses station or through the halls of the hospital. We have been told we no longer need to use hair or shoe covers. The masks are under lock and key and you have to receive permission to get a new one. Although, respiratory therapists, MD's, PA's, NP's, etc. are allowed N95 masks
17 days ago we were told we'd take 2 patients per nurse because of how heavy these patients are and how quickly they decline, many within hours, are being transported to ICU. We are now taking 4 patients per nurse. And it was then instructed that we will be increasing up to 8 per nurse. Mind you, when we increased to just 3 patients per nurse, we were having patient falls because we could not get into their rooms from our other patients room in time while putting on the PPE we've been given. Our patient techs, who would help with patient care and safety are no longer allowed to help in the rooms, so they're not being exposed unnecessarily. The hospital has 1 code blue nurse who is in charge of assessing each patient that is declining to decide if they need to be moved to ICU or PCU for more interventions. That nurse was on our unit for 3-4 hours each shift this past weekend for patients who were declining. While on our unit they received multiple calls from other units for help also. So it's not only a shortage of PPE but also of staff to take care of the increase in demand of patients.
While myself and other nurses are taking as many precautions that we are allowed, the morale around the hospital is permeable. I thankfully have a N95 mask of my own, but again I have to use it every shift with every patient. I then store it in my locker awaiting my next shift. I change into street clothes after my shift, double bagging my scrubs in disposable bags, while still at the hospital and store my shoes in my trunk until my next shift. Once home I take those clothes immediately to the washing machine and proceed straight for a shower. I then also wash the clothes I changed into at the hospital, just in case. At that time, I change for a 3rd time at home and can finally say hello to my children. My husband then goes to my car and decontaminates the best he can, just in case anything traveled home on my person or belongings. He then also washes his clothes and showers.
I can only hope I am being as safe as possible during this time. It is extremely scary how dangerous this virus truly is. If the expectations continue to be increased as far as patient demand and corners continue to be cut for our safety and those of the next patient, I do not know if I can continue to risk my health and those of my family, for a company who thinks this is okay. The staff have not been informed what the complete PPE numbers are, only that we get 1 mask only.
Things are changing everyday with what is acceptable and each time it's less and less.
Community Health Network provided the following statement in response to the letter:
With a declared Public Health Emergency due to the COVID 19 Pandemic, our ability to care for patients while ensuring the safety of our caregivers is a top concern. Health care systems across the country realize that some of the items that are critical to our ability to provide care to patients are ventilators and to protect our caregivers are masks, gowns, gloves and other personal protective equipment (PPE). Teams across Community Health Network are closely monitoring all supplies and are working in conjunction with state and local health departments and other healthcare organizations to ensure resources are available for both patients and caregivers. This coordination will help all of us better allocate resources as the entire region ramps up for a potential surge in COVID 19 patients.
These are unprecedented, challenging times and our healthcare workers are at the forefront of this crisis. We couldn't be prouder of Community's caregivers who come to work each day committed to providing exceptional care, no matter the circumstances. We know we will make it through this pandemic because of their determination, compassion and strength in the face of adversity.