I graduated from nursing school in 2008. My first nursing courses included the topics of infection control and the use of personal protective equipment (PPE). As nursing students had done for decades before me, I also practiced the ritual of “donning PPE”; each piece meticulously added in a logical order, with purpose. When removing each article, “doffing PPE”, there is just as much consideration given to avoiding contaminating yourself or your environment. While these were some of the more mundane things I learned as a new nurse, this is a universal experience of all nurses. You learn to use different pieces of equipment, depending on how each specific illness is transmitted. You learn precautions that are necessary to prevent the spread of various diseases from one patient to another. This equipment, and this knowledge, not only protects patients, but it protects you, your coworkers, visitors, the families that they go home to, and your own family too. Arguably, infection control and disease prevention are at the very heart of nursing, as Florence Nightingale wrote in 1860, “True nursing ignores infection — except to prevent it.” In other words: Nurses are not afraid of how sick you are, but we surely don’t want anyone else to get sick.
Today in Philadelphia, there are thousands of nurses and many other medical professionals working in teams at hospitals, taking care of sick patients. Some of these patients are sick due to the COVID-19 outbreak; however, a pandemic doesn’t stop heart attacks, hip fractures from a bad fall, asthma exacerbations, or any other ailment found in a hospital on any given day. Healthcare professionals are working hard to ensure that patients with COVID-19 receive the best care they can provide, while also making sure those without COVID-19 do not get it. Nurses and their colleagues rely on infection control measures and personal protective equipment to protect their patients, as well as themselves, their coworkers, and their families. Unfortunately, as we have heard in the past weeks, there is a national shortage of PPE.
Hospitals are now rationing supplies and instructing their frontline healthcare providers to re-use this PPE. This is a phenomenon that some would argue is just as unprecedented as the wide-reaching effects of this pandemic. It sounds outlandish that such vital equipment isn’t available. However, hospitals functioning with a nursing shortage, with medication shortages, with supply shortages, is not new. This has been happening for many years and still is during this pandemic. Hospital administrations are well aware of staffing shortages that spread overworked staff too thin and place patients’ lives at risk. They know about medication shortages and supply shortages that leave our hands tied at the bedside, preventing us from giving our patients the care they deserve. Our government has long been informed about these issues as well. Our government knew about this pandemic, and still sent almost 18 tons of our medical supplies to another country, even as COVID-19 entered our own. This is not a new problem. COVID-19 is revealing the holes in our healthcare system that frontline providers have been trying to fill for decades.
Nurses and other medical professionals working at the frontlines of this pandemic are now, at best, likely to receive an N-95 mask that they will wear for an entire week or longer. These masks meant to be single-patient use items that, at any other time, would be reserved for use with one patient for one shift. The need for re-use of PPE is unprecedented. This is going to cause further spread of this disease, from one patient to the next. This is unsafe.
New York City recently gave instructions to emergency service workers not to transport patients who have suffered cardiac arrest to a hospital unless they can successfully resuscitate them outside of the hospital. The hospitals are filling up with so many patients with COVID-19 that there are no beds to put these patients in; there is no staff available to care for them; there are not enough resources. There are reports of medication shortages; we are running out of the medications we need to sedate those who need ventilators in order to breathe. Hospital overcrowding is not new. Medication shortages are not new. Diverting patients when a hospital is full happens, but not to this extent. This is unprecedented.
Frontline providers are working hard for their patients, risking their health, and fearing that they might contract COVID-19 and spread it further, infect their coworkers, and their families. In return, many hail them as heroes. Corporations and companies seek to try to make a profit by declaring on social media platforms that “Not all heroes wear capes.” They offer a donation of PPE for every like or repost they receive while they are gaining the benefit of public approval and advertisement. Get it straight — there are no heroes in this situation. We should be careful about hailing people as heroes to make them feel good — to make this all feel more bearable. We would not think of sending soldiers to war without armor. We believe that heroes deserve the tools they need to fight. It is an atrocity that we are expecting our healthcare workers to endanger themselves, without the necessary protection to care for others. It is disheartening that hospitals in America are asking people to donate supplies. It is outrageous that our government did not prepare for this, and put us all at risk. Putting healthcare providers at risk, making them choose between their wellbeing versus the wellbeing of others, and then calling them “heroes” is demoralizing.
I ask that you do not call them heroes in order to feel better about this situation. Instead, you should be angry. You should remember this when you go to a hospital. Remember this when you vote. Contact your representatives and demand PPE for your hospitals. You should be angry, and also concerned that some day nurses and other healthcare providers could decide to stop risking their health and the health of their loved ones on behalf of systems that fail them. Nurses, and all those who benefit from their care, should be angry as hell. I am angry and horribly sad. Healthcare providers do not want to be your heroes — they didn’t sign up for that. There is nothing heroic about this situation. They only want to be able to do the job they love and do it safely.
