National Nurses United

something, you shouldn't have to ration it!" And the reuse of PPE was not limited to N95 respirators. Some nurses reported being asked to reuse gowns between patient rooms or to spray them down with bleach solution to wear for multiple shifts, to extend glove use by rubbing with hand sanitizer, and any number of unheard-of, untested practices. The reuse of PPE became officially sanctioned by the government when the Food and Drug Administration (FDA) granted emergency use authorization in late March and in April to two companies, Battelle and Advanced Sterilization Products, for systems that claimed to "decontaminate" N95 respirators during the surge. Major hospital systems, including Kaiser Permanente, Adventist, MedStar Health, have started using these systems, which treat used masks with vaporized hydrogen peroxide. In April, the federal government began subsidizing the adoption of Battelle by hospitals around the country when it granted a $400 million federal contract to the company to process masks. Some states, such as California and Illinois, are also contracting with these companies. Nurses who started coming into contact in April with these reprocessed, used masks reported various problems. For example, when Kaiser first rolled out these reprocessed masks to nurses, many could not tolerate the intense, noxious smell and the odor gave some nurses intense headaches. Kaiser quickly stopped their issuance and tried again weeks later, claiming that they were "airing them out" for a longer period of time before redistribution. Some nurses are still bothered by the smell. Others have noticed the face piece part of the masks come back deformed, that the elastic straps have lost their tension, and, in some cases, the metal nose-clip piece which must be able to shape around the nurse's nose bridge for a tight seal are too misshapen to work properly. Kaiser nurses report that they are not being fit tested with the "reprocessed" masks, even though fit testing is critical to their safe use. At facilities where hospital systems are collecting and "decon - taminating" masks, nurse leaders are encouraging coworkers to not cooperate in the process and to ask for new N95s. "I'm asthmatic, so I won't even entertain the idea of using a reprocessed mask," said Nicole Fisicaro, an emergency department nurse and interim chair of the professional practice committee at Kaiser South San A P R I L | M AY | J U N E 2 0 2 0 W W W . N A T I O N A L N U R S E S U N I T E D . O R G N A T I O N A L N U R S E 17 87,137 cases, 2,977 deaths in 59 countries MARCH 1 62 cases, one death in the United States MARCH 1 Before COVID-19, I was working in an inpatient women's health clinic in Brooklyn. But when COVID-19 happened, I was pulled back to Brooklyn intensive care unit because I used to work in ICU. With COVID, we are told to limit the amount of time we spend in the room with a patient, but [as a patient] every time you open your eyes, you see you are alone in the room, and the only thing you hear is the sound of the ventilator machine. It makes the patient feel so sad, alone and scared. When I go to the room, I try as much as possible to spend time with the patient and touch the patient. Even if I am not in the room, I will stand at the door and try to engage them if the patient is awake and looking at me. It makes the patient feel like they are not abandoned. PPE is one of the biggest challenges because you have to gown up with COVID. You can't just rush in when your patient is crashing or in respiratory distress. You have to put on your mask, your gown, your gloves, and then go into the room which is time consuming. The situation with the PPE supply is very frustrating. When we started, we had these blue plastic gowns, but then we ran out and we have just these thin yellow gowns. We also have to reuse our N95 respirators for an entire day per patient. Before COVID, we would never reuse our PPE because the risk of contamination and exposure is too great. As you are going home, you think, "Did I do everything? Did I miss this, did I miss that?" As a nurse, your first instinct is to go above and beyond what your job requires you to do. You keep play- ing the day back in your head, over and over again. It is very daunting for my spirit. When you have all this going on in your head it brings you to the point of almost borderline depression. But then you wake up and you say this is what we signed up for, and you get dressed and you do it all over again and you just pray that it will be better than yesterday. One step at a time, one foot in front of the other. And now they are making it hard to take a day off. Management said there is a new rule. If you call out sick you have to bring a doc- tor's note. After working so hard taking care of these sick, sick patients, we are human. You have to treat us like a human being too. We have days when we are just tired, our bodies just can't take it, we are exhausted and emotionally drained. If I need a day a day to myself, just to breathe and take care of myself emotionally, physi- cally for that one day, I think I am entitled to do that. It is tough and it is rough right now, but I love my job. I love nurs- ing. Yes, it is frustrating and thank god we have the union to fight for us. The nurses work together and feed from each other emotionally and keep each other going. —Kafilet Katie Lewis, RN, Veterans Affairs NY Harbor Healthcare System, Brooklyn, New York Kafilet Katie Lewis, RN

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