Mask, protective gear shortage for Nevada health workers has risks

Facing shortages, Las Vegas Valley hospitals are rationing masks and other protective gear used by doctors, nurses and other staff to keep them and their patients safe.

Typically free-flowing, the supplies are now treated like precious commodities as global demand has skyrocketed amid the coronavirus pandemic.

Henderson nurse Geoconda Hughes is among those pushing back.

“They seem to think we’re replaceable and masks are not,” said Hughes, a nurse in the intensive care unit at St. Rose Dominican Hospital, Siena campus.

Hughes, a union representative, said she’s voicing concerns she’s heard from nurses around the valley contending with supply shortages stemming from the rapid increase in COVID-19 cases. Nurses at multiple local hospitals have been told not to wear close-fitting N95 masks until patients with COVID-19 symptoms have tested positive for the new coronavirus, she said.

Although the administration at Rose Dominican, Siena late last week reiterated that nurses could wear a mask before a patient tests positive, Hughes remains unnerved by what she and others see as shifting standards.

Dignity Health-St. Rose Dominican Hospitals acknowledged concern about a “rapidly decreasing inventory,” leading the hospital to strictly follow conservation guidelines set by the Centers for Disease Control and Prevention, spokesman Gordon Absher wrote in a statement. He said, however, that because of the tight controls, the Rose Dominican hospitals do have the inventory to protect their staff members.

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“Their safety and their efforts to ensure the safety of our patients is key to our healing mission,” Absher said.

Despite such assurances, Hughes’ concerns are echoed by front-line health workers at some of the valley’s other major hospitals, all of whom spoke to the Review-Journal on the condition of anonymity, fearing retribution by their employers.

Sunrise Hospital and Medical Center is giving each worker only one surgical mask per shift, a critical care nurse said. The hospital’s chief medical officer, Dr. Jeff Murawsky, said Wednesday that masks are replaced mid-shift if they become dirty or damaged, and those that are not are collected at the end of day for potential reprocessing, a strategy that the hospital has not yet employed.

Workers at multiple Valley Health System’s hospitals are required to treat at least five patients while wearing the same single-use N95 mask before they receive a new one, according to interviews with three employees. At at least one of the hospitals, other single-use protective equipment, such as surgical masks and bonnets, must be worn for an entire shift if the staff member is treating patients with the same diagnosis, one of the workers said.

Valley Health System spokeswoman Gretchen Papez was unable to provide a comment on Wednesday.

“This is the first time in my career that our hospitals are going with the least stringent requirements,” Hughes said earlier this week, after ending a 12-hour shift.

Shifting standards

The changes come as hospitals across the nation prepare for an anticipated surge of COVID-19 patients.

The respiratory disease can be spread through droplets produced when an infected person coughs or sneezes, according to the CDC. Masks can help prevent health care workers from inhaling those droplets or catching them in their mouths or noses.

But masks may become unavailable because of increased demand, the CDC wrote on its website last week. The federal agency issued new guidance allowing for the use of bandannas, scarves and other homemade masks as a “last resort,” acknowledging that their capabilities to protect against COVID-19 transmission is “unknown.”

Those on the front lines are balking at the changing standards.

“You wouldn’t send a construction worker to a site without a hard hat,” the critical care nurse at Sunrise Hospital said. “Just because you run out of hard hats doesn’t mean you don’t need hard hats anymore.”

And the ongoing changes have created a chaotic work environment, according to some hospital employees who spoke to the Review-Journal.

‘Terrified to … be doing my job’

“The rules change so much we don’t know if we’re doing the right things for our patients and ourselves,” said one of the nurses who asked that her employer not be identified. “It’s making me terrified to even be doing my job.”

Sunrise Hospital’s Murawsky wrote in an email that his hospital has made changes to conserve protective equipment based on CDC recommendations. He said no surgical masks are being reused right now, but the hospital is collecting used equipment so it can be reprocessed if and when such a process is approved by the federal government.

“Our colleagues are our family, the very heart and soul of our hospital,” he said. “We will protect them and ensure they have the right equipment to provide excellent care to our patients all the time.”

But some workers said they believe the measures for conserving supplies may end up causing more harm than good. Complicating matters is that someone infected with the coronavirus may be contagious before showing signs of the disease.

One nurse who asked that her hospital not be named said employees are required to keep coming to work even if they were exposed to someone infected with coronavirus, so long as they wear a mask and aren’t exhibiting symptoms themselves.

She is currently under quarantine because she began displaying COVID-19 symptoms. However, she said her hospital was unable to test her for the disease.

“I was told to go through my own doctor or the emergency room,” she said.

Supply shortages

Local and state public health authorities note that a national shortage of protective gear for medical practitioners is being felt at every level of government and in the private sector.

In the face of high demand across the country, hospitals and government agencies are now competing for resources with people who have begun to stockpile masks, Southern Nevada Health District spokeswoman Stephanie Bethel wrote in an email. The health district is working with local governments to address their needs.

The state has received only about 25 percent of the protective gear it had requested from the federal government, according to Shannon Litz, a spokesman for the Nevada Department of Health and Human Services.

Litz said that the state has begun distributing gloves, gowns and masks from both the federal resupply and its own warehouse.

Another request has been made to the federal government, but Gov. Steve Sisolak said at a news briefing Tuesday that he expects to again receive 25 percent of what was ordered.

A number of private companies and community organizations are sending hospitals masks that they have in stock or have purchased from private vendors. Local residents are also sewing and donating homemade masks to hospitals.

Keeping safe

Hughes, who is 47 and has two teenage sons, said she knows how to keep herself and her family safe. She had treated patients with infectiousness illnesses such as meningitis, shingles and tuberculosis, all without getting sick.

But now she takes her temperature each night before she returns home. She takes her clothes off in her backyard before she enters her house, and immediately takes a shower.

She’s even sent her sons to live with her sister.

“I am afraid of my work environment getting more and more unsafe,” Hughes said.

Contact Michael Scott Davidson at sdavidson@reviewjournal.com or 702-477-3861. Follow @DavidsonLVRJ on Twitter. Contact Mary Hynes at mhynes@reviewjournal.com or 702-383-0336. Follow @MaryHynes1 on Twitter.