(Note: Out of respect for the author’s privacy, the author requested to use a pseudonym byline. The author is a Nurse and the content of the Op-Ed is 100 percent accurate. Updated as of March 27, 2020 at 2:08pm to include Publisher’s note.)
I am a Registered Nurse at University Medical Center in New Orleans. I work on a 32-bed unit that now treats exclusively patients with Covid-19. Almost every day I work there is a code blue or an actual death on our unit. Most of our patients are stabilized with a little extra oxygen, some have even been discharged to home quarantine, but when they go down, they go down fast.
Last shift I came in and there were no N95 masks in my size.
Dear readers, let me explain the difference between an N95 respirator and regular surgical mask: N95 respirators are made of a special material that filters particles from the air. They come in several sizes, and each healthcare worker is “fit-tested” to ensure that the mask forms a complete seal to the wearer’s face. Getting fit-tested is weird. You mask up, and stick your head into a big cylindrical hood, which is then filled with a saccharine smog. When the mask fits properly, you taste nothing, absolutely everything is filtered out. If there’s even a small gap in your N95, you’re hit with an overpowering mixture of bitter and sickly-sweet. (This is why the general public should not use them, you have not been fit tested, so you’re probably wearing the wrong size, and you’re going to keep touching your face, so they won’t work anyway.) In contrast, a surgical mask is a napkin hung from the ears with rubber bands. The World Health Organization has stated unequivocally that N95 masks are needed to protect healthcare workers from Covid-19.
Before, we had come to work to find shortages of these respirators and had to figure out how to stretch them. In the course of use, virus-containing droplets are trapped on the outside of the respirator, which is then carefully removed and thrown away after each visit to a patient room, under normal conditions. Other hospitals gave their workers instructions on how to re-use their N95s, by layering them with surgical masks, storing them in paper bags, specifying the number of times they were to be reused. For us there has been no guidance about anything; we have been on our own. Over the course of a few days, individual nurses had combed the websites of the CDC and WHO looking for information on how to protect ourselves, and taken advice from our colleagues at other hospitals with functional leadership. There are wildly different standards of isolation for Covid patients on the different UMC floors and units, underscoring the fact that there is no central leadership.
And then I came to work to find the signs abruptly changed, the bold tricolor announcing AIRBORNE PRECAUTIONS removed from the doors, with no further explanation, despite all scientific evidence that this is required. Doctors still wear N95 respirators to even walk down the hallways of our unit, but UMC tells us nurses are not worth the money to protect. Many of these MDs stand outside of closed hospital room doors and speak to their patients over the phone, asking the nurse to make all physical assessments. Two of our nurses are already out sick with Covid-19 symptoms. For the rest of us it is only a matter of time.
The situation is even worse for other hospital workers. New Orleanians making $12/hr must transport Covid-19 patients and clean their rooms wearing only flimsy paper droplet masks, without protective gowns or face shields. They receive no extra pay for the risks they are taking, no instructions on how to avoid passing the illness to their families.
Considering these risks, it has become hard to keep our unit fully staffed. The first week, many pool nurses signed up to take shifts on our unit. They wanted to help out in this time of need. But with inadequate equipment and no extra pay, who can blame people for wanting to work somewhere else?
Last night, we had to make do with one nurse for every six patients. We do not have enough staff to monitor these patients as closely as they should be monitored. LCMC could take a lesson from Seattle, which has also been hard-hit by Covid-19. Seattle hospitals are recruiting nurses from all over the country, offering RNs over $4k a week to maintain their 4:1 nursing ratios in the face of crisis.
Our hospital is of course billing the government for all the care we provide. UMC is a public-private partnership, it has a contract that any services not reimbursed by patient insurance will be covered by the federal government. These funds are not being passed on to staff. Our unit director has been doing his best to advocate for us in receiving hazard pay, but his superiors don’t even dignify us with a response. There was a petition circulated among nursing staff for increased pay during this time, to support our quarantined families and attract adequate staff; the response for our unit was a box of Krispy Kreme doughnuts and cold pizza.
From conversations with our nurse colleagues at other hospitals, we at UMC seem to have less and lower-quality protective equipment and worse nurse-patient ratios than those with wealthier and whiter patient populations. This recalls the situation after Katrina, when patients at LSU hospital were airlifted to safety, while the largely black and low-income patients of Charity Hospital were left to die. We need intervention now to make sure that history does not repeat itself.
The upper administration of LCMC is sitting safely at home. They are keeping 100% of the profits from this crisis for themselves, while leaving 100% of the risk for nurses and frontline staff. If CEO Greg Feirn continues to maximize profit above all, we will not have enough healthy staff to care for our patients, and many more people will die.
New Orleans nurses have no union, no seat at the corporate table. We will do anything to avoid abandoning our patients, but we can’t keep going on like this. We need your advocacy. We need political action. We need the public to pressure UMC into doing the right thing. We need City Hall to CEO Greg Feirn, and we need ordinary citizens to picket outside his house, and force him to release the funds for hazard pay, protective equipment, and full staffing for all of us on the front lines. Our lives depend on it.