Confronting COVID-19: Nurses on the front lines

This content origi­nally appeared in the Spring/​Summer 2020 issue (PDF) of The Washington Nurse magazine.

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Nurses across the state have stepped up and cared for COVID-19 patients under extra­or­di­narily diffi­cult circum­stances. From the first chaotic days when guidance and proto­cols seemed to change on a daily basis, through extreme short­ages of PPE and a lack of testing, you have served, and you have cared.

While we honor your work and your dedica­tion, we also know that it shouldn’t be this way. You should not have to carry a single mask around in a paper bag. You should not have to clean and reuse PAPR shields until they crack or lose their seals. You should not have to fight for testing and paid leave to stay home if you get sick.

That is why WSNA has been fighting for you every day. We’ve pushed employers, public health officials and elected leaders for a wide range of policies and actions. We’ve lifted up the voices of members in the media and online to make our case. And all along the way our efforts have been based on the input we’ve received from members.

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Danielle O’Toole

Life as a critical care nurse in the age of COVID-19

When I pull into my garage after my 13-hour shift, the first thing I do is strip off my scrubs. I throw every­thing I’m wearing into the washing machine, turn it to the sanitize setting, and start it up. My shoes never come into the house. I walk through the house naked, straight to the shower, trying not to touch anything along the way. Read more…

Credit: Graphic by Ben Tilden

In late march and early April, nearly 2,000 WSNA members filled out our healthy workplace survey.

You told us that, even as hospi­tals were pushing to re-open elective surgeries, an overwhelming majority of WSNA-repre­sented nurses were contin­uing to deliver
care without suffi­cient PPE. You were contin­u­ally operating in contin­gency or crisis capacity: masks worn for extended periods of times and between patients; masks reused — removed, stored and redonned — over a period of hours and sometimes days; respi­ra­tors worn until breaking or becoming ineffec­tive and face shields re-worn without proper cleaning according to manufacturer’s recom­men­da­tion.

WSNA took these results to public officials and issued a state­ment demanding that the ongoing, severe PPE shortage be addressed before hospi­tals restarted surgeries, poten­tially creating internal compe­ti­tion for a limited supply. As the Spring/​Summer 2020 issue of The Washington Nurse magazine went to press, Washington state was moving forward with reducing restric­tions and the safe expan­sion of non-urgent medical and dental proce­dures under guidance issued by Governor Jay Inslee. WSNA continues to monitor hospital avail­ability and usage of PPE as required by the State.

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Christina Harrington, RN, accepts face masks from AFT organizer Zachery Seikel in Bellevue on May 20

In your facil­i­ties — We’ve worked with employers to secure new agree­ments, clear policies and resources for nurses. Where employers have fallen short, we’ve filed complaints with the Depart­ment of Health and Occupa­tional Safety (DOSH) and other relevant bodies to hold employers account­able.

With public officials — 
WSNA’s advocacy has helped move officials to act decisively in this crisis. As a result, Washington has flattened the curve faster and more effec­tively than many other states.

Protecting Your Practice — Throughout this crisis, we’ve worked to ensure nurses have access to the infor­ma­tion and resources you need and to protect nursing practice during this pandemic and beyond. WSNA produced resources and guidance to help members navigate the changing landscape during this challenging time.

In the media — The voices of front line nurses have been critical at every step of the fight, and WSNA has worked to ensure that your stories are being told while working to protect you from retal­i­a­tion. We’ve lifted up nurse voices in hundreds of media and online outlets — local, national and inter­na­tional — telling the real story of what’s happening on the front line. Through the media, we’ve helped move public opinion and policy to benefit nurses and other essen­tial workers.

What are Crisis Standards of Care”? #

During the COVID-19 crisis, planning has included examining Crisis Standards of Care in the event the health care system is overwhelmed by the volume and needs of patients. Washington state has to date success­fully flattened the curve, and the poten­tial need for surge capacity was not realized although lack of adequate PPE and concerns about the reuse of PPE continue to be a major concern. While Washington state has not needed to imple­ment Crisis Standards of Care, a second surge of COVID-19 cases could require our state officials to revisit these standards.