MultiCare nurses forced to reuse disposable masks due to coronavirus-induced shortage
This article has been updated.
A Tacoma-based health system is rationing surgical masks for its staff because, otherwise, supplies would last only one or two days.
Nurses and other staff members at several MultiCare Health System hospitals and clinics contacted The News Tribune this week to report the change in procedures.
Staff are now asked to keep disposable masks in sealed bags, pockets or on hooks outside patient rooms so that they can be used all day long.
The News Tribune received copies of a staff-wide email stating that inventory for some personal protection equipment is critically low.
“We will now be re-using masks. We are in a critical health situation,” the email stated. “If we do not do this, we will be out of masks in one or two days.”
The measures do not apply to sterile procedures, the memo said, which would include surgeries.
Staff at Good Samaritan, Tacoma General and the Auburn Medical Center told The News Tribune they are uncomfortable with the measures.
Marce Edwards, a spokesperson for MultiCare, confirmed nurses complaints and the email sent to staff.
“We are trying to stretch the supplies we have,” Edwards told The News Tribune.
MultiCare has implemented “best-practice” policies to ration masks, she added.
Masks are expected to last a 12-hour shift, to be replaced only if visibly soiled.
Edwards said MultiCare is receiving small shipments from suppliers and has requested masks from the state and the federal stockpile. A small amount of supplies was provided from the national reserve.
Asked what the plan is if the current supply runs out, Edwards said the system would continue to ration mask supply from the small shipments.
MultiCare’s novel coronavirus resource center page states the hospital chain is following World Health Organization guidelines for staff safety:
“MultiCare’s commitment to the safety of every staff member within our health system is unwavering. We will take care of patients with COVID-19 following all the appropriate safety policies. That includes following the WHO evidence-based guidelines for personal protective equipment. The WHO guidelines have been endorsed by the Washington State Department of Health and local health departments.”
According to WHO’s website, protocol calls for disposable masks to be used once and disposed of immediately afterwards. Health care providers treat several patients in a shift, and using the same mask carries germs from one room to the next. One registered nurse at Good Samaritan said sealing a surgical mask in a bag means all the germs trapped in the front of the mask travel to the back, eventually touching staff noses and mouths.
“That mask is harvesting any amount of bacteria just sitting there,” one Good Samaritan nurse said. “And then I put it back on my face.”
Edwards said in an ideal situation, the hospital would be following WHO’s ideal guidelines.
“We are not in an ideal situation, and we don’t have enough masks to make that happen,” she said.
CHI Franciscan, another local health system, told The News Tribune their operations’ supply chain had benefited from its joining CommonSpirit Health’s Organized Health Care Arrangement (OHCA) in 2019 — allowing them to have adequate supplies.
However, after multiple CHI Franciscan employees came forward to The News Tribune raising issues about their available supplies of face masks, Cary Evans, vice president for communications and government affairs for CHI Franciscan, told The News Tribune on March 14: “We are following CDC and health department guidelines for masking, which is one per healthcare worker/per patient/per shift with a maximum use of five times.”
Coronavirus, which causes COVID-19, is spread through contact between people within six feet of each other, especially through coughing and sneezing that expels respiratory droplets that land in the mouths or noses of people nearby.
As of Wednesday, Washington had 366 reported cases, with 29 fatalities. Pierce County had 17 confirmed cases and no deaths.
The virus has caused school closures, teleworking and the prohibition of all social gatherings of more than 250 people in King, Pierce and Snohomish counties. The World Health Organization called the outbreak a global pandemic on Wednesday.
‘We’re not prepared’
Employees from different MultiCare hospitals report different protocols in place to mitigate the mask shortage. Previously, masks were kept at nurse stations or carts outside of patient rooms, but the nurses said visitors or patients were taking those masks.
The surgical masks are held and doled out by staff in management positions, like charge nurses.
The identity of the following workers’ accounts are known to The News Tribune, but they asked to remain anonymous for fear of losing their jobs.
Last week, MultiCare directed its nursing staff to take an inventory of masks daily, an employee who works in the front office of a primary care clinic said. That information was sent to supervisors on a daily basis.
The front-line worker, who has been at MultiCare for over a decade, said the normal procedure is to use the masks when tending to a single patient and then disposing of them. If the patient has a dangerous and/or contagious infection like tuberculosis or measles, the masks were disposed of in a biohazard bag.
The new policy, she said, contradicts that.
“It’s the exact opposite of what we should be doing to stop contamination,” she said.
Two registered nurses at Good Samaritan told The News Tribune they are asked to keep a disposable mask in a Ziploc baggie labeled with their name. A mask intended for single use is expected to be used for the entire shift, the nurses said.
At the Puyallup hospital, nurses are directed to use the same mask from room to room.
“It’s going to hit the fan, because we’re not prepared,” one nurse said.
Another said she understands there is a mask shortage nationally, but she has to protect herself, her family and her patients.
“That’s way too much cross contamination and it doesn’t sit right with me at all,” the registered nurse said.
At Auburn, one registered nurse said the medical center is adding hooks outside of each room so the same mask is used for the same patient.
She is concerned about surgical masks being used. The Centers for Disease Control and Prevention recommends health care providers use N95 masks to filter out viral exposure, not surgical masks, which cannot filter out smaller virus particles.
She has called into work sick because she doesn’t feel comfortable with the protocol.
“I’m no longer safe,” the nurse told The News Tribune. “I’m a healthy individual and I’m pretty sure I would recover, but I am putting my kids and other patients at risk with having this exposure.”
Management said in the staff email that the supply conservation included surgical/ procedure masks and eye protection to include eye shields, face shields and goggles.
MultiCare hospitals include Allenmore Hospital, Mary Bridge Children’s Hospital, Auburn Medical Center, Covington Medical Center, Deaconess Hospital, Gig Harbor Medical Park, Good Samaritan Hospital, Rockwood Clinic, Tacoma General Hospital, Valley Hospital, and Wellfound Behavioral Health Hospital.
This story was originally published March 13, 2020 at 5:10 AM.
