Nurses Battling COVID Still Short on PPE, Increasing Stress

Megan Brooks

November 16, 2020

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

Eleven months into the COVID-19 pandemic, and with the United States experiencing record new daily cases, basic infection control and prevention measures are still lacking in US hospitals, including an inadequate supply of personal protective equipment (PPE), according to a survey by National Nurses United (NNU).

"More than 240 registered nurses have died from COVID-19. Enough is enough. Nurses need PPE now to do their jobs safely," NNU Executive Director Bonnie Castillo, RN, said in a statement.

"Hospitals are continuing to fail when it comes to preparation for COVID-19, even as flu season begins. They have had nearly a year to get their act together. We should not still be operating under crisis standards of care,” she said.

Medscape Medical News reached out to the American Hospital Association for comment but did not receive a response by press time.

Lack of Equipment, Patient Screening

NNU surveyed 15,000 registered nurses (RNs) in all 50 states plus Washington, DC, and two US territories. The preliminary results cover the period October 16 to November 9.

Just 16.5% of nurses in hospitals say they have universal PPE in emergency departments. More than 80% of nurses report reusing single-use PPE, and about 20% say their employer has recently limited the use of N95 respirator masks.

Screening patients for COVID-19 is also a concern for RNs working in hospitals. According to the survey, only 20% say patients are screened for respiratory symptoms before being admitted and fewer than half say all patients are screened for COVID-19.

One third of RNs overall and 42% of RNs in hospitals report having ever been tested for the virus, although this an improvement from July, when only 23% of RNs overall reported being tested. More than 70% of nurses say their employers do not inform them of on-the-job exposures in a timely manner.

Pressure to Keep Working

Staffing shortages are a top safety concern for 30% of nurses surveyed, a problem that 42% of hospital nurses say has gotten worse recently. One in five nurses report being reassigned to units where new skills or competencies are required, without adequate training.

Feeling under the weather? Forget about staying home; only 36% of hospital nurses report being able to always stay home if they have influenza or COVID-like symptoms.

The survey also looked at the fast-approaching influenza season, which is predicted to further strain resources needed to respond to COVID-19. Only 18% of RNs in hospitals report any preparation for surge capacity and planning at their hospital. Hospital nurses also report mental health effects from the ongoing pandemic, including trouble sleeping (50%), feelings of stress (nearly 80%) and anxiety (nearly 75%), and feeling sad or depressed (62%).

About 20% of nurses report increased workplace violence on the job, which they attribute to decreasing staffing levels, changes in the patient population, and visitor restrictions.

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