Fort Worth area nurses describe confusion, mask shortages: ‘I’m afraid to go to work’
Fort Worth area nurses say a lack of transparency, mask shortages and poor communication have created an atmosphere of fear and confusion among health care workers as they prepare for a surge of coronavirus patients.
Over the past week, the Fort-Worth Star-Telegram has spoken with 14 nurses, health care workers and hospital staff who say new CDC recommendations and local protocols go against everything they’ve been taught. Most of these workers spoke on condition of anonymity because they feared retaliation by employers who bar them from speaking to the media.
Critical shortages of personal protective equipment have resulted in the Centers for Disease Control downgrading its recommendations for health care workers treating COVID-19 patients. Once, respirators were urged. Now homemade cloth masks are acceptable. Some Fort Worth area hospitals have also mandated that some health care workers wear face masks at all times and use them for up to a week.
“Every day health care workers are being asked to accept personal risk and go beyond their limits of duty,” said Cindy Zolnierek, head of the Texas Nurses Association. “We must protect our nurses and health workers, because if they get sick who’s going to take care of us?”
Limited supplies
A radiologist nurse practitioner who asked for anonymity said there were no face masks anywhere on her floor last week. She went to the inventory closet, which she usually helps stock, but they were all gone.
“Patients and staff have been stealing them,” she said. “But our supervisors keep telling us that everything is OK and that we are not running short on supplies.”
She said bi-weekly huddles on her floor have been suspended in line with social distancing orders, but these meetings were the main places where nurses could raise questions and raise concerns with their managers. Protocols and mandates have been changing so fast that it’s been hard for employees like her to keep up. “We honestly don’t know what to believe anymore,” she said.
On Thursday, Texas Gov. Greg Abbott began taking bids and donations for personal protective equipment from the public, including masks, respirators and oxygen tanks. The city of Fort Worth has been accepting PPE donations at libraries since March 25, two days before several hospitals in the county started reusing face masks.
JPS Health Network officials said the hospital’s mask supply is “still good” and were establishing a policy to reuse masks as a precautionary measure. They also said those who care for patients would not have to reuse masks.
CDC guidelines state that extended use alone is unlikely to degrade respiratory protection. The center also advises health care facilities to develop clearly written procedures to help staff extend the life of the protective equipment.
An atmosphere of fear
A nurse practitioner for JPS who asked for anonymity for fear of retaliation, said he was handed a mask at the beginning of his shift last weekend along with instructions on how to extend the life of it, but within the first hour his mask was torn.
“These are flimsy masks that were not made to be used for an extended period of time,” he said. “I tried to go get a new one from someone on my floor but it was like pulling teeth.”
In an email, JPS spokeswoman Diana Brodeur wrote: “Masks are available at all times to all JPS team members. As instructed, anyone with a ripped, soiled or damaged mask should get a new one immediately.”
Zolnierek, who represents more than 12,000 health care workers as head of the Texas Nurses Associations, said they’ve been getting similar complaints from all over the state. TNA has an online survey where nurses can voice their concerns and offers resources on its website.Masks are available at all times to all JPS team members and as instructed, anyone with a ripped, soiled or damaged mask should get a new one immediately.
“So I think part of the problem is that this is so different for nurses and what we’ve always been taught to do,” Zolnierek said. “So there’s a big shift in our mindset about is this really OK, is this safe? Am I protected, are my patients protected?”
She said a big problem has been communication and lack of consistency between health organizations. Another problem has been fear of retaliation. Some Fort Worth area nurses said they received emails from superiors saying they could be fired if they were caught without a mask or with one brought from home.
The radiologist nurse practitioner said she didn’t know where to go for help so she reached out to the Star-Telegram. “I’m afraid to go to work and so is my boyfriend who also works in the hospital,” she said. “I wish they’d just give us an opportunity to ask questions instead of smiling at us in the hall and saying, ‘Everything is going to be OK.”
Zolnierek said nurses and health care workers who raise concerns to their supervisors, law enforcement or state regulatory agency have protections under the Texas Health and Safety Code. She also said it’s rare for health care workers to lose their job for raising concerns or talking to the media.
“I’ve been a nurse a long time, almost 30 years and I can assure you that every health organization has a rule that anything that’s discussed to the media goes through their communications department because they want to control the message,” Zolnierek said. “Especially in times like these.”
Lack of testing
Elizabeth Handen is a physician assistant for a neurosurgeon who operates in multiple hospitals around the Dallas Fort Worth area. Each hospital she’s been to recently has a different coronavirus protocol, which can be confusing.
“Everyone’s a little bit anxious,” Handen said. “I think it’s a lot to process and hospitals are doing the best they can but this virus really caught everyone off guard because many, including myself, didn’t think it could get this bad.”
One month ago, she thought COVID-19 was being overblown and so did some of her colleagues. That was before the World Health Organization declared a pandemic and hospitals began shutting down floors. An intensive care unit she works in was quarantined.
A few weeks ago one of the nurses in her practice tested positive for COVID-19, which prompted many of her colleagues to get tested.
“That’s when I realized this wasn’t just the media causing hysteria and the situation was more grave than we initially thought,” Handren said.
But not all nurses are being tested. One registered nurse from Fort Worth said his colleague was coughing but was not sent home until he had a high fever. A few days later the same colleague was back at work and was never tested.
During a news conference this week, Tarrant County Public Health Director Vinny Taneja said there have been health care workers who have tested positive but there aren’t enough supplies to test everyone.
“Hospitals are deciding to retain tests for the critically ill and for others,” Taneja said. “If it looks like COVID-19, they do not test, but send them home to self-quarantine.”
For a week, the Star-Telegram asked individual hospitals specific questions about staffing, equipment availability and how they plan to treat a surge of patients but details have been scarce.
This story was originally published April 3, 2020 at 3:00 PM.
