COVID-19 Nurse Survey Report - 10/20

Throughout 2020, the valor of nurses and doctors caring for coronavirus victims has been recognized. Many articles have highlighted PPE and medical equipment shortages, as well as, the long working hours and stress endured by health care personnel (HCP). This page gives voice to the frontline experience of nurses during this difficult time.

COVID-19 healthcare casualties 10/8/20

• 10/8/2020 Kaiser Health News Many People of Color, Immigrants Among Over 1,000 US Health Workers Lost to COVID
  
• 9/25/2020 CDC - Morbidity and Mortality Weekly Report (MMWR), Update: Characteristics of Health Care Personnel with COVID-19 — As of July 16, 2020, 100,570 COVID-19 cases in health care personnel (HCP) and 641 deaths among HCP with COVID-19 were reported in the United States.

Nursing Surveys During COVID-19

• Mar 11, 2020, New York State Nurses Association reported , 47% of respondents said that their facility’s plan to protect employees during the coronavirus/COVID-19 epidemic was inadequate, 36% said COVID-19 screening was inadequate, and 36% said that their access to N95 respirators was inadequate. https://www.nysna.org/blog/2020/03/13/our-members-are-caring-patients-amidst-covid-19-pandemic#.X5ILtUJKiDs
• April 3, 2020, to April 29, 2020, and during October 2020, RnCeus.com asked nurses throughout the U.S. about their access to appropriate protective gear and ventilators as well as adequate staffing. A total of 100 healthcare professionals responded to the April survey, another 100 responded in October. Respondents were 87% RNs, 7% were LPNs, and 6% were student nurses or technicians. The participants identified 27 distinct environments: Medical/surgical units (26%), ICUs (18%), and Emergency Departments (9%) being most prominent.

  The following table compares results from the two RnCeus.com surveys asking nurses to describe the availability of appropriate PPE in the work place during April and October of 2020. There has been some improvement in the availability of PPEs from  April to October with some inadequacies remaining.

The nurses reported improved numbers of personal protective equipment in October. However, N95 masks still are an issue, with 16% describing them as scarce and 4% not available in October. There are reports of surgical masks, gowns, and gloves being scarce or not available in October.

In the October survey, RnCeus.com included the following survey questions because of nurses reported increased stress and work safety concerns.

1.	You requested and were denied testing for SARS-CoV-2 under the following circumstances (check all that apply)
•	You had signs or symptoms consistent with COVID-19.	2%
•	You were asymptomatic with known or suspected exposure to SARS-CoV-2.	8%
•	You were asymptomatic, without known or suspected exposure to SARS-CoV-2, and sought early detection to protect a vulnerable population, e.g., nursing home, immunocompromised, etc.	7%
•	You have been diagnosed with SARS-CoV-2 infection and wanted to determine if you were no longer contagious.	0%
•	You have never requested SARS-CoV-2 testing.	83%
2.	Rate your work environment for COVID-19 safety on a 1 ★ to 5 ★ scale. Responses, ★= 4%, ★★=7%, ★★★=23%, ★★★★=24%, ★★★★★=42%	Avg.= 3.9★s
	Respondent Comments: We have had patients come to preop that were not tested for COVID and placed in a non-closed non-air pressurized curtained room. There has also been confusion about using aerosol breathing treatments before surgery. The surgical staff are reusing n95s.
3.	Indicate your current work stress level. (Scale 0-100).	Avg. 59
4.	Indicate your current home stress level. (Scale 0-100)	Avg. 49
5.	Indicate your preference to keep or change the current Federal Administration in the 2020 election.  Change    44%  Undecided 37%  Keep as is 19%
	Other write in comments Presidential recommendation to take hydroxychloroquine puts health professionals in the role of political operatives when patients ask about it. We took an oath to do no harm. Tax dollars and staff time are spent on political initiatives while patients cannot get needed treatments, such as biopsies, heart catheterization, and so forth. I feel completely abandoned and betrayed by the CDC, an organization which, I once esteemed greatly. Trump has been a disaster Trump 2020 We need an honorable president Vote him out The current administration is attempting to cut healthcare to 20 million people in the middle of a pandemic. No way can I support that. Two participants felt the questions were irrelevant to continuing education.
	Additional Nursing Concerns for themselves, their families, and staff Concerned that no vaccine is available at this time. I do not want to bring this virus home to my family. Need more testing for all staff Seeing firsthand how sick and lonely these patients are is depressing!

 

• The July 24-August 14, American Nurses Association survey of 20,000 nurses revealed PPEs still are in inadequate supply, with nurses being required to reuse single-use PPEs. Some are reusing PPEs for up to 5 days.
• July, 2020 survey of nearly 10,000 U.S. nurses conducted by the American Nurses Foundation found 50% of nurses feel overwhelmed, with 30% saying they experience depression and 73% having sleep difficulties. https://www.nursingworld.org/news/newsreleases/2020/new-pulse-on-the-nations-nurses-survey-series-half-of-frontline-nurses-emotionally-overwhelmed-by-covid-19/

Category	May	August
Required to reuse N95 masks	62%	68% (+6%)
Reusing masks for 5+ days	43%	58% (+15%)
Feel unsafe reusing masks	59%	62% (+3%)
Feeling unsafe using decontaminated masks	53%	55% (+2%)
https://www.nursingworld.org/~4a558d/globalassets/covid19/ana-ppe-survey-one-pager---final.pdf

Historic Commentary - The New England Journal of Medicine is the world's top medical journal has avoided any political commentary for its 200-year existence, until now. The NEJM editors published an editorial entitled, Dying in a Leadership Vacuum about how the U.S. leaders have taken a crisis and turned it into a tragedy. You can read the article in its entirety here. https://www.nejm.org/doi/full/10.1056/NEJMe2029812?query=featured_home

Here is one significant paragraph;

Anyone else who recklessly squandered lives and money in this way would be suffering legal consequences. Our leaders have claimed mainly immunity for their actions. But this election gives us the power to render judgment. Reasonable people will certainly disagree about the many political positions taken by candidates. But the truth is neither liberal nor conservative. When it comes to responding to the largest public health crisis of our time, our current political leaders have demonstrated that they are dangerously incompetent. We should not abet them and enable thousands more American deaths by allowing them to keep their jobs.

Summary

Nurses are concerned about the continued lack of adequate PPE. Being front line responders, they know better than most about the communicability and seriousness of COVID-19. They are worried they may not only contract the disease but may bring it home to their family. They are also forced to use masks for an entire shift or up to five days and then recycle them for later sanitization. All these approaches are contrary to the rules and regulations that have been standard practice.

Nurses are also concerned that testing of the staff for the virus is inadequate.

Nurses find it heart wrenching to see patients be so ill and lonely without the comfort of friends and family members.

These preliminary surveys indicate a need for more research on how this pandemic affects nurses in practice. More data can identify what needs to be done to protect nurses from becoming ill from the coronavirus. More data from the experiences of nurses caring for these patients can improve outcomes for patients.

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