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Healthcare Workers Prohibited From Using Their Own PPE Supply

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A Nurse’s Hospital Wouldn’t Let Her Wear an N95 Mask. She Hasn’t Been Back to Work in Weeks.

by Marshall Allen, ProPublica

On March 31, Florida emergency room nurse Naomi Moya took a big risk. Though her hospital didn’t allow staff to wear N95 masks when treating patients who were not diagnosed with the coronavirus, Moya brought one from home and put it on to protect herself.

A supervisor noticed the N95 right away and ordered her to remove it.

“I have my own supply,” Moya recalled saying. “It’s protection for me and you and my coworkers and the community and my family when I come home.”

The impasse was polite, but both sides held firm. Thus, at the height of a pandemic, when there’s a shortage of nurses, Moya stepped away. She and the hospital agreed that she would go on unpaid leave.

Clinicians across the country are weighing similar choices when their hospitals lack the protective gear they believe they need to care for patients. A New Jersey doctor said she left her urgent care position because of safety concerns. “This is an unstable situation with a novel coronavirus with a company that could be protective but is not being adequately protective,” she said.

In North Carolina, Angela Allen said she watched warily as the coronavirus spread, waiting for her hospital to do something to protect the staff. Administrators considered the psychiatric unit where she works as a nurse “low risk,” Allen said. By mid-March, she said she asked for the staff to be tested for the coronavirus, so they could also be sure to avoid infecting the patients, and her manager said that wasn’t necessary. “If we can’t rule out that we are carriers then we have to assume that we are,” Allen said. “And if you’re not giving us the right equipment to at least protect our patients, then I can’t do my job.”

Allen said she didn’t quit but took a leave of absence and hasn’t been back since March 19.

ProPublica spoke to 15 doctors and nurses from New Jersey to California to North and South Carolina who said their administrators have normalized poor infection control practices — putting them at risk and likely spreading the virus. A study published Tuesdayby the Centers for Disease Control and Prevention found that health care workers are getting infected at high rates, which also makes them a source of transmission.

ProPublica and others have reported on staff who were suspended or fired for bringing their own gowns and masks and other protective equipment, or speaking up about it. But clinicians are saying there’s an even deeper problem. The conditions are so unsafe they’re being forced to choose between their livelihoods and risking their lives — and that means some are walking away.

Moya works at AdventHealth Heart of Florida, a 193-bed facility in Davenport, near Orlando.

AdventHealth did not respond to ProPublica’s questions about Moya. But it said in a statement that it does not have a shortage of N95 masks or other gear. Its statement said staff are not allowed to wear masks unless they are issued by the hospital, to ensure they are medical-grade and properly fitted. The N95 masks are provided to staff who care for suspected or known COVID-19 patients, the statement said.

Lowering Infection Control Standards

In the upside-down world of American health care in the era of coronavirus, a nurse in an N95 is often considered both safe and defiant.

N95 masks are superior to surgical masks for coronavirus protection, but like many hospitals, AdventHealth Heart of Florida has restricted their use.

But the policy doesn’t account for the spread of disease by people who have not yet tested positive or who aren’t showing symptoms, Moya knew.

“We know the disease process,” Moya said. “I don’t know who may be infected or not.”

The United States was caught so unprepared for the pandemic that hospitals don’t have enough N95 masks and other important gear. So facilities have been lowering their infection control standards — and demanding compliance from staffers.

Moya had been prepared. She purchased her own N95 masks, and on that final day of March she put one on under the surgical mask AdventHealth had given her.

When she was told to remove it, she got called to the office of the emergency department director, she said, who told her if she wore the N95 other staff would also want one. Also, the hospital didn’t want patients to feel scared by seeing everyone in a mask, Moya recalled the director saying.

Moya is known for her calm demeanor, according to a nurse who works with her. She speaks English, Spanish and American Sign Language and is nonplussed by even the most aggressive patients.

The problem isn’t just a lack of supplies, Moya and other clinicians who spoke to ProPublica said. The administrators are not acknowledging the hazards, causing a breakdown of trust.

“They know this is real and that people are dying,” Moya said of her administration. “Would you send a firefighter into a burning building without appropriate gear?”

The Joint Commission, which establishes quality and safety standards for hospitals, accredits AdventHealth. It put out a statement on March 31 — the same day Moya went on leave — supporting clinicians bringing their own face masks, including N95s, to work. “It is better to allow staff the opportunity to enhance their protection, even if the degree of that increased protection is uncertain,” the statement said.

Moya said she went on unpaid leave at great cost, having to defer her mortgage and car payments. She wants to return to her job. AdventHealth is a large organization that operates in nine states. It should be aware of the Joint Commission’s recommendations, she said. It’s also a Christian organization that pledges to “extend the healing ministry of Christ,” she said. So it should do better at the command to “love thy neighbor,” she said, when it comes to protecting its staff and patients.

Clinicians Getting Silenced

Most of the clinicians who spoke to ProPublica would not speak on the record because they feared retaliation. They said their administrators have been changing policies to try and adapt to the pandemic. But the rules are often not consistent with what’s known about the virus.

A nurse in northern New Jersey said her hospital is reassigning staff to units for which they may not have adequate training. One supervisor suggested that refusing an assignment could result in a complaint against the nurse’s license, the nurse said. “My problem is they feel like they own us or something,” the nurse said.

Kate McLaughlin, a nurse who runs the advocacy organization NJ Safe Ratios, said she has heard of hospitals threatening to file complaints against nurses’ licenses if they quit or refuse to take assignments they consider unsafe. The intimidation “will make nurses reconsider whether they should come back to the bedside,” she said.

The widespread nature of retaliation against health care workers who complain about the lack of personal protective equipment led to the creation of Beacon, a nonprofit advocacy organization in Massachusetts. Dr. Sejal Hathi, a co-founder of the group and a resident at Massachusetts General Hospital, said Beacon sent a letter Thursday to hospitals that had suspended or fired workers, demanding fair treatment and threatening legal action if they didn’t respect the rights of their staff. Health care workers are being forced to choose “between professional duty and personal safety,” Hathi said. “Those are competing ethical and existential obligations.”

Allen, the North Carolina nurse, works in a unit that’s part of the emergency room at Mission Hospital in Asheville. She has launched a website, The Unmasked RN, to give voice to nurses around the country who believe they are being muzzled. “We have executives making medical and scientific decisions without consulting the people who went to school for this,” she said.

April Creamer, a behavioral health technician who works with Allen, said she is also thinking about leaving Mission Health because of the conditions. She’s been told the hospital has N95 masks, but the management doesn’t think they’re necessary in the psychiatric unit, she said. “For a while they were not providing us with any protection,” Creamer said. “They were ignoring the fact that COVID is a real thing.”

Mission Health spokeswoman Nancy Lindell said in a statement that “all our departments are appropriately equipped with hygiene supplies for both our staff and patients.” She did not address the specific concerns raised by Allen and Creamer.

Many hospital executives say publicly they have the gear to keep their staff safe. But then their workers say they are not getting what they need.

Mark O’Halla, president and CEO of Prisma Health in South Carolina, gave a reassuring message in an April 8 video. “We have plenty of personal protective equipment to cover all of our employees and team members across the system,” he said.

But two Prisma Health nurses who spoke to ProPublica said that has not been the case. Both the nurses said they have not been given N95 masks for use throughout their shifts and that staff have not been allowed to bring them from home. They said nurses have resigned because of the lack of protective equipment. Others were sent home with threats that they would be fired. Still others are looking for other jobs, the nurses said.

Prisma Health told ProPublica in a statement that it “is able to provide the appropriate personal protective equipment for treating suspected or confirmed COVID-19 patients.” Prisma has “sufficient stock of surgical masks” which are “deemed appropriate for COVID-19 patient contact excluding aerosol generating procedures,” the statement said.

Rick Boothman, who retired as chief risk officer for the University of Michigan Health System in 2018, said the coronavirus crisis is cracking open the fissures that sometimes exist between hospital administrators and clinicians. Health care providers are remarkably resilient, he said, and that’s allowed administrators to be too cavalier with them. “It’s unethical and immoral to shove somebody into harm’s way when that’s not what they signed up for,” Boothman said.

The administrators should be up front with the clinicians and tell them that they’re sorry, but the resources are limited and the challenge is at the doorstep, Boothman said. The leaders should tell the staff that they see that the safety situation is not optimal, he said, but that nobody will be pushed into an avoidably dangerous situation. Such an approach would build trust and be well received by doctors and nurses, he said.

“I think you’d find an amazing number of people who would step up and not complain,” Boothman said.

ProPublica is an independent, nonprofit newsroom that produces investigative journalism with moral force. We dig deep into important issues, shining a light on abuses of power and betrayals of public trust. Follow on Twitter at @ProPublica 

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County Hospitals Receive 300 iPads for Patients to See Family

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LOS ANGELES – 300 iPads have been donated to Los Angeles County hospitals to facilitate patient-family communication during the COVID-19 pandemic. The gift is through a partnership with the Annenberg Foundation, Brilliant Corners, and the Los Angeles County Center for Strategic Partnerships.

“The engagement of loved ones during hospitalization has been shown to improve clinical outcomes,” said DHS Director, Dr. Christina Ghaly. “Clinical staff identified a role for virtual visiting through technology in order to facilitate this family involvement. The generous donations by the Annenberg Foundation and MobileDemand will help support this critical element of our patients’ care.” 

Due to the COVID-19 pandemic, patient visitation by family and loved ones is limited at facilities in order to prevent exposure and the spread of disease. While there are some exceptions, such as the birth of a child or death of a patient, visitation is not permitted for the vast majority of patients and not allowed at all for COVID-19 patients. 

The donation provides 300 iPads to ensure patients and their families are able to connect, despite restrictions in access to the hospital. A second donation, by MobileDemand, provides rugged, protective healthcare iPad cases to protect against damage and loss. The rugged case also has an adjustable easel attached, providing effortless viewing for patients who are too weak to hold a tablet. Additionally, it frees health care staff from having to hold the device for patients.

“This is a wonderful example of how philanthropic organizations, nonprofits, government, and businesses can collaborate and meet an immediate need in our community,” said Wallis Annenberg, Chairman, President and CEO of the Annenberg Foundation. “Being able to offer an opportunity for comfort and connection to those suffering and to alleviate some of the stress from our frontline caregivers is of utmost importance.”

While social distancing has been successful in flattening the curve of the COVID-19 surge in Los Angeles County, it is anticipated that it will continue for several months. With this gift, physicians and nurses will be able to place an iPad in the room of COVID and other critically-ill patients for the duration of the admission and reduce potential exposure and use of personal protective equipment going in and out of the room. Having a stationary iPad helps relieve medical staff who would otherwise have to hold the phone for a patient or search for the person’s personal phone. It also will allow patients who do not have a personal mobile device to communicate and “visit” with their family.

The Los Angeles County Department of Health Services (DHS) is the second largest municipal health system in the nation. Through its integrated system of 26 health centers and four hospitals – LAC+USC Medical Center, Harbor-UCLA Medical Center, Olive View-UCLA Medical Center, and Rancho Los Amigos National Rehabilitation Center – and expanded network of community partner clinics, DHS annually provides direct care for 600,000 unique patients, employs over 22,000 staff, and has an annual budget of over $6 billion.

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Processions to Cedars Will Salute Healthcare Workers on National Nurses Day

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The coronavirus (COVID-19) outbreak is putting a strain on essential workers such as first responders and healthcare workers who are on the frontlines in the effort to care for coronavirus patients so the City of West Hollywood is setting out to recognize them in a special way on May 6.

National Nurses Day is a day of recognition to celebrate and honor the contributions that nurses have made and continue to make in our communities and throughout the nation. National Nurses Day is celebrated annually on May 6, which marks the beginning of National Nurses Week, a week-long celebration to raise awareness of the value of nursing and educate the public on the role nurses play in meeting the healthcare needs of Americans. National Nurses Week concludes on May 12, the birthday of Florence Nightingale, or as she was more commonly known, “The Lady of the Lamp” and founder of modern nursing.

The West Hollywood Sheriff’s Station of the Los Angeles County Sheriff’s Department is coordinating two motorcades to honor healthcare workers on Wednesday, May 6, 2020, which is nationally recognized as National Nurses Day. The processions will begin at 9:45 a.m. and at 7:15 p.m. on Santa Monica Boulevard at La Cienega Boulevard and the motorcades will head west and then travel southbound on N. San Vicente Boulevard passing multiple medical center locations in West Hollywood en route to a destination outside the emergency room entrance of Cedars-Sinai Medical Center on Gracie Allen Drive. First responders will briefly stop, exit their vehicles and applaud healthcare workers while wearing face coverings and practicing appropriate social distancing.

“Our nurses and healthcare workers are nothing short of heroes,” said City of West Hollywood Mayor Pro Tempore Lindsey P. Horvath. “The coronavirus pandemic has reminded us just how critical their work is to our everyday health and safety. This National Nurses Day means so much more to all of us — the City of West Hollywood and our LA County Sheriff’s West Hollywood Station and LA County Fire Stations; the City of Beverly Hills and Beverly Hills Police and Fire; the City of Los Angeles and LAPD and LAFD; the California Highway Patrol, and more — and we will honor these heroes in a special way for the care that they provide, which often goes unseen and unrecognized, in carrying us through this crisis.”

“As the worldwide response to the novel coronavirus (COVID-19) continues, the critical importance of nurses in our society has been brought sharply into focus,” said City of West Hollywood Councilmember John Heilman. “More often than not, when a coronavirus patient ends up in a hospital, it is the nurses at the frontlines who are responsible for their care and treatment, putting themselves at risk in the process. We can’t say ‘thank you’ strongly enough.”

The City of West Hollywood encourages residents and community members to participate during this day of celebration while still adhering to LA County Safer At Home Orders and social distancing requirements. Suggested forms of participation include amplifying posts on social media channels, making yard or window signs and banners, participating in a coordinated daily applause or shout out for nurses and healthcare workers, and donating to organizations that are addressing the emerging needs of nurses and healthcare workers during the coronavirus (COVID-19) health pandemic.

According to the American Nursing Association, nursing is the nation’s largest healthcare profession, with more than four million registered nurses in the United States. Registered nurses comprise one of the largest segments of the U.S. workforce and are the primary providers of hospital patient care, delivering most of the nation’s long-term care. In nursing, where workers are on the front lines of patient interactions, women make up more than 85 percent of the workforce. This year, with the onset of coronavirus, nurses have stepped up and shown the incredible impact they have on our healthcare system. It is more important than ever that we recognize National Nurses Day and celebrate the significance of nurses every day.

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Texas & California Wet Markets Show Full Extent of Vile Conditions

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Texas & California Wet Markets Show Full Extent of Vile Conditions

(TMZ) — It’s becoming more clear by the day that wet markets are NOT just a China problem — it’s an American problem too … just take a look at these latest clips from Texas and California.

TMZ has gotten a hold of even more graphic videos of two different live animal shops in TX and CA — where people pick out the animal, have it slaughtered on the spot and then sold to them right then and there — and you see the mixed-in livestock runs the gamut.

There are pigs in pens, goats and sheep hoarded together … and, of course, as we’ve seen in New York and elsewhere — chicken and rabbits cooped up in cages — all in the same area within earshot of each other, and all getting butchered.

Ya got pigs hanging from hooks out in the open, chicken beaks, feathers and guts all over the floor and in an exposed trash can — this while customers (including kids) come in and browse the freezer for whatever cuts of meat they want. It’s downright dirty and gross.

As we’ve been told by the experts, these one-stop-shop slaughterhouses/storefronts can be breeding grounds for disease — including new viruses, like COVID-19, which supposedly got started at a wet market in China.

We already know of lawmakers in Cali and New York working to get these things shut down, but it’s pretty apparent there needs to be federal legislation rolled out to address this. Can’t call the kettle black when we’re swimming in the freakin’ pot.

Tune in to TMZ on TV weekdays Monday through Friday (check syndicated/local listings)

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