April/October 2020 COVID-19 Nurses Report


During this COVID-19 pandemic in the U.S., there are multiple reports about nurses' and doctors' bravery in taking care of patients who are ill with the coronavirus. These reports also describe long working hours and stress for hospital staff and shortages of N95 masks, surgical masks, gowns, and ventilators.

COVID data 10/19/20

In a survey of 3,300 nurses in New York reported by the New York State Nurses' Association on April 1, 2020, 64% of the nurses said they have inadequate protective personal equipment, and 72% said they had been exposed to COVID-19.https://www.nursingworld.org/~4a558d/globalassets/covid19/ana-ppe-survey-one-pager---final.pdf

In May 2020, the National Nurses United surveyed 23,000 nurses. Their results show more than 100 nurses have died from COVID-19. Here are some additional results:

Results from the July 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/news-releases/2020/new-pulse-on-the-nations-nurses-survey-series-half-of-frontline-nurses-emotionally-overwhelmed-by-covid-19/

From April 3, 2020, to April 29, 2020, and during October 2020, RnCeus Interactive asked nurses throughout the U.S. about the accessibility to protective gear and ventilators as well as adequate staffing. A total of 100 healthcare professionals responded to the survey in April, with 100 responding in October. 87% of the participants were RNs, 7% were LPNs, and 6% were student nurses or technicians. The participants worked in 27 distinct areas with 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 availablity 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.

  Plenty Adequate Scarce None N/A Total (n)
  April Oct April Oct April Oct April Oct   April Oct
N95
masks
5% 18% 45% 55% 22% 16% 11% 4% 7% 100 (n) 100 (n)
Surgical
Masks
15% 35% 46% 52% 23% 16% 2% 1% 5%    
Protective
gowns
7% 26% 51% 52% 19% 12% 4% 2% 8%    
Ventilators 9%   33%   6%   3%   49%    
Adequate
Staffing
30%   50%   7%   0%   13%    
Eye
Protection
  25%   52%   12%   2% 9%    
Gloves   52%   40%   3%   0% 5%    
* N.A. – nurses not in clinical areas – green indicates combined groups

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.

The American Nurses Association survey of 20,000 nurses conducted July 24-August 14 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.

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% (+13%)

Feeling unsafe using

decontaminated masks


53%


55% (+2%)

https://www.nursingworld.org/~4a558d/globalassets/covid19/ana-ppe-survey-one-pager---final.pdf

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%

3. Indicate your current work stress level. (Scale 0-100).  Avg. response was 59

4. Indicate your current home stress level. (Scale 0-100)  Avg. response was 49

The New England Journal of Medicine is the world's top medical journal and has avoided any political commentary for its 200-year existence up until now because of our dire circumstances. The 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.

Another question from the RnCeus.com October Survey sought nurses preference regarding the outcome for the Federal administration in the 2020 election.

Indicate your preference to keep or change the current Federal Administration in the 2020 election.
 Change = 44.00%  Undecided = 37%  Keep as is = 19%

Comments of RnCeus survey respondents offered in no particular order.

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.

Trump has been a disaster

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 did not see the questions are relevant to continuing education

Nurses' 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!

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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