Safety in a Time of PPE Shortages
Working through a pandemic isn’t the most fun thing in the world. For some of us, it’s been the most terrifying months of our working lives, caring for active Covid-19 patients while having limited protective equipment. Re-using N95 masks, sometimes until they literally fell apart. Working without gowns or shoe covers, because none were to be had, or because they were being rationed.
So…how do you maintain safety in a time of major PPE shortages? How to think and act in a way that maintains safety? How do you handle this unprecedented situation?
What is safety? Acceptable risk versus recklessness
Let’s start by talking about safety, what it is and what it is not.
Working in healthcare is inherently dangerous. We use dangerous equipment every day. We administer drugs that, if accidentally ingested, injected, or inhaled, just might kill us or cause serious harm. Nurses are among the professions at the greatest risk for workplace violence, back injuries, and burnout, not to mention biological hazards. Nursing is not safe.
However, although nursing is inherently unsafe, we must distinguish between acceptable risk and recklessness. Acceptable risk is the level of risk that must be accepted to effectively perform a job. Recklessness is intentionally placing oneself or others into positions where mental or bodily harm is highly likely to happen, when this would not be necessary for the effective performance of the job.
In nursing, then, there are some risks that are inherent to the profession, and we accept them, work to mitigate them, and generally don’t worry about it. There are, however, some risks that are considered unethical to ask a nurse to accept as part of the job.
Does working without adequate PPE fall into that category? I am not prepared to say that it does, but for many nurses, the answer would be an unequivocal Yes!
This means, then, that each person must determine what level of risk they are prepared to accept as part of the job, and what is unacceptable. Having decided that, the rest of the article is devoted to various ways in which you can deal with the reality of working in an environment with limited personal protective equipment available.
Your options
Leave. Or work with it.
That’s it, basically.
And for some of you, leaving is going to be your best option and that’s okay. If the lack of PPE in your workplace leaves you feeling uncared for, stressed out, and angry, and there is no response to your concerns, perhaps you need to leave for your sanity’s sake. If you choose to do so, I encourage you to leave without burning all bridges, but be open about why you left. (Obviously, there are times when there is simple no protective gear to be had anywhere and patients are dying. In this sort of situation, leaving is not a good option; it is tantamount to patient abandonment. But if you have been or are working in this sort of environment, I am so sorry. No one ought to have to face that sort of work environment.)
For those who choose to stay, which is most of us, there are many ways to work with it. Let’s take a look at some of them.
Create a healthy workplace culture
The changes that we need to see start with the people we work with. Actually, it starts with me. With you. With the individual. It starts with recognizing that we are all on the same team. We are not fighting against each other, trying to get “our share” of the limited resources. No, we are working together to make sure that everyone has what they need.
Encouraging and honoring each other is key. If you are in a leadership role, communicate to your team that you trust and appreciate them. Look for the things they are doing right and recognize that. If you are a staff nurse, do the same, and don’t forget to communicate that to your leadership people as well.
In this culture of trust and honor that you are working to build, you will be better heard when you speak up about unsafe working conditions. Do speak up! And do it in the context of communicating trust, respect, and a belief that they will do what needs to be done to keep the team safe. Repeat the message, up the ladder as far as you need to go.
Sanitize
Clean hands are still your first line of defense. And even if you run out of sanitizing wipes, most equipment can still be cleaned with a soapy washcloth. Where you cannot prevent exposure with a barrier, think of creative ways to clean. And don’t forget the importance of intact skin. Non-allergenic moisturizers should accompany every hand sanitizing station, and people should be encouraged to use them.
Get healthy
A quick look at the CDC’s list of conditions at high risk for severe COVID and morbidity shows that most of the high-risk conditions are lifestyle diseases. This has some stunning implications in multiple directions, including what you can do to decrease your risk.
Obesity and severe obesity make that list (being overweight is on the “increased risk” list, not the “high risk” list). In practical terms, this means that weight loss is one of the best things you can do to decrease your risk of severe illness in this pandemic.
Diabetes mellitus (type two diabetes) is also a high-risk comorbidity. So, while you are losing weight, you are also decreasing your risk for diabetes. Both weight loss and blood sugar control are easiest with a nutrition plan that is filled with vegetables and other whole foods. This in turn leads to better overall health and therefore a drastic decrease in your risk for developing severe illness if infected with SARS-CoV-2.
In summary
In summary, health is your best defense against illness. Healthy workplace culture, creativity, and healthy bodies, together, provide a strong game plan for working in an environment without sufficient protective equipment.