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Told She Can't Wear Her Own Mask, Nurse Walks Off Job

<ѻý class="mpt-content-deck">— Are hospitals more concerned about image than their workers' health?
Last Updated April 3, 2020
MedpageToday
Photo of a N95 mask

A nurse said she quit her job at an unidentified Chicago-area hospital this week when she was assigned to a COVID-19 unit and was told she couldn't wear her own mask.

Imaris Vera, RN, shared her story in a on Tuesday.

When she arrived at work this week, Vera was surprised when she noticed that none of the other nurses were wearing masks, even surgical ones, in the hallways while giving their reports. Vera, who had brought her own N95 mask to work, said she approached her manager to explain why she felt she needed the protection.

"I told my manager 'I understand we're short on supplies, but let me protect myself. Let me feel safe. I have family that I have to come home to,'" she said through tears in the Instagram video.

In a written post accompanying the video, Vera said the charge nurse had been passing out single N95 masks to nurses in brown paper bags, where they would be stored, and reused throughout the day.

Vera said she asked her manager about "possible contamination" from having to reuse the masks.

The manager said that the hospital was following the CDC's guidelines and that N95s are only needed when a COVID patient is given an aerosolizing treatment, such as a ventilator, nasal cannula, or nebulizer.

But Vera continued to press her manager, saying that 90% of their patients are intubated and positive for COVID-19. She also reminded her manager that some nurses who had worn only surgical masks on their units are currently intubated and "fighting for their lives."

"Can I please just wear my own N95 mask?" Vera recalled asking her manager one final time through tears and fogged glasses.

Her manager said it wouldn't be allowed.

"So I gave report, & left," Vera wrote.

Another Chicago-based nurse, Laurie Mazurkiewicz, RN, said she was fired from Northwestern Memorial Hospital on March 26, after warning colleagues that the hospital-provided masks were "less safe and less effective" than N95 respirators. Mazurkiewicz, who is suing the hospital, said staff were prohibited from wearing N95s on hospital grounds, according to .

Before quitting her job, Vera may have been employed by Northwestern Medicine's Central DuPage Hospital in Winfield, Illinois.

A spokesperson for Northwestern said he could not comment on an individual's employment history and that the hospital could not answer any questions regarding Mazurkiewicz due to "pending litigation."

"What I can tell you is the health and safety of our employees, physicians, and patients is our highest priority. Since the outbreak of COVID-19, we have gone to extraordinary lengths to maintain an environment that protects everyone. We continue to follow the recommendations of the CDC for personal protection equipment and have been fortunate to date to secure sufficient personal protective equipment to do so. We update our guidance daily for caring for COVID-19 patients as it continues to evolve. We provide multiple channels for communication including a dedicated hot line so that our staff can ask questions and receive support. We are incredibly proud of the extraordinary work happening each day in our health system to care for our patients, our community and each other," the spokeperson said in an email.

In Texas, Henry Nikicicz, MD, a 60-year-old anesthesiologist at University Medical Center of El Paso who has asthma and hypertension, was removed from the schedule -- essentially suspended from his work without pay -- after refusing to take off his respirator in the hospital's hallways, according to

The hospital confirmed these actions, then later told The Times that Nikicicz had been reinstated and would be allowed to wear a surgical mask around the facility and an N95 during procedures.

Similarly, Sarah Iosifescu, an emergency medicine resident at Mount Sinai Morningside and West, in New York City, and a member of the (CIR), said during a that she usually wears a surgical mask during flu season. When COVID-19 cases began showing up in New York, she chose to wear an N95 and was explicitly told not to.

She emailed the hospital's leadership.

"I have a 7-month old child. I have asthma. I work in the emergency department. I don't feel safe," Iosifescu wrote in the email.

The hospital's response was that a surgical mask would suffice, she said. Iosifescu said she's continuing to wear her N95.

The problem isn't just the hospital's leadership, it's the CDC's guidance, she said. Hospitals can and do turn to CDC guidelines to back up their decisions, and in recent weeks, the agency has said that can be used in desperate situations, Iosifescu noted.

"It's shocking to see a government organization that basically doesn't seem to be using evidence at this point, but is completely reacting to supply issues," Iosifescu said. "I think that there's a big discrepancy ... between what we feel safe having" and what the CDC will allow.

Hospitals have also tried to silence clinicians who express concerns about their safety on social media and other platforms.

During Tuesday's webcast, Susan Naranjo, director of public affairs for CIR, said some residents have been asked to delete Twitter messages and even GoFundMe accounts they created to address personal protective equipment (PPE) shortages.

Hospitals could be working with physicians to better understand the problems with PPE and to identify solutions, said Linda Alvarez, MD, CIR's secretary-treasurer. "They instead are either shutting us out, threatening us, or just trying to keep our residents quiet ... because they are so concerned about the public image."

On Tuesday, the advocating for hospital staff to be allowed to wear respirators and other face masks brought from home, particularly in cases where healthcare organizations "cannot routinely provide access to protective equipment that is commensurate with the risk to which they are exposed."

The commission acknowledged that hospitals must conserve PPE -- including face masks, N95s, gowns, and gloves -- and when shortages do occur, hospitals must direct limited equipment to those clinicians performing high-risk procedures.

At the same time, however, the commission noted that the amount of protection provided by these privately-owned masks and respirators "is uncertain," however, "the balance of evidence suggests that it is positive," the Joint Commission noted.

Patrice Harris, MD, president of the American Medical Association, .

"The people working round the clock to combat this virus should not be penalized or punished for taking precautions necessary to protect themselves, their patients, and their families from the spread of COVID-19," Harris wrote.

Harris said the AMA had sent a letter to President Trump this week repeating its concerns over PPE shortages and "urging the federal government to lead a coordinated effort to make sure facilities capable of manufacturing PPE are doing so at the maximum possible capacity."

On Friday, the president in order to force several companies to step up production of critical PPE, according to CNN.

And on Tuesday, it was reported that the CDC is considering a recommendation that when leaving their homes. Such a move could further squeeze supplies for frontline clinicians.