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Laurie Mason has been a nurse for nearly 30 years, working in hospitals through some of the busiest flu seasons. But the coronavirus outbreak is something entirely new.
“This is the most serious thing I’ve been through personally,” said Mason, who works in an ambulatory surgery center for BayCare in St. Petersburg.
While health care workers in hospitals across the Tampa Bay area are preparing to identify, diagnose and treat potential patients with coronavirus, they’re also hoping to protect themselves from exposure. Gov. Ron DeSantis said this week the state anticipates more cases in Florida after four people tested positive in Hillsborough, Manatee and Santa Rosa counties.
The Florida Department of Health is monitoring 248 people in the state with possible exposure to the virus, known technically as COVID-19. That’s down from more than 700 earlier in the week. There are 69 cases with pending test results in Florida right now.
National Nurses United, a large and fast-growing union with 150,000 members, said 80 nurses across the country have been quarantined due to COVID-19 exposure. Some health care workers, like nurses and a physician from Doctors Hospital in Sarasota, are being quarantined after a man in his 60s was diagnosed and is being treated there.
“Registered nurses face the unknown every single day at our facilities, and they are there 24/7,” said Bonnie Castillo, a registered nurse in California and executive director of the union. “In many clinics and hospitals, nurses do not have the necessary protective equipment or the education and training."
The union released survey results Thursday from more than 6,500 working nurses across the country which showed they felt unprepared to properly handle the coronavirus outbreak. Only 44 percent said they received education about COVID-19 from their employer and 23 percent responded that they weren’t sure if their employer had a plan in place.
“One patient can sideline so many health workers at once,” Castillo said. "And once we’re quarantined, we’re not only prevented from caring for that COVID-19 patient, but also the cancer patients, the cardiac patients and the premature babies.”
The union, at a news conference, called for better protections for nurses in American hospitals, including improved screening and testing capacity from the U.S. Centers for Disease Control and Prevention, and emergency assistance from the Occupational Safety and Health Administration to protect nurses exposed to infectious disease.
Cathy Kennedy is a registered nurse who works in the neonatal intensive care unit at Kaiser Permanente Hospital, where one California patient has died from coronavirus. She said nurses are being given contradictory information.
“Imagine working in a negative pressure room for eight hours, wondering if anyone will get you the resources you need to care for this contagious patient or come to relieve you," she said. "That is the reality that nurses are facing.”
Bayfront Health St. Petersburg, which operates a Level 2 trauma center in St. Petersburg and a freestanding emergency department in Pinellas Park, has been closely following the CDC guidelines, said Dr. Traci Ryan, the medical director in Pinellas Park.
“It’s a moving target,” she said. “Our goal is prevention. We have to keep our health care workers safe in order to prevent spread in the community.”
Clinical teams are meeting daily to discuss updates from state and federal agencies, which change quickly and often, Ryan said. But the hospital system has been working for more than a month to get ready.
“We’ve been steadily preparing for this since the news was coming out of China,” Ryan said.
Preparations include making sure protective gear — gowns, gloves, goggles and masks — is available to all clinical staff, said Dr. Jeremy Kirtz, emergency room medial director for AdventHealth Carrollwood and AdventHeath Westchase hospitals.
If patients are suspected to be contagious, and they meet the CDC criteria for potential coronavirus testing, they are put into an isolation room, he said.
“All non-essential staff who don’t need to physically examine the patient can communicate with them through a portable phone,” Kirtz said. “They don’t have to go in the room.”
There are three areas of main concern when it comes to preparing for emergency management, said Jay Wolfson, a professor at the University of South Florida’s College of Public Health and an expert on health care policy. They are inventory and supply management, staffing appropriately to avoid burnout, and keeping all staff and the community up to date on current outbreak information.
“Given the current shortage of masks and gowns, hospitals are working aggressively with their supply companies to ensure backup inventories,” he said.
On Wednesday, the U.S. Department of Health and Human Services announced it intends to purchase 500 million N95 respirators over the next 18 months to help stockpile materials needed to treat patients with COVID-19. But hospital operators still worry about a shortage of needed supplies — including N95 masks in the short term.
“In recent years, ‘just-in-time’ inventory management had become the standard for maintaining levels of supplies,” Wolfson said. “But emergency planning includes advance inventory acquisitions and storage plans. And hospitals in the community are communicating and collaborating with each other.”
Florida has learned from hurricane season that advanced staffing plans are important during times of high volume and long-lasting emergency situations, Wolfson said.
“This involves modifying shifts, carefully monitoring staff alertness, resting options and ensuring proper nutrition,” he said.
At Bayfront, staff are communicating daily to keep up with how the outbreak continues to change, said Ryan, the emergency department director.
“It’s a lot like Hurricane Irma, honestly,” she said. “We don’t know if it’s going to go down the middle, or the left or the right. So we have to prepare for every outcome.”
Mason, the nurse from BayCare, said information is constantly flowing on new protocols and updated guidelines. She said she feels that her employer is keeping everyone in the loop, which makes her feel safe.
“We are constantly getting updates about what’s going on,” she said. “I feel like we are well-equipped to handle what comes next.”
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