CHICO — Nurses and staff at Enloe Medical Center are sometimes working with sick patients with limited or without personal protective equipment like N95 masks, according to union representatives.

The concerns come as the nationwide spread of the coronavirus strains supplies of personal protective equipment everywhere and state and federal officials scramble to secure and distribute additional gear. Butte County has eight lab-confirmed cases as of Monday evening and has not yet seen an overwhelming surge of patients in hospitals. Public health officials recommend staying at home to avoid spreading the virus.

Enloe Medical Center’s CEO Mike Wiltermood said the hospital was providing gear to staff at risk of exposure and following guidelines from the Centers for Disease Control and Prevention. But union representatives from the California Nurses Association and the SEIU United Health Care Workers West provided examples where they said staff at Enloe felt unsafe because of inadequate protection.

Pamela Stowe, the California Nurses Association Chief Nurse Representative for Enloe Medical Center, said some nurses are working with patients who have tested positive for COVID-19 with only a surgical mask.

“We don’t have these masks to protect us,” she said. “We have nurses on the front lines, in our emergency rooms throughout our hospital, who are dealing with these patients with surgical masks.”

Due to the shortage of N95 masks worldwide and the CDC’s recommendation to use surgical masks as a secondary option.

However, Stowe stressed the importance of using the proper personal protective equipment and following the California Division of Occupational Safety and Health’s legal standard for state hospitals. The agency bases the highest level of protection for the coronavirus.

Also on the California Nurses Association’s board of directors, Stowe said nurses must be provided with N95 masks or PAPRs, a powered and air-purifying respirator when dealing with the coronavirus and its many unknowns.

The 15-year Enloe nurse explained that N95 masks provide a seal that forms around the face while surgical masks leave open space and merely protect directly in front.

According to Stowe, Enloe will allow nurses to use N95 masks only when dealing with “high-acuity patients.” Examples of these high-risk interactions include patients on ventilators or breathalyzer treatment.

Stowe also believes Enloe is not being transparent with the nurses in regards to the N95 mask supply, despite the nursing committee trying to discuss the issue on “several occasions.”

“They tell us only enough to appease, but they don’t really want to work with us,” Stowe said. “They want to oversee every action and they’re not listening to their nurses.”

She said the hospital is choosing to stockpile the masks for when the virus hits a surge locally.

“They are being reactive and not proactive,” Stowe said.

Stowe added that Wiltermood has sent out memos suggesting nurses bring their own N95 masks.

She also commented on the CDC recommendation of nurses wearing homemade masks, such as bandannas, as a last resort when caring for patients with COVID-19.

Stowe called the bandana suggestion “ridiculous” and said nurses would not wear them.

She also warned against not correctly protecting the people who care for the ill and healthy.

“We’re going to have more people infected,” Stowe said. “It’s going to take us longer to get this under control. Who’s going to take care of these sick people if the nurses are sick?”

Acknowledging that many health care providers are scaling back protections across the state, Stowe encouraged Enloe to reach out to its community for donations and ideas on how to produce N95 masks. Wiltermood said the hospital was reaching out for supplies through several avenues, including donations.

SEIU coordinator cites concerns

Lorena Alvarez, a Redding-based regional coordinator for the SEIU United Health Care Workers West, said she had also heard concerns from some of the union’s 1,200 members at Enloe.

One example she provided was a phlebotomist going from room to room where patients were isolated with symptoms — but with no mask at all.

She said that some of the staff had been told they couldn’t have the N95 masks because those were for nurses.

Workers who were concerned they may have become infected from exposure to a patient and wanted to quarantine were told to come into work until they showed symptoms, she said.

The union includes housekeeping and technical staff, many of which make minimum wage.

The local representative, Heidi Horn, said workers were “extremely disappointed” in Enloe’s response in a prepared statement.

“They do not seem prepared in terms of training, equipment and planning for a surge in patients,” she said. “Their communication with employees has been defensive and resistant when they should be going out of their way to work together to meet this challenge. I worry for our community.”

CEO outlines hospital’s steps

Wiltermood said he understood that there was anxiety in the community. He said that it was “possible that someone may have been in the line of their responsibilities been exposed to a potential COVID-19 patient” at the beginning of the outbreak when not much was known yet. He called it “very unlikely” that anyone would be exposed now.

Some of the steps the hospital has taken to limit exposure included setting up a triage area outside the emergency room and a special unit inside the hospital to separate people with respiratory symptoms from the general population. Currently, there are 11 individuals at the unit, he said. Related Articles Coronavirus: California’s numbers keep going down as US crosses 200,000 deaths

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The hospital has also chosen to pause some elective procedures to conserve resources.

“There’s no question that if we had tons of tons of PPE readily available we would be using it more often, if nothing else but to make people feel better, but we don’t have that luxury right now,” he said. “Thankfully we have the guidelines to determine how our PPE can best be used.”

The hospital is restocking through several routes, said Wiltermood, including through donations; through normal, though reduced, orders with manufacturers; and through potential upcoming federal and state sources.

“In the event that we had a major surge we believe we could handle the surge with the PPE that we have, but a lot depends on how big that surge is,” he said.

Wiltermood turned down this weekend an offer by the SEIU to provide millions of masks from a supply it said it had secured. He said that was because he wasn’t sure where the masks were coming from, calling the deal “very suspicious.”

He did say that staff would be allowed to bring in their own gear, like hand-made masks, “in excess of CDC guidelines”, for example for protection in areas of the hospital where N95 masks were not provided. Sewing enthusiasts in the community have been creating hundreds of the reusable masks for local health care workers.

Efforts at national reform

National Nurses United, which oversees the California Nurses Association, has begun an online petition directed at the U.S. Congress. The petition, https://act.medicare4all.org/signup/covid-19-protect, urges the public to sign and “demand nurses are protected during COVID-19.”

Stowe implores the community to sign not just for the Enloe nurses, but “for the nurses of California and this nation.”

“By protecting the nurses, they’re protecting themselves,” Stowe said.

This story has been updated to reflect that the it was the CDC that recommends bandannas as protective equipment for health care professionals only as a last resort.