By Nicole Nixon and Sammy Caiola

Nurses across California say they feel unprepared to address the coronavirus threat, with hospitals in some cases lacking protective equipment or emergency protocols for working with sick patients.

Meanwhile, hospitals say they’re following federal guidelines and working with local public health agencies to keep workers safe.

On Thursday, a major hospital workers union announced that more than 50 employees were sent home after possible exposure to patients at various facilities.

The UC Davis Medical Center says 89 employees were placed on “in-home isolation precautions” due to exposure to COVID-19, the illness caused by coronavirus. They all tested negative and will be returning to work, according to the hospital.

And National Nurses United, an affiliate of the union group California Nurses Association, released a survey on Thursday of 1,400 state nurses. Less than half say their employer has given them information on how to respond to cases of COVID-19, the disease caused by coronavirus, and one-in-five say their workplaces have enough protective equipment to handle a surge in patients.

“Nurses are confident that we can care for COVID-19 patients and even stop the spread of the virus if — and that is an if — we are given the protections and resources we need to do our jobs,” said Bonnie Castillo, executive director of National Nurses United.

The nurses spoke about a lack of communication between employers and health workers about what plans and protocols are in place. They said they are not clear on when emergency health practices — such as heavier gowns, isolation rooms and special masks — can and should be used, and that training for how to put on and take off protective equipment has been slow to roll out.

Hospitals are required to provide protective equipment for employees working in areas or with people suspected of having COVID-19, according to new state guidelines released this week.

But Jan Emerson-Shea with the California Hospital Association said that doesn’t apply to all employees.

“It’s very possible that many of the people who were surveyed are not in caregiving positions that have been identified as people who will respond to a coronavirus patient,” Emerson-Shea said.

She added that hospitals are trying to limit the number of health care workers who treat potential COVID-19 cases, both to curb risk of exposure to the disease but also to manage the limited supply of N95 respirator masks.

Still, nurses say there should be hospital-wide procedures and education in place.

“I can tell you, nurses are extremely frustrated, confused and concerned about their well-being, the well-being of their patients, families and the public,” said Cathy Kennedy, a nurse in the intensive care unit at Kaiser Permanente Roseville.

The National Nurses United survey included feedback on how nurses view hospital and health-center preparedness for the virus:

Just under half report that their employer has provided them information about the coronavirus and how to recognize and respond to possible cases.

Only 21% report that their employer has sufficient protective equipment on hand to protect staff if there is a rapid surge in coronavirus patients, and 42% don't know.

About one third report that there is a plan in place to isolate a patient with a possible coronavirus infection, while 43% report they don't know if there is a plan.

Only 16% report that their employer has a policy to address employees with suspected or known exposure to novel coronavirus, and 48% don't know.

The survey comes as health care workers on the front lines are already being affected by COVID-19.

At least 15 Roseville health care workers — 10 employees at the city’s Kaiser Permanente hospital and five emergency responders — were exposed to the first California patient to die from the virus earlier this week.

Placer County Health Officer Dr. Aimee Sisson said the workers are not exhibiting symptoms but are in self-quarantine.

At least three health care workers at NorthBay VacaValley Hospital, where the first patient who became ill from community transmission was treated before being transferred to UC Davis Medical Center in Sacramento, have tested positive for the virus. Those workers are residents of Placer, Solano and Alameda counties.

The new COVID-19 guidelines from the California Division of Occupational Safety and Health require hospitals to provide personal protective equipment for employees working in areas or with people suspected of having COVID-19. The Cal/OSHA guidelines also require training employees on the use of such equipment, as well as other ways to limit exposure to hospital employees.

Patients suspected of having the virus should be given masks and tissues and have limited contact with hospital workers.

If possible, the guidelines say patients in health care facilities should be put in isolation rooms with special ventilation to prevent spreading the illness.

Emerson-Shea with the California Hospital Association said hospitals make decisions on when to send workers home in conjunction with local health departments.

Democratic Asm. Lorena Gonzalez, D-San Diego, introduced a bill Thursday aimed at protecting health care workers quarantined for exposure to the virus.

“Workers shouldn’t be fired if they miss work because they’ve been quarantined or isolated due to a public health emergency like the coronavirus,” Gonzalez wrote in a statement. “We need to support workers so they can take every action necessary to prevent the spreading of this disease.”