Nurses coping with mask supply issues

An adequate amount of personal protective equipment (PPE) for area nurses remains an ongoing issue, according to B.C. Nurses Union president Christine Sorensen.

"We do know that personal protective equipment shortages are showing up all across the province and the north, of course, is not immune to that," she said in an interview. "We have heard from the Ministry of Health that everyone collectively is working incredibly hard to access the appropriate for healthcare workers but of course it's a supply and demand issue across the world."

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The BC Centre for Disease Control has put out directives for mask usage and those are standards that WorkSafe BC is enforcing.

"So if nurses are not able to access the masks that they require according to this standard we are certainly urging them to report that to the BCNU," Sorensen said. There is a 24-hour hotline nurses can use.

There have been reports made and nurses have exercised their right to refuse work because they have not had access to masks and where they've had inappropriate masks provided, she added.

There are different types of masks used depending on the circumstance of the work a healthcare provider is doing.

"So a procedural or surgical mask that staff are advised to wear is not to protect the nurse but to protect others and to keep droplets in, with the assumption the nurse is the potentially infectious vector," Sorensen said.

Staff could potentially wear one procedural mask all day, she added.

The other masks being talked about are the N95 respirator masks. Those are used to protect the healthcare provider from becoming infected.

What mask is used depends on what area of work staff are in.

If healthcare workers are caring for people who have COVID-19 or are potentially infected they need to protect themselves with the N95 mask, including in the emergency department or intensive care unit or if they need to intubate or ventilate a patient, Sorenesen said.

"The N95 masks are in very limited supply in Canada and elsewhere and definitely in British Columbia and at some points we only have just-in-time replacements and that is concerning but I am very well aware that the government and health authorities are working incredibly hard to increase our supply of those particular masks," Sorensen said.

If any masks are soiled or damaged they would absolutely be replaced, she added.

Under the precautionary principles that came out of the Sinclair commission after SARS in 2003, a nurse has the right to determine the appropriate level of personal protection equipment they require, based on their own judgment and the environment and time they are in.

"It's difficult for the public to understand why a nurse might wear a mask," Sorensen said. "The biggest concern nurses have is that this is a change of practice compared to all the other times we've worked in health care. In all of our previous experience masks are single use. They are discarded after each patient interaction so that we minimize the risk of transferring communicable disease or infectious disease from one patient to another. So we are very concerned about that. However in light of the fact that we have very limited supplies and we are under orders to conserve masks we are doing our very best to ensure that we are protecting the patient while we continue to advocate for protection of the worker because we do know that healthcare workers are being infected." 

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