Nurses aren't prepared for coronavirus Graphic via Shutterstock / Courier

A recent survey from National Nurses United found only 44% of nurses have received guidance on how to recognize potential cases.

Nurses, who are often on the frontlines of health emergencies caring for patients, have begun speaking out about the handling of the novel coronavirus, or COVID-19, outbreak. A new survey conducted by National Nurses United (NNU), the United States’ largest nurses union, found that just 44% of surveyed nurses had received information about how to recognize and respond to potential coronavirus cases. 

What may be more alarming, however, is that a mere 29% of those surveyed reported their place of work had official protocol to isolate patients who tested positive for the virus. Only 19% said their employer has a policy in place should a staff member become exposed to the virus. 

The NNU survey, which came out March 3 and surveyed 6,500 people, echoed recent statements from the American Nurses Association (ANA), which represents 4 million nurses.

ANA’s Vice President of Nursing Programs Cheryl Peterson, who is also a registered nurse, said that whatever plans hospitals and other medical facilities may have in place regarding coronavirus are not being communicated effectively to their nursing staffs. “When there is confusion then everyone is unsafe,” she told COURIER. “When we don’t know what to do, we’re unsafe.” 

“It really is a challenge,” Peterson continued. “It is almost unconscionable because it truly does put people at risk.” 

Although Congress has allocated $8.3 billion in emergency funds—a move Peterson acknowledges is a “solid first step”—nurses have reported shortages of N95 respirators, a heavy-duty mask that protects wearers from a majority of airborne and liquid contaminants. As a result, ANA has urged lawmakers to increase the supply chain of personal protection equipment (PPE), lab equipment, and preparedness supplies in order to protect healthcare workers.

“If nurses do not have access to appropriate PPE to keep themselves and others safe from the novel coronavirus, then it is possible for nurses and other healthcare workers to become either exposed or ill,” explained Melanie Rogers, a public health nurse and volunteer communications chair of the Public Health Nursing Section of the American Public Health Association.

Exposure to the virus could mean a shortage of healthcare workers, including nurses, Rogers said. Both she and Peterson expressed concerns that the Strategic National Stockpile, the U.S.’s largest reserve of emergency medical supplies and pharmaceuticals, has already been tapped into for PPE.

“If the Strategic National Stockpile or the infrastructure necessary to activate and distribute it has not been maintained, then there may be delays of providing appropriate personal protective equipment to the nurses on the frontlines providing care to patients with novel coronavirus,” Rogers said. 

“If nurses do not have access to appropriate PPE to keep themselves and others safe from the novel coronavirus, then it is possible for nurses and other healthcare workers to become either exposed or ill.”

NNU’s survey found that 63% of nurses have access to N95 respirators on their units, and 27% have access to Powered Air Purifying Respirators, which medical personnel can wear to protect themselves against contaminated air. Only 30% of respondents said they had enough personal protection equipment on hand. 

Peterson lamented a lack of consistent planning in outbreak preparedness as a major ongoing issue. She added, however, that the Trump administration wasn’t solely responsible for these systemic failings. 

“Where we are failing—not due to this administration but due to all the administrations, actually—is we don’t have a public health infrastructure to help us respond effectively and efficiently to this type of crisis. We pretty much decimated public health and we don’t have enough public health workers,” Peterson said. “Every admin has failed to put the kind of resources necessary to build a public health infrastructure that would really be the underpinning for any response to this type of event in the future.”

According to an April 2019 report by Trust for America’s Health (TFAH), a nonprofit, nonpartisan public health policy, research, and advocacy organization, America’s public health system has been chronically underfunded overall. From 2003-2019, the CDC’s Public Health Emergency Preparedness (PHEP) fund, the primary source of federal funding for state and local public health emergency preparedness, has been cut by a third. 

As for the current coronavirus outbreak, another issue that has plagued the response of public health officials, according to one California nurse anyway, is general incompetence. 

Last week, Deborah Burger, NNU President, held a press conference where she read a statement by an anonymous quarantined nurse who works at a northern California Kaiser facility. The statement was largely an indictment of the Centers for Disease Control and Prevention (CDC), which delayed her ability to get tested after being exposed to coronavirus and demonstrating key symptoms. 

“The public county officer called me and verified my symptoms and agreed with testing. But the National CDC would not initiate testing,” the nurse said in a statement. “They said they would not test me because if I were wearing the recommended protective equipment, then I wouldn’t have the coronavirus. What kind of science-based answer is that? What a ridiculous and uneducated response from the department that is in charge of our health in this country.” 

While the CDC has not been updating or tracking cases, leaving much of the work to journalists to aggregate state and local tallies, the New York Times reports there have been 730 known cases in the U.S. and 26 deaths so far.