UNM Doctors Respond To PPE Concerns After Nurse Speaks Out About Working Conditions

Apr 30, 2020

Hospital workers around the U.S. have been speaking up about concerns over working conditions and the lack of personal protective equipment (PPE). Former UNM Hospital nurse Hunter Marshall says he was threatened with discipline after speaking to the media about staff concerns at the hospital. So he decided to resign, he says, and look for another hospital to work in during the pandemic. Your New Mexico Government spoke with a nurse, a union representatives and doctors at UNMH about PPE and workers' rights to speak out.

On the April 28 episode of Your New Mexico Government, KUNM spoke with nurse Hunter Marshall, who was also on our call-in show Let's Talk New Mexico on April 23.

MARSHALL: The bedside nursing right now is really hard. There's an added stress of uncertainty, of not knowing if and when I will be either disciplined or let go, not of my own volition. Yeah, it's just it's stressful seeing administrators and stuff in the hallway and kind of wondering if and when that hammer will drop. I'd like to work somewhere where I'm not going to be distracted with that and can just give on the attention to my patients.

KUNM: You did come on our our talk show Let's talk New Mexico. And you got a written notice that you were violating hospital policy by speaking with the news media about the conditions that you are working in right now. What do you make of that?

MARSHALL: What employees can expect in terms of protection is kind of up in the air. And I really think it's important that bedside staff, whether nurses or [environmental services department] or a respiratory therapist, they need to be part of that conversation, because this is going to leave an indelible mark on the culture of health care organizations as well as the culture of health care professionals. Collectively, we're going to come out of this weaker if we feel that as bedside staff, our voices are being silenced or we're not part of the conversation. We're not disparaging the hospital or anyone making any of the decisions with regard to PPE practices. That being said, there's a nationwide global shortage. Yeah, I think there needs to be a dialogue about in which all stakeholders are included rather than silenced.

KUNM: What additional problems are you seeing and have those problems manifested at all?

MARSHALL: Many of the nurses on my unit, which is now the COVID ICU, have procured our own reusable respirators that can be wiped down after each use. Many other hospitals are fit testing staff for these to make sure they fit them appropriately and letting them use them in the workplace to free up additional masks for other folks who don't have those. And as of now, the hospital is not willing to let us use our own protection despite our protests that we don't feel safe with what the hospital is currently offering. Currently, they're offering masks to be used for extended, extended periods of time or masks that have previously been worn and then decontaminated with vaporized hydrogen peroxide.  To hear the hospital say, like, 'our health care heroes' -- or the government -- seems a little bit disingenuous. I would rather hear, 'we are sorry that the system failed you. You were left unprotected or inadequately protected in a way that makes you feel scared for not only yourself, but perhaps your family. And thank you for doing what you continue to do in spite of that lack of protection.'

KUNM: To find out more about union protections for health care workers, I'd like to welcome Eleanor Chavez to the show. She's the executive director of the National Union of Hospital and Health Care Employees District 1199 for the great state of New Mexico. We've heard from Hunter Marshall. He's a former nurse at UNMH that he was threatened with disciplinary action for speaking to the media about health care worker concerns at UNMH. They said he agreed to a policy not to talk to the media. Question for you: is that legal?

CHAVEZ: The policy that they're talking about is the hospital's own internal policy that says that employees or whoever at the university, you know, should go through them. And that does not cover employees who are speaking up about health and safety concerns, which is what he was doing, number on. So that's covered under [the Occupational Safety and Health Administration], right? And then the other piece that protects him because he is a public employee is the First Amendment, that he has the right to free speech. There's at least one other employee who is also threatened with discipline. So the action that the union has taken is that we have filed whistleblower complaints against UNMH for at least two employees at the hospital. So basically, OSHA needs to come in and investigate. Then they will issue a finding and determine whether or not the hospital was in violation. 

KUNM: Now, tell me what's important about hearing directly from health care workers on the frontlines right now about how hospitals are responding.

CHAVEZ: That's the only way that you're gonna know if what the hospital is is saying is true.

Officials with the University of New Mexico sent us this statement regarding discipline against staff who speak to media.

“We recognize and support our employees and provide several outlets for employees to express concerns, questions or opinions on matters. Those range from direct communication with their supervisor, or during the regular leadership rounding that takes place with each unit, and of course emailing leadership or speaking to them at the regular town halls and other management meetings. When it comes to interaction with the media, we work with our employees to make sure they understand our policies regarding representing their opinions as their own, and not those of the hospital.”

 

KUNM discussed Hunter Marshall's concerns about safety and personal protective equipment with Dr. Eve Espey, professor and chair of Department of Obstetrics and Gynecology, and Dr. Steve McLaughlin, chair of Emergency Medicine. They are both on the PPE committee at UNMH and they talked about how they’re engaging with frontline healthcare workers about decisions regarding personal protective equipment.

ESPEY: When we started, we came up with guiding principles that prioritized patient and employee safety and health and also being good stewards of our PPE through utilization of the guidelines. We have done over 20 individual unit specific Zoom meetings to talk to everybody on the units.

MCLAUGHLIN: Those kinds of mass communications are good. But in this case, you have to really have face-to-face conversations with the leaders and the individuals. And so we've spent a lot of time doing video or in-person rounding with the unit leaders, the frontline nurses, physicians, technical staff to answer questions and really help make sure that the guidelines are working for them and that they understand what they're supposed to do and how they're supposed to say stay safe.

KUNM: Hunter indicated that many of the nurses on his unit have procured on their own reusable respirators that can be wiped down after each use. But I gather UNMH does not want people to use these. Can you tell me why?

ESPEY: The hospital has the appropriate equipment available for our staff and for our providers at this time. We also have processes in place to ensure that all of that PPE is in working order and is functional. That's one of the concerns that we have about people bringing in their own PPE, is that those processes are not in place as they are for the hospital-based respirators. So we absolutely want everybody to have the equipment and supplies that they need to keep themselves safe and that the hospital has the available equipment in order to do that right now.

KUNM: He says he and others still don't necessarily feel safe when they're being asked to extend the use of masks for up to three days and use masks that have been worn and decontaminated with vaporized hydrogen peroxide. Can you address the safety of doing that?

ESPEY: We are following well-established guidelines, including CDC guidelines, in order to ensure safety today with an appropriate supply today, as well as safety throughout what's looking like a longer term need to be able to fight the pandemic.MCLAUGHLIN: And so that's we're looking at every single aspect, whether it's decontamination and reuse, looking at how we make the supply chain coming in better, how we can get the work done safely with using less equipment. Those things are important today, but they're also really important six months from now because we're still going to be doing this and we want to make sure that people are still safe in six months.

KUNM: We all understand the incredible difficulties right now on the supply chain. [Marshall] felt like it would be great to have some validation from folks who are working on this that 'we're sorry that this is the equipment we have, that we're trying to keep you safe.' Do you feel that's being communicated?

ESPEY: When we do our communications to the units, we're not just explaining the guidance. We're also getting input in their perspectives.MCLAUGHLIN: And I think that the really important thing to understand in this is that this is a group of peers, right? We're all clinical people. I was working yesterday in the emergency department taking care of coronavirus patients. And so we're really here to translate science, supply chain practicalities and then add to that the practical understanding of what the work is like so that we can make sure that we're safe now and safe, you know, going on through this.I will also acknowledge that this is really hard. It's anxiety-provoking. It's stressful. And a lot of that stress and anxiety, like some it falls on to issues around equipment because we're all concerned about our safety. I think the really amazing thing of what makes me very proud to be part of this group is that we all keep showing up at work and we're taking great care of our patients and our safety record so far using these approaches has been very good.

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