10 coronavirus-unit nurses are suspended, potentially for weeks, for refusing to work without N95 masks

By: CNN

Posted: Apr 17, 2020 9:02 PM CDT

Outside of PSJHC, nurses hold a protest over the nurses suspended for refusing to enter coronavirus patient rooms without N95 masks. By Paul P. Murphy, CNN

(CNN) -- Ten nurses were placed on administrative leave from Providence Saint John's Health Center in Santa Monica, California, for demanding they be given N95 masks while treating Covid-19 patients, two of the nurses told CNN.

Two nurses at PSJHC told CNN that they, along with eight other nurses, were suspended with pay after refusing to enter coronavirus patient rooms on April 9 without N95 masks.

The hospital said there were no N95 masks for them and insisted they wear surgical masks instead, the nurses said?, even though other healthcare workers at the hospital were provided N95 masks.

In a photo shared with CNN, taken after nurses refused to enter Covid patient rooms inside the facility, eight nurses are seen with seven raising their fists inside PSJHC.

"I really was just fed up and demanded that my hospital do better and do right for us," Michael Gulick, one of the suspended nurses, told CNN. "Especially when we saw blatant signs that there's no reason why there should be a shortage."

The hospital says the nurses were provided surgical masks, which it says are appropriate personal protection equipment according to CDC and WHO policies.

PSJHC refused to comment specifically on the issues with their staff, saying they don't comment on personnel issues to protect their employees' privacy, but confirmed 10 nurses have been put on paid administrative leave.

"Every one of our nurses caring for Covid-19 positive patients and patients under investigation (PUIs), was provided appropriate PPE per CDC, WHO and state guidelines," hospital spokesperson Patricia Aidem said in a statement. "These same guidelines are followed by most hospitals across the United States."

The current CDC policy recommends that healthcare professionals treating Covid-19 patients or PUIs wear N95 or higher level respirators. Although the N95 masks are "preferred," healthcare workers should only wear facemasks--surgical masks-- when respirators are not available.

Since the nurses refused to enter the patient rooms, the N95 policy has changed. Aidem says that's because the hospital has received "an increase" in N95 masks and is beginning to sanitize and reuse masks, "enabling us to provide them to all caregivers treating Covid-19 patients."

PSJHC's human resources has been meeting individually with the 10 nurses, according to Gulick and Jack Cline, another suspended nurse, telling them they are still under suspension while they conduct an investigation that may last weeks.

Their suspension comes as hospitals across the country are seeing an overwhelming surge of patients as Covid-19 continues to spread.

On Friday afternoon in Los Angeles County, where Santa Monica is located, the County Health Department said they've experienced the largest increase in Covid-19 deaths for three days in a row. In the last 24 hours, the city of Santa Monica says they've seen an increase of 100 Covid-19 cases.

The N95 masks are critical in preventing healthcare workers from acquiring the coronavirus because they block at least 95% of particulates in the air—like the novel coronavirus—according to the FDA. Many hospitals across the US are scrambling to get more masks for their workers during the global pandemic, but it's proving difficult because there's a global shortage of the masks.

Labor and delivery nurses got N95 masks, Covid-19 nurses didn't

Gulick and Cline told CNN the hospital would not give them N95 masks when they asked for them.

They said they only were given surgical masks while doctors, technicians and clinicians that were involved with the treatment of coronavirus patients were given N95 masks.

The nurses say they doubted the hospital's claim it was low on N95 masks because they saw so many colleagues wearing the masks. The nurses said all the coronavirus unit nurses were given surgical masks.

Aidem described that characterization as incorrect, saying, "N95s are required when clinicians perform aerosolizing procedures," or any procedures that could cause moisture from the patient to enter the air.

But the nurses say other employees not treating Covid-19 patients, like labor and delivery nurses, were given N95 masks.

CNN spoke with Lizabeth Baker Wade, a labor and delivery nurse at PSJHC and union labor representative at the hospital, who confirmed she had access to N95 respirators "whenever we have asked for them."

Baker Wade took the photo of the nurses protesting on April 9.

"N95s are always available on all units to be used for emergencies and aerosolizing procedures," Aidem said, when asked to explain why some hospital units like labor and delivery nurses were given N95 masks. "All of our clinicians are provided the proper equipment based on patient acuity, and in accordance with CDC recommendations."

Although the nursing staff had been upset for weeks over the lack of N95 masks, Gulick and Cline say two factors pushed the staff over the edge.

On April 6, PSJHC Covid unit nurse Angela Gatdula tested positive for the virus. She told CNN in the weeks prior to her getting coronavirus, she had been treating coronavirus patients while wearing a surgical mask.

AIdem says whenever a hospital employee contracts a contagious illness, the hospital investigates in accordance with state laws. She did not know whether that investigation has begun or had determined how Gatdula contracted coronavirus.

The next morning, news spread around the hospital that Gatdula had tested positive. Cline and Gulick told CNN they spoke with some doctors at the hospital who were surprised the nurses still didn't have the masks.

Nurses remain suspended even after policy change

Gulick says that he and other protesting nurses were then called in, one by one, to a meeting room with hospital administrators.

In that room, administrators read a pre-written script, saying their refusal to treat the patients constituted abandonment and negligence, Gulick said. If they refused, Gulick and Cline said, the hospital threatened to report the nurses to the California Board of Registered Nursing.

Aidem refused to comment on that, citing PSJHC policy to not comment on personnel issues to protect their employees' privacy

"We all said to them, 'No, we are not refusing the assignment, but we are refusing to take care of these patients without being offered the minimal protection of the N95 mask,'" Gulick says. "And they said, 'We cannot provide that to you.'"

After asking the nurses three times to treat the patients, hospital administrators told Gulick he was suspended and to leave the building, Gulick said.

Gulick says he called California's Board of Registered Nursing and asked if a complaint had been filed against him. He was told that no complaint had been filed yet, and was given the opportunity to file a complaint against PSJHC, which he did.

The CBRN confirmed to CNN that a complaint had been filed against a nurse at PSJHC, but declined to identify the nurse or what the complaint was about, saying complaint information is confidential. The agency did not say whether a nurse had filed a complaint against PSJHC.

"The [CBRN] is investigating this complaint," California Department of Consumer Affairs public information office Michelle Cave told CNN in a statement. "It is important to remember that the board does not have jurisdiction over employment matters. If patient abandonment is reported, the board will investigate those complaints and, depending on the findings, may take disciplinary action against the license."

According to the CBRN, for patient abandonment to occur a nurse must accept a patient assignment, and then sever it without giving reasonable notice to the appropriate supervisor or the patient so that "arrangements" can be made.

The nurses, some of whom met again with hospital Human Resources, remain suspended despite the hospital changing its policy about N95 masks.

"As nurses with a science-based practice, we know what protections are needed to stop transmission of this disease and to allow us to safely provide the care our patients need," Bonnie Castillo, a nurse and the executive director for the California Nurses and National Nurses United , told CNN in a statement.

"It is unconscionable that these brave nurses who are standing up for themselves have been suspended and we support them completely as they demand what they need to do their work safely. We demand that Saint John's reinstate them immediately without further disciplinary action."

During their suspension, some hospital nurses have been holding protests outside PSJHC and other nearby hospitals. The latest protest was held on Friday at 7 a.m., coinciding with the hospital's shift change.