How protective gear shortages are causing tension between hospitals, clinicians

As COVID-19 cases continue to surge in the U.S., hospitals and health systems across the country are facing shortages of personal protective equipment such as masks, gowns and face shields. This has prompted healthcare workers to speak publicly about a lack of protections, resulting in disciplinary action at some organizations.

In Washington state, an emergency room physician at PeaceHealth St. Joseph Medical Center in Bellingham was removed from his position after claiming the hospital wasn't doing enough to protect employees from exposure to COVID-19.

Ming Lin, MD, who has worked in the St. Joseph emergency room for 17 years, is an employee of TeamHealth, which contracts with the hospital's emergency department.

He told The Seattle Times his employment was threatened after he accused PeaceHealth to reporters and on his Facebook account of a lack of urgency to protect employees, including what he called a refusal to screen all patients outside the hospital, rather than in the ER. He said he did not take down social media posts about the hospital after being asked to do so. Dr. Lin was notified on March 27 that he had been removed from his position. TeamHealth tweeted March 28 that it had not fired Dr. Lin and would work to find him a position at a different hospital.

In Missouri, Sonny Saggar, MD, CEO of St. Alexius Hospital in St. Louis, said he was fired for his COVID-19 response plans. A bankruptcy trustee managing the hospital told the St. Louis Post-Dispatch she suspended Dr. Saggar's position while exploring a hospital sale, which she said is common when a trustee begins managing a hospital. Dr. Saggar claims he was fired due to his plans to allow other hospitals to use St. Alexius' beds during the pandemic and to convert one of its empty buildings into a homeless shelter.

Another example is a former Northwestern Memorial Hospital nurse who sued the Chicago-based hospital, claiming she was fired after warning co-workers that the surgical masks they were given were less effective than N95 respirator masks. Additionally, Henry Nikicicz, MD, an anesthesiologist at University Medical Center of El Paso (Texas) who has asthma and hypertension, was removed from the hospital schedule after putting his respirator mask back on in the hallways, which is against hospital policy, according to The New York Times. The hospital confirmed his removal, but later the same day, Dr. Nikicicz told the newspaper he was reinstated and told he could wear a surgical mask around the hospital and an N95 for procedures.

The growing tension between healthcare providers and administrators comes as workers have died in states such as Georgia, Florida and New York. The tension is mostly over issues concerning masks, such as if they should be donned outside of treatment rooms, which kind should be worn and how long they should stay on, according to The New York Times, which notes that some hospitals allow masks outside treatment rooms and some require them. 

Media communication policies have also come up amid the COVID-19 pandemic. For example, employees at New York City-based NYU Langone Health were notified that workers who spoke to the media without authorization would be "subject to disciplinary action, including termination," according to Bloomberg.

Jim Mandler, a health system spokesperson, told Bloomberg the policy was for confidentiality purposes, and "it is in the best interest of our staff and the institution that only those with the most updated information are permitted to address these issues with the media."

Union leaders have been vocal about workplace protections and advocated for workers' ability to publicly express their experiences amid the COVID-19 pandemic.

Rick Pollack, president and CEO of the American Hospital Association, recently responded to concerns in a letter provided to Becker's Hospital Review. In the letter, he acknowledged the challenges healthcare workers and organizations are facing.

"Our healthcare system is being challenged like never before, and the shortage of personal protective equipment and ventilators is putting even more stress on healthcare providers," he wrote. "From the beginning of this pandemic, the AHA has been sounding the alarm to government leaders … about the dire shortage of PPE. We continue to work with the federal government on increasing supplies of these vital resources."

As far as healthcare workers voicing concerns, he said the AHA has not independently heard reports of hospitals or health systems restricting workers' free speech regarding conditions related to COVID-19. "Furthermore, numerous clinicians have spoken to the media about conditions on the ground and we see their stories appear on the news and in articles and social media regularly," he said.

Mr. Pollack added: "Ensuring the public knows the challenges our hospitals, health systems and providers face — the need for PPE and how important it is to follow public health officials' advice to stay home, practice social distancing and only go to the hospital with COVID-19 symptoms after consulting with a healthcare provider — is vital to flattening the curve so we can stop the spread of COVID-19 and save lives."


More articles on healthcare leadership:
Coronavirus April 1: 13 notes from physicians, hospitals
Bristol Health CEO tests positive for COVID-19
Cleveland Clinic's strategy in 2020 and beyond: 6 takeaways

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