The union representing B.C. nurses is calling on the Ministry of Health to update rules to allow health-care workers easier access to N95 respirators, saying the province’s policy on personal protective equipment puts workers and patients at risk.
Dannette Thomsen, interim vice-president of the B.C. Nurses Union, said nurses feel unsafe at work and she has heard from hundreds of colleagues about their struggles to get proper equipment.
“We see paramedics and firefighters bringing people into emergency rooms and they have N95s. They have full face shields and they’re handing off to a nurse with a surgical mask,” she said. “It’s beyond comprehension to me as to why that nurse does not deserve the same protection.”
Currently, nurses and other health-care workers are issued surgical masks to wear during their shifts. If they want to upgrade to an N95 mask, they must go through a point-of-care assessment to ensure all other safety measures are in place. A supervisor then decides whether an N95 is warranted. Thomsen said there is no consistency in how those decisions are made, and many nurses are being refused their requests for an N95 mask or other protective gear.
During a media briefing Wednesday, B.C.’s provincial health officer, Dr. Bonnie Henry, defended the current policy and suggested N95s are not needed in all settings.
“There are higher-risk settings and lower-risk settings, even in health care,” said Henry. “So if you are working in a vaccination setting where there are not people who are ill … the level of (protective equipment) you need as a last line of defence is different from working in a COVID ward or an ICU or an emergency department.”
Thomsen agreed nurses in COVID wards have virtually unfettered access to N95s, but said there is no reason to not expand that practice.
“A nurse’s clinical judgment needs to be respected, and if we feel we need an N95, a nurse should be able to use her own clinical judgment to get one,” said Thomsen.
The Ministry of Health policy, which applies to all people in health-care settings, including staff, patients, long-term care residents and visitors to health facilities, was created at the beginning of the pandemic in March 2020. At that time, the province had a shortage of N95s and it believed COVID-19 was only spread through droplets, which surgical masks can protect against. That is why the policy only requires N95s to be worn under specific circumstances where a lot of aerosol spray is generated, such as when intubating a patient.
Henry said she is satisfied the current infection prevention and control guidelines are “robust” and do not need to be changed.
“N95 respirators are widely available and being used in ICUs, in COVID wards and in higher-risk settings now, and will continue to be. The guidance that we have allows for that and allows for that individualized assessment to happen on an ongoing basis,” she said.
Thomsen pointed out there are many other procedures that are high-risk and produce aerosol spray. She said having to go through an assessment or find someone to unlock the cupboard of N95s masks wastes precious time during an emergency.
“If you’re having a cardiac arrest and we don’t have access to N95s because they’re locked up, then we are wasting valuable moments,” Thomsen explained. “When you are doing chest compression, you are spewing aerosols yourself so patients need to be protected from that as well. So a nurse needs quick access to an N95.”
Thomsen called the policy “hit and miss” because some nurses have easy access to N95s, while others do not.
She is worried about care home nurses and community care nurses who work in people’s private residences. She said gains made by some to get N95s are not applied to all.
“Last fall, I personally asked my health authority that each community nurse be given an N95 to be protected and we did get masks for that particular unit that I was fighting for, but not (for every community nurse in the province). Since then, one of the nurses in the northern unit has told me she has been unable to get a new N95 mask.”
The union fears the health-care system will continue to suffer from a shortage of nurses due to illness, which will have both short and long-term effects.
“WorkSafeBC data show 54 per cent of all claims are from nurses. Over 1,000 of their claims are from registered nurses and licensed practical nurses. My concern is that many of them are long-haulers as well, and we have to prevent that from happening to even one nurse,” said Thomsen.