Wednesday, 8 April, 2020
Every day in our daily report we profile an issue or respond to some those raised by you. Please continue writing!
- April 6 - Physical distancing also at the hospital: A member writes: “I see groups of staff in PPE posting pictures on Facebook with their arms around each other and big grins! They are motivated by a positive intention to boost team morale and solidarity, but the message they send does a disservice.”
- April 6 - Cloth caps: We also heard that: “Staff are wearing cloth scrub caps and/or headbands, often with a button on each side over the ears to hold the elastic ear loops off the backs of their ears. I’m concerned about impact on fit if the masks are worn this way, and also concerned that some may not realize that caps and headbands must be washed after every shift, just like scrubs.”
- April 6 - Not enough swabs: A reader reacts to our calls to escalate testing: “The province doesn’t have enough swabs, that’s why there is case definition for swabbing now opened to healthcare workers and nursing home residents. They are anticipating getting more swabs at which point more people will be swabbed. Right now the priority with the swabs we have is to test the most critical people.”
- April 6 - Keeping cell phones clean: A reader writes “Can cell phones spread COVID-19 within our clinical spaces? Most patient/staff alike access their phones at work, on breaks, or when waiting to be seen by medical staff. Everyone should be asked to wipe their phones down (or leave them in cars) when they enter the hospital, then put it in a plastic bag, and leave it there within all clinical areas.” Good advice. For more info, read here.
- April 6 - Making a will: “I'm an RN on the front line. Both my wife and I are nurses, and we have two teens. I don’t have a will and am afraid of leaving my kids without a will. The likelihood that one of us gets sick is very high. Is there a lawyer or software that is actually free to create our own will? Obviously time is of the essence.” Although this is not my area of expertise. I found this article useful.
- April 6 - Public using medical masks: “When I see the general public wearing medical masks I want to cry! Two thirds of the customers at the grocery store were wearing surgical masks and not one of them was a homemade mask. Those wearing a homemade mask in public are protecting everyone from COVID-19 and respecting frontline workers who deserve to have all of the medical/surgical masks available.”
- April 6 - Telehealth: A reader writes: “I can’t believe that telehealth has not gotten their act together, I waited yesterday 15 hours and gave up.” RNAO shares on this disappointment. RNAO has repeatedly been calling for Telehealth to hire more nurses (which RNAO can deploy instantly) and start providing timely service. Minister Elliott was asked about people experiencing COVID-19 symptoms and having to wait two or three days before receiving a call back from a Telehealth nurse. The health minister said this was "not acceptable." She responded: "We really want to get that down to within 24 hours, so that’s something that we’re continuing to work on," Elliott said, encouraging people to call their family doctors for a "more timely way to deal with it." Minister, even 24 hours wait for Telehealth is unacceptable. We have the nurses – please hire them.
- April 6 - Thank you: “I just want to take this opportunity to thank everyone! I want to thank all of our frontline workers (RNs, RPNs, PSWs, DOCs, ADOCs etc.). I also want to thank all other essential workers too that are not healthcare related (we are a huge team of people; not just healthcare workers who are fighting hard in this pandemic). Finally, I want to thank all of you at the RNAO – I read your email postings every day; thank you so much.” To you and the many others who thank us daily: We are honoured to be here for you!
- April 5 - Window visits in nursing homes: This is an inspiring practice to enable loved ones to visit through a window – however, please keep the window surfaces clean. If visitor A, asymptomatic, touches the glass and visitor B comes to visit his mum and touches the glass, then spreading happens. Also not a good practice is to pass items through the window, such as chocolates, thus defeating the point of isolation.
- April 5 - People not keeping physical distance and Medical Officers of Health remain silent: A few individuals wrote to us, asking: Where is the physical distancing? Stores continue to let crowds in without physical distancing. At a bank line up no one was self-distancing. Young people still don’t get it – at the pet store helping consumers without self-distancing. Thankfully, there are new Plexiglas barriers at Shoppers checkouts. Is the situation better in British Columbia because they educate better the public? RNAO urges all our Medical Officers of Health to speak strongly and frequently about staying at home and physical distancing.
- April 5 - A must read: I encourage all to read a magnificent piece by Toronto Star reporter Moira Welsh on the inspiring work of nurses and personal support workers with residents in a nursing home. Please share also your comments. I did, thanking Moira for her detailed and accurate account of the awesome work of front-line nurses and PSWs, as well as the solid evidence-based leadership at the Henley Place long-term-care home (in London, Ontario). I also added that their impeccable and inspiring work is aided by the home having the necessary PPE to protect residents and staff. This is why they can focus on what's most important: caring for residents in a dignified and safe way.
- April 3 - Violation of the measures for physical distancing, or other actions that create risk, are a concern we all share. Colleagues have written to report they’ve seen health workers, still wearing their scrubs and masks, doing grocery shopping or in other public spaces; that’s a serious risk to others. Others have heard colleagues sharing their plans to meet with extended families for Easter. I urge all of us to avoid these types of lapses in judgment and abide by physical distancing rules.
- April 1 - Many concerns address PPE shortages in different sectors. There are still hospitals not allowing front line workers to use PPE, while other hospitals have moved to supply two surgical masks per day. There are community health organizations – home care and primary care – suffering from dire shortages, and some have lost hope and tried to obtain their own PPE. RNAO’s urgent recommendation is that all front line health care workers facing patients – in all sectors and settings – must wear a surgical mask. Kudos to Pembroke Regional Hospital – a staff shared her pride that they are directing staff to mask for every encounter with a patient.
- April 1 - There is a horrific crisis unfolding in nursing homes, and a direct link between lack of proper protection and mounting infection clusters reported by the media in at least 41 nursing homes and 77 by our account. RNAO has been sounding the alarm bell for well over a month. We will not stop saying it: The time is NOW, to ensure all nursing homes are provided with sufficient quantities of surgical masks and other essential PPE, so that all staff wear one at all times – to prevent outbreaks and NOT after an outbreak has happened. We must #flattenthecurve of nursing home outbreaks!
- April 1 - Fourth year BScN nursing students are expressing concern, as they are eager to graduate and begin working as RNs to protect and care for patients during this difficult time. They share with RNAO that they face barriers to complete their studies and registration with the CNO, as well as in their application for temporary licenses. Many want to be in clinical placement to help with this crisis and are not allowed in. We are speaking with government and hope to have answers for you soon.
- April 1 - Should the public wear a surgical mask in public spaces, as many do in south east Asian countries? Given the shortages of regulated PPE for health care workers, the public should not be purchasing those. There is a live discussion on whether to wear home-made and other unregulated types of masks. The general advice has been to keep two meters physical distancing and thus it is optional to wear a mask. However, if you have to shop groceries, take public transit, work as an essential worker, or other activities where you cannot keep physical distancing, a cloth-made mask is recommended. The CDC in the US has issued such a recommendation.
- April 1 - We reported earlier about Michael Garron Hospital launching #MGH1000masks campaign. The hospital is challenging makers in the community to fabricate 1,000 masks a week, which will be worn by all approved visitors who enter the hospital, all discharged patients as they reintegrate into the community, and the broader east Toronto community to prevent the transmission of COVID-19.