Nurses refuse coronavirus care without N95 masks

10 nurses at Santa Monica hospital suspended for refusing to work without coronavirus protections

Nurses at Providence St. John's Health Center in Santa Monica raise their fists April 10 in solidarity after telling managers they can't care for COVID-19 patients without N95 masks.

April 16, 2020 Updated 12:36 PM PT

Ten nurses at Providence St. John’s Medical Center in Santa Monica have been suspended after refusing to work inside a coronavirus ward without what they deem adequate protective gear.

“We told them we’re willing to reuse the same mask all day long and cover it up with a surgical mask, just issue us one mask a shift,” said Jack Cline, one of the nurses suspended last week. “That’s all what we’re asking for.”

The hospital declined this week to specifically comment on the suspensions, citing labor and patient privacy laws, but said, “We are so grateful for the heroic work our nurses perform each day and will not let the actions of a few diminish the appreciation we have for all our nurses and their commitment to our community. ... Saint John’s cherishes its nurses and is taking precautions sanctioned by leading world, national, state and local health agencies to ensure their safety.”

Three of the nurses have been suspended since Friday, when they learned that a co-worker on the ward had tested positive for the virus and first demanded more protective gear.

A source who was not authorized to speak about the situation on the record said Thursday that nurses treating suspected and confirmed coronavirus cases have been instructed by administrations to wear only paper surgical masks in most cases — a protocol that has been authorized by the CDC but that has become increasingly controversial as more health care workers fall sick with the virus.

After Cline and colleagues demanded N95 masks, which offer a greater level of protection, the source said management at the facility gave a direct order to the nurses to return to their duties, and threatened to report them to the California Board of Registered Nursing, which handles licensing, for patient abandonment if they refused.

Nurses on subsequent shifts Saturday and through the weekend made similar demands to Cline’s, and were also suspended, said the source.

In its statement, the hospital said it is “using the same protocols followed by our 51 sister hospitals as well as major academic medical centers across the nation and in our service area.”

Earlier in the outbreak, the CDC had been recommended that all providers wear N95 masks, but they loosened the guidelines recently, in part to stretch limited supplies nationally.

On Wednesday, the Providence health system announced they would begin disinfecting N95 masks so they could be reused to help ease a shortfall. The protocol has been granted emergency authorization by the FDA, according to the hospital system.

“Our nurses, providers, respiratory therapists and others working the front lines deserve the best protection possible,” said Sylvain Trepanier, chief clinical executive for Providence Southern California, in a statement.

The facility declined to say how many staff members at St. John’s were positive, citing patient privacy laws, but said across Providence Southern California’s 11 hospitals, fewer than half a percent of 33,000 employees have contracted the virus.

Cline, the suspended nurse, said that on Friday, he refused to enter a patient room without an N95. The patient was suspected of having COVID-19, he said, and multiple doctors, who did get masks, told him not to enter.

“I’ve been a nurse for 25 years; I don’t need the CDC to tell me when I need an N95,” Cline said. “When I have a patient coughing directly in my face ... I’m not going into that room unless they provide me with one.”

He said he has been disappointed by Gov. Newsom’s promise that hospitals have all the supplies they need.

“I don’t know when we’re going to get them because we need them,” he said. “They say we have it, and we don’t.”

“I’m immune compromised, I’m a diabetic,” Cline said. “They’re saying I’m refusing my assignment, I’m not ... It’s not that I’m afraid to go in there, I’m afraid because I don’t have the equipment.”

Angela Gatdula, also a nurse at St. John’s, said she believes she contracted COVID-19 while treating patients with the virus. Her symptoms earlier this month began with body aches and a cough, and she tested positive last week, she said.

She said she felt angry the hospital administration did not give her an N95, though it knew she was treating COVID-19 patients. She was told she would be protected by a surgical mask, she said.

“They could’ve done more,” she said, her voice breaking. “I don’t want it to be one of our nurses who ends up needing hospitalization, needing ICU admission, possibly even dying.”

Cline said he believes the hospital has enough N95s, but they are trying to conserve them for a surge. He said some department nurses are getting them and some are not.

“I don’t understand their logic,” he said. “Unless they’re trying to get rid of the nurses so they can replace them with young, cheaper ones.”