New policy puts Prisma nurses in danger from coronavirus, staffers say

As South Carolina hospitals brace for an increase in coronavirus patients, some nurses at a Columbia-area medical center say they’ve been discouraged from using protective equipment that would shield them from infection by the virus.

Prisma Health, which like other hospital systems faces a shortage of medical supplies, is under fire from nurses who say they have been told not to wear high-grade protective masks — called N95s — when they are around some of the patients who have tested positive for COVID-19.

Nurses also have been told not to wear the high grade masks around people waiting to see if they are positive for the coronavirus, according to three nurses and a doctor who discussed their concerns with The State.

Instead, the nurses, who work at Prisma’s Richland campus, have been told to wear lower-grade surgical masks that do not provide adequate protection, they said. The N95 masks they are being discouraged from using are among the highest-level protective masks available to hospital workers, nurses say.

Meredith Johnson, a Prisma nurse with five years experience, said the hospital’s guidelines are new ones that are less protective of the staff members who are taking care of coronavirus patients and those suspected of having the disease.

If staff members violate the guidelines, they could face disciplinary action, she and other nurses interviewed by The State said.. The guidelines went into effect last week, she said.

“It was definitely nerve wracking,’’ Johnson said, explaining her reaction to the policy change. “I’m not necessarily scared. I have taken an oath as a nurse. But I did not sign up to put my life in danger’’ without the proper equipment.

Worries about Prisma’s policies on equipment are part of a growing chorus of concerns locally and nationwide by health care workers over what many say is a lack of adequate protection while helping coronavirus patients.

A nurse in Chicago was fired after she emailed colleagues to say she needed a more protective mask, while a physician in Washington state lost his job for saying he didn’t have adequate protective equipment, Bloomberg News reported Tuesday.

In a statement Tuesday night, Prisma acknowledged it had recently changed its policy on protective equipment for hospital personnel, but the policy does not put workers at risk. Prisma has aligned its policy with guidelines from the U.S. Centers for Disease Control and the World Health Organization, spokeswoman Tammie Epps said in an email.

“We take very seriously the responsibility to keep each team member and patient healthy and safe every day, including during this public health crisis,’’ the email said. “This policy modification in no way jeopardizes the safety of our team members or our patients.’’

The hospital corporation, which runs medical facilities in Columbia and Greenville, announced furloughs over the weekend, in part because a 77 percent reduction in elective surgeries is costing the system money.

The company said in a news release last weekend that it also faces “significant new costs” as a result of a rapid rise in Covid-19 patients. The company indicated that its costs were rising because of the need for more equipment to protect workers from the virus.

For now, some nurses at Prisma remain concerned about how well protected they will be through the coronavirus crisis.

The biggest issue is the availability of N95 masks. Under the new policy nurses said was adopted by Prisma, the masks should only be used when a confirmed coronavirus patient is having a medical procedure, such as insertion of a tube needed to help the patient breathe on a ventilator.

Those types of medical procedures are likely to result in the spread of germs, but it’s also easy to become infected by simply being in the presence of someone with the disease, two of the nurses said.

Sneezes or coughs from people who aren’t undergoing a procedure can spread the virus, which some research shows can remain airborne for three hours.

N95 masks are among the highest grade masks used in hospitals to protect medical personnel from catching diseases that patients have. The federal and state governments are racing to find and ship more N95s to hospitals to ease the growing mask shortage.

Johnson, who is leaving Prisma for another job, said in the past, the hospital had not discouraged the use of N95 masks in tending to patients with airborne infectious diseases. Now, the hospital is relying on looser rules approved by the Centers for Disease Control and Prevention, she said. But neither the CDC nor Prisma should have made those policy changes, she said.

“This is an unreasonable risk and an unacceptable risk,’’ said Johnson, who spoke with ABC News about her worries over the weekend.

Scott Sasser, acute care chief clinical officer for Prisma in the Midlands, said the CDC and World Health Organization have based their recommendations “on science and what is best worldwide.’’ But he said Prisma’s policies, like those of the CDC and WHO, are subject to change.

Two nurses and a doctor, who asked not to be named, agreed with Johnson that Prisma needs to improve its policies.

They said Prisma should allow the N95 masks to be worn around any patient who is positive for the coronavirus or awaiting tests results. Surgical masks are not enough, they said. The nurses and doctor asked that their names not be used to protect them from being fired or from gaining future employment.

One nurse texted state Sen. Dick Harpootlian, D-Richland, to share her worries about the use of N95 masks.

“The public/our patients need to be made aware that our hospital system is ... no longer allowing us to protect ourselves by wearing N95 masks’’ when caring for people under investigation for coronavirus and some patients already confirmed to have it, according to the text message.

In an interview, the nurse who wrote the text told The State she’s worried she will contract the virus or spread it to other patients hospitalized for non-coronavirus related ailments, if she can’t use the N 95 masks anytime she is in contact with a patient suspected or known to have the disease.

“I’m terrified, absolutely,’’ the nurse said, noting that health care workers are dying worldwide. “I would be more than willing to take this (coronavirus) on, as long as I’m protected and they are protecting me to the best of their ability, and my patients.’’

Another nurse said she recently resigned from Prisma because of the lack of precautions.

After receiving the text from the nurse, Harpootlian said he checked with others in the medical community and learned that the nurse’s concern was shared by others. He said the N95 mask issue is one of multiple questions about Prisma’s performance in South Carolina.

The message and “inquiries I made raise grave concerns about Prisma’s ability to meet its obligations to its employees,’’ Harpootlian said.

Officials at Lexington Medical Center, one of the two other major health care systems in the Columbia area, said in an email that their nurses are allowed to use N95 masks when they enter a room with a suspected patient or one who is confirmed, regardless of whether a medical procedure is being done.

This story was originally published April 1, 2020 at 5:19 AM.

Sammy Fretwell

The State

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Sammy Fretwell has covered the environment beat for The State since 1995. He writes about an array of issues, including wildlife, climate change, energy, state environmental policy, nuclear waste and coastal development. He has won numerous awards, including Journalist of the Year by the S.C. Press Association in 2017. Fretwell is a University of South Carolina graduate who grew up in Anderson County. Reach him at 803 771 8537. Support my work with a digital subscription