Health

Nurses say hospitals rarely in compliance with OSHA’s new COVID-19 protections

Nurses frequently report that their hospital employers have initially fallen short of the emergency temporary standard issued by the Occupational Safety and Health Administration (OSHA).

The standard was released in early June and went into effect across July. It requires workplace safety requirements—such as the provision of personal protective equipment—for workers in healthcare settings that treat suspected or confirmed COVID-19 cases.

According to a nationwide survey of more than 5,000 registered nurses conducted by National Nurses United (NNU) around the time OSHA’s emergency temporary standard went into effect, about 23% of respondents say their hospital employer reported COVID-19 exposures in a timely manner. This was down from the 31.6% rate reported in another survey from March.

Roughly 41% of the respondents said COVID-19 testing was available to any staff member that requests it, whereas 20% said it was limited and 7% said that it was wholly unavailable where they work, according to NNU. Among a subset of the respondents, 58% said testing was only available if the individual is symptomatic.

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Two-thirds of the hospital nurses said that all patients arriving at their facility are being screened for COVID-19, and less than a third said they were being tested.

PPE use declined in the time since NNU’s March survey, with the number of respondents who reported wearing a respirator for every COVID-19-positive patient encounter dropping from 75% to 61%, according to the national union.

Two in 5 said respirators were being worn when caring for patients with suspected COVID-19 or incomplete test results, while 62% reported using surgical masks in the same situation.

“COVID cases are surging to their highest levels yet in some areas of the country, and some ICUs are over capacity,” Bonnie Castillo, executive director of NNU, said in a statement. “Nurses need optimal personal protective equipment. Health care employers must notify nurses as soon as possible when they are exposed and make it easier for RNs and other health care workers to get tested.”

NNU’s survey was conducted between June 1 and July 21 and included unionized members and non-union nurses living in all 50 states, Washington D.C. and Puerto Rico.

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The report also found that nearly half of the respondents’ facilities were using “excessive” overtime to run their units and that roughly 2 in 5 hospital nurses fear they will contract COVID-19. Nearly a third said they had faced an increase in workplace violence—up from 22% in the March survey—which they credited to decreased staffing, fewer visitor restrictions and changes in the patient population.

Professional organizations representing nurses and hospitals have been split on this summer’s new pandemic protection standard.

The American Hospital Association submitted comments saying hospitals’ evidence-based measures are already doing enough to protect front-line workers. The Association of American Medical Colleges said compliance would require “significant modifications” to policies and facility structures, which could be difficult with the short time frame for implementation.

The American Nurses Association, however, generally praised the requirements but called for greater clarity in certain areas, such as whether or not state-level PPE supply requirements should take precedence.

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