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Raincoats and paper towels: Nurses and doctors flag lack of protective gear

Nurses have sometimes been advised to fashion makeshift masks using paper towels, staples and rubber bands.

Suojavarustukseen pukeutunut hoitaja ottaa näytettä potilaalta.
A nurse in full protective gear takes a sample from a suspected Covid-19 patient. Image: Roni Lehti / Lehtikuva

Just over 60 percent of doctors caring for Covid-19 patients say they have enough personal protective equipment (PPE) for their work, according to a survey by the Finnish Medical Association, FMA.

Meanwhile a similar poll by the national association of nurses has found that many nursing professionals are concerned about workplace and patient safety as a result of a shortage of protective gear.

Nurses concerned about patient and worker safety

Nursing professionals responding to a survey by the Finnish association of nurses said that they felt that no one cared or took responsibility for occupational health and safety and for workers' security, with respondents flagging a severe shortage of protective equipment in many places.

According to the association, some 740 nurses had responded to the online survey up to last Friday. Some respondents said that in cases where supplies of protective gear were insufficient, employers called on nurses to improvise by using raincoats instead of protective gowns.

"A message came from the head doctor: We are trying to ensure we have sufficient PPE in service housing units. However [you should] prepare to improvise. You can quickly make masks to protect the mouth and nose from paper towels, staples and rubber bands," one nurse recounted in the survey.

"Today we received new guidelines according to which caregivers working in the facility could 'briefly' go into rooms with patients who have tested positive and those suspected of having coronavirus without any protective gear. That doesn't really make any sense," another wrote.

"We are already running low on protective clothing and hand sanitiser at this stage of the epidemic. At my workplace nurses have begun to transport soap and water in canisters in their cars so they can wash their hands," still another nursing professional declared.

Association worried about conflicting guidelines

Of the respondents, 86 percent work in hospitals, eight percent in other healthcare facilities, five percent in supervisory roles, two percent are paramedics and two percent work as midwives, while the rest represent students and other nursing professionals.

Some 86 percent work in the public sector and 12 percent are employed in the private sector.

The nurses' association said that it expected answers about the shortage of protective equipment, but noted that the responses have caused some consternation in the organisation.

"We are especially worried about the situation of the elderly in care homes. There seems to be a particular absence of guidance there and a shortage of PPE," association chair Nina Hahtela said.

Nurses have also spoken out about conflicting guidelines and while many fear for their own health, they are also concerned about patient safety.

"We have been told that we should not begin to revive coronavirus patients without proper protection, the kind that in practice, is not available in hospitals. This simply means that if there is no protection, there is no resuscitation. Let them tell that to loved ones," Hahtela commented.

Raincoats as backup in some hospital districts

Meanwhile Juhani Sand, chief medical director of the Pirkanmaa hospital district, said that the local authority has purchased disposable raincoats in the event that other protective garments are not available.

"The do-it-yourself face masks are not in our guidelines," he pointed out in an email.

The Helsinki and Uusimaa hospital district, HUS, said it has fallen back on a similar contingency and has also stocked up on disposable raincoats. HUS also said that it had not advised nursing staff to use paper towels to make masks.

According to Sand, the Pirkanmaa district is already seeing a shortage of surgical masks.

"Perhaps in relation to the ideal situation where disposable surgical masks would be used in all healthcare contacts - without Covid-19 - there is a shortage of protective equipment. And we have not been able to recommend the use of protective masks these situations, at least not so far," he noted.

The medical chief of staff said however that over the past two weeks the situation has improved with regard to protective gear. He added that it seems that it will continue to improve with the arrival of imported products as well as due to locally-produced items.

Hospital doctors best-equipped

The doctors' survey found that 30 percent of more than 8,500 respondents said that there were occasional shortages of safety gear in their units, while six percent reported equipment shortages as ongoing.

The FMA survey suggested that physicians working at hospitals were the best-equipped when it came to protective outfits, with 60 percent working in such institutions saying that they had enough PPE at the time of the survey. One in four professionals said however that they had not been given sufficient guidance on how to avoid the risk of personal infection with the virus in the workplace.

The FMA also asked doctors experiencing respiratory symptoms whether or not they had been able to get tested for Covid-19. The survey revealed that 83 percent of physicians with symptoms who had been working with coronavirus patients had been tested. However just over 65 percent of doctors working with other patients and who experienced the same symptoms said they had been tested.

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