St. John's nurses protested the suspension of 10 of their colleagues who refused to enter patients' rooms without N95 masks. (Madeleine Pauker)

Nurses at a Santa Monica hospital held a rally Friday to protest management putting 10 of their colleagues on paid leave for refusing to treat coronavirus patients without N95 masks.

Since last Thursday, Providence St. John’s Health Center has suspended 10 nurses who said they would not enter coronavirus patients’ rooms without an N95 respirator, which provides a higher level of protection than a surgical mask. About 10 St. John’s nurses have tested positive for coronavirus, three of whom work in the hospital’s COVID-19 unit.

Earlier this week, a St. John’s spokesperson said recent donations and deliveries ordered months ago have helped bolster the hospital’s supply of N95 masks. Going forward, nurses will be provided with one N95 mask per shift and disinfecting them for reuse using a system recently approved by the Food and Drug Administration.

“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 press release. “We truly honor their dedication to our patients and are gratified we can ease their fears by reprocessing each individual’s N95 mask, utilizing approved technology.”

But nurses said at the Friday rally that they could cross-contaminate positive and negative patients and staff if they only wear one N95 mask per shift. They would also have to take the same mask on and off during a shift, putting them at risk of infection, said Harmony McGehean.

N95 masks do not seal as tightly around the nose and mouth after they are worn for several hours and disinfected, McGehean said.

“There remains a serious global shortage of these masks and conservation methods are critical,” said St. John’s spokesperson Patricia Aidem. “Testing has proven the reprocessing system is highly effective.”

Jack Cline, who has been a nurse at St. John’s for 20 years and was working in the COVID-19 unit when he was put on administrative leave last Thursday, said St. John’s management has told staff that the hospital has a supply of N95s but is refusing to disclose exactly how many.

Doctors throughout the hospital and nurses in other units have been provided with respirators, said Michael Gulick, a nurse who was put on leave on the same day as Cline. On the day they were suspended, six doctors told him they felt it was unsafe to work with COVID-19 patients without N95s, he said.

“They saw us only wearing basic surgical masks on an all-COVID unit and they were surprised and appalled as to why we were only being given that level of protection when they were … going into patients’ rooms with hospital-issued N95 masks,” Gulick said. “They said this is a very unknown and new disease process, and until there’s scientific research … to really conclude the best PPE needed for patients like this, the hospital needs to err on the side of caution.”

Cline said he would treat patients with any available PPE, including surgical masks — but only if the hospital was unable to procure N95s and did not have a stockpile available.

“We need transparency,” he said. “Show us how many masks you have and if I have to, I’m a nurse, I’ll use whatever I have. If I only have a surgical mask I would go into those rooms with that, but I’m not going to go in there if I don’t have to.”

McGehean said St. John’s has refused offers to purchase KN95 masks, a type of mask that performs similarly to N95s and is more widely available. The Centers for Disease Control and Prevention lists KN95s as a suitable alternative to N95s.

Friends and family of nurses with connections to suppliers have offered to sell the hospital tens of thousands of KN95s at between $3 to $4 each, depending on the quantity ordered, according to emails reviewed by the Daily Press.

A donation of 13,000 KN95 masks donated by the Lakers has not yet arrived, McGehean said.

Cline and Gulick said they want to return to their patients as soon as possible, and are calling for the hospital to put them back to work with either N95 masks or KN95 masks that they can dispose of between patients.

“I didn’t abandon my patients, I had six security guards escort me off the hospital property,” Cline said.

madeleine@smdp.com

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4 Comments

  1. Here is the hospitals PR on the matter. They have blown it with the average public person.

    Dear

    It’s hard to believe a month has passed since we began the quarantine in
    Los Angeles due to the COVID-19 pandemic. We have all adapted to this new but temporary world of maintaining physical distance while connecting and supporting one another in creative ways. All of you, our beloved community, have reached out and championed us in this trying time, ensuring that we rise to the challenge, and we indeed feel the love. There are no words to express the immense gratitude we have for all you’ve done and continue to do.

    In just the last four weeks we have received dozens of in-kind donations resulting in personal protective equipment (PPE), hundreds of free and catered meals for our front-line caregivers, and temporary showering facilities so that our medical staff can go home confident that they won’t contaminate their loved ones. We’ve also received nearly $800K in funds that have allowed us to purchase additional PPE and a sterilization machine to safely decontaminate items for re-use to ensure that our staff remain safe and healthy during a time when there is a national shortage of supplies. Through these efforts and an increase in the Providence N95 inventory, we have N95 masks for all of our caregivers providing direct and indirect care to our COVID-19 patients.
    And on a lighter note, the Mullin Plaza in front of the health center has blossomed this spring with potted trees, tables and chairs so that our caregivers and future visitors can enjoy a relaxing moment of fresh air in a calming environment.

    Saint John’s has been the focal point of some unfortunate and mostly one-sided news media coverage generated by the California Nurses Association, the union representing our nurses. We want to reassure you that the safety and wellbeing of our caregivers and patients is our number one priority, and they are given the appropriate equipment needed to safely perform their jobs. We follow the strict guidelines established by the World Health Organization (WHO), the Centers for Disease Control (CDC) and the Los Angeles County Department of Public Health (LACDPH).

    We are so grateful to the heroic work our nurses perform each day and will not let the actions of a few diminish the appreciation we have for those who selflessly and tirelessly come to work each day to care for these critically ill patients. The news stories should be about them and their dedicated efforts.

    It appears the early efforts by our government leaders to isolate and self-distance is working. Saint John’s is not seeing the number of patients we expected, but we are treating some of the sickest who are being transferred to receive Extra Corporeal Membrane Oxygenation (ECMO), a treatment performed by our highly skilled critical care teams. ECMO allows us to attach an external device that oxygenates the blood, allowing the patient’s heart and lungs to rest and heal. It makes us proud to know that we are providing some of the most advanced care available to treat these and other patients who come through our doors.

    Saint John’s is also the home to several clinical trials with the goal of finding a cure to COVID-19. Our Clinical Research team has partnered with biopharmaceutical companies to lead three world-class clinical trials with two of the most promising approaches to treating COVID-19 patients, (1) Remdesmivir, currently the most promising anti-viral agent, and (2) Sarilumab, an IL-6 antagonist that inhibits the deadly anti-inflammatory response of the virus in the lungs and other vital organs. We are also conducting a trial performing plasma infusions that contain antibodies from recovered patients. These COVID-19 clinical trials were developed, approved and activated at Saint John’s Health Center in less than one week, a monumental feat in the research world.

    Additionally, our laboratory team at Saint John’s was influential in procuring rapid on-site COVID-19 testing not only for ourselves, but for all of the PSJH Southern California ministry laboratories. This new test provides results in 1-2 hours, a tremendous improvement from the 48-72 hour turnaround times we and the rest of the region were experiencing. Timely laboratory confirmation of COVID-19 infection is necessary to initiate any of the clinical trial therapies currently underway at Saint John’s.
    Yet, with so much amazing work done in the last month, we still face an uncertain future until a vaccine for COVID-19 is found. Your continued support will enable us to remain at the forefront of research and providing some of the most advanced care available, something that traditionally has been found at academic medical centers, not your local community hospital. How comforting it is to know that this level of care is there for you and your loved ones.

    During these uncertain times, you, our community and supporters, continue to amaze and humble us by coming together for the greater good, supporting your local hospital. Thank you for all you do for Saint John’s!

    In gratitude,

    Michael Ricks
    Chief Executive, Providence Saint John’t Health Center

    Jim Fordyce
    Chairman of the Board, Providence Saint John’s Health Center

    Bob Klein
    President & CEO, Saint John’s Health Center Foundation

    Mary Flaherty
    Trustee & Board Chair, Saint John’s Health Center Foundation

    The mission of Saint John’s Health Center Foundation is to provide
    leadership and philanthropic support to Providence Saint John’s Health Center,
    John Wayne Cancer Institute and Pacific Neuroscience Institute that serveas catalysts for exceptional health care and research.

    To contact Saint John’s Health Center Foundation, call 310-829-8424.

    SaintJohnsFoundation.org

  2. This is disgusting behavior on the part of St John’s management. What is wrong with these people???
    Doctors saying they are appalled.
    Abhorrent behavior.
    Lawsuit on the way, I suppose. Hope so.
    Unfortunately, this is the only way management ever “ gets it”.

  3. Honestly what everyone needs to do is contact the local law enforcement to place charges against Sylvain Trepanier. Sylvain’s actions could directly and intentionally lead to the serious harm of a nurse and they need to be held legally accountable. This is the only way a change will be made. If enough complaints are made on the legal level to law enforcement it is the only way they will care- otherwise Sylvain will only care about their administrator bonus.

  4. A hospital should do the most they can to protect all their people working with Covid 19 patients. If workers need more N 95 masks to change between covid patients then the hospital should transparently make every effort to get enough masks.. I don’t know or understand the technology involved in sterilizing masks between uses, but I do know that taking the same mask on and off throughout the day could weaken the seal of the mask and potentially put a worker at risk. If the best solution is a new mask with each new entry into a patient’s room then I hope all hospitals’ goals are to give out the appropriate number of masks to the nurses and staff . I do wonder if the cost, especially now that a lot of price gouging is going on with buying N95 masks, is driving hospitals to push these sterilization machines instead of procuring a greater number of new n95 masks. All hospitals need to be open and transparent with their doctors, nurses, and supporting staff about what resources they have available. These workers need to know that the administrators are working for the utmost safety of their employees and assure the public that there is total trust, cooperation and transparency between administrators and hospital staff. Hearing about nurses being dismissed or standing on a picket line because of their personal health concerns at work is extremely disconcerting. We, the public, rely on the safety of these brave and necessary people risking their lives during this horrible pandemic. I implore all Providence hospital administrators to try and openly resolve any complaints of safety issues nurses or staff have so that everyone can be satisfied that no undo risk is felt or taken among these hospital worers stepping into a room with a covid 19 patient to take care of them.

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