By Rose O. Sherman, EdD, RN, NEA-BC, FAAN
A nurse manager recently confided that “I know this may sound a little crazy after all the hoopla around lack of PPE in March and April but my biggest problem now is keeping staff vigilant about using it.” I told her that she was the fourth ICU or ED manager who had told me the same thing in the last 4 weeks. The staff is tired of wearing all the PPE. Some are even a little overconfident in their ability to assess the risk of when it is needed and when it is not.
We know that proper donning and doffing PPE is essential for it to be effective and prevent exposure. Yet many staff who wear PPE for long periods of time report having headaches, suffering dehydration, profusely sweating, suffering skin irritation, and having challenges breathing. There is also a general feeling of exhaustion that comes with being constricted by the equipment and often skipping meals because of the time it takes to redon the PPE.
Frustration with the impact of wearing PPE shift after shift leads can lead to staff letting down their guard in attempts to be more comfortable. One manager told me that her staff members often share with her that if the future of nursing involved wearing PPE all the time – they might not be interested in practicing. They are tired of social distancing and miss the hugs and support of their colleagues.
Nurses are not alone in their feelings. In recent global research involving surgeons, decreased overall comfort was cited by 66%, and 82% experienced increased surgical fatigue. Visual impairment was reported by 63%, whereas 54% had communication impediments. The majority feel their discomfort and increased fatigue may have inhibited their optimal surgical performance. The study authors concluded that more user-friendly PPE was needed along with some recommendations about how often professionals should take breaks when wearing it.
A recent Cochrane site review of the evidence on this topic found that healthcare workers point to several factors that influence their ability and willingness to follow PPE guidelines when managing respiratory infectious diseases. These include factors tied to the guideline itself and how it is communicated, support from managers, workplace culture, training, physical space, access to and trust in personal protective equipment, and a desire to deliver good patient care.
COVID-19 has turned from being the sprint that most of us initially believed it would be into being a marathon. How you run a marathon is much different than how you would run a sprint – we have to run the race we are in. The reality of marathons is that runners get tired, often experience soreness, and may have issues sleeping. Some don’t pace themselves well enough and end up dropping out. We can’t overlook the reality of where we are with the virus today. Fatigue is the overwhelming emotion that I hear from nurses. Yet PPE will be a critical part of getting through this marathon safely.
Leaders should know the PPE fatigue is a challenge that professionals will need to confront and look for resilience strategies to mitigate it whenever possible. This would be a great issue to have a professional practice council evaluate within a unit or healthcare setting. The best solutions will come from the staff – they always have when it comes to culture change.
Don’t let nurse leaders in your organization go without development in 2020. Virtual programs include Nurse Leader Coaching, Coaching Staff to Promote Resilience and Leading Teams in Turbulent Times, or schedule your customized Nuts and Bolts of Nursing Leadership Virtual Workshop taught by experts for either new or experienced leaders. Nuts and Bolts Flyer
Read Rose Sherman’s book available now – The Nurse Leader Coach: Become the Boss No One Wants to Leave
© emergingrnleader.com 2020
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