You'll seldom find me unhappy about somebody criticizing hospital administrators.
The good ones are few and far between.
As density of cases rise, increase protections become prudent.
There's no reason for me to walk around in a PAPR and face mask like my ED colleagues and I Don't likely need an n95 to go about my duties with my obstetric patients. If anesthesia or the ED is using these items and wish to leave them in place to avoid the risk of taking them on and off go right ahead.
On the other hand I am increasingly concerned that most likely I will get infected from a nurse or other chain, not direct patient care where I am most aware of my precaution needs.
I'm also increasingly concerned about my own asymptomatic spreading As our local density of cases increases and the hospital inevitably becomes the focal point of infection.
I am 100% masked in all patient care at this point with surgical mask. Not for me to avoid getting sick from these patients as much for me to not be a spread of infection to my patients.
Because masking and unmasking requires a technique, l leave my mask in place the entire time that I'm in the hospital.
I watched my own behavior today as I went around the hospital, stopping to use a telephone to dictate, using a computer, etc.
How clean are these workstations? The doctor's computers are in the nursing area pod. When was the same telephone wipe down recently? when will we have our first missed case that ends up positive on the floor unexpectedly?
I dump my hospital mask after use. I put a new one on for clinic. I use an n95 with proper PPE for higher risk patients, but there is no intentional caronavirus evaluation in the outpatient setting right now. If you called me and sounded like a covid You're staying home for mild symptoms or you're going to the ED for evaluation. They've got the right gear.
We're not off in a bad way at our hospital right now. But I am seeing many of my colleagues being asked to perform care with substandard protection At other institutions around the country. The ED and anesthesia stand out to me is the absolute highest risk and should be provided whatever they need. Those health care workers that are in high risk groups by age or comorbidity should absolutely have the flexibility to be better protected.
Overall I am most concerned about the lack of standard guidance and response. The institutional and geographic variation in American medicine is showing itself in this response as well and it's not comforting to me.
@Splinty ,
