COVID and crowded workspaces

[Strawberrylover]

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Just wondering if anyone else has noticed this too...once everything opened up, many work spaces were good about distancing-but that hasn't been my experience in rotations.
The workspaces we have are extremely crowded, definitely not following the 6 feet or even 3 feet rule. I've often been shoulder to shoulder with other residents, MAs, techs in crowded workrooms. Many people are not adherent to COVID guidelines either-they frequently have been maskless even when not eating or drinking, talking loudly and laughing while maskless, etc. Such people have sometimes come to work coughing, one of them even outright felt sick and was still at work.
Officers from Infection Control visited us once and warned us to be careful and left-no changes were made.
COVID is spreading heavily in my geographic region and cases are rising. I'm very worried but also feel that as a student I'm powerless. What do I do?

 

[ArteryStudyPainting]

Talk to your student affairs.

 

[Tenk]

Nobody likes a snitch.

 

[NicMouse64]

wear a N95 at all times if uncomfortable, along with proper eye protection. Its what I do and I get some judgy looks at first but then people just kinda shrug their shoulders and say whatever.

 

[Matthew9Thirtyfive]

**** that. I’m not getting covid because some dingus doesn’t want to put a mask on in a hospital. Report that ****.

 

[TwoHighways]

I wear a self contained breathing apparatus 24/7. You can’t be too safe. N95’s just don’t cut it.

 

[jurassicpark]

First of all, no one should not be wearing a mask when not eating/drinking/etc. Masks should be on at all times. If not wearing a mask, safe distances should be observed. That should be reported and dealt with.

That being said, in a hospital setting otherwise safe distance is non existent when working on the floor. You are up close and personal with everybody, there's no room to separate and do our work. But most of the hospitals I work at, we are masked and shielded on the floor to minimize transmission to the best of our ability. Some lucky sods get paprs. I really wanted to come in with a military gas-mask, but administration has repeatedly threatened to discipline me if I did that, and told me I can't wear my skull masks, etc. They're real party poopers truth be told.

 

[wholeheartedly]

Nobody likes a snitch.

True, but at my hospital we had two different groups have major exposure episodes in one week doing crap like this when one of those folks later turned out to be positive and then others subsequently become positive after the exposure. Small hospital and the consequences of a break room birthday party shut down the surgery dept.

That pissed off way more people. Plus notifying patients they were exposed to a positive staff member sucks as well.

Despite knowing this another dept had a birthday potluck days later, one of them was pos, and more chaos ensued. Now people are finally doing what they’re supposed to.

OP, humans are a bit hard headed and healthcare workers are no exception. I work as a hospital epidemiologist and infection preventionist and this is the pattern everywhere. They aren’t going to get it until it bites them in the rear or they have a close call. Then they do better.

Try to protect yourself best you can with your own masking/face shield etc., if comfortable report it anonymously if you can to either infection control or your someone from your school (it doesn’t doesn’t even have to be a report, you can just ask how you can best protect yourself in that situation).

 

[Mass Effect]

Just wondering if anyone else has noticed this too...once everything opened up, many work spaces were good about distancing-but that hasn't been my experience in rotations.
The workspaces we have are extremely crowded, definitely not following the 6 feet or even 3 feet rule. I've often been shoulder to shoulder with other residents, MAs, techs in crowded workrooms. Many people are not adherent to COVID guidelines either-they frequently have been maskless even when not eating or drinking, talking loudly and laughing while maskless, etc. Such people have sometimes come to work coughing, one of them even outright felt sick and was still at work.
Officers from Infection Control visited us once and warned us to be careful and left-no changes were made.
COVID is spreading heavily in my geographic region and cases are rising. I'm very worried but also feel that as a student I'm powerless. What do I do?

As @Matthew9Thirtyfive said "report that ****." Every teaching hospital has an anonymous GME hotline. I would try to report it anonymously to your hospital's GME hotline. Give department, resident versus attending, and details of what's going on. Then call risk management and let them know. Risk management is notorious for being the most annoying dept in the hospital because their sole job is to protect the hospital from lawsuits.

You can also report it anonymously to your city's mayor and DPH who may take swift action against the hospital and send in their own peeps to scope things out. When the hospital's on their radar, you better believe from a liability standpoint (no hospital wants to be sued by dozens of patients who get sick from COVID), there WILL be changes.

Nobody likes a snitch.

Then they should stop being idiots. Otherwise, snitch away.

 

[mehc012]

Yeah, they cram like 6 of us into a tiny workroom 'rated' for 2, but that should really only safely house 1 person if social distancing were taken into account. The elevator limits are a joke.

Sure, they'll make us all wear N95s for 15min after intubating a patient who tested negative within 3d, but god forbid they actually give residents safe spaces to work in.

I commented on it once and got SHUT. DOWN. 7 people in a tiny, airless, windowless room so hot that we kept the lights off all day to minimize any additional heat, we all eat our meals in that room so masks come off frequently. You can't even get up and leave the room without making 3-4 people move out of your way because there is not enough space between people to walk through. Seriously can't be more than a 6ft x 12ft room with 4-5 people stationed there for the entire day, often up to 7 people for short periods. But I mention it once, and get yelled at.

I'm not a huge stickler, but damn.

 

[Strawberrylover]

Nobody likes a snitch.

In normal conditions, I wouldn't even have thought about it. But this is in the middle of a pandemic. There's clear research showing that conditions like this can lead to the spread of the virus. It wouldn't be doing patients or anyone any good to have techs/doctors/nurses who had the virus.

 

[NicMouse64]

Yeah, they cram like 6 of us into a tiny workroom 'rated' for 2, but that should really only safely house 1 person if social distancing were taken into account. The elevator limits are a joke.

Sure, they'll make us all wear N95s for 15min after intubating a patient who tested negative within 3d, but god forbid they actually give residents safe spaces to work in.

I commented on it once and got SHUT. DOWN. 7 people in a tiny, airless, windowless room so hot that we kept the lights off all day to minimize any additional heat, we all eat our meals in that room so masks come off frequently. You can't even get up and leave the room without making 3-4 people move out of your way because there is not enough space between people to walk through. Seriously can't be more than a 10ft x20ft room with 4-5 people stationed there for the entire day, often up to 7 people for short periods. But I mention it once, and get yelled at.

I'm not a huge stickler, but damn.

same thing at my hospital. I refused to take my eyewear and envo mask off in that specific room. Would wear a surgical mask elsewhere. People started to get the point. When an attending walked in and saw me looking at them with full battle gear on they moved medical students elsewhere.

 

[Strawberrylover]

Yeah, they cram like 6 of us into a tiny workroom 'rated' for 2, but that should really only safely house 1 person if social distancing were taken into account. The elevator limits are a joke.

Sure, they'll make us all wear N95s for 15min after intubating a patient who tested negative within 3d, but god forbid they actually give residents safe spaces to work in.

I commented on it once and got SHUT. DOWN. 7 people in a tiny, airless, windowless room so hot that we kept the lights off all day to minimize any additional heat, we all eat our meals in that room so masks come off frequently. You can't even get up and leave the room without making 3-4 people move out of your way because there is not enough space between people to walk through. Seriously can't be more than a 10ft x20ft room with 4-5 people stationed there for the entire day, often up to 7 people for short periods. But I mention it once, and get yelled at.

I'm not a huge stickler, but damn.

This is what I've observed too-that when many other companies, etc opened up, they made sure to observe safe distancing, etc. But that rule hasn't seemed to penetrate hospital systems. I get that sometimes, when we are supervising patients etc, working with others, 6 feet can't always be observed. But there are other situations, like the ones you and I mentioned, where the spread of illness is totally preventable, but administration just doesn't see it as a priority. I don't understand that-as medical personnel we are really helping everyone stay healthy-so, just like the preventable spread of illness is indeed prevented for everyone else, why not for us? I too was in that kind of situation, where you couldn't even get up and leave w/o making others move around. Sitting shoulder to shoulder with people-who then would often not wear masks (even when not eating/drinking).
Someone straight up came in sick once, and with congestion so bad her voice sounded muffled-she was coughing. A supervisor asked her why she's here if she is sick, she said she "needed the hours" ( was a trainee)-and they let her stay...

 

[Tenk]

As @Matthew9Thirtyfive said "report that ****." Every teaching hospital has an anonymous GME hotline. I would try to report it anonymously to your hospital's GME hotline. Give department, resident versus attending, and details of what's going on. Then call risk management and let them know. Risk management is notorious for being the most annoying dept in the hospital because their sole job is to protect the hospital from lawsuits.

You can also report it anonymously to your city's mayor and DPH who may take swift action against the hospital and send in their own peeps to scope things out. When the hospital's on their radar, you better believe from a liability standpoint (no hospital wants to be sued by dozens of patients who get sick from COVID), there WILL be changes.



Then they should stop being idiots. Otherwise, snitch away.

In normal conditions, I wouldn't even have thought about it. But this is in the middle of a pandemic. There's clear research showing that conditions like this can lead to the spread of the virus. It wouldn't be doing patients or anyone any good to have techs/doctors/nurses who had the virus.

I didn’t say you shouldn’t snitch.

I said nobody likes snitches (which they don’t).

Tread carefully. People are on edge.

 

[Tenk]

I wear a self contained breathing apparatus 24/7. You can’t be too safe. N95’s just don’t cut it.

This is actually false. They do. I’ve seen plenty of covid 19 patients and am doing just fine.

 

[NicMouse64]

This is what I've observed too-that when many other companies, etc opened up, they made sure to observe safe distancing, etc. But that rule hasn't seemed to penetrate hospital systems. I get that sometimes, when we are supervising patients etc, working with others, 6 feet can't always be observed. But there are other situations, like the ones you and I mentioned, where the spread of illness is totally preventable, but administration just doesn't see it as a priority. I don't understand that-as medical personnel we are really helping everyone stay healthy-so, just like the preventable spread of illness is indeed prevented for everyone else, why not for us? I too was in that kind of situation, where you couldn't even get up and leave w/o making others move around. Sitting shoulder to shoulder with people-who then would often not wear masks (even when not eating/drinking).
Someone straight up came in sick once, and with congestion so bad her voice sounded muffled-she was coughing. A supervisor asked her why she's here if she is sick, she said she "needed the hours" ( was a trainee)-and they let her stay...

Revolutionary reusable respirator masks | envo masks there saved you a whole lot of time and trouble. As others have said...no one likes a snitch, but in that regards you should also protect yourself. If you want just make up some story about how some guy you knew ended up in an ICU or something and that's why you are extra careful.

 

[calivianya]

Revolutionary reusable respirator masks | envo masks there saved you a whole lot of time and trouble. As others have said...no one likes a snitch, but in that regards you should also protect yourself. If you want just make up some story about how some guy you knew ended up in an ICU or something and that's why you are extra careful.

I wish. Anybody else's hospital also say the only acceptable masks are the surgical ones provided by the hospital, and you can't wear outside masks when on premises? I would 1000% buy that to wear in the hospital, but wouldn't bother for just going to the grocery store (pretty low rates here in the community).

To be fair, the hospital isn't letting medical students (or even first year residents) see COVID or r/o COVID patients... but we all know of patients who weren't even suspected of having COVID when we saw them either due to misinterpretation of symptoms and/or negative initial tests, but who were tested (again) later and popped positive.

Also, funny joke when the doc and a nurse go in to swab the patient for COVID wearing protective gear and N-95s... and it's a pediatric patient that you just saw first, who was screaming bloody murder in your face and thrashing while you were trying to look at their ears, nose, and throat for a good few minutes with your trusty surgical mask protection, who you were allowed to see because the rapid strep/flu/RSV hadn't come back negative yet and they hadn't yet had a reason to suspect COVID during triage.

 

[NicMouse64]

I wish. Anybody else's hospital also say the only acceptable masks are the surgical ones provided by the hospital, and you can't wear outside masks when on premises? I would 1000% buy that to wear in the hospital, but wouldn't bother for just going to the grocery store (pretty low rates here in the community).

To be fair, the hospital isn't letting medical students (or even first year residents) see COVID or r/o COVID patients... but we all know of patients who weren't even suspected of having COVID when we saw them either due to misinterpretation of symptoms and/or negative initial tests, but who were tested (again) later and popped positive.

Also, funny joke when the doc and a nurse go in to swab the patient for COVID wearing protective gear and N-95s... and it's a pediatric patient that you just saw first, who was screaming bloody murder in your face and thrashing while you were trying to look at their ears, nose, and throat for a good few minutes with your trusty surgical mask protection, who you were allowed to see because the rapid strep/flu/RSV hadn't come back negative yet and they hadn't yet had a reason to suspect COVID during triage.

I'd escalate to student affairs in this case.

 

[calivianya]

I'd escalate to student affairs in this case.

Nah, I had to move nearly 1,000 miles to be here. I’m sure as heck not paying another $5k+ to have to move back closer to the school again, if they could even find me a different rotation site.

This is the same rule that applies to the employees, so if I have a problem with it, I’m not welcome in the building. Besides, it’s a pretty common rule (many of my employed friends are working under a similar rule... was just curious how many other hospitals are taking this precaution). Hospitals can only guarantee the quality of the masks they provide - it’s a liability issue to let outside masks in, especially if it proves faulty (unlikely, but possible) and someone pops positive after coming into contact with a worker/student wearing a non-approved mask.

 

[NicMouse64]

Nah, I had to move nearly 1,000 miles to be here. I’m sure as heck not paying another $5k+ to have to move back closer to the school again, if they could even find me a different rotation site.

This is the same rule that applies to the employees, so if I have a problem with it, I’m not welcome in the building. Besides, it’s a pretty common rule (many of my employed friends are working under a similar rule... was just curious how many other hospitals are taking this precaution). Hospitals can only guarantee the quality of the masks they provide - it’s a liability issue to let outside masks in, especially if it proves faulty (unlikely, but possible) and someone pops positive after coming into contact with a worker/student wearing a non-approved mask.

Are they forbidding you from wearing n95s? Do they do aerosolizing procedures? This policy makes no sense.

 

[wholeheartedly]

Are they forbidding you from wearing n95s? Do they do aerosolizing procedures? This policy makes no sense.

There has been a huge proliferation of counterfeit and poor quality masks, so it is a valid concern. The process to review/approve all of them individually as people bring random stuff in is too tedious. The other issue is that sometimes people want to bring in masks with exhalation valves which gives you some protection from the patient but doesn’t protect the patient from you. Lastly it can create a lot of confusion as to what staff are supposed to be doing if they see other people doing something different, a lot of confusion.

That said, since we’re a small shop I usually have a chance to address any concerns on rounds and approve any alternatives. I also made sure our policy states that staff are not prohibited from bringing in a higher level of protection if we are unable to provide it, but that they are recommended to clear it with us to ensure its not counterfeit, they know how to use it, fit testing, etc.

 

[NicMouse64]

There has been a huge proliferation of counterfeit and poor quality masks, so it is a valid concern. The process to review/approve all of them individually as people bring random stuff in is too tedious. The other issue is that sometimes people want to bring in masks with exhalation valves which gives you some protection from the patient but doesn’t protect the patient from you. Lastly it can create a lot of confusion as to what staff are supposed to be doing if they see other people doing something different, a lot of confusion.

That said, since we’re a small shop I usually have a chance to address any concerns on rounds and approve any alternatives. I also made sure our policy states that staff are not prohibited from bringing in a higher level of protection if we are unable to provide it, but that they are recommended to clear it with us to ensure its not counterfeit, they know how to use it, fit testing, etc.

it's a weird policy to have a surgical mask be better than a counterfeit n95. I get the principle but it really makes no sense in my opinion. People should be allowed to wear a N95 at all times if they so choose.

 

[Type2Fiber]

As a student your risk is so low its not worth worrying about. The data (table 1, scenario 5) are explicitly clear that 20-49 year olds are at very low risk (IFR of .0002). I don't understand why people get offended by reality, medical students face a very marginal risk

Wear a high-quality mask any time you're around patients and stay home if symptomatic, that's the extent you can be useful. Most of this distancing in the hospital is complete theatre and we all know it. Snitching on people is a fantastic way to ensure a miserable rotation, especially if people learn it was you

 

[wholeheartedly]

it's a weird policy to have a surgical mask be better than a counterfeit n95. I get the principle but it really makes no sense in my opinion. People should be allowed to wear a N95 at all times if they so choose.

I agree with you in principle, but you should see all of the weird not at all ok some of the staff have wanted to do....

 

[calivianya]

Are they forbidding you from wearing n95s? Do they do aerosolizing procedures? This policy makes no sense.

They would let us wear an N-95 if we were in a situation where we needed to - we would just have to use hospital stock, which is why we're forbidden from going in to see COVID and COVID rule-out patients in the first place. After the last N-95 shortage, there's no reason to let a med student ever be in a situation where he/she needs to use a N-95. There's always the possibility the US runs into supply chain problems again in the winter, and it would be really stupid to run out of N-95s for the respiratory therapists, nurses, etc. because they wasted them on a bunch to med students who can't do anything useful anyway.

The logic is sound - it just falls apart when a patient isn't a COVID or a COVID rule-out until after the med student has already seen the patient.

 

[NicMouse64]

They would let us wear an N-95 if we were in a situation where we needed to - we would just have to use hospital stock, which is why we're forbidden from going in to see COVID and COVID rule-out patients in the first place. After the last N-95 shortage, there's no reason to let a med student ever be in a situation where he/she needs to use a N-95. There's always the possibility the US runs into supply chain problems again in the winter, and it would be really stupid to run out of N-95s for the respiratory therapists, nurses, etc. because they wasted them on a bunch to med students who can't do anything useful anyway.

The logic is sound - it just falls apart when a patient isn't a COVID or a COVID rule-out until after the med student has already seen the patient.

every patient is potential COVID in my book. But I guess someone has convinced you that you are safe without a N95 so good for you, I guess. I don't see COVID patients or r/o either. I still wear a n95 the entire day.

 

[mehc012]

There has been a huge proliferation of counterfeit and poor quality masks, so it is a valid concern. The process to review/approve all of them individually as people bring random stuff in is too tedious. The other issue is that sometimes people want to bring in masks with exhalation valves which gives you some protection from the patient but doesn’t protect the patient from you. Lastly it can create a lot of confusion as to what staff are supposed to be doing if they see other people doing something different, a lot of confusion.

That said, since we’re a small shop I usually have a chance to address any concerns on rounds and approve any alternatives. I also made sure our policy states that staff are not prohibited from bringing in a higher level of protection if we are unable to provide it, but that they are recommended to clear it with us to ensure its not counterfeit, they know how to use it, fit testing, etc.

Yeah, and the policy of only allowing hospital masks is common here.
The problem is, most of the counterfeit/poor quality masks I've seen have been the ones the hospital itself uses. Ear loops that will snap off within 5min of wearing it, plastic non-conforming nose strips instead of metal malleable ones, designed such that they slide off your nose at default...the masks I have at home are better quality, by far.

 

[mehc012]

every patient is potential COVID in my book. But I guess someone has convinced you that you are safe without a N95 so good for you, I guess. I don't see COVID patients or r/o either. I still wear a n95 the entire day.

Then you are by far in the minority. I only see this in the ED or trauma wards.
Which is fine, you do you...but no need to be on a high horse about it.

 

[TwoHighways]

As a student your risk is so low its not worth worrying about. The data (table 1, scenario 5) are explicitly clear that 20-49 year olds are at very low risk (IFR of .0002). I don't understand why people get offended by reality, medical students face a very marginal risk

Wear a high-quality mask any time you're around patients and stay home if symptomatic, that's the extent you can be useful. Most of this distancing in the hospital is complete theatre and we all know it. Snitching on people is a fantastic way to ensure a miserable rotation, especially if people learn it was you

There is no room for facts and reason when discussing the rona!

 

[Candidate2017]

The worst offenders for clustering around tight workspaces and workrooms are med students huddled together and pecking away on keyboards for way too long on pretend notes. Med students are also prone to clustering around the attending. This isn't the African savannah where you get eaten by lions if you hang back and don't cluster.