Using Trash Bags for Gowns: Interview with a New York Nurse

The United States now leads the world in confirmed coronavirus cases and New York City is the epicenter of the outbreak with over 30,000 confirmed cases.

Health care workers in New York City say the hospitals feel like a war zone. Patients are stacked in beds that line the hallways. So many people are dying that semi-truck trailers in hospital parking lots are being used as make-shift morgues.

The lack of personal protective equipment (PPE) for health care workers has gotten so dire that nurses at New York’s Mount Sinai West hospital posted photos of themselves wearing large plastic trash bags on social media, with the hashtags #heftytotherescue and #riskingourlivestosaveyours. Some nurses blamed the hospital’s lack of preparation for last week’s death of their colleague Kious Kelly, a 48-year-old assistant nursing manager who tested positive two weeks ago.

While Mount Sinai nurses are begging for resources, the hospital’s top executives, who earn millions in compensation every year, are working from the safety of their luxurious oceanfront homes in Florida, according to the New York Post.

RN Diana Torres, a member of the New York State Nurses Association, has been publicly challenging the hospital’s executives, state government, and federal agencies over the dangerous conditions. She spoke with Labor Notes' Chris Brooks.

Labor Notes: Can you describe for me what the hospital is like?

Diana Torres: This virus is not like anything that anyone in my lifetime has seen before. We have failed at stopping it, containing it, and we are paying the consequences for it. I’m scared shitless.

Everyone working in my hospital has been exposed. Most of my coworkers are sick. They don’t know whether they can be tested. We are being told on any given day that you have to present a different range of symptoms to qualify for a test. All these health care workers don’t know if they have it and can’t go home to their families because we don’t know if they will be OK. If hospitals don’t test, then they aren’t taking the precautions necessary to keep the virus from spreading further.

It’s not unrealistic to assume the U.S. could end up in a worse situation than Italy. Our numbers are already worse than every other country. The only people who have been tested are the rich and famous, they are given priority, and the people who are sick enough to be admitted to the hospital.

Because we didn’t have testing in place and we weren’t testing people until they were symptomatic, we couldn’t track the spread of the disease. The only solution to the situation we are in now is for everyone to act as if they have already been exposed. Every single person in the general public should consider themselves a possible carrier of the disease and do everything they can to keep from sharing it with other people. Stay home, don’t go to work if you are not essential, practice social distancing.

We are quickly approaching the day when we are going to have to start picking and choosing who lives and dies based on the availability of equipment in the hospital. That might be the day I throw in the towel and say I can’t do this anymore. I don’t have it in me to make a call like that. Everyone’s life is as important as everyone else’s. We all have a purpose on Earth. And for anyone to die because of government failure is just another form of murder. Health care was already verging on destruction. We were hanging over a cliff by a thread and now we are dropping and are about to hit the bottom.

LN:What could have been different? For health care workers in places that haven’t been hit like New York City yet, what should they learn from your experience?

DT: When we started getting patients, it was complete chaos. We were never prepared. We didn’t have anything in place. The hospital’s leadership, the top executives, the Chief Nursing Officer and Chief Medical Officer, the people that decide how things are going to be done and who is going to do them, refused to acknowledge that we were not ready. They kept reassuring everybody we were ready and everything was in place and once the virus arrived here, then we would be told the plan. And then that never happened.

The day that the first confirmed case came in the door is the day they decided to finally train nurses how to properly use PPE. When you are at ground zero, you don’t wait until the first day of disaster to prepare and get everyone mentally and physically ready. So sure enough, panic hit. Hysteria. Some people were afraid to treat patients because they have children at home they were worried about exposing, they are pregnant, they have underlying conditions, they were scared to death.

Mistake number one: they didn’t prepare any of the staff to take these patients. They didn’t know what the proper PPE would be or how and where to get it. We had been struggling with supplies and staff for over a year now, it was the major focus of our union’s last contract campaign. The pandemic has made all the existing problems so much worse. So from day one, just getting PPE was a major challenge.

Mistake number two: testing took between two and four days to come back. If you don’t have a process in place to get testing done quickly to avoid spreading the disease quickly, then you have to have processes in place to treat everyone as if they have the disease; otherwise you risk spreading it to everyone in the hospital.

Because of these mistakes, the very first COVID-positive patient who came in to our hospital exposed multiple other patients and staff.

It’s literally getting worse every day. We have a responsibility as health care workers, who have the knowledge and are on the front lines seeing the devastation, to sound the alarm and stand up and fight for what we need to protect everyone. Nurses everywhere need to organize and make demands. It’s do or die.

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LN: The Centers for Disease Control (CDC) recently loosened requirements for PPE, going so far as to say that health care workers can use bandannas in place of masks as a last resort. How has the CDC’s decision to lower requirements made things more dangerous?

DT: Everyone in the public needs to understand this: before COVID hit, every single piece of PPE you put on to get in to any encounter was disposable. If I walk into an isolation room where a contagious patient is, then I am wearing a gown, a mask, and gloves. As I come out of the room, everything comes off and I wash my hands, because I have to protect all my coworkers and every other patient who might catch the disease if I become contaminated.

If a disease is airborne, you need an N95 mask. If a disease is passed through droplets, you need a surgical mask and a shield. And either way you need a gown and gloves. Now, after weeks of seeing how the disease was spreading in China and Italy, the pandemic finally hits New York City and infection control goes out the window. Suddenly, all of our PPE is considered recyclable and reusable. We are told by the hospital that there is only one gown or one mask for everyone. The result is that everyone is being exposed to the virus and then contaminating others.

The hospital leadership, the state government, and federal agencies have all made this virus so much more dangerous for everyone through their systemic failure to prepare and then implement processes that would keep us safe.

The CDC and OSHA (Occupational Safety and Health Administration) have lost all credibility among health care workers. These federal agencies lowered their standards and recommendations for what PPE all hospital workers should be required to wear. They said that PPE can be reused.

The hospital administration then does not provide us with the equipment we need, saying they are following the recommendations of the CDC and OSHA. So these federal agencies have limited the liability of the hospitals and increased our exposure. I don’t know who is more guilty, the hospital leadership that made these decisions that resulted in all these health care workers getting sick, or our government and every single agency that was supposed to protect us but instead issued statements that have made this situation far more dangerous.

They are just as bad as the virus. They are guilty.

LN: The photos of Mount Sinai nurses wearing trash bags for gowns has gotten widespread national attention. How did it ever come to that?

DT: We should treat the virus as airborne. We see health care workers in China covered from head to toe. That’s what we want. I want to look like I’m about to go to Mars.

Instead, we were given one gown and were told we could only have that one gown for the entire shift. The gown we were given, the blue gown, is plastic and doesn’t cover our backs.

All of us have patients with COVID and patients without COVID. So if I treat a patient who is confirmed or expected to be COVID, we need to take the gown off before treating a patient who does not have COVID. Since we only have the one gown, we started wearing trash bags over it to try and preserve it. This just shows how desperate things are in the hospital right now.

For any other nurses across the country where the disease hasn’t hit yet, I will just say that those trashbags could be your future. You can’t be quiet about your working conditions. You have to speak up. In New York, we are at our breaking point and things just started.

LN: Some right-wing politicians and corporate mouthpieces are calling for the government to have people return to work. Given how bad things are already, what do you think will be the result of prioritizing the health of the market over the health of human beings?

DT: If New York City starts going back to business as usual, then I am sorry for all of us. The economy is going to be hit no matter what because this virus is spreading like wildfire. We shouldn’t be worrying about corporate profits, we need to worry about saving as many lives as we can right now. The government is hammering the public with messages that we need to save the stock market, but how many people are we willing to sacrifice to make that happen?

The virus is still mutating as it moves from person to person. Increasing the likelihood of mass exposure will not only overwhelm the health system more than it already is, it creates ripe conditions for the virus to mutate and possibly become even more lethal.

LN: Right-wing politicians and media outlets like Fox have been saying that health care workers like you are alarmists, that the coronavirus is no worse than the common flu, that the claims about lack of PPE in hospitals are overblown. How do you respond?

DT: I would invite any of these people to come in to the hospital and spend one day walking in the shoes of a nurse. Come in to Mount Sinai and wear what we are given: a small gown that goes down to our knees and doesn’t cover us fully, one mask and one face shield and one set of gloves that you have to reuse as you walk around to see patients. Then we will see if they still want to claim we are being alarmist as they spend every day over the next two weeks wondering if they are going to become symptomatic from exposure.

So I would challenge anyone who doubts us to put their money where their mouth is and come in here and put yourself in the shoes of the nurses and then tell me if you think we are overreacting.