Covid 19 Precautions Are Too Inconsistent

• Covid 19 precautions have be inconsistent throughout various healthcare settings. Variations even range depending on the region and state. 
• Inconsistencies among requirements, restrictions and precautions remain as variants continue to evolve. 
• These discrepancies are not only confusing for patients, but also employees.  Things like mask policies, COVID testing, and vaccination status should be more uniform across the nation for the sake of continuity of care and patient safety.

The topic of this blog is addressing the ever-present issue of COVID-19, and the inconsistent, almost confusing requirements, restrictions, and covid 19 precautions that have been put in place at various hospitals, nursing homes, home health agencies, and assisted living facilities.  

I have been a nurse for almost 15 years. I am a LPN with a formally educated background in wound care. My wife is an RN, currently a full-time student in an NP graduate program.  

Together, she and I have had quite a difficult time these last couple of years, as you might imagine. We both do home health nursing, and contract nursing for third party companies.  

One of the biggest issues that I personally seem to encounter regarding COVID is the “mask/no mask” situation. For various home health companies, I see patients in multiple types of facilities. Most of the time, I see patients in an assisted living facility. 

Covid 19 Precautions Are Inconsistent

It is not uncommon to walk into a given facility and be stopped at the door by someone holding a thermometer. This person would promptly scan your forehead, ask you to sign in, and send you on your way.

If you are wearing a mask of any sort, they will usually not bring the topic up. Then you have the facility that goes a step further. Along with being greeted by the thermometer person, you will also be asked to fill out a short questionnaire.

This questionnaire asks the basic questions regarding signs/symptoms, contact with symptomatic people, travel, etc. So long as you answer the questions with answers that make you seem uninfected, you are sent on your way.

Then finally, we have the facility that you will want everything short of an on-site PCR test before allowing you entry into the building.  

Don’t get me wrong…I am all for continuing to protect ourselves and our patients by having covid 19 precautions in place. The struggle, I think, is the inconsistency.  

I have recently performed nursing duties in facilities that did not even require staff to wear a mask, then in the same day, performed nursing duties in a facility that would not permit anyone to enter without a N95 mask.  

I simply do not understand the wide margin of covid 19 precautions. I’m not saying we should all wear a N95 every time we interact with a patient, but we should at least be able to agree on whether a mask is needed at all. Some do, some don’t, and the rest of us are in the middle, wondering what we should be doing.

This confusion is also passed on to our patients.  

Vaccination Policies

There are several different disciplines of clinicians that see a given patient. Some of which may be contracted through a third-party company.

This particular company may not require a mask if the clinician is vaccinated. So the patient, in this case, may see a nurse with a mask, then a therapist without a mask, then a facility staff member without a mask.

Yet a different facility staff member may have a mask on, so on, and so forth. This type of professional clinical inconsistency causes anxiety for patient. I have been involved in the frustrating task of trying to explain to a geriatric patient why some precautions are observed by some clinicians, then disregarded by others.

Often times, I find myself unable to fully explain to the patient, as it doesn’t make any sense to me either. You can imagine the effect it has on a patient when the clinician’s response is, “I don’t know why some clinicians wear masks, and some do not.” 

In addition to the mask issue, I often find myself in the middle of the vaccination debate. I personally do not feel the need for anyone to disclose whether they have had a COVID vaccination.  

I say this because I look at it like every other vaccination we do or do not get. It seems to me that this is simply another aspect of HIPAA information. I don’t care if anyone knows whether I have been vaccinated or not. If you ask me, I will tell you.  

This topic arises since some facilities such as assisted living, or memory care, require nurses to be vaccinated prior to providing clinical care to their residents. The only way to enforce this requirement is to require a nurse to divulge whether or not he/she/they has received the vaccine. 

The Bottom Line

There are many different aspects of care that have been altered and brought up for debate amidst the COVID pandemic. All we can do is try to maintain consistency in covid 19 precautions and continuity of care, so that our patients are not the ones that end up getting the short end of the stick.

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