As nurses grapple with burnout and staffing shortages, new guidance has them fearing for their own health

Marcial Reyes, an ER nurse and a COVID-19 survivor, stands outside the ambulance entrance at the Kaiser Permanente Medical Center in Fontana on Monday, Jan. 18, 2021.
Marcial Reyes, an ER nurse and a COVID-19 survivor, stands outside the ambulance entrance at the Kaiser Permanente Medical Center in Fontana on Monday, Jan. 18, 2021.
  • Updated guidance instructs nurses to provide chest compressions to COVID-19 patients without delay.
  • The guidance means nurses must forego personal protective equipment to quickly perform compressions.
  • A petition condemning the guidelines has amassed more than 11,000 signatures in two weeks.

In late December, nurses began filling TikTok, Reddit, and Twitter with exasperated comments about recent updates made by the American Heart Association to its CPR guidelines.

When nurses need to administer CPR to patients with suspected or confirmed cases of COVID-19, the updated guidance now instructs them to provide chest compressions without delay or interruption, even if it means foregoing personal protective equipment (PPE).

The AHA cited a more stable PPE supply chain, increased vaccination rates, and limited data on the incidence of COVID-19 transmission to health care providers during chest compressions as rationale for its reassessment and update of the guidelines.

The AHA told Insider, it "cares deeply about healthcare providers" and will "continually assess the science" so that it protects both patients and health care providers.

"We strongly support wearing appropriate PPE during incidence of cardiac arrest, while recognizing how crucial it is to minimize delays in compressions. Currently, volunteer resuscitation experts are actively working to update the recommendations in light of the rapidly evolving pandemic and new variant," an AHA spokesperson told Insider.

Decisions by regulatory bodies have left nurses feeling 'disposable'

Nurses voiced their opposition to the new AHA guidance by starting a petition in honor of Celia Marcos, a Los Angeles nurse who died in April 2020 after contracting COVID-19 from an infected patient experiencing a "code blue," a medical emergency indicating either cardiac or respiratory arrest.

Marcos did not stop to obtain an N95 mask and attempted to save the patient in the thin surgical mask she was already wearing, the Los Angeles Times reported in May 2020. She died 14 days later.

"We recognize and honor our fallen sister, Celia Marcos, RN, who died of COVID-19 after rushing into a patient's room to perform CPR without donning PPE. She died fighting this terrible virus and attempting to save the life of a patient. The new AHA guidelines do not appropriately reflect the sacrifice and heroism of Nurse Marcos and ask the rest of us to do the same," the petition states.

More than 11,000 individuals have signed the petition, which asks the AHA and other regulatory bodies like the Centers for Disease Control and Prevention to reevaluate their guidelines in order to prioritize the health and dignity of health care providers.

In addition to changes in care guidelines, nurses are also grappling with staffing shortages, poor mental health, and overall burnout amidst the pandemic, causing many to consider leaving the profession.

In June 2021, Beth Armentrout decided to pursue a PhD in neurological-based clinical research and leave the nursing profession, which she said made her feel disposable. Armentrout told Insider that governing bodies like the AHA tend to espouse support for nurses, physicians, and hospital staff while simultaneously making decisions that negatively impact their day-to-day work.

"The fact of the matter is that the governing bodies that tout support of medical professionals are siding with greedy hospitals and hospital administrators putting nursing, physicians, and support staff at risk," Armentrout told Insider in an email. "Nurses are a female-dominated profession so apparently we can be treated as disposable. To quote a TikTok I saw today, 'They would never do this to firemen.'"

Hospital staffing shortages may worsen if more nurses contract COVID-19 at work

Nurses who have chosen to remain in the profession are predominantly treating patients with the highly transmissible Omicron variant, which now makes up the majority of COVID-19 cases in the US.

As a float nurse in a community hospital, Julia B., whose identity Insider has independently verified, worries that the new AHA guidance will exacerbate the industry's existing staffing shortages and ultimately cost health care providers their lives.

"The AHA decision is just one in a long line of choices from the health care industry that has disenfranchised its workers, but it certainly further legitimizes this mistreatment," Julia said in an email to Insider. "We are dying. And we are not replaceable... Patients die due to short staffing. And staffing has never been as short as it is now."

Nurses who have chosen to stay at the bedside told Insider that they do their best to provide quality care in light of staffing shortages but struggle as patients far exceed the number of medical professionals available to care for them. Low wages and an increased workload have plagued nurses across the country, prompting many to push for better working conditions through unions.

"We've been criminally underpaid for 50 years, and been gaslit into believing that's okay because 'just think of the patients,' or 'it's your calling,'" Conrad said. "Hospitals view nurses and CNAs as an expense to be cut as often as possible, as opposed to what it really is: the only thing keeping patients alive."

Still, health care regulatory bodies have already pushed some nurses past the brink. Joy B., whose identity Insider independently verified, left nursing after more than two decades of service because decisions made by organizations like the AHA had worn her "down to a stump."

"I read a post on Reddit saying nurses don't have to light themselves on fire to keep other people warm. Truer words have never been stated," Joy said. "I miss patient care most days, but I've realized through reading this [Reddit] board, and organizations like AHA demanding nurses set themselves on fire for subpar working conditions, possibly death, and zero support, that 24 years was enough."

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