Whether we want to admit it or not, the COVID19 pandemic is not ending anytime soon. Even with the vaccines coming soon, there is still be months of hard work ahead of us. Using these COVID nursing tips might be able to help!

As nurses, COVID can be exhausting and even somewhat demoralizing. I have felt plenty of burn-out since this all began, and nurses across the nation can relate.

In this article, I will list some COVID nursing tips for ER and inpatient nurses – to help you get through your shift safely!

1. Minimize Contact

This is easier said than done – but minimize your contact with patients who have symptoms consistent with COVID. If you need a refresher, common symptoms of COVID include:

• Fevers
• Cough
• SOB
• Body aches and Headache
• Nausea and Vomiting
• Loss of taste/smell

As an NP, this is actually fairly doable. I can conduct my history at 3-6 feet away, and perform a very limited physical assessment, often without even touching the patient. Sounds terrible, but the safety of healthcare workers is essential.

Bedside nurses are much more hands-on. What I’m going to say might be controversial, but you do not need to listen to every patient with lung sounds. We are going to get a chest X-ray anyway. Minimize contact, minimize exposure, and minimize your risk as best possible.

Patients with COVID often have normal or somewhat diminished lung sounds. Knowing this does not change management. When I do listen to lung sounds, they are patients with asthma, COPD, or CHF, because I’m specifically looking for wheezes or rales.

Make sure you get everything you need before garbing up and entering the room. Bring with your IV equipment and blood tubes, vital sign hookups if not already in the room, any medications already ordered, a COVID nasopharyngeal swab, etc.

If the patient may be discharged and an ambulatory pulse ox might be ordered – might as well get them up and walk them around the room while recording their SPO2. This is using your nursing judgment to anticipate orders. Let’s face it – not all Providers are great about putting in every order at the same time (guilty!).

2. Reduce, Reuse, Recycle (Your N95)

Don’t take your N95 for granted, because they’re running out! At least, that was the worry when this pandemic started and is definitely a possibility if infections and hospitalizations continue as they have been in the US.

However, we can’t afford to be wasteful. Before COVID, we would use an N95 like a surgical mask – apply it when taking airborne precautions, and removing it upon leaving the room. This life of luxury is no more.

Many hospitals have decontamination protocols for N95s – where they decontaminate them in some capacity. However, not every hospital will do this. If needed, there are multiple ways that you can decontaminate your N95 yourself using the following COVID nursing tips.

Bake It

No, really – throw that N95 in the oven! Baking with dry heat at 75° C (167° F) for 30 minutes effectively kills Sars-COV-2. Researchers at Stanford found that this can be done for 20 cycles without significantly reducing the filtration efficiency. Other studies indicated that only 2 cycles proved safe.

Hang the N95 from the oven rack with a wooden paperclip, or place an oven-safe fabric on a metal sheet. Do not place the N95 directly on the metal as this can overheat the mask.

Rotation Schedule

COVID has been found to survive on hard surfaces for 48 hours, plastic for 72 hours, and cardboard for 24 hours. While scientists aren’t 100% sure on the specifics of covid spread via surfaces, they do know that COVID doesn’t spread much through touch.

An alternative method to decontaminating your N95 is to leave it in a safe, warm, dry area and allow it to “air-dry” for 3-4 days. Placing it in a paper bag may be useful for this. This will kill the coronavirus without degrading the filter.

If you have three or four N95s, you can start a rotation cycle and effectively never run out of N95s.

Please note this does not appear to be a well-studied decontamination procedure and is solely based on theory.

Other methods

There are other methods to decontaminate your N95, including moist heat, UV radiation exposure, boiling, and even steaming. These all kill COVID but degrade the N95 at varying rates, and are likely more difficult to perform while at home.

If the idea of having to decontaminate and then reuse your N95 does not fit your desires – you can always skip this COVID nursing tip and buy a reusable N95 Device.

3. Buy a Reusable N95 device

They do make reusable N95 devices which are somewhat affordable and probably worth it.

Using a reusable N95 is more comfortable, less of a hassle, and can leave you feeling more protected.

Envo Mask is all the rage in my ER, and for good reason. This reusable N95 is comfortable and won’t fog your goggles. There are replaceable filters that you use, making this usable forever (but hopefully COVID won’t last forever too).

You can also buy a respirator, which can be cheaper depending on which one you get. If you do, you need to make sure you buy the appropriate filter though, as many of these respirators were intended to be used for occupational exposure. The 2091 filter is recommended by the CDC.

Please be aware it can be somewhat difficult to speak to people with a respirator on, as they can have a hard time hearing. This can be especially difficult over the phone.

4. Protego Skin!

We’ve all seen those horrid photos of nurses who worked 12+ hours in an n95 mask, with deep facial markings to prove it. Many of us have experienced this firsthand.

You shouldn’t only worry about your patient’s skin breakdown. Wearing an N95 for 12 hours straight can cause your own skin-breakdown, and it can be very irritating, painful, and eventually lead to open wounds. There are a few different COVID nursing tips regarding your skin protection that can help!

Take Breaks

To minimize skin breakdown, frequent removal of the N95 is recommended. However, with the COVID pandemic among us – that is not always feasible.

If able to safely remove your N95, the recommendation is to take a 15-minute break every 2 hours. For the vast majority of us, this just won’t work.

Skin Protectant

Probably one of the safest options, you can apply a liquid skin protectant onto your skin. Once applied and allowed to dry, this creates a protective barrier that minimizes moisture and friction.

Any skin protectant should work, and skin repair creams with dimethicone can also be effective. Apply it over the areas where the N95 will cause the most skin breakdown (nasal bridge, cheeks, behind ears). Avoid getting the product in your eyes or mouth.

Good skin protectants to use:

• No Sting Barrier Film
• No-Sting Skin Prep
• Medline Remedy

Make sure to always allow the product to fully dry before applying your N95.

Protective Dressing

If skin protectant doesn’t do the trick – you can try a protective dressing.

The issue with protective dressings is they can alter the fit of the N95. Unfortunately, that could mean catching COVID. This is why skin protectant is a safer option. Still – if your skin really needs it – you can likely put a protective dressing in a safe manner.

Cut a thin dressing into small pieces, and apply a thin layer to the nasal bridge, the cheekbones, and behind the ears.

You should use a foam dressing that has a non-permeable outer layer, so any hydrocolloid dressing should work well. A good example is the Duoderm Hydrocolloid Dressing.

You should attempt to confirm the N95 fit by blowing out and seeing if there are any leaks. Definitive fit testing can also be done and is more accurate, although may not be feasible on the unit.

5. Surgical Mask Woes

Even with using our N95s, we are still recommended to be using a surgical mask on top of that. This prevents soiling of the N95 mask and adds that extra layer of protection for splashes.

Unfortunately, surgical masks wrap around your ears and they can lead to skin breakdown of your ears and just hurt.

There are scrub caps and headbands with buttons sowed on which you can loop the surgical mask onto, which takes the pressure off of your ears entirely.

They also make plastic devices that connect both sides and loop around the back of your neck. You can even MacGyver your own version with some rubber hands and/or paper clips.

 

 

6. Bad Breath

No – wearing a mask won’t give you hypercarbia… But it can give you hyper-halitosis. If you have bad breath – you’ll definitely notice it now. Sure, bad breath won’t kill you, but it’s just not fun to be breathing in for 12 hours.

Working 12-hour shifts without time for water breaks will cause dry mouth and will increase the odor of your breath as well!

One easy fix is to buy some gum. This leaves your breath smelling minty and fresh. If you’re someone who needs more help for your halitosis, you can try special toothpaste or special mouthwash.

Make sure you are able to stay hydrated. Drink plenty of water before your shift (not that you’ll have much time to pee). Try to take a few breaks throughout the shift just to drink some water and stay hydrated.

7. Wrap it Before you Tap It

No – I’m not talking sex-ed. I’m talking about your smartphone!

Let’s be real, we all bring our phones to work. No, we probably don’t have time to scroll Instagram (follow me!), but we occasionally check the time and maybe our messages.

I personally use multiple apps on my phone throughout my shift to help with antibiotic selection or to reference something related to patient care.

The problem is, we don’t want to contaminate our phones with COVID or who knows what else.

One simple COVID nursing tip is to bring a Ziplock baggie to work that your phone easily fits in. Ziplock it shut. Your touch screen actually works through the ziplock bag!

You could also just leave your phone at home – but if that doesn’t give you anxiety thinking about it, then something is wrong with you.

If you risk it and just use your phone while at risk, you should know how to decontaminate your phone. Pro Tip: Don’t put your phone in the oven like the N95!

8. Decontamination Station

After a long shift working with COVID patients ALL day (or night), there is nothing you probably want more than to get home and crawl in bed. But you are also aware of all the NASTINESS on your body, scrubs, and everything else you’ve touched.

You need to have a procedure for how you clean yourself and your items. The last thing you want to do is infect members of your household!

Leave anything items you can at work, like your stethoscope, scissors, pens, penlights, etc. If you have a locker – use that!

Make sure you carry hand sanitizer in your car. Use it immediately once you get in before touching the steering wheel. Do not touch your face now that you are maskless.

Once you get home, find a way to strip quickly without touching anybody or anything. I put anything in my pockets (like my phone) on the island counter. I put my clothes directly in the washing machine. Take an immediate shower with hot water and plenty of soap.

After this, I personally go through and wipe down everything I touched including the doorknob, the bathroom door, etc with a disinfectant. I then wipe down all the items I had placed on the island counter. You can use clorox wipes, lysol wipes, but I personally use Original Pine-sol which kills COVID within 10 minutes (THAT’S the power of Pine-sol baby).

Other related content:

• 10 IV Insertion Tips for Nurses

• 10 Nursing Hacks Every ER Nurse Should Know
• Arterial Blood Gas (ABG) Interpretation
• 5 Advanced Physical Exam Maneuvers

COVID Nursing Tip: Always Follow Hospital Policy

As always you should ALWAYS be following hospital policy and procedures whenever implementing any of these COVID nursing tips. This is an unconventional time, so there may not be much oversight regarding infection control practices, but make sure anything you do is safe for you and your patients.

Comment down below your COVID Nursing tips!