Has Critical Thinking Given Way to Rigid Protocols in the Medical World?

N95 Mask

During a busy week at the hospital where I work, it is announced that we need to be fit-tested for N95 masks. It has been two years since the start of the Covid 19 pandemic and this particular yearly task dictated by the Occupational Safety and Health Act (OSHA) of 1996 for medical institutions, has been allowed to be extended to two years. We have been wearing regular surgical masks throughout this whole time continuously and also wearing N95s during high-risk aerosol generating procedures and other contacts in the operating room. Covid numbers have now dropped significantly, and Employee Health has the time to concentrate on making sure all employees have the proper fitting N95s to wear.

There are to be several days during work time when we can sign up to be fit-tested at the hospital building. There is only one day available that I actually work. I find this requirement somewhat useless but decide I might as well sign up and get it over with. I try to follow the rules most of the time. One of my co-workers gives me the phone number to make this appointment. I dial the number.

“Do you have a time available on Tuesday for me to be fit-tested for the N95?” I ask.

“Yes,” says the Employee Health nurse, “We have a 12:30 slot that day. But wait… There is a note here that you need to have a medical evaluation before fit-testing.”

“No,” I say, “I don’t. I was fit-tested when I started working here almost two years ago and nothing has changed. I have been wearing an N95 for this whole time.”

“Well, let me check on this and I will get back to you,” she responds.

I don’t understand this. It makes no sense to me, but I let it go for the time being and go on with my day. My cell phone rings late in the afternoon while I am waking my last patient of the day from their surgical procedure. I let it go to voicemail. Once I am done, I call the nurse back.

“Yes, you need to be medically evaluated before you can be fit-tested. I don’t feel comfortable having you wear a mask until you are medically cleared.”

“What…..??? I don’t understand. I answered that questionnaire 18 months ago and no one seemed concerned at the time. Now they want to hold me to some standard from something I answered months ago. “What seems to be the problem?” I am totally frustrated.

“You marked some things on your pre-evaluation sheet that red-flagged you. You marked that you have had broken ribs, an arrythmia, and a stroke. You also marked that you have anxiety when wearing a mask. You should never have been fit-tested a year and a half ago before being seen by a doctor. I don’t know how you got through.”

This is totally ridiculous and now I am angry. My broken ribs were 10 years ago. The arrythmia has existed since I was a teenager with no one being concerned about it. The stroke several years ago was a mild one from which I am totally recovered. I have gone through the Covid 19 pandemic wearing my N95 without a problem. I have done my job diligently. I have never called in sick or even remotely been ill in the last 2 years. I have not contacted covid either but now suddenly I am too ill to wear an N95 without a doctor’s permission. The sheet I filled out 1 ½ years ago should be being replaced by the current one that I have ready for the appointment that will now not occur. What is even more ludicrous is that the medical establishment has been telling the public that they should all wear N95 masks now to protect themselves, but I apparently need a doctor’s approval to do so.

“Apparently, I need to stop being so honest and just check the boxes as you want them checked,” I grumble. “How about you write down that I refuse to be medically evaluated,” I shoot back at her.

“Then you can’t wear an N95 mask,” she follows the script set for her, “you will have to wear a C-papper (a large over the head hood). And I will have to notify your supervisor.”

I don’t know if I should laugh or cry. If the anxiety of mine is one of employee health’s concerns, then how is the astronaut suit going to help? Does she realize how irrational she sounds? I am not opposed to being fit-tested or wearing the mask. I am opposed to sharing my medical history with a physician who has no reason to even question me based on responses from time long gone by. I have proved I can successfully wear an N95 mask and that I am not going to die from doing so. The rest of this process is so unnecessary. I should be able to sign off that I am medically capable of successfully wearing the mask at this point. It is not my fault that they didn’t follow through on their proper procedures in 2020.

So this is what the medical field has come to? It is guided by protocols and algorithms from which one is to follow without question. No one is allowed to think anymore. No one is to analyze a situation or to think critically. The public especially the sickest people are told by the CDC that they should be wearing N95s at all times for protection from this virus, but the medical profession is still following a standard set forth by OSHA 25 years ago. And no one dare change how those who are responding to the pandemic on the front lines are treated or advised. If wearing an N95 is so potentially dangerous to one’s health, why are we asking millions of people to wear them and why haven’t millions of people keeled over from doing so? Have we all lost our ability to be rational? But then maybe I should just go back into my “I don’t care hole” before I lose my frickin mind.

Double masking with eye shield early in pandemic

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