A Nurse Offers Some Advice To Priests Giving Last Rites to Covid Patients

I received an email this week from a Catholic nurse whose family I’ve known for over twenty years. She works in an ICU at a large hospital in Michigan, and she’s on the front lines dealing with incoming cases.

She offers some information about the situation. This email is a few days old, and the number of cases in Michigan are ramping up, so it may be quite different by now. I’ve edited the email and removed identifying information, but this is mostly unabridged:

There are so many more cases of COVID-19 that we know of and it’s not just because there aren’t enough tests. If your symptoms aren’t severe enough to need hospitalization, then we don’t want you in the hospital exposing others. We would rather you stay at home and quarantine there, because it’s better for you and everyone else.

The biggest problem with this virus is how contagious it is. AND that nurses and doctors are not being provided with the proper protective equipment (PPE), I’m sure you’ve seen articles that mention this.

My hospital 2-3 weeks ago went through our stock rooms and removed all N95 masks, which we use for certain types of respiratory infectious patients, like those with TB. Remember, 2 weeks ago, we didn’t know how hard it was going to hit in the U.S. So hospitals were already preparing and hording our PPE for what was to come. There are hospitals in Detroit that are severely overwhelmed and have run out of protective gear. Many nurses and docs have been unintentionally exposed to the virus by caring for patients that they didn’t know had it. They are then told to self-quarantine at home for 2 weeks and report to our occupational health if they have any symptoms.

As of yesterday that was the protocol, however, that changed…no need to quarantine for 2 weeks, if you’re asymptomatic, come on back to work. Despite the fact that we know, you can still spread the virus being asymptomatic, although you are less likely to. The hospital is trying to preserve their work force instead of following the recommended protocol for quarantining exposed individuals (just change the protocol and everything is fine).

They also finally initiated the protocol for all people entering our hospital to wear a surgical mask at all times.

To give you an example, one patient unknowingly had the virus, then tested positive, affected about 30 nurses/docs that came into contact with him. You can see by just one patient how it can affect a hospital’s workforce.

People in their 20s, 30s, 40s, relatively healthy, are dying. Most people recover, yes. But for those that are sick, it can escalate quickly; 2 liters of oxygen via a nasal cannula at 0800 to intubation by 1700.

It is chaotic. My hospital this week is rearranging ICUs and step-down units in order to cohort patients (clean patients and covid patients), because in the next 2-4 weeks it will get worse.

She also saw that I had been discussing, on our most recent podcast, the problem some priests are having with administering last rites as hospitals are locking down to avoid the spread of infection from coronavirus.

While she wasn’t able to specifically address the issue of hospitals not allowing priests in to give last rites to the dying — I’m still unclear of how widespread of a problem this might be at the moment — she did have some advice on what priests can do to minimize their chance of infection in general, and in particular when entering these hospital environments:

As of Sunday, I had already contacted my canons to take extra precautions: wiping down pews and confessionals, among other things. Also, made sure my priests know if they need anything to contact me.

What to wear for a priest to stay protected to administer last rights: well, it will depend on the facility and the amount of patients they are overwhelmed with to even know if they are allowed entry. Upon entry to the hospital, you will need at least a surgical mask.

However, here’s what they would need upon entering the patient’s room: N100 masks (N95 masks at bare minimum, I’m assuming hospitals would only sacrifice a surgical mask for them), basic disposable gowns (typically get at the unit), eye protection (glasses or goggles), surgical caps (not vital, but recommended) and finally gloves, but they should wear 2 sets of gloves. Gloves should be worn, but if they’re blessing someone, they need to just make sure they wash their hands thoroughly before exiting a patient’s room.

As for any instruments they bring into the room, i.e., a crucifix, place it in a paper bag after cleaning it off with some sort of sanitized wipe and then leave everything in that bag for at least three days before using it again.  All protective gear should be thrown out when exiting a patient’s room. Goggles and or glasses should be wiped clean with sanitary wipe. Place a clean surgical mask on when exiting the hospital.

When a priest gets home after visiting with these patients, he shouldn’t enter the rectory fully. Make sure you have left an extra set of clerics just inside along with a pair of shoes. Change once you’re just inside your home. Put disposable gloves on and take contaminated clerics and wash immediately, then clean shoes with sanitary wipes.

Studies say that the virus doesn’t stay on clothes for too long, maybe just a few hours, so it’ll be up to the priest how cautious he should be.

Finally, she offers a message of hope:

I do think everything will be okay. I have this odd problem, or maybe it’s a blessing, that when it comes to big things like this I’m quite calm, because besides the precautions I take and everyone else, you’ve just got to give up and know you’re not in control, so just give it over to God.

I hope this helps!