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Additional guidance is available in the collaborative document Ethical dimensions of COVID-19 for frontline staff. Raising concerns The RCN expects that all employers support their staff to make known their needs in respect of PPE. The RCN also recognise that certain health conditions will make it more difficult to tolerate wearing PPE. Employers should assess any risks to these individuals and make necessary adjustments under both health and safety and equality law. See ‘PPE for staff with disabilities or impairments’ above. You can also see our Health ability passport guidance. Further information Our guidance on skin health is here along withour publication on maintaining skin health when using PPE. Raising concerns

For information on how to reduce the risk of heat stress and related illness, please see Rest, Rehydrate and Refuel. HSE have also produced a heat stress risk assessment toolkit for employers Safer alternatives or latex free products should be used and staff and patients with known latex allergy should never be exposed to NRL containing products. Powdered NRL gloves should never be used. It is recognised that wearing PPE for long periods can also create additional health and safety risks for nursing staff. PPE can be uncomfortable and potentially lead to heat stress, fatigue and heat related illness.

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Any allergic type reactions to PPE, including skin rashes, should be reported using the organisations incident reporting form and through the yellow card reporting system to the MHRA. regular rest breaks during the shift: manufacturers’ recommendations on maximum time for wearing FFP3 face masks should always be followed (see RCN workplace risk assessment toolkit) It is always important to recognise that for many reasons the impact of the menopause may differ greatly for individuals.

Where there is a change in PPE requirements such as in response to a pandemic, new issues can arisefor health care professionals who have not previously been disabled at work. It is essential that processes allow theopportunity for employees to discuss their specific needs regarding PPE and that theyare supported by managers in this process. The RCN expects that line managers undertake a workplace risk assessment and refer to Occupational Health for further advice if appropriate. Where adjustments cannot be made, temporary redeployment to work that does not require PPE should be considered. You can also see our COVID-19 workplace risk assessment toolkit.

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Proteins found in NRL are known sensitizers which can cause allergic reactions in some individuals and may lead to serious health effects and should be avoided if possible. Your employer should work with you to ensure that any risk of PPE affecting your impairment and ability to continue in your role is recognised and processes put in place to mitigate the risk. This may mean adjusting processes around donning and doffing of PPE, exploring options for adapted PPE and/or opportunities to fit PPE, and be confident that it is fit for purpose prior to use in a clinical setting. Fit testing must be carried out by a competent person as described by the Health and Safety Executive (HSE). What if I have concerns about fit testing?

Where risk assessments require staff to wear FFP3 masks, all staff must have passed a face fit test for the mask being worn. Further information The RCN expects employers to meet their legal duties by taking all appropriate steps to both assess and mitigate the risk of nursing staff developing heat stress and related illnesses. These steps include:Menopause at work: managing hot flushes and PPE - Nursing Standard article which may require signing in to access in full the workplace temperature: while there is no upper legal limit on workplace temperatures, the regulations state that workplace temperatures should be reasonable; the Chartered Institute of Building Engineers recommend that hospital environments should be 18 degrees centigrade. Symptoms can be compounded when having to wear PPE, especially for long periods of time, and it is important that staff are supported to enable them to cope in these challenging times. Grab a marker or tailor's chalk and mark the measurements for your apron on the fabric (25" x 4" x 9"). Cut the fabric accordingly, and you will have your template. Next, draw an inch-wide seam allowance around the outline you just drew. Remove the template and set it aside.