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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? 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: The NMC statement on personal protective equipment during the COVID-19 pandemic(April 2020) supports the RCN guidance and reflects the realities of clinical decision-making in the context of this pandemic.

The Health and Safety Executive also provides guidance for employers and employees on reasonable adjustments. Raising concernsIt is always important to recognise that for many reasons the impact of the menopause may differ greatly for individuals. Your manager or organisation should send out a communication to all patients and their families explaining why this is important and encourage them to look at government advice. When considering gloves members should also review if a plastic apron is required. Aprons should not be worn routinely and only if required. 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. Your organisation should provide accessible information on this and on what the household can do to reduce risks, in advance of and during any visits. You can also see our COVID-19 workplace risk assessment toolkit. Guidance for adult social careis also available Some of the patients I visit refuse to have the window open where I am working to increase ventilation. What should I do?

RCN guidance on skin health, also RCN publication on Maintaining skin health when using PPE. Raising concerns 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. Forinformation on how to reduce the risk of heat stress and related illness, please see Rest, Rehydrate and Refuel. Where no safer alternatives are available and the risk of exposure to a biohazard exists, then a COSHH risk assessment will inform whether the use of PPE containing NRL is acceptable for use by staff without NRL allergy. Incident reporting The RCN advice is that members outside of the acute hospital setting, should conduct a risk assessment and use their professional judgement to decide whetheror not toprovide Basic Life Support CPR; taking into consideration the individual needing CPR, the current situation, the environment and their own safety, local policy, and any knowledge of the individual. Standards in the NMC Code must continue to be upheld, as they are useful to support decision making.

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Many health care professionals have impairments that could mean standard issue PPE is not effective. These include but are not limited to: 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 Remember, PPE is just one way of protecting staff at work. Handwashing, social distancing measures, training, workplace cleaning practices, ventilation, vaccination and risk assessments for staff health also play an important role in infection prevention and control and managing the safety of staff and patients. 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. Our guidance on skin health is here along withour publication on maintaining skin health when using PPE. Raising concerns

raise awareness amongst staff of the signs of dehydration and heat stress and measures that can be taken to reduce the risk Menopause at work: managing hot flushes and PPE - Nursing Standard article which may require signing in to access in full The RCN expects all health and social care organisations to have and to follow their policies on the management of latex allergy in staff and patients.Double gloving is not required for care of patients with COVID-19 in any care setting. Please see your respective country national IPC guidance. Raising concerns See also NHS England and NHS Improvement: Accessing supplies of Personal Protective Equipment (PPE). Scotland