Will you work during a Pandemic? - page 5

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  1. by   RN4NICU
    Quote from indigo girl
    ...And, there are other concerns as well, such as what happens when the caregivers in the home get sick?
    What about those people that live alone? What about the children that may be left without parents?
    There is planning that does address these particular issues, plans that utilize schools, armories, etc.
    Many plans rely heavily on volunteers to help provide this basic care for large numbers of victims
    in designated non-hospital casualty areas.
    This still does not address the issue of PPE for these community volunteers. The hospitals will have to protect their supplies - they'll be short enough without sharing it with non-hospital providers (recall that in the given scenario, hospitals are running out of PPE). Most people do not keep a personal stash of PPE - where would they get it?
  2. by   JaredCNA
    Quote from Goju
    Scenario:

    H5N1 (the bird flu) mutates to become efficient at transmitting Human to human causing a Pandemic, with a case fatality rate of 60% and with 80% of the cases in the 0-40 year old age range.

    see:
    http://www.wpro.who.int/NR/rdonlyres.../0/S4_1113.jpg

    Hospitals will be quickly overrun. Hospital staff shortages are 50%. The Government orders all nurses to work. There is not enough Personal Protection Equipment (N95 masks, gloves, goggles, tamiflu, vax, etc)

    Home quarantines become common (in the Fed plans).
    Your family is also quarantined in your home. You are running out of food and the Government promises you will be "taken care of" if you report to work.

    Will you go?
    O, Cannnaadddaa.
  3. by   Ayrman
    Quote from RN4NICU
    This still does not address the issue of PPE for these community volunteers. The hospitals will have to protect their supplies - they'll be short enough without sharing it with non-hospital providers (recall that in the given scenario, hospitals are running out of PPE). Most people do not keep a personal stash of PPE - where would they get it?
    A pandemic will of necessity require thinking outside the box for everyone, healthcare workers as well as lay public. PPE can be improvised in a pinch if people have an idea of what they are trying to gaurd against. There is a model on the internet for a (relatively) simple homemade mask that can be reused after disinfection, made from a common cotton t-shirt. It was in fact developed in light of the future pandemic.

    Gloves can be of the common kitchen cleaning variety, so-called Playtex gloves. Having a bowl of strong bleach water to dip them into is the first step in preparing them for reuse.

    Garbage bags can be the basis of simple barrier "gowns." Hot and sweaty sure, but definitely proof against coughs, sneezes and other means of spreading infectious agents towards the clothing worn underneath.

    It is possible to construct an almost total isolation barrier using household items - simply requires adjusting your thinking. The gowns we use in the hospital offer only simple splash protection - they aren't moisture-proof by any means. We are offered only simple facemasks, not N95's much less P100's, and the gloves are typical low-bid latex, 20% of which tear as you attempt to don them. Higher quality means higher cost, and I work for a for-profit company so you know how that goes.

    Simple work-arounds for a lack of purpose-designed PPE yet I have yet to see any public awareness material mentioning same. Perhaps as we get closer to the real event? If we as healthcare workers won't set our minds in gear to figure out ways to address a lack of PPE how can we expect Joe and Sally Citizen to do so?

    Ayrman
  4. by   linzz
    I do plan to keep reading on this topic. Honestly, I don't think that I would be willing to work during a Pandemic. I just doubt that that proper PPE will be available here.
  5. by   Goju
    I have posted the link to this discussion on HHS Secretary Mike Leavitt's blog here

    http://secretarysblog.hhs.gov/my_web....html#comments
  6. by   gr8hart
    Quote from Goju
    what it would take to make you willing to work under circumstances such as I have described.

    What would you want?

    PPE -- OK, which ones? N95s enough or would you want a higher grade perhaps even 1/2 masks with P-100 filters, goggles? or would you request full face? Would you supply your own?

    Would you expect Tamiflu, for you families? vaccine priority? Would you spend your own money on it?

    would you work if you received extra (hazard) pay?

    would you work if you were supplied a hotel room paid for so you don't have to go home and possible expose your family?

    Would it be easier for you to do all that if you knew that ALL hospital executives were living on site and working?

    1. I would expect the highest level of PPEs to be provided, in sufficient quantity.

    2. I would expect Tamiflu to be given to all HCW for free, if working. And scripts for family members to be filled at a discount in the hospital pharmacy.

    3. The hazzard pay would be a BIG bonus, though I'm not quite sure if I'd demand it.

    4. Yes, I'd expect to be given acceptable accomodations while working. But also want to be assured that I can see my family when I want/ need to.

    5. ABSOLUTELY! In fact, that would be a huge factor in my deciding to stay and work. Executives can answer phones....and be messangers as well as anyone. To see them on site w/ us would be a huge plus.
  7. by   Goju
    Has anyone addressed the "other essential" workers in a hospital setting who without the hospital would come to a grinding halt?

    Like the cleaning crews, Laundry crews, stocking/loading/unloading crews, kitchen crews?

    No clean sheets could be a big problem no?
  8. by   karlita
    I would be willing to work during a pandemic. I don't have a family of my own yet, and as long as that were the case I would have no objections. I would expect my mom, who works as a CNA in a hospital, to stay home to watch my little sisters. If anything should happen to her then of course I would stay to take care of my family. I think people have brought up some good ideas about having your own supply of PPE even if it means disinfecting and re-using it since we know we can't rely on the government for our most basic needs as healthcare workers. I'm no martyr, but someone has got to do it.
  9. by   Mulan
    Quote from canoehead
    "taken care of" with no PPE or meds available? What are they referring to when they say that? Probably a ride to and from and meals on duty, but not much more. Yes, I think I would go in anyway, but I'd be pretty realistic about not expecting any thanks or recognition. I haven't heard of any of the nurses that stayed during Katrina getting anything special, and I often wonder if they were paid for that last week or so. Anyone know?

    I think if I went in, I'd expect to end up dead.
  10. by   bagladyrn
    Quote from 4gr8greens
    1. I would expect the highest level of PPEs to be provided, in sufficient quantity.

    2. I would expect Tamiflu to be given to all HCW for free, if working. And scripts for family members to be filled at a discount in the hospital pharmacy.

    3. The hazzard pay would be a BIG bonus, though I'm not quite sure if I'd demand it.

    4. Yes, I'd expect to be given acceptable accomodations while working. But also want to be assured that I can see my family when I want/ need to.

    5. ABSOLUTELY! In fact, that would be a huge factor in my deciding to stay and work. Executives can answer phones....and be messangers as well as anyone. To see them on site w/ us would be a huge plus.
    I'm not sure if many really have a full appreciation of what the situation will be like in a full pandemic of this nature.
    PPE's may not be available not only because they are being used, but because they are not being produced - the factory workers will be quarantined like everyone else, as will those who would transport the goods to your hospital. No doubt travel between areas of high to low infection will be closely regulated.
    Tamiflu may not be available at ANY price, for the same reason.
    Hazard pay - not a chance - the economy is going to have taken the big dive shortly after this happens, barter will likely become the most common form of transaction and where would you spend that money anyway? Most centers of commerce will be restricted from operating to avoid congregations of citizens passing on the virus.
    Acceptable accommodations may become any horizontal place to sleep between shifts of patient care and the safest thing for your family may be for you NOT to see them.
    I could see martial law being declared and enforced because too many of our citizens believe the restrictions shouldn't apply to them and that "just this time won't hurt", and "I'm a VIP". Ever been stopped at a checkpoint with National Guard aiming weapons at your vehicle? I have, and it's a weird feeling even when you know they are the "good guys".
    This isn't aimed at you personally, merely using this post to encourage people to consider what this type of pandemic would truly mean.
  11. by   elizabells
    I probably would, because

    a) I don't have a family of my own yet, and
    b) I have a nearly pathological lack of a sense of self-preservation.

    Just tellin it like it is.
  12. by   indigo girl
    Quote from RN4NICU
    This still does not address the issue of PPE for these community volunteers. The hospitals will have to protect their supplies - they'll be short enough without sharing it with non-hospital providers (recall that in the given scenario, hospitals are running out of PPE). Most people do not keep a personal stash of PPE - where would they get it?
    I believe that Ayerman is referring to this type of home-made mask, tested
    in this study. It is better than no protection at all, apparently, but still there
    are problems with it:

    http://www.cdc.gov/ncidod/EID/vol12no06/05-1468.htm

    Here is another link addressing the use of our plain surgical masks if N95
    is not available. I offer this only because it seems obvious that we will
    run out of N95 masks rather quickly:

    http://www.flutrackers.com/forum/sho...4&postcount=34

    It is true that most people do not keep PPE at home. But, yes they can buy
    it. I have seen gloves and masks in drug stores, some Sam's Clubs, Home
    Depot etc. My local drug store has N95 masks. Of course, in a time of great
    need none of these are likely to remain on the shelves which brings us back
    to the home made masks for our volunteers. It is better than nothing.

    That is all that I can think of that community volunteers might have access to.
    But, I am saying also that if our volunteers are senior citizens, and I think
    that they might well have to be, then these folks are not as likely to be at
    risk (at least for dying) from H5N1 if that is the virus that we will be dealing
    with. The bigger question might well be, will they volunteer to help? I think
    so, if the statistics are made very public, that the younger people represent
    the majority of cases. Our senior citizens are very civic minded people, and
    a valuable resource. We will need them to help us.

    These are my own personal conclusions and does not represent any type of
    study. Perhaps we should ask AARP or some other group to poll their members.
  13. by   RN4NICU
    Quote from indigo girl
    I believe that Ayerman is referring to this type of home-made mask, tested
    in this study. It is better than no protection at all, apparently, but still there
    are problems with it:

    http://www.cdc.gov/ncidod/EID/vol12no06/05-1468.htm

    Here is another link addressing the use of our plain surgical masks if N95
    is not available. I offer this only because it seems obvious that we will
    run out of N95 masks rather quickly:

    http://www.flutrackers.com/forum/sho...4&postcount=34

    It is true that most people do not keep PPE at home. But, yes they can buy
    it. I have seen gloves and masks in drug stores, some Sam's Clubs, Home
    Depot etc. My local drug store has N95 masks. Of course, in a time of great
    need none of these are likely to remain on the shelves which brings us back
    to the home made masks for our volunteers. It is better than nothing.

    That is all that I can think of that community volunteers might have access to.
    But, I am saying also that if our volunteers are senior citizens, and I think
    that they might well have to be, then these folks are not as likely to be at
    risk (at least for dying) from H5N1 if that is the virus that we will be dealing
    with. The bigger question might well be, will they volunteer to help? I think
    so, if the statistics are made very public, that the younger people represent
    the majority of cases. Our senior citizens are very civic minded people, and
    a valuable resource. We will need them to help us.

    These are my own personal conclusions and does not represent any type of
    study. Perhaps we should ask AARP or some other group to poll their members.

    The question I was responding to asked if we AS NURSES would volunteer in the community. This is a much different question. As you point out, seniors are at a lower risk of death from H5N1 than many nurses would be. It is a different situation for nurses in the age group at the highest risk of death from H5N1. I, for one, would not be willing to make do with makeshift and reused PPE if my life were on the line.

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