Will you work during a Pandemic?

Nurses COVID

Published

  1. Nurses, would you go to work during a Pandemic?

    • 1926
      No
    • 5592
      Yes
    • 1288
      undecided

1,893 members have participated

admin note: we just added a poll to this thread today, april 25, 2008, please take a second and vote in the poll so we can have a graphical representation of the responses. thanks

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/fd4ac2fd-b7c8-4a13-a32c-6cf328a0c036/0/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?

Don't underestimate your skills and knowledge. I know nothing of nursing and taking care of sick people. Most people are like me and would not have any idea about home care or nursing.

What volunteer nurses can and should do in the event of a pandemic is be prepared to instruct family, friends, and neighbors (from a distance or with your own PPE) in basic nursing tasks that could be done in the home. If a pandemic is as bad as Goju, myself, and others expect, the medical industry will be set back a hundred years. The home care practices of the 1918 pandemic will again become the modus operandi.

Exactly.

I don't underestimate my skills or knowledge. However, care in the community is pretty much going to be comfort measures only - family members are perfectly capable of providing this. There is nothing a nurse can do that a family member cannot do to provide comfort measures in the absence of medical supplies. What basic nursing tasks do you think people will be unable to figure out for themselves?

Some very good points have been raised during the course of this thread. Thank you to those who have raised their hands with questions; it is how we all learn.

Someone asked what 800 lbs of food looks like and where would you store it? Using canned goods by way of example it would fill a normal size clothes closet with stacks of cases of canned goods ranging from meat products to vegetables to fruits (which BTW, aside from tomato products have the shortest shelf life). 800 lbs of whole grains, which some people store with an eye towards cost-effective calorie counts, would likewise fit into a similar area in sacks of 50, 80 or 100 lbs depending upon what you store.

My lovely bride and myself have both over the years of our lives faced shortages of food, funds and more. As a result we have become ardent preppers if you will, laying back during good times for the lean periods. Food of course, during which course we have found that canned goods stored inside the home (not the garage or storage unit) will last 10 years except as noted above (peaches in particular, as well as some tomato products, will leak out of the cans after as little as 2 years). Toilet paper too, as we both remember the acute shortage of the mid-70's when a night show comedian joked about such, thereby creating an actual shortage as product flew off the shelves, lasting 2-3 months (how many of you have to buy TP every 2 weeks or face doing without?).

Both of us are beyond the "endangered" ages for H5N1 - at lower risk merely due to age but as she is a teacher (also trained as a Wilderness First Responder with IV, suture, injection and other skills) and I'm an RN we both are involved in high-risk employment when it comes to OTJ exposure - so we have built up medical stores that will allow us to care for each other if it comes to it (assuming the other is well), or those whose care may be entrusted to us such as family or friends, assuming their condition is such that they would not be hospitalized. In fact, I dare say my personal stash of PPE would outlast my floor's (Med-Surg) if resupply were an issue. With attention to waste I could provide care to 2-3 people for 2 weeks if it came to it before running out of gowns and masks any way. I have well more than just PPE - until a couple years ago I ran a small medical supply business out of my home as a sideline and set back a certain portion of my stock for personal use so I'm well set with IV and injection supplies, non-electric suction, soft goods, patient care items and even a portable ventilator.

If push comes to shove and the pandemic hits hard we can retreat to a location of safety where we'll be implimenting protective quarantine and we'll have a small group of medical people in caring for any that become infected amongst the dozens that encompass our collective families.

The answer to the question "Will I work" is yes, to a point. Once it becomes clear that safety is a serious issue then we will retreat and I'll be working for beans and billet (something you sleep on, not what you shoot) for a few months. I do know that my current employer has done nothing more than talk about the possibility of pandemic and has no plans to address the issue of same save that they'll cross that bridge when they come to it.

I understand calculated risk, having worked EMS for 24 years before the career change a few back. That's why I say I'll work while I can but once the risk becomes too great (no PPE, patient loads beyond dangerous, onerous schedules, etc) I'll fall back. Even firefighters don't run into a burning building without certain safety parameters and factors in place.

Ayrman

Specializes in Too many to list.

...care in the community is pretty much going to be comfort measures only - family members are perfectly capable of providing this. There is nothing a nurse can do that a family member cannot do to provide comfort measures in the absence of medical supplies. What basic nursing tasks do you think people will be unable to figure out for themselves?

Yes, you are correct in that most people will be cared for at home by family

or friends. That is the CDC and HHS strategy. For some, it will be comfort care only,

but others might have more of a chance of survival with a little extra

care, and knowledge of how to provide hydration without IV fluids.

We live in a culture where when people get sick, they depend on the medical

system to not only tell them what to do, but to do it for them. Most are totally dependent

on that system. Now, it is not going to be available. People are going to panic when their loved ones

start to become very ill, and the hospital is not

an option. Someone has to give them some basic information. To us it is basic, but it is not for them.

We can not assume that they will know what to do. I can

only imagine how terrifying this is going to be for some parents.

I feel certain that govt and health departments will be forced to provide

this kind of information. We also have other resources that could be

distributed prior to this event such as this link:

http://www.flutrackers.com/forum/showpost.php?p=67719&postcount=1

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.

indigo girl,

That is an excellent link. This has been an eye opening thread to say the least.

Nurses will be the front line and by the sound of it... the lines will be very porous.

...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?

Specializes in ICU. Med/Surg: Ortho, Neuro, & Cardiac.
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/FD4AC2FD-B7C8-4A13-A32C-6CF328A0C036/0/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.

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

Specializes in Geriatrics, Med-Surg..

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.

I have posted the link to this discussion on HHS Secretary Mike Leavitt's blog here

http://secretarysblog.hhs.gov/my_weblog/2007/10/express-lane-sc.html#comments

Specializes in med/surg, cardiac.
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.

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?

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.

+ Add a Comment