Just released today that the ebola patient in Dallas in now on the ventilator and receiving dialysis. How would you guys feel about doing this treatment or setting up the CRRT?
Honestly, I would be very nervous about it, but I would do what I had to do. I'm not sure if I would want to be around my family after that. Thank you to all the doctors, nurses, techs, and hospital workers in Dallas for your devotion!
I've seen it reported that Mr. Duncan was on dialysis and that being particularly risky for transmission. Why? Is it because the circuit is blood filled and therefore there's more chance of conamination?
Not only is the circuit filled with blood it is under pressure caused by the dialysis machine pump. On the circuits we use there are no less than 7 connections or ports where blood can escape. On the return side of the circuit you will be sprayed with blood if any of those connections fail.
I just left dialysis nursing about a month ago, but for reasons that had nothing to do with the Ebola scare, since it wasn't really even on most Americans' radar at the time. I can't deny that I am very relieved. I realize that we could all be at risk in some way, since diseases like this have a way of spreading exponentially and the government is doing such a horrific job of containing it, but with my new position in home hospice nursing I am probably most at risk, at least for the time being, of getting it from a patient's family member who contracted it unknowingly in a public venue, since most of our patients are pretty housebound. I can't see any competent physician sending a dying Ebola patient home with hospice to expose everyone around them.
I just wonder if this Ebola scare will cause a shortage of dialysis nurses nationwide. The risks described in this thread are very real, and I can't even imagine running a 3-4 hour dialysis treatment in a hazmat suit and respirator hood.
I pray for all of you who are still in dialysis nursing to be safe and healthy.
We had a staff meeting this week asking for "volunteers" if we need to dialize a patient with ebola. The hospital has space in an older part of the building that they are trying to convert into a ICU for these patients. Management stated up front if you agreed you would be in quarantine for 21 days after you cared for this patient. No one said yes. I have a feeling there might be a mass exodus from my unit if they force us but I've never felt confident management ever had our safety as their concern. Might be time for early retirement.
I think back in my nursing career when I have spoken out about safety concerns to management and it has always been the patient that paid the price. When they asked us to take three patients in ICU, if something went wrong I still walked out at the end of the day even if something bad happened. When management wouldn't staff CRRT as a one to one the patient suffered but I went home to my family. Now some suit says "not to worry, just don your paper thin gown and your gloves that tear every so often and be a good kamikazi." We are being led by fools and if you want to march headlong into the wall of fire I salute you and stand aside. Not me.
I know how frightened everybody is about Ebola but how can we seriously refuse to look after or provide dialysis to any patient?
Even though I no longer do dialysis treatments, I think I can take a stab at this:
Because as much as we may love nursing and love caring for our patients, we love our families more. At the end of the day, the risk of taking a deadly disease home to our loved ones or contracting it ourselves and potentially dying and leaving our loved ones behind will trump the desire to help a patient who has already contracted the disease. We are caring and compassionate, but most of us are not willing to die or expose our loved ones to a potentially fatal disease for our job.
If and when the day comes that I am asked to care for an Ebola infected patient by some manager sitting at a desk nowhere near the risk of patient contact who hasn't trained or equipped me properly to do so (and how can you really know, since information and knowledge of this disease is still evolving), I will leave my job and potentially the entire field of nursing. After 24 years of giving of myself over and over and over in this field, I would feel qualified to leave it all behind and seek out a less risky line of work. Simply put, I want to live, not be the "poor nurse who gave her all and ended up dying of Ebola due to selfless service to her patients". I'm just not that saintly.
Specializes in Nephrology, Dialysis, Plasmapheresis.
I am young, much like Nina and amber. Newly married, maybe kids in my future. I didn't join nursing under the impression that my life was at risk. It makes me very uncomfortable when people say it is my duty. I dare them to do the job then. Maybe I am just not brave, but they don't pay me enough, and I don't have proper support. We are not military here.. We are not police officers. I really never thought my life would be on the line. It isn't yet, but I don't like the idea that it could be. Until they provide proper protection and I learn more, I won't walk out into the dark, hoping for the best and risking my future.
So if you all refuse to look after a patient with Ebola-do you just let that patient die?
I would most defiantly look after any patient with any disease its my job. Do I want to die? NO! when I came into nursing I knew I would be exposed to all sorts of diseases and illnesses, any one could seriously injure my health. I did not have the luxury of picking and choosing who I looked after-you just did!
Specializes in Nephrology, Dialysis, Plasmapheresis.
I have read a couple news stories today that the cdc have changed the guidelines officially. Double gloves, hoods over the head, N-95 respirators, fully covered gowns... Anyone heard this? Is it true?
If I truly felt trained and protected, I think it's a different story. Nurses contracting ebola in Texas, simply by doing their jobs with minimal PPE, freaks me out. Give me the necessary tools to do my job and I will do it. But don't leave me vulnerable to a deadly, incurable disease due to concerns of expenses or back order supplies.
If the patient's sweat is even contagious, how the heck do we keep our equipment free from contamination? I wouldn't even want to be another patient in that hospital who was on dialysis, because you would be using the same machine. I suppose we would just scrub the machine with bleach, but still, how can we contain the infectious material? The sicker they get the worse it is? I read that the deceased patient's body is more contagious then when they were alive. Are we keeping that patient's ICU bed for another patient? Or that ventilator? I have so many questions and I am not gonna lie, I am scared! I know we are not in immediate danger, but it is possible in the future.
I heard that hospital is like a ghost town now. I can't say u blame the patients. I think we need to plan for the worst and hope for the best instead of just hoping for the best.
I would have a hard time using that equipment on anyone else.
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On a side note...I heard Mr. Duncan specifically came to the U.S. knowing he had Ebola and was seeking treatment for it. I'm not sure how true it is.
Chisca, RN
745 Posts
Not only is the circuit filled with blood it is under pressure caused by the dialysis machine pump. On the circuits we use there are no less than 7 connections or ports where blood can escape. On the return side of the circuit you will be sprayed with blood if any of those connections fail.