Ebola - do you have the right to walk away?

elkpark · Oct 14, 2014

Yes, I would. Can't find it now but I saw a list showing that the average ebola patient passes it on to two other people, the same or less infectious than many diseases. TB infects 10. I'm trying to find that information about meningitis which has a comparable fatality rate but not having any luck. It's scary, no doubt, and I agree it would be great if hospitals took bigger precautions and they will if they have any wits at all.

Is this what you're looking for?

No, Seriously, How Contagious Is Ebola? : Shots - Health News : NPR

idialyze, BSN, RN · Oct 14, 2014

As I posted yesterday on another thread, I am a Dialysis RN, and I could not, in good faith, refuse to care for an Ebola patient, I would demand a full HazMat get up, and invite some of the CEO's and others who claim it is safe, to join me in the room. We should be okay, right?

sistrmoon, BSN, RN · Oct 14, 2014

Being provided inadequate PPE and training and protocol to care for a patient with an infectious highly deadly disease should not be part of being a nurse. Dying should not be part of it. Infecting my kids and watching them die should not be part of it. I am no martyr. Sound dramatic? What do you think Pham thinks?

I'm not sure what I would do. With the proper PPE and bunking at the hospital for 21 days, perhaps.

Here.I.Stand, BSN, RN · Oct 14, 2014

I don't know about you, but I have family members in various parts of the country. Caring for them myself would not be a realistic option. Are you talking about keeping your loved ones at home and caring for them yourself? That would be, basically, a death sentence for them. Are you expecting them to be able to be admitted to the hospital where you work? Are you saying you would you care for them yourself there in the hopsital, but you would understand if no physicians at your hospital were willing to get involved? If that were the case, what kind of treatment would they be getting? "I would take care of my own loved ones" must seem like a satisfying answer when the original question is posed, but how realistic an answer is that?

Or if she got Ebola herself.

Here.I.Stand, BSN, RN · Oct 14, 2014

I'm wondering if I might have been a bit flip originally... it's probably true that statistically, driving is riskier. But the more I read, the more this hits home.

So I am leaning now toward insisting on the Hazmat suit, etc. If gown, gloves, and basic eye mask isn't good enough for the CDC, it shouldn't be enough for us.

I do have ethical issues with refusing the patient altogether, though. Like others have said, what if every RN, MD, RRT, CNA refused to help the pt? What if it was our own family?

FLAlleycat · Oct 14, 2014

remember, several patients have been cared for in the US to date in various hospitals and only one report of infected healthcare worker. Go to CDC website to get up to date information on proper PPE donning and doffing. www.cdc.gov

Better yet, watch Dr. Gupta contaminate himself while demonstrating donning/doffing PPE.

CNN's Dr. Sanjay Gupta suits up in Ebola protective gear - CNN.com Video

Editorial Team / Admin · Oct 14, 2014

Can you or do you have the right to walk away?

Sure, you can walk away. You may not walk away with a job though. And knowing how some facilities work, if it's in the middle of your shift, you may find yourself threatened to be reported to the board for patient abandonment- maybe not accurately, but that hasn't stopped some places in the past from at least threatening it.

Personally, I would not refuse to care for a patient diagnosed with Ebola. I would, however, expect prompt and timely education on the proper use of the necessary PPE, preferably before any patient would present to the facility. (Note to administrators/educators/whoever else makes the decisions: an email does not count as providing that education. Hands on is required.)

amyshell · Oct 15, 2014

I wouldn't accept the assignment. My life and health and that of my family is more important then my job and title. Not worth it. That being said... I think there's a lot of hulabaloo about something that almost all of the nation doesn't have to worry about.

This is where I'm leaning. Look at the Dallas nurses who have it now. My kids already lost their father., no job is worth them having to lose their mother too.. Or heaven forbid, me bringing this home to them!

3fins · Oct 15, 2014

Cmon people, grow some!

You have a RESPONSIBILTY to refuse an assignment, legally, provided you have not received adequate training! Most of us have NOT received any such training!

By accepting such an assignment without adequate training you put yourself, not to mention others at risk.

Use some common sense - something that obviously was lacking considering the decrepit conditions RNs were working in at Dallas Presbyterian. Duncan wasn't even a 1:1 patient according to details coming to light!!!

What good is a job if you lose your life?

chadrn65 · Oct 15, 2014

Cmon people, grow some!
You have a RESPONSIBILTY to refuse an assignment, legally, provided you have not received adequate training! Most of us have NOT received any such training!
By accepting such an assignment without adequate training you put yourself, not to mention others at risk.
Use some common sense - something that obviously was lacking considering the decrepit conditions RNs were working in at Dallas Presbyterian. Duncan wasn't even a 1:1 patient according to details coming to light!!!
What good is a job if you lose your life?

I agree, also one has to have proper equipment as well as the training. The healthcare workers at Dalla had their necks exposed and were told to wrap surgical tape around the exposed area!

2nd Dallas worker tests positive for Ebola - CNN.com

Nurses were told to wrap their necks with medical tape when equipment left their necks exposed; they felt unsupported and unprepared, and they received no hands-on training, union co-president Deborah Burger said.

yorkieloveRN · Oct 15, 2014

I just watched the video of Dr. Gupta, and this should be a huge alarm for everyone. He was donning the same ppe that I believe most hospitals are telling nurses that we will be using in the case of an Ebola pt. He EASILY contaminated himself 3 times while following CDC protocol to remove the ppe.

At this point, NO I would not care for an Ebola pt bc the hospitals are not providing adequate safety measures and education for direct pt care workers. Pt should be 1:1 period. There should be a buddy system in place. We should have the same protective gear as the CDC.

I think Everyone involved screwed up when Duncan was not transported to one of the bio containment centers. These centers have cared for 4 Ebola pts without it being transmitted to anyone inside the facility. They are prepared and obviously capable of handling the Ebola virus. The Dallas facility gets 1 Ebola pt and now 2 healthcare workers are infected, and Phams boyfriend was taken to the hospital and isolated for showing symptoms yesterday I believe.

Come on CDC wake up and take control of this situation before it gets out out of control.

they had no problem transporting the infected pts from Africa into the US for treatment, so why is there a problem transporting from one facility to another? Hmmmmm makes me wonder

hoversonk · Oct 15, 2014

I urge everyone in the Nursing Community to donate to National Nurses United:

National Nurses United

They have shown up in a major way to advocate for appropriate occupational safety for healthcare workers in this situation!

The MSDS states that persons working in a laboratory with a vial of Ebola should don Haz-Mat suits for protection, while in the clinical setting healthcare workers who are working with confirmed, contagious individuals with limited control of their own secretions-ie. cough, projectile vomit, and other bodily fluids, are not required to wear Haz-Mat suits per the current CDC protocol.

I suggest patients with this illness be transported to one of the 4 bio-containment units in the US with equipped and trained staff with Haz-Mats suits to prevent the spread of this illness. If this transportation is not possible and we are required to treat these patients in our community hospitals, then we should be fitted and trained with Haz-Mat suits in order to responsibly care for these patients. Based on the the high rate of mortality among infected patients, the risk of human-to-human transmission, and the lack of FDA-approved vaccine and therapeutics the highest and most conservative level of protection is necessary.