Ebola in Texas

Nurses COVID

Published

Specializes in Community, OB, Nursery.

In my area it's not unusual to use this equipment so we're pretty confident in its use. I'm just not confident this PPE is sufficient, especially since the CDC goes way beyond this when they are near a victim.

Exactly. I'm not so sure I believe anyone who says a splash-resistant gown, shoe covers, gloves, and a face shield are enough. When CDC and USAMRIID play with level 4 biohazards like Ebola, they wear space suits with their own air supply and go through multi-stage decon after the fact. When they start wearing the standard gown/gloves/mask that most of us have for PPE at work, then I will take notice.

Specializes in Critical care, tele, Medical-Surgical.

Nurses Reject 'Scapegoat' Accusations After CDC Head Blames 'Protocol Breach' for Dallas Nurse Infection of Ebola

Nurses and other healthcare experts have rejected the accusation by Centers for Disease Control and Prevention director Dr. Thomas Frieden that a "protocol breach" led to the infection of a Dallas nurse from Ebola, arguing that there should be no "scapegoats" made during a troubling situation like this.

"You don't scapegoat and blame when you have a disease outbreak," said Bonnie Castillo, a registered nurse and a disaster relief expert at National Nurses United, according to Reuters on Monday. "We have a system failure. That is what we have to correct."...

... Healthcare and infection control experts in the U.S. have reportedly said that hospital staff need to be coached through the proper stages of treating Ebola patients, however, responding to Frieden's comments...

...Castillo noted a lack of organization and said that hospitals often "post something on a bulletin board referring workers and nurses to the CDC guidelines. That is not how you drill and practice and become expert."

Dr. Gavin Macgregor-Skinner, an expert on public health preparedness at Pennsylvania State University, also spoke out against blaming the infected nurse for the incident.

"I think that is just wrong," said Macgregor-Skinner, who has helped the Nigerian government train healthcare workers in proper Ebola outbreak response.

"We haven't provided them with a national training program. We haven't provided them with the necessary experts that have actually worked in hospitals with Ebola," he added about American nurses...

http://www.christianpost.com/news/nurses-reject-scapegoat-accusations-after-cdc-head-blames-protocol-breach-for-dallas-nurse-infection-of-ebola-127957/

Good for Nurse Castillo! Dr. Frieden has since gotten a raft of shite for that stupid comment, and justifiably so.

Specializes in Community, OB, Nursery.
Liberian Ebola patient was left in an open area of a Dallas emergency room for hours, and the nurses treating him worked for days without proper protective gear and faced constantly changing protocols, according to a statement released late Tuesday by the largest U.S. nurses' union.Nurses were forced to use medical tape to secure openings in their flimsy garments, worried that their necks and heads were exposed as they cared for a patient with explosive diarrhea and projectile vomiting, said Deborah Burger of National Nurses United.

Burger convened a conference call with reporters to relay what she said were concerns of nurses at Texas Health Presbyterian Hospital, where Thomas Eric Duncan — the first person to be diagnosed with Ebola in the U.S. — died last week.

Dallas Nurses Cite Sloppy Conditions In Ebola Care

This sounds like a story I might be able to believe. Prepared my ass.

Specializes in Maternal - Child Health.

News was released last night of a second nurse infected by Ebola in the Dallas hospital where Thomas Duncan died. Making the story even worse is that this woman flew on a commercial flight shortly before she fell ill.

Once the first nurse was diagnosed, and CDC officials publicly acknowledged that there would likely be other caregivers to develop infection, why on God's Green Earth, were those at risk not restricted from travel?!?!?

Is there anyone out there who has any faith left in our nation's supposed "top public health agency and officials?"

http://dfw.cbslocal.com/2014/10/15/ebola-patient-traveled-day-before-diagnosis/

Specializes in Critical care, tele, Medical-Surgical.

Hospitals need to pay attention to STOP ignoring nurses concerns.

Those nurses must not be afraid to tell the truth o the CDC or other a regulatory agency. Texas has an excellent nurse whistle-blower law passed by the legislature and signed by Governor Perry:

https://allnurses.com/nursing-activism-healthcare/bill-protect-nurse-642485.html

Nurses Pretend to Die During Ebola Protest in Las Vegas

Sep 24, 2014

Dressed in hazmat costumes and red shirts, roughly 1,000 nurses gathered on the Las Vegas strip to call attention to the United States' level of preparedness in fighting a potential Ebola crisis at home.

The so-called "die-in" demonstrators, organized by nurses in Vegas for the Planet Nurse convention, said they don't believe U.S. hospitals could handle an Ebola outbreak.

The protesters marched through the Planet Hollywood casino and dropped to the ground in front of the Bellagio, pretending to be dead. Once on the ground, they outlined their bodies in chalk like a crime scene and wrote out the hashtag #StopEbolaRNRN...

http://mashable.com/2014/09/24/nurses-vegas-ebola-protest/

RNRNEbolaByVME8OCcAALxU0_zpscdbef171.jpg

Specializes in Hospice.

Part of the truth about the CDC:http://www.mcclatchydc.com/2014/10/13/243243/pols-trade-blame-for-ebola-but.html?sp=/99/104/244/112/

Some budget analysts believe both parties share blame when it comes to cuts to the CDC. The CDC's discretionary budget shrunk to about $5.9 billion in 2014 from about $6.5 billion in 2010.

Since 2001, there's been a 42 percent cut to federal funds from the CDC to support state and local preparedness programs, according to a 2013 study by the Trust for America's Health on protecting Americans from infectious diseases.

Like many federal agencies and programs, sequestration took a chunk out of the CDC's budget. The mandatory budget cuts agreed to by Congress and the White House in 2011 ripped $285 million from the CDC's budget in fiscal 2013. The cut included $195 million from the CDC's Chronic Disease Prevention and Health Promotion Program, which tries to prevent deaths from infectious diseases.

Larry Sabato, director of the University of Virginia's Center for Politics, called attempts to link budget cuts directly to the Ebola virus "ridiculous."

"It's such a stretch and it hits me as unethical," Sabato said. "The Ebola virus wasn't even an issue at the time (of the cuts). It's scare-mongering, it's the panic of the moment."

Dr. Francis Collins, head of the National Institutes of Health, said that years of cutting or stagnant budget growth has "slowed down" researchers from discovering vaccines for infectious diseases such as Ebola.

"We would have been a year or two ahead of where we are, which would have made all the difference," he told the Huffington Post.

Stan Collender, a veteran Washington budget analyst, said the Ebola outbreak is giving lawmakers in both parties a painful lesson that "budget cuts have consequences."

"Do Republicans deserve all the blame for the cuts? No. But I'd give them 90 percent," said Collender. "Some of the automatic cuts like sequestration have the fingerprints of both parties."

Laurie Garrett, a global health analyst for the Council on Foreign Relations, said both parties are doing the public a disservice by playing politics with Ebola.

"I don't think this should be a political issue," said Garrett, author of "The Coming Plague: Newly Emerging Diseases in a World Out of Balance." "I don't think anything good comes from putting Ebola into partisan camps."

The bolded italics are added by me.

Since 2001, there's been a 42 percent cut to federal funds from the CDC to support state and local preparedness programs

I present this as a slightly more detailed look at the budget cuts previously minimized in one of these threads as a "mere" 3%. It all depends on how you gerrymander the context.

"The Ebola virus wasn't even an issue at the time (of the cuts). It's scare-mongering, it's the panic of the moment."

The point of prevention is to keep something from becoming an issue in the first place. After our experience with the HIV epidemic, it's a little disingenuous to claim innocence because you didn't know ebola could hurt us.

Stan Collender, a veteran Washington budget analyst, said the Ebola outbreak is giving lawmakers in both parties a painful lesson that "budget cuts have consequences."

In other words, what the dickens did y'all think would happen? You don't get to demand cut-rate prices then complain about the quality of the work. You don't get to de-fund prevention then complain that nothing has been prevented.

"budget cuts have consequences."
Indeed :rolleyes:

Do I think the CDC performance to be 4-star ... far from it. Pretty pitiful, in fact. But a simple-minded knee-jerk condemnation of a government agency without looking at the mistaken assumptions that landed us in this situation is less than helpful, to say the least. More like a very dangerous distraction. It CAN happen here.

Specializes in Critical care, tele, Medical-Surgical.
Part of the truth about the CDC:WASHINGTON: Pols trade blame for Ebola, but both parties cut budgets for health | Congress | McClatchy DC

The bolded italics are added by me.

I present this as a slightly more detailed look at the budget cuts previously minimized in one of these threads as a "mere" 3%. It all depends on how you gerrymander the context.

The point of prevention is to keep something from becoming an issue in the first place. After our experience with the HIV epidemic, it's a little disingenuous to claim innocence because you didn't know ebola could hurt us.

In other words, what the dickens did y'all think would happen? You don't get to demand cut-rate prices then complain about the quality of the work. You don't get to de-fund prevention then complain that nothing has been prevented.

Indeed :rolleyes:

Do I think the CDC performance to be 4-star ... far from it. Pretty pitiful, in fact. But a simple-minded knee-jerk condemnation of a government agency without looking at the mistaken assumptions that landed us in this situation is less than helpful, to say the least. More like a very dangerous distraction. It CAN happen here.

If we had a Surgeon General I wonder what He or She would do?

Now there is a department without a leader.

Surgeon General | SurgeonGeneral.gov

Specializes in Maternal - Child Health.

And in the "Never Pass up an Opportunity to Throw Others Under the Bus" category, we have Dr. Frieden again.

Today, he stated that since the first nurse was diagnosed with Ebola, the second nurse should have been placed in the "no public travel" category. I agree with that 100%, but where is the evidence that she was ever instructed so?

The news articles state that she had already flown out of Dallas to Cleveland prior to Ms. Nina Pham's diagnosis. But once the first nurse fell ill, would it not make sense that the CDC or other public health entity would have reached out to all involved in Thomas Duncan's care at the Dallas hospital and instructed them not to engage in mass travel or gather in large crowds? If she was told to do so and ignored the instructions, then she is 100% responsible for this new (highly predictable) wrinkle. But I have my doubts that she (or any healthcare worker) ever received any such instructions.

Ironic that airport thermometers may be more useful in detecting American healthcare workers than African immigrants.

God help us.

Specializes in Critical care, tele, Medical-Surgical.

You still can to register and listen live to a National Nurse's United Conference on Ebola and Hospital Preparedness. It just started.

https://www.webcaster4.com/Webcast/Page/731/6167

Specializes in ER.

Interesting:

CDC LC Quick Learn: Recognize the four Biosafety Levels

BSL-4

bsl-4.png

BSL-4 builds upon the containment requirements of BSL-3 and is the highest level of biological safety. There are a small number of BSL-4 labs in the United States and around the world. The microbes in a BSL-4 lab are dangerous and exotic, posing a high risk of aerosol-transmitted infections. Infections caused by these microbes are frequently fatal and without treatment or vaccines. Two examples of microbes worked with in a BSL-4 laboratory include Ebola and Marburg viruses.

BSL-4, Continued

In addition to BSL-3 considerations, BSL-4 laboratories have the following containment requirements:

Laboratory practices

  • Change clothing before entering.
  • Shower upon exiting.
  • Decontaminate all materials before exiting.

Safety equipment

Facility construction

  • The laboratory is in a separate building or in an isolated and restricted zone of the building.
  • The laboratory has dedicated supply and exhaust air, as well as vacuum lines and decontamination systems.

______________________________________________________________________________________________

and working at a level 1 where we are "shown" the suits, but are not actually having the opportunity to put them on and have real time drills is unacceptable. It's like learning how to use a rifle in the middle of a warzone. We ARE unprepared. A regular ER is not the place for a BSL 4 Pathogen. Period.

FYI -

Class III BSC

A gas-tight sealed container that is designed to allow for the manipulation of objects, hazardous substances, or infectious disease agents. Class III BSCs have a HEPA filtered air supply and double HEPA filtered exhaust. They provide the ultimate protection for personnel, product, and the environment.

Specializes in ER.
You still can to register and listen live to a National Nurse's United Conference on Ebola and Hospital Preparedness. It just started.

https://www.webcaster4.com/Webcast/Page/731/6167

would've loved to hear this.... I am so glad that this Union is able to step up and really bring media attention to this issue. It's awesome.

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