Was watching "Downton Abbey" Sunday night and it got to where the great Spanish Flu pandemic of 1918-1919 hit.
Program seemed to get much of the details down right; healthy young persons were fine one minute, greatly ill the next and often dead within 24-48 hours.
From one's own (limited) research on the matter found out that many nurses and other medical persons came down with and subsequently died from being exposed to the flu whilst caring for patients. Of course many knew they shouldn't have been anywhere near such sick persons but "duty" kept nurses on the wards and in the cases of public health nursing going from house to house caring for the stricken.
With almost one hundred years of hindsight and modern adances in medical care one would think if such a thing hit again things would be different. However one does wonder if a bulk of nurses today have the "self sacrificing" gene.
Say this because clearly remember what things were like during the 1980's when AIDS began to appear. Was working as a CNA and often it wasn't the most shining hour for some nursing staff. Indeed on more than several occasions it came down to threats of being written up for insubordination to get some nurses anywhere near afflicted patients.
If there was a major outbreak of unknown or serious disease such as another major flu outbreak would *you* go in? If the hospital was going on lock-down for the duration would you stay or bolt for the door before it's locked?
Sorry aobut not mentioning SARS and skipping right to AIDS, totally forgot about that one.
In the historical context during the 1900's most nurses would have been unmarried young women or matrons with no one to "worry about" leaving aside from perhaps parents and or family. Nursing sisters in religous orders had only God, their order and maybe some family but as many took vows regarding care of the poor and sick under *all* circumstances they wouldn't have had much choice nor probably gave reporting for duty a second thought.
Over ninety percent of the nursing work force in the United States are female. Of those many are married women with children, single mothers, and so forth. This is rather *new* as it was law if not mandatory for nurses to be discharged upon marriage and or discrimination against women with children (single or otherwise). Even after such laws were struck down many female nurses left the profession after marriage and or to have/raise their babies. Now of course that has changed as the economy almost requires two incomes and the large number of single parents have no choice.
While can understand why some would feel it's a betrayal of the profession not to report/remain on duty during an epidemic/pandemic do feel we should cut family women (and men) some slack.
If the events of the past several years have taught us anything it's that corporate America and for that matter much of the US and local government only care about themselves. Under those circumstances does anyone really trust those bodies and the giant healthcare conglomerates to do the *right* thing by one should one be stricken or one's survivors should one die from exposure during the outbreak? How much life insurance does your employer provide if any? Can any amount replace a mother to a wee baby or child?
Finally we should consider many nurses are married to other first responders (EMTs, LE, etc...) so depending upon the nature of the disease a household may be exposed on two fronts. What happens then?
If the disease is another major flu outbreak first likely cases will be infants, children, and the elderly. Again this would leave many female (most always the go to person in the household when anyone is ill) nurse with choices. In the case of the 1918 Spanish flu early symptoms were usually mild to middling moderate, but often quickly turned south. What does one do if you've left a baby at home with a bit of a cold and halfway through your shift a text or call comes that wee baby is spiking 105F? Worse his grandmother (your mom the babysitter) suddenly "isn't well" and is quickly going south as well?
I would just like to point out that in all the professions mentioned when the emergency presented is outside of the normal risks and has a high likelyhood of death they ask for volunteers. I.E. the meltdown in Japan, they asked for workers who were willing to go back in. I understand that in my choice of nursing as a profession there are daily risks but the situation of a highly contagious disease that causes death running rampant in large numbers is not one of them (or if it is I haven't been taught that yet!). To be effective in such a situation a person has to be more emotionally invested that it is the "right" thing to do, however that is right for them, and IMO has nothing to do with degree of professionalism or intelligence. I am saddened so many have posted with such negative attitudes towards others of differing viewpoints. Yes if I were sick and likely going to die I would want someone to care for me, but if I were also very contagious I would only want people who knew and accepted the risk willingly. I do have children and likely would not expose myself to such a pandemic if it were that contagious and fatal despite PPE, but once my kids are grown and out of the house I would feel that it is part of my duty as a human being since out of the available humans I would be (as a nurse) in much better capacity to help than the average person off the street. I would also never join the military since I have children, but that doesn't change the respect I have for those that have. It is just a personal choice and I respect that, whether it is the same choice I would make or not.
If Ebola was at a hospital I wouldn't go there. If it is something that death is almost guaranteed I would throw in the towel. I wouldn't be proud of it, but at this point I would be lying if I said otherwise.
If I were to stay at the hospital I wouldn't go home until I knew for sure my family would be safe.
I'm exposed to potential infection daily, however, if it was some new illness that was spreading and can't be stopped, no, I would stay home. Sorry. My job isn't worth my life. If it was something known and that can be prevented with protection but pandemic/epidemic, and my job provided me with a hazmat supply of PPE, I wouldn't mind going in, but I wouldn't go on my day off or volunteer. I'm not going to infect myself with something horrible or fatal to help others though, I know that's my job, but if I'm dead, my job doesn't matter. I do enough as it is.. I can't do anything for anyone if I'm dead. I follow universal precautions to protect my patients and I do the same to protect myself. My job is to help others, NOT to be given a disease or die for them. I would not go into work for this kind of situation.
If there were a fire, I'd try to save as many people as possible until I felt I were going to die, then I'd get out. If there were an explosion and I was going to die trying to get someone out, like building was crumbling, I'd get out myself. If there were a shooter, I'd hide myself as soon as I could, I'm not gonna get shot trying to protect anyone else, sorry. I wouldn't use someone else to protect myself, they can't expect me to sue myself to protect others. There's no sense getting shot.
Depending upon the nature of the disease causing the epidemic/pandemic and what department or unit one works in many nurses/healthcare workers probably would be infected during the prodrome phase. So by the time things started to hit the fan many would be taken ill already and worse may have infected family members and others.
If one works say in the ER or PEDS when there is a spike of patients with complaints of "flu like symptoms" and they are treated as run of the mill it could be days or even weeks before anyone starts connecting the dots. Using SARS as an example does anyone know off the bat what to look for?
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
working in a large, tertiary inner city medical center, i probably would have already been exposed to the contagin by the time an epidemic was noted/reported. the reality of the situation is that many of us will already of been exposed before having an opportunity to decide whether or not to risk exposure. once exposed, we'd probably be on lock down.
if i were home, not exposed and given the opportunity to decide what to do, i'd hope i'd do the right thing. but very few of us really know what we'd do in a situation until we're in that situation. and if there were a pandemic, there will be a need for caregivers in the community because honestly, there won't be room enough in the hospitals for everyone that needs to be there.
I work peds/adult ER and if I were scheduled, I'd probably go in. If I weren't, however, I can't say for sure that I'd volunteer.
I work in a city hospital and safety is also an issue. An ER full of scared, sniffly people who have to wait for hours because of volume would be a dangerous place. Heck, we get angry, loud complainers if they have to wait 30 minutes. Imagine if they were all fearing for thier lives.
I have a family at home. I don't want them exposed. As someone above said, though, working ER, I'm probably already exposed.
Ps - every year that my PPD has come back negative has surprised me LOL
While can understand why some would feel it's a betrayal of the profession not to report/remain on duty during an epidemic/pandemic do feel we should cut family women (and men) some slack.
I've already spent my entire career "cut(ting) family women (and men) some slack" (or, at least, being expected to) -- I need the holiday off, I have children; I have to call in, my child is sick; I need to be off, my child is in the school play (or my child's team has a game); etc., etc., etc ... I'm not much inclined to give them special consideration on this issue, too.
Nurses and physicians throughout history and around the world have cared for people who had contagious, terminal illnesses, with a lot less in the way of protection and resources than we have available these days. It's only since AIDS first appeared that I've heard anyone talk about how it might be reasonable and understandable that some healthcare professionals might choose to "opt out." Again, I'm not talking about being a martyr or hero -- just showing up and doing your job, as you agreed to do when you took the job, in an occupation you chose to enter. If that doesn't work for people, they are perfectly welcome to choose some other occupation beside nursing.
These discussions always remind me of all the people who join the military for the benefits, travel, etc., and then, when we actually send troops into active combat somewhere, suddenly say, "Oh, but I didn't want to actually have to get shot at ..." If you aren't willing to do the job, don't take the job in the first place ...
hecallsmeDuchess
346 Posts
So many things to consider but I know I would not put my family second place to my patients.