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Nursing and the Ebola Virus

0.adamantite specializes in Acute Care - Adult, Med Surg, Neuro.

For those of us in unaffected countries, are you concerned about the ebola virus spreading? Would you care for ebola patients? I live in an area with a very high density of African immigrants and come into contact with these individuals regularly. We have a lot of African immigrants who bring back tuberculosis from their home countries and at my unit we end up caring for them. We take care of a lot of rare infectious diseases. I was reading an article and it dawned on me how plausible it would be for me to encounter this virus. And I admit, it's terrifying and I might refuse that assignment. Many healthcare workers in Africa are dying because of caring for the ill.

Edited by Joe V

Zara, RN specializes in Rehab, Skilled Nursing.

I've been following the news also and this is very serious. This disease progresses quickly. No cure and 90% of those who come into contact with it die. Physicians and nurses are dying :(

Early treatment gives some kind of good prognosis, but it's symptoms are initially fever, flu like symptoms and then finally internal bleeding! At that point too late! With the upcoming flu season that will seem like everyone.

I'm not sure what would happen if we end up having a case here. It would really become a nightmare for all healthcare providers.

I would hope that they would isolate them all from the public. How frightening for all!

Nurse SMS specializes in Critical Care; Cardiac; Professional Development.

Yep, I am getting pretty darned concerned. I think we can only contain this for so long. It is going to spread.

Esme12 specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

we had a thread about this recently....https://allnurses.com/nursing-news/liberia-nurses-abandoned-932032-page2.html

imintrouble specializes in LTC Rehab Med/Surg.

I don't see how we can refuse to care for those patients. That's not a saint/nurse response. Our job description does not exempt us from caring for diseases that present the greater risk.

As a practical question, how would you make assignments?

There would obviously be strict isolation, but who would staff it?

If every nurse said "not me", then who?

Would a hospital continue to employ nurses, who decided the risk involved in that part of their job was unacceptable?

If those nurses who refused were fired, how many would be left?

Would the nurse managers be expected to take a turn in the isolation areas, if nobody wanted to go?

I've been following this outbreak since it was first reported back in Feb/March. I don't see how it can be contained.

Edited by imintrouble

HouTx specializes in Critical Care, Education.

Houston has one of the largest population of Nigerian immigrants in the US & lots of international travelers. Yep, it's very concerning. Lots of very difficult ethical/legal issues involved.

I believe the incubation period is 7-10 days meaning that a person who is exposed will not be symptomatic for a week or so. In today's world one can travel just about anywhere in less than 7 days.

It will be interesting to see how this evolves.

With the wars and the climate and the ebola scare, etc some are reviewing the Biblical prophecies for end of time.

I don't think you're actually contagious until you start showing symptoms, I could be wrong it was just a tidbit I picked up when reading about that doctor who died. There was another man who actually flew to Texas (Abilene?) or maybe it was his family, the potentially infected are being quarantined, though the article didn't say those exact words, something about they were just staying with family. It's definitely scary, and containment should have been done months ago. When I first started following this story back in Feb/March I told my husband to watch it spread like wildfire. It could hop the ocean and be here at any time. Not at all fear mongering, but this is a very serious illness. The mortality rate on this is extremely high, even with early detection.

I was trying to think of ways this doctor could have become infected. Knowing the disease like he did, and knowing the precautions to take, I wonder how he actually contracted the virus in the first place. I'm sure he wasn't being lax about proper procedure, and the fact that he knew the virus so well, and contracted it anyway scares me. I would like to think that because we have more readily available medical care and don't have the same funeral customs as the Nigerians do that this could be contained better on our own soil. I guess the good thing about the virus is that it kills too quickly to mutate into something airborne, which is when the crap would really hit the fan. Scary stuff for sure.

I don't know how I would be able to provide care for someone with this virus and not make a mistake being so nervous about possible infection. But I am also just a student and have no formal training as of yet. Thinking about outbreaks like this does make me nervous though, when it comes to my future nursing profession. You can't just say you're not going to help treat someone because the disease is more dangerous. But the quality of care and the safety of that care to myself is something I'd be concerned with, because I honestly think that even with many many years of training and experience under my belt I'd be scared to death that I'm going to do something that will cause me to become infected, while providing care for those who already are.

Nurse SMS specializes in Critical Care; Cardiac; Professional Development.

Don't be too sure that it can't mutate to airborne. It is possible it already has and that is why doctors and nurses who take proper precautions are still getting it. Hard to say at this point.

Follow-up question. Dr. Ken Brantly, working for Samaritan's Purse in West Africa is now infected with Ebola. If he survives, will he be able to treat Ebola patients without wearing any protective clothing as long as he decontaminates after work to keep from being a carrier? Just curious.

I dont see how you would have an ebola pt in a hospital, I would hope they would be quarantined before they got to one, that would just be a disaster if it got to a hospital, seeing how MRSA, cdiff etc can sometimes spread and infect other pts on a unit. I would think they would have a special team of people volunteering to work with them in a separate facility, because I would walk out rather than be forced to care for ebola pt, sorry! Also, if you're a pt or a family member and you see people going into a room down the hall in hazmat gear, wouldnt you wonder what is going on! I would leave AMA.

NurseGirl525 specializes in ICU.

Not to be picky, but the mortality rate is 55%, not 90%. Several countries have already shut their borders, lets hope all do until this is contained. It's a reality though that we will have to deal with at some point in our lives. We just do the best we can.

Zara, RN specializes in Rehab, Skilled Nursing.

Kent Brantly is fighting for his life. No news of his death.

Zara, RN specializes in Rehab, Skilled Nursing.

Not to be picky, but the mortality rate is 55%, not 90%. Several countries have already shut their borders, lets hope all do until this is contained. It's a reality though that we will have to deal with at some point in our lives. We just do the best we can.

My source was the World Health Organization and I quote, "EVD outbreaks have a case fatality rate up to 90%"

50 or 90 percent chance still means death to me.

I'm not sure how I should feel if I were put in a position to care for highly contagious patients in which caring for them would lead to my fatal demise.

Why has all this time passed with no vaccine? First outbreak recorded in the 70's..

Makes you wonder..

Rose_Queen specializes in OR, education.

My source was the World Health Organization and I quote, "EVD outbreaks have a case fatality rate up to 90%"

50 or 90 percent chance still means death to me.

Many places are reporting that the fatality rate of this outbreak is 60%, owing to faster identification and earlier treatment. So, while still quite serious and threatening, it sounds like we are getting better at controlling the disease.

Nurse SMS specializes in Critical Care; Cardiac; Professional Development.

I had read this outbreak shows mortality of 60% when identified and treated early. The challenge has been...identifying and treating early. I have read articles about medical workers being regarded with high suspicion and villages going so far as to blow up bridges to keep them from entering their township.

It bears noting that a 60% death rate only sounds good when held up to a 90% death rate. It also says nothing about where on the scale between "full recovery no deficits" and "living the rest of life debiliated/ventilated/etcetcetc" the survivers fall.

Throughout recorded history, there have been communicable diseases with high mortality rates for which there was no known cure, and physicians and nurses have cared for the victims without making a big fuss about it. You use the best practices and protective equipment available, and do your job. I was around for the same panicky discussions when HIV first became a problem, and now everyone is used to it and it's not considered a huge deal, just something we all deal with.

canoehead specializes in ER.

If we treat Ebola aggressively, the system is going to run out of blood/blood products quickly. We'll have to cohort patients, and deal with how to contain any visitors. I'd rather have them sleep over than be walking around the hospital.

the CDC and WHO are not clearly stating when a person becomes contagious. Is it before symptoms start? I did see that the virus can remain in sperm up to 7weeks after recovery. That is a long period of isolation.


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