Nursing and the Ebola Virus

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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.

Specializes in L&D, Women's Health.
OK, first of all, I can refuse any assingment I want, for any reason I want, and there's nothing the BON can do about it.

As long as I do not accept the assingment before it is handed off to me by the off-going nurse, it is not abandonment. I can't abondon a patient I never accepted in the first place. I could loose my job, sure, but not my license.

I don't know what I would do in this situation. It would depend on whether or not I felt the hospital had the technology and equipment available to provide some reasonable degree of saftey.

This is such a myth, at least in right-to-work state FL! Well, maybe *technically* you won't be abandoning a pt but you sure as heck can still get fired, and there's nothing BON can do about that, either. But, you cannot be assigned a pt for whom you are not trained to care; however, your orientation can be about 5 minutes.

Alley

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I guess my main concern is this: There seems to be inconsistencies in what is being given out in terms of information. It is called "difficult to contract" but then requires pretty much a hazmat suit and there are recommendations to test people who have similar symptoms even if they have not had direct exposure. I feel a bit like they are talking out of both sides of their mouth. "Don't worry! Even healthcare workers won't catch it here! Everyone is very safe! Well. As long as you wear this suit. And goggles. And double glove and cover your shoes when it gets really bad and watch out for spray and droplets and don't touch anyone and go 21 days symptom free after taking care of them. No worries! Very safe!"

I am not a conspiracy theory type of person at all, but it feels just on the edge of "We have no freaking idea really how certain people contracted this but we'll keep presenting what we DO know as fact until we can figure it out."

Didn't we read somewhere that they were rewashing the gloves, etc and reusing them and other PPE equipment? Also, these were not specialist caring for these patients. The Dr that was admitted to Emory was a General Family Practitioner who has been in practice for 5 years. Not an infectious disease specialist. I think the lady was a non-medical volunteer. I think it's things like this is why they are saying "we" can control it a little better.

Not that I trust the CDC.

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Also, I think at issue here, is that it has already spread to 4 countries. Now days, that is a big deal. And persons from those 4 countries, that have been in and around those infected, have left to safer countries. A Dr that was working in the same hospital as the Dr admitted to Emory also came home this week. He put himself in quarantine for 21 days since the lest time he worked with an Ebola patient. It didn't sound like he chose to leave, but was sent home. He would go back if he could.

We are freaking out about a known case, that has been in issolation during transport. I'm worried about all those that traveled among the people, who might be infected and not know it. I want Emory to get a grip on it and come up with procedures that ALL HOSPITALS can use to contain it if and when it hits the small towns.

IMHO, I honestly think that the only reason they got approval for this, is because it's so easily possible for it to come here and be here from those fleeing this. Not that it has, but that it's the POSSIBILITY. Emory thinks thinks they can do it. They have plans drawn up. They have the research, but can they? This is their test, and with patients that might be on the mend. Not full blown, surprise, guess what the new patient in ER has. I think they want to 'test', and learn. AS for the rest of us that might be getting the 'surprise', this is a good thing. Maybe the powers that be, will learn something and share that information to those on the ground floor.

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Specializes in L&D, Women's Health.
I guess my main concern is this: There seems to be inconsistencies in what is being given out in terms of information. It is called "difficult to contract" but then requires pretty much a hazmat suit and there are recommendations to test people who have similar symptoms even if they have not had direct exposure. I feel a bit like they are talking out of both sides of their mouth. "Don't worry! Even healthcare workers won't catch it here! Everyone is very safe! Well. As long as you wear this suit. And goggles. And double glove and cover your shoes when it gets really bad and watch out for spray and droplets and don't touch anyone and go 21 days symptom free after taking care of them. No worries! Very safe!"

I am not a conspiracy theory type of person at all, but it feels just on the edge of "We have no freaking idea really how certain people contracted this but we'll keep presenting what we DO know as fact until we can figure it out."

First, IMHO, I think the hazmat suits, in the US, are probably to give the public some "reassurance" that health care workers are going all out to make sure this does not spread when in reality normal PPE would suffice. I mean, if all you see in affected countries are people in hazmat, I'd think one would be pretty freaked out if they saw anything less here. Also, I wear shoe covers at work just because I don't want to drag anyone's potentially infected (with anything) vomitus home on my shoes, but that's just me. I practically wear a hazmat suit in labor and delivery. And there really is a big difference between droplet and spray.

CDC does not say to test everyone with symptoms or to isolate everyone for 21 days. If you have not been exposed to the virus either by human or animal contact but have symptoms and labs are abnormal *without* an explanation as to why, then testing is recommended.

I don't see CDC recommendations as double speak but as reinforcement of what we as nurses already know regarding PPE and as guidelines (protocols) for whom to test and when. Our posts are being read by medically uneducated people (not our problem, I know, but still . . . ). I feel we have an obligation to make sure what we pass on is medically accurate.

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Specializes in L&D, Women's Health.

BTW, thanks, edmia, for posting the CDC info.

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Correct me if I'm wrong but aren't there three types of the Ebola virus with Ebola Zaire being the deadliest with a 90% death rate while the other two were around 50%. And these patients are dying from massive amounts of hemorrhaging, compared to Tb I feel your chances with coming into contact with their blood are a lot higher. That's what makes me nervous about potentially taking care of these Patients. One microscopic rare in your PPE and you're at tremendous risk. I agree that we need to close the boarders to prevent a pandemic. Hopefully the experimental vaccines turn out to be effective at combating it so we can eliminate it before it mutates or becomes impossible to contain.

Knowledge is power.

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Specializes in NICU, PICU, PACU.

I think I would rather know that the patient I am taking care of has Ebola. Scary, sure, but at least I know what I am dealing with! I was in nursing school when the AIDS scare started....I could have been easily exposed and never knew it. We didn't wear PPE back them or follow universal precautions.

It is those patients that we don't know about that scare me.

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Specializes in Oncology; medical specialty website.

I would like to sincerely thank whoever it was that recommended the book The Hot Zone. I started reading it yesterday. Last night, I was up at 0030, 0230, 0430, 0530, and then at 0700. Who needs sleep? ;)

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Specializes in Rehab, LTC, Peds, Hospice.

I will not lie -moving Ebola infected people to our country worries me. Infectious protocols are only as good as the equipment and staff used in caring for them. Human errors happen. Quarantines should be just that, no exceptions because of the risks to others, unless the benefits outweigh the risks. And I'm not sure in this case the benefits do, not even in terms of medical care just for their sake as care at this point is simply supportive.

That being said - yes, I would take care of these patients. I wouldn't care for it simply because I dislike all that is involved. Protective equipment is time consuming to apply, cumbersome, uncomfortable and I feel alienates you from your patient. But I would care for them simply because they need me to. And although I wouldn't judge someone for being afraid to, I can't really relate to someone is a afraid. Or so afraid that they can't care for them. If I can help, I'm going to.

To me our job often is no different than when a medic drags a wounded soldier to safety or a fireman enters a burning building to rescue someone - of course there is risk involved. It's what I signed up for.

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I'm a little curious as to what the decontamination regimen looks like for the plane and transport to the hospital. I'm confident that Emory is the right place for these patients, as it is a specialized unit.

Going to dig out my old worn copy of The Hot Zone. I bought and read it the week it came out.

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Specializes in L&D, Women's Health.

While everyone is cracking out "The Hot Zone", please keep this data in mind:

Over nearly 40 years, Ebola has infected fewer than 5,000 and killed fewer than 3,000 worldwide. More than 35 million people worldwide are infected with H.I.V., and close to 39 million have died of its complications.

And to further balance the scale, watch "The Normal Heart" (I think that's it) or "The Philadelphia Story" and see how we treated AIDS pts during its early days. I see no difference in the fear factor but we have more awareness and protective equipment.

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Specializes in Oncology; medical specialty website.
While everyone is cracking out "The Hot Zone", please keep this data in mind:

Over nearly 40 years, Ebola has infected fewer than 5,000 and killed fewer than 3,000 worldwide. More than 35 million people worldwide are infected with H.I.V., and close to 39 million have died of its complications.

And to further balance the scale, watch "The Normal Heart" (I think that's it) or "The Philadelphia Story" and see how we treated AIDS pts during its early days. I see no difference in the fear factor but we have more awareness and protective equipment.

Just for clarification, The Philadelphia Story was a movie with Katherine Hepburn and Spencer Tracy that was released in 1940. Philadelphia was the Tom Hanks movie released in the early 90s that was a true story dealing with the bias AIDS patients experienced in the beginning of the AIDS epidemic.

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