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.

I would not consider someone selfish for refusing to care for a patient, except in the event that the same person expects others to help with them or a love one when sick.

First they came for the Socialists, and I did not speak out—

Because I was not a Socialist.

Then they came for the Trade Unionists, and I did not speak out—

Because I was not a Trade Unionist.

Then they came for the Jews, and I did not speak out—

Because I was not a Jew.

Then they came for me—and there was no one left to speak for me.

Martin Niemöller
(1892–1984)

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In your everyday life, you can come in contact with the infection. At work, or shopping. It can happen. How many times a day are we exposed to persons who show signs of cold or flu? You don't have the personal option of refusing to be exposed. You will not even be aware of it.

Yes, but it's a whole different story when an infected person is voluntarily and willingly brought into the US for treatment, due to the immense pressure of Samaritans Purse- an organization that knows next to nothing about infectious diseases. Also the infections we come into contact with on a routine basis are nothing remotely as deadly as Ebola.

Obviously I understand the risks of nursing, but this isn't a normal circumstance.

Again, I'll reiterate this: I have no idea what I would do if I were on the team of nurses at Emory in this situation....

But i do believe that they deserve the fair chance to refuse the pt if they so choose (again, under these circumstances only- I am not referring to routine hazards of the job)

I see a lot of amazing nurses on this site and I am honored to be able to (hopefully) work alongside you guys!

But I also understand that everyone has to draw the line somewhere.

I won't judge anyone who physically/mentally feels that they cannot handle the Ebola scenario.

And by the way, cleaning up a 400 lb patient with constant diarreah and needing to be turned over etc is not included as one of the things that I think nurses can run away from. They knew that this was part of the job!

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The team at Emory has been specially trained to work in the isolation area for infectious disease. If they didn't want the job, then they shouldn't have taken the job, got trained for it, etc. Unless you have such specialized training and work in a hospital with such specialized wards, it's not an issue you will have to deal with.

When you deal with it, they will be brought to the ER, it will be unknown what they have. Once they figure it out, many people will be exposed. When it comes time to put that person in isolation, who should go help them?

Sounds like many want volunteers. Which works, when you want an easy way to give someone else the responsibility. But it's an unrealistic choice. In such a situation, persons have already been exposed in the ER. Those that have been exposed, if they really are using their love ones as an excuse for not wanting to treat such patients, what are they going to do? Run home to their families and risk contaminating them? It's an unrealistic excuse, which is why I don't buy it.

When the time comes, the choice should be among those all ready exposed. It sucks, but would you really want to risk bringing it home?

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Specializes in SICU/CVICU.

I find it interesting that so many people are all freaked out about these 2 people with Ebola in a self contained isolation unit yet there is no uproar about the vast numbers of people out there with drug resistant TB or other resistant organisms. Those are far more likely to pose a threat to you and your family!

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Specializes in L&D, Women's Health.

I posted this site on the other thread. It is really a fascinating and relative article. Unfortunately, you'll have to cut and paste the link. It gives first-hand interviews of nurses who were among he first to encounter AIDS. Many nurses refused to care for these patients where others volunteered to do so even though there were MANY unknowns about the disease. Deja vu.

The AIDS Epidemic in San Francisco: The Response of the Nursing

The AIDS Epidemic in San Francisco: The Response of the Nursing Profession, 1981-1984, Vol. II

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Specializes in Pediatrics, Emergency, Trauma.
I posted this site on the other thread. It is really a fascinating and relative article. Unfortunately, you'll have to cut and paste the link. It gives first-hand interviews of nurses who were among he first to encounter AIDS. Many nurses refused to care for these patients where others volunteered to do so even though there were MANY unknowns about the disease. Deja vu.

The AIDS Epidemic in San Francisco: The Response of the Nursing

The AIDS Epidemic in San Francisco: The Response of the Nursing Profession, 1981-1984, Vol. II

I just want to say it was an interesting read. :yes:

My mother worked as a caseworker during the early 80s (while pregnant with me ;) ) during that time to help with access to healthcare, and prevention outreach in LA County.

She shared with me her experiences, especially when movies such as "The Band Played On" and "Philadelphia" came out the stigma that many faced and at times, it was the caseworkers that were their link to healthcare; they were treated as lepers.

Unfortunately, from time to time, you will find people that STILL, despite all the information, treat HIV-infected individuals as such.

The thing about Ebola is that there is information out there; people have to be willing to seek out the proper information; and in this day and age, there's no reason not to; it is available at ones fingertips. :yes:

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Just for a bit of perspective, from a first-hand observation and well respected organization (medecins sans frontieres): Ebola: My last day in the isolation zone | MSF UK

I don't know about y'all but I'm seeing a huge disconnect between the published assurances and the level of PPE that appears to be required to work there (relatively) safely.

Said PPE seems to far exceed anything available to us at my facility...

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The thing about Ebola is that there is information out there; people have to be willing to seek out the proper information; and in this day and age, there's no reason not to; it is available at ones fingertips.
Not that I've been able to easily find...

For example, what does "close contact" with bodily fluids mean? Mucous membrane? Blood-blood? Fecal-oral?

And in what quantities? For HIV, we know that a minor needle stick is unlikely to transmit the virus. I've not been able to find anything definitive and quantifiable regarding Ebola. (Not that I've tried that hard but it's not "at my fingertips.")

Even in general terms, how contagious is it? For example, a patient is being wheeled into the ED by their family, sneezes or coughs in their hands, and then touches the door handle... which is then touched 30 minutes later by a staff member who then inadvertent rubs their nose... is transmission (a) impossible, (b) very, very unlikely (say

I don't consider that there's enough factual and evidence/science-based information for me to make an informed decision about whether I would or would not knowingly provide care for an Ebola patient with diarrhea and hematemesis.

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Specializes in Critical Care; Cardiac; Professional Development.
Just for a bit of perspective from a first-hand observation and well respected organization (medecins sans frontieres): Ebola: My last day in the isolation zone | MSF UK

I don't know about y'all but I'm seeing a huge disconnect between the published assurances and the level of PPE that appears to be required to work there (relatively) safely.

Said PPE seems to far exceed anything available to us at my facility...

EXACTLY. This is what I see as well and there seems to be a HUGE disconnect.

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Specializes in ICU / Urgent Care.

There is a big difference between dealing with day to day sick patients and a patient with a class 4 contagion which if caught will likely kill you. I for one will not be treating anyone with Ebola, my life is worth more then that.

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It's pretty scary how quickly it's spreading. Honestly I kinda would love to go there and help the people and try to contain it. And there is already a scare in NY about a possible person who just came from Africa and showing signs of Ebola. So unfortunately it might not be long before it is here.

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I find it interesting that so many people are all freaked out about these 2 people with Ebola in a self contained isolation unit yet there is no uproar about the vast numbers of people out there with drug resistant TB or other resistant organisms. Those are far more likely to pose a threat to you and your family!

Or the people calling the Emory nurse advice line and making death threats. The public should worry more about those crazies than the crazies should be worried about Ebola.

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