Nursing and the Ebola Virus

[0.adamantite]

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.

[MassED, BSN, RN]

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.

HIV was.is not airborne (saliva does go airborne, read up on transmission).

I think it is great. These people are so selfless and great human beings. Dr Brantly and Nancy deserve every possible chance at life they can get.

We have all the resources and technology to bring them here and offer superior care to them safely. This isn't an airborne virus that infects people before symptoms show up or anything like that. Lethal? Yes. However, we are totally capable of caring for them safely.

Send the "safe care" there, to where Ebola can be contained. Don't bring it here. Why sacrifice millions for a few?

If I were your manager, I would send you packing, and report you to the BON in case I could get your license in trouble. I recall seeing people flatly refuse to care for AIDS patients back in the day, and I still don't understand why they weren't fired and stripped of their licenses on the spot.

Of course as others have remarked, this is ridiculous. One can have an objection to caring for a patient who is having an abortion. If a nurse is uncomfortable or feels in danger, who are you to judge? We all have different ideas of nursing.

Makes you wonder what they know about this disease that we don't. Setting up quarantine stations and bringing people over here that are infected with the disease to use as human guinea pigs to try and find a cure makes ME wonder. Can you imagine the mass panic if word got out that it IS airborne now......

Saliva does go airborne.

http://news.nationalgeographic.com/news/2012/08/120814-why-do-we-sneeze-health-science-sinusitis/

As far as putting our health on the line, I do it every day I work in the ER. We never know what the patients have, that's part of our job, to treat the unknown with kindness and compassion, not to say my life is worth more than theirs. If you didn't want to deal with the possibility of catching something, then nursing was the wrong field for you.

This isn't true. Of course we risk our lives (which is why we should get hazard pay) working in the ER, but THIS threat is like no other. Even following proper precautions, healthcare workers are becoming infected. Think about it. Why would anyone assume this risk? Why do you think they haven't been able to corner it since it's onset in the 1970's?

Just forget the moral and ethical issues of caring, or not caring for, patients with Ebola. Forget about conspiracy theories, or what ulterior motives might be involved in bringing the infected Americans from Africa to the US.

Forget about the families. Forget about the patients as people.

Then just put your nurse and science hat on, and consider one thing. From a purely scientific viewpoint.

How does it make any sense to move a deadly virus from an area of contamination, to an area that is so far secure?

Definitely. It's an idiotic move. Probably more politically motivated decision.

Okay: Did anyone catch the interview with Dr Gupta and the head of the CDC?. Its not the CDC that is wanting these patients over here. Its was arranged and is the organization Samaritan Purse who is run by Franklin Graham son of Billy Graham. So it looks to me like we have insurance companies deciding the level of our care, and Religious groups making decisions on the fate of bringing a epidemic and a unstable disease to out country. In fact when the head of the CDC, which BTW had a bit of an Anthrax incident not long ago told both Dr Gupta and later in an interview Anderson Cooper. That this organization is taking the lead in the transportation. So I ask while the entire crew be quarantined for 21 days?, and will the Rev Franklin Graham be onboard and part of the evacuation team?

I saw another article that said the CDC and State Department coordinated the efforts to return those two. Love the blame game.

first we had well meaning christians shouting that the refugee children had ebola and dengue fever and were a threat to national health, now we have a christian group arranging for the transport of actual ebola patients (citizens) into the country

go figure

Awesome. Why don't they go there to help them?

There is a whole lot of misinformation being thrown around! I suggest we all do some serious studying about the Ebola virus and how it spreads.

It is not airborne. Go to NPR.org and search for Ebola. Just today I heard a story about this. Very informative. CNN is not a credible source of news these days, unfortunately...

The spread to healthcare workers in Africa is due to lack of resources and myriad other social factors that are not present in the US. With proper PPE and isolation facilities, there is very low risk of contagion.

I would have no problem caring for an Ebola patient. I'd find it fascinating actually.

Read my previous link on sneezing and saliva. Airborne, voila! We all know this to be true.

I don't understand these Ebola threads. I seriously don't. It's an unnecessary panic. Really. We're all required to have taken Microbiology aren't we? Didn't they go over viral infections and how they spread? Why some diseases only infect certain species... stuff like that. I'll just repeat what I said in the other thread. It's not a matter of will ebola come to the US, it's a matter of when ebola will come to the US. Just like Dengue Fever, SARS, West Nile, and every other foreign born disease.. it will eventually migrate here. Ebola has been around since the mid to late 70's. It's not something new and when it does finally land here we won't see mass, uncontrollable contagion like in the movies or see a difficult, chaotic spread of the disease like in Africa. We are far better equipped and capable of doing so. Context of environment, and certainly a difference in culture, is one of the things that you have to look at when considering the dangers of possible outbreaks of anything.

Read a bit more on Ebola, cross reference your links with other reputable sources and you will understand a bit more. It is a formidable opponent and one that SHOULD cause fear.

[Rose_Queen, BSN, MSN, RN]

Send the "safe care" there, to where Ebola can be contained. Don't bring it here. Why sacrifice millions for a few?

What guarantee exists that Ebola will be contained there? With the global nature of the world population, Ebola is only a flight away. These two were brought back through very controlled conditions. The person who isn't symptomatic yet who boards a plane isn't under those strict conditions. It's not a matter of if Ebola will become present in this country aside from these two cases but when.

[preddish]

Kudos to you for your rational opinions regarding this issue. Where would infection control and many other aspects of nursing be if Nightingale had not gone to Crimea. We should laud these nurses, doctors and all of the other healthcare workers involved in the care of these patients.

[FLAlleycat]

"HIV was.is not airborne (saliva does go airborne, read up on transmission)."

No one knew how HIV was spread when it first appeared. More is known about the transmission of ebola than was known about the transmission of HIV. Ebola is in saliva which can be transferred via droplet transmission and travels only so far as the droplet will go. From reading about the history of ebola, the reason it has not been contained appears to be due to the lack of quality healthcare, inability to educate citizens, and beliefs of the citizens in those countries affected. SARS was transmitted via droplet, close contact, and possibly airborne. Using SARS as an example, it was rapidly contained since it first appeared in China. It was brought to the US and again rapidly contained. Conditions in those countries affected by SARS differed greatly from those in Africa.

As with AIDS, I also feel that, should an outbreak of ebola occur in the US, there would be healthcare providers who would volunteer to care for these patients. They would be highly trained in ID and correct use of PPE. Personally, I don't think ebola would have a chance in the US or in other developed countries. Just my thoughts.

[Mulan]

If I were your manager, I would send you packing, and report you to the BON in case I could get your license in trouble. I recall seeing people flatly refuse to care for AIDS patients back in the day, and I still don't understand why they weren't fired and stripped of their licenses on the spot.

Vindictive much?

[Miss.LeoRN]

Read a bit more on Ebola, cross reference your links with other reputable sources and you will understand a bit more. It is a formidable opponent and one that SHOULD cause fear.

The CDC is a reputable source. So were the scientific journals we used in my Micro class of which I took just last semester. We spent 3 weeks on Ebola. It's not some "mysterious disease to which we know almost nothing about". We know how it's contracted, it's NOT AIRBORN. There are plenty of studies that have proven that and despite all the fear mongering it simply hasn't mutated to that. Ebola is a slow mutating virus. The faster a disease kills you, the slower it mutates! Seriously I am starting to wonder if ANYONE has taken Micro!! They took all the precautions? SO WHAT?! Did they really? Everyone takes precautions all the time and still things go wrong. And how do you know they took ALL precautions ALL the time? How do you know WHAT precautions they took? Some nurses take shortcuts all the time. They get comfortable in what they are doing and they overlook or they forget. Just because YOU WOULDN'T, doesn't mean someone else didn't. And even so, what standard those precautions are? All this talk about not knowing anything about the virus or not knowing what it does or how it does this is absolute crap. We know what it does to the body, we know how to avoid infection, and what precautions to use to NOT get it. WE know how to quarantine and stop the spread of infection. WE, as in, the medical professions of the US. What's mind boggling is that some people are completely convinced that Ebola is going to spread like a plague across the US... WE ARE NOT some back washed third world country. That is the very reason these two people were brought to the US. Their chance of surviving the disease is immensely better here than it is there. There chance of infecting others and spreading it here? Likely so negligible that it's irrelevant.

Sanitation and infection control in Africa are NEAR IMPOSSIBLE. Have you ever gone to a developing country? Have you ever seen the lack of anything resembling modern sanitation they have? Limited running water and toilets? Have you bothered to even LOOK at the places where ebola is currently spreading, at how these people live? What their believes and culture in caring for ill family are? It's certainly not how you live. There are reasons they are having difficulty controlling the disease and it's not because of the virus itself. It's the culture of the people living with the disease. We feel ill, we go to the doctor, or the hospital. We don't want until we're bleeding out of our eyes and all over our family members to think that something is wrong with us. When a sick person dies, we don't steal the body and take it home to prepare it for burial ourselves. We don't storm into hospitals with guns in the middle of the night and run off with an infected family member because "doctors are demons". How many people were infected by that family doing that?! How many people are infected because the 3 year old has to pay respects to her aunt by cleaning her dead body?

Those things simply wouldn't happen here. It's not all about the virus... it's about the environment which the virus exists. To think that the same thing going on in Africa could happen in the US is just plain stupid. At this point, all this thread is good for is amusement of how paranoid and stupid people become from fear ("A person is smart. People are dumb, panicky dangerous animals..." go ahead, name the source.). I'm glad I brought popcorn. I seriously hope a lot of you have never bothered to check out the "Monster's Inside Me" series on Animal Planet... there are far worse things in your back yard and you're worried about Ebola.

[macawake, MSN]

Read my previous link on sneezing and saliva. Airborne, voila! We all know this to be true.

Read a bit more on Ebola, cross reference your links with other reputable sources and you will understand a bit more. It is a formidable opponent and one that SHOULD cause fear.

Seriously!?!

First of all, there's a significant difference between droplet spread and airborne transmission.

Nothing in this current Ebola outbreak suggest airborne transmission is taking place. Have you've ever encountered an influenza epidemic where it took six months to infect a mere 1.300 people out of a combined population of more than 21 million?

According to the CDC between 5 and 20% of the population in the United States get influenza during each year. Compare and contrast the numbers.

Seasonal Influenza Q&A | About (Flu) | CDC

Consider the often crowded housing situation and poor sanitary conditions in the region. This Ebola outbreak is serious but the mode of transmission isn't airborne.

I've said it before but I'll say it again. We as nurses have a responsibility to only spread information that we know is factual. We should not be spreading rumors and speculation.

We've all seen new members open an account to ask for advice about their symptoms, illness, upcoming surgery or the like. Plenty of folks not in the medical field come here looking for information. I'm sure that's also happening now with all the attention the Ebola virus has gotten in the media lately.

I've read the comments made by readers of several online newspapers and most of these commentators are ill informed and some are downright scary. Some suggested very violent acts should be carried out against the hospital now caring for the two American Ebola victims. The crazies don't need any more encouragement.

Nurses, I implore you! Don't fan this fire with unsubstantiated speculations. What I'm seeing is the online version of running down the street in your scrubs with your hospital ID badge and stethoscope dangling around your neck screaming "The End is Nigh!", only this has the potential to reach and affect many more people.

Enough already with the airborne transmission nonsense!

[Mulan]

Everyone has people who love them, and no one is more expendable than another.

Same applies even if one doesn't.

[LadyFree28, BSN, LPN, RN]

The CDC is a reputable source. So were the scientific journals we used in my Micro class of which I took just last semester. We spent 3 weeks on Ebola. It's not some "mysterious disease to which we know almost nothing about". We know how it's contracted, it's NOT AIRBORN. There are plenty of studies that have proven that and despite all the fear mongering it simply hasn't mutated to that. Ebola is a slow mutating virus. The faster a disease kills you, the slower it mutates! Seriously I am starting to wonder if ANYONE has taken Micro!! They took all the precautions? SO WHAT?! Did they really? Everyone takes precautions all the time and still things go wrong. And how do you know they took ALL precautions ALL the time? How do you know WHAT precautions they took? Some nurses take shortcuts all the time. They get comfortable in what they are doing and they overlook or they forget. Just because YOU WOULDN'T, doesn't mean someone else didn't. And even so, what standard those precautions are? All this talk about not knowing anything about the virus or not knowing what it does or how it does this is absolute crap. We know what it does to the body, we know how to avoid infection, and what precautions to use to NOT get it. WE know how to quarantine and stop the spread of infection. WE, as in, the medical professions of the US. What's mind boggling is that some people are completely convinced that Ebola is going to spread like a plague across the US... WE ARE NOT some back washed third world country. That is the very reason these two people were brought to the US. Their chance of surviving the disease is immensely better here than it is there. There chance of infecting others and spreading it here? Likely so negligible that it's irrelevant.

Sanitation and infection control in Africa are NEAR IMPOSSIBLE. Have you ever gone to a developing country? Have you ever seen the lack of anything resembling modern sanitation they have? Limited running water and toilets? Have you bothered to even LOOK at the places where ebola is currently spreading, at how these people live? What their believes and culture in caring for ill family are? It's certainly not how you live. There are reasons they are having difficulty controlling the disease and it's not because of the virus itself. It's the culture of the people living with the disease. We feel ill, we go to the doctor, or the hospital. We don't want until we're bleeding out of our eyes and all over our family members to think that something is wrong with us. When a sick person dies, we don't steal the body and take it home to prepare it for burial ourselves. We don't storm into hospitals with guns in the middle of the night and run off with an infected family member because "doctors are demons". How many people were infected by that family doing that?! How many people are infected because the 3 year old has to pay respects to her aunt by cleaning her dead body?

Those things simply wouldn't happen here. It's not all about the virus... it's about the environment which the virus exists. To think that the same thing going on in Africa could happen in the US is just plain stupid. At this point, all this thread is good for is amusement of how paranoid and stupid people become from fear ("A person is smart. People are dumb, panicky dangerous animals..." go ahead, name the source.). I'm glad I brought popcorn. I seriously hope a lot of you have never bothered to check out the "Monster's Inside Me" series on Animal Planet... there are far worse things in your back yard and you're worried about Ebola.

I had Micro; one of my last refresher classes before I started nursing classes...and I agree with you 1,000%.

Ebola is MILD compared to the other insidious bacterias out there that damage the nervous system, produce chronic morbidities, and can be cross infectious that are in the US NOW.

For perspective, the number of people killed by Ebola since the original outbreak in Zaire is fraction of the number killed annually by influenza, a disease for which safe vaccines are refused.

[MassED, BSN, RN]

What guarantee exists that Ebola will be contained there? With the global nature of the world population, Ebola is only a flight away. These two were brought back through very controlled conditions. The person who isn't symptomatic yet who boards a plane isn't under those strict conditions. It's not a matter of if Ebola will become present in this country aside from these two cases but when.

Do you know that it was in a "very controlled condition?" You only know what is delivered to you. I agree with you about not if, but when. I just have a huge issue with an agency (private, or more likely governmental agency) deciding to BRING it!

[MassED, BSN, RN]

So, hmmm....to those who say that the doctor and the nurse should not have been brought to America....it would be okay with you if your husband or wife who were helping to care for Ebola patients in Sierra Leone/Guinea/Liberia and contracted the disease were left there? Or, if YOU were the one, it would be okay? As to the comment about whomever is responsible for sending the patients back to America suiting up and going into isolation with you (I think it was Biff who made the comment)....I have no doubt that Franklin Graham and the leader of SIM (the organization that Mrs. Writebol is with) would do that very thing.

If I took that upon myself to go to that region, knowing what I was getting into - then YES, I would want to keep myself there. This was something they signed up for.

You have "no doubt" about Franklin Graham? Really? Do you know him or that organization? NONE of us know what another would do. Don't let the guise of religion fool you that they make the best decisions for the greatest good. Puullease.