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.

[CrunchRN, ADN, RN]

It was noted on the triage form from the triage nurse. Somehow it was not "communicated" to the treating team per our local news here in Dallas.

[MassED, BSN, RN]

It was noted on the triage form from the triage nurse. Somehow it was not "communicated" to the treating team per our local news here in Dallas.

how do you know it was noted in the triage? People (and media) can say all they want, but until we see the documents, it is all speculation. None of us have seen the triage, as per privacy laws, obviously. All over the news, the hospital is stating "it wasn't communicated to the provider" - EVEN if it wasn't noted in triage, the DOCTOR is responsible for their history and physical, AS WELL as the discharge plan.

[MassED, BSN, RN]

So I've been doing some digging. Trying to remain factual, but I'm not going to lie, my head can't help but to do the "what if" dance, every time I see someone from over there dying, who's traveled. I'll try to lay it all out without jumping all over the place, please bear with me.

9/16- Duncan's sister dies from Ebola

9/19- Duncan leaves Liberia, and goes to Brussels, then Washington, headed for Dallas

9/20- Duncan arrives in Dallas

9/26- Duncan goes to an ER and complains he's not feeling well and has come from Liberia (nurse fails to communicate) Duncan sent home

9/28- Duncan is picked up by ambulance and taken back to the same hospital he went to previously.

9/30- Is proven to have Ebola

So this guy was flying while infected. They say that because he was showing no symptoms he wasn't contagious, so people on the planes are fine. It's only the time from 9/26-9/28 that we need to worry about according to the news and CDC. They say there was about 18 people he came into contact with, and they're all being monitored. Schools have sent out letters to parents, schools are being wiped down and cleaned. Now some news sites are saying that United Airlines is trying to get in contact with people who flew on the same flights as this man because it is now released that he flew in from Brussels to Washington Dulles on his way to Dallas. Why are they trying to find the passengers who flew with him if he wasn't symptomatic? Just to make sure? That's great but they have repeatedly said it's not a droplet transmission and there's no risk until symptoms show. Weird.

There's absolutely 0 reason that we should be accepting flights from affected countries. The world is too mobile these days, and as such much smaller than it used to be. This sort of thing while we can possibly deal with in a correct and safe manner in trickles, does not lend itself well with the shape our hospitals are in when it comes to people being infected in droves. In my mind it's a recipe for disaster, and that's not being a sensationalist. There's 0 reason we should be risking the lives of the people here at home, and our already overworked medical professionals. While our level of care here is better than a third world country obviously, we're just not ready to take on the kind of numbers that something like this could possibly bring if it gets out. So why bother even testing the waters? They wanna bring back sick workers being monitored from Liberia to here and expecting them and knowing where they're going to put them and preparing for them beforehand? Fine. That I'm not crazy about, but I can handle that a whole lot better than the idea of every sick African who thinks the USA is now a magical place of ZMAPP cures and lollipops hopping a plane to our shores because they think their life is worth risking millions and our government agreeing with them.

I just don't understand.

Duncan helped "a seizing women" to the hospital, it wasn't anyone he was related to... apparently.

[ceccia]

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.

you want to take away something that I don't want and that I regret ever pursuing /obtaining in the first place? looks like you completely failed at shock value.

[Chaotika]

Thanks for clearing that up Mass. I guess the guy vomited all over the side walk at his sister/girlfriend whoever's apartment complex too while waiting for the ambulance. There's some body fluid nastiness for you. Wonder if they ever got that cleaned up properly.

[Despareux]

I think healthcare workers are far better at hand and respiratory hygiene than the majority of the population; especially compared to those who are sick, as the sick tend to not really care. Most hospitalized patients have no qualms about coughing in your face and despite educating my patients over and over again about hand hygiene, they still refuse to wash their hands. Then you have folks coming in from other countries who are not familiar with hand and respiratory hygiene customs of the U.S., probably because they just don't have the facilities where they're from. While I may be washing my hands and covering my mouth and nose, I think it decreases my chances of coming into contact with viruses, but it doesn't completely eliminate the chance. There is still a chance.

[dudette10, MSN, RN]

So if she can do that, in such close proximity to those infected and not die herself, why are the healthcare workers getting infected and dying from treating the sick? Is it the sheer number of infected? Is it fatigue? It can't be said that it's poor equipment. This girl saved her family minus 1 and didn't get herself infected using trashbags and stockings and gloves, far from the moonsuits and space gear that the actual healthcare workers sent there are getting. And good for her, she's a nursing student! Even though 1 died and things were very trying for her, she pulled through and so did the majority of her family. Pretty uplifting, hopefully they can learn a thing or two from her!

I tend to think she is immune. Some individuals are genetically immune to HIV, so why not Ebola?

[dnnc52]

Do you really believe that the pt with the Ebola and his family, who BTW and thankfully was aggressive for a diagnosis. Only told the nurse?. I can’t believe that they did not tell the MD as well. However it looks like the media is leaning towards the blame of miss-communication to be the nurse. Hey in ER it’s a team and the captain goes down with the crew. Let’s not work on who to blame but the how to prevent this from occurring again. Perhaps John Q Public will realize how dangerous and important nursing is and give respect. Better yet the hospital administrators give the nurse enough help to provide this “Excellent Care” we are always hearing about.

[Nurse SMS, MSN, RN]

For those concerned that the nurse(s) are getting thrown under the bus:

Ebola Update, Oct. 2, 8:35 p.m. CDT - Arlington - Texas Health Resources, Dallas, Fort Worth, Metroplex, Texas (TX)

This hospital is known to be very pro nurse, very pro transparency and very focused on fixing systems, not blaming individuals. Nurses come to work at this hospital and in general tend to stay for the rest of their career. It is not easy to get a job there. They pay well and work conditions are better than most. The media blame game is not that of the institution.

[dudette10, MSN, RN]

For those concerned that the nurse(s) are getting thrown under the bus:

Ebola Update, Oct. 2, 8:35 p.m. CDT - Arlington - Texas Health Resources, Dallas, Fort Worth, Metroplex, Texas (TX)

This hospital is known to be very pro nurse, very pro transparency and very focused on fixing systems, not blaming individuals. Nurses come to work at this hospital and in general tend to stay for the rest of their career. It is not easy to get a job there. They pay well and work conditions are better than most. The media blame game is not that of the institution.

Thank you for that. My brother was in ICU at Presby Dallas earlier this year, and his care was phenomenal. I'm so glad the hospital took this situation and made a system change. It makes me angry at the media, though.

[sistrmoon, BSN, RN]

An EHR issue! I'm not actually that surprised.

[Flatlander]

Having recently read Five Days at Memorial by Sheri Fink, I'm not surprised. It recounted another tragic lack of preparedness, that time for a major New Orleans hospital during Hurricane Katrina. The choices the medical and nursing staff faced were horrific.

I'm afraid the "it can't happen here" mentality of administrators and bureaucrats holds sway, while the opinion of nurses who know how easily things can go awry, is swept under the rug.

See Medscape Nurses online today for survey results of nurse opinions on preparedness for ebola. I see those results echoed here on allnurses.com.

By the way, the media certainly did throw nurses under the bus in the first round of the blame game, whether that originated from hospital spokespersons or elsewhere. The next bunch of justifications to be trotted out are the ones crafted by the legal teams, hence the EHR explanation.

I wonder if Ebola "exercises" would help. I know these are done for other disasters, so that problems with actual implementation (hello!) can be identified and targeted for further planning and training. All first responders, community health workers and agencies should also be involved.

I love to hear that nurses are speaking up to voice frustration for the lack of training and planning. At this point, all we can hope for is that this contagion burns out fast and the overconfident predictions are the ones that prevail. Sometimes it turns out that way.