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.

[IVRUS, BSN, RN]

http://www.cdc.gov/hicpac/2007IP/2007ip_fig.html

Gloves are the first thing you remove... Check out this CDC website.

[CrunchRN, ADN, RN]

I read this morning that Nigeria has eliminated Ebola. No new cases since August. Teams are headed there to study what they did.

If they can do it then certainly it can be handled and eradicated here.................

[dudette10, MSN, RN]

CDC - 2007 Isolation Precautions:Figure - HICPAC

Gloves are the first thing you remove... Check out this CDC website.

And according to ATI, one of the two standardized testing companies used in nursing schools, gloves can be removed with the gown. I, too, was taught to remove gloves with the gown. Have many of us ben taught incorrectly?

http://www.atitesting.com/ati_next_gen/skillsmodules/content/infection-control/equipment/ppe.html

[LadyFree28, BSN, LPN, RN]

And according to ATI, one of the two standardized testing companies used in nursing schools, gloves can be removed with the gown. I, too, was taught to remove gloves with the gown. Have many of us ben taught incorrectly?

http://www.atitesting.com/ati_next_gen/skillsmodules/content/infection-control/equipment/ppe.html

Guess you have been misinformed.

I just went though orientation at my new employer; gloves off FIRST.

[SandyB]

Guess you have been misinformed.

I just went though orientation at my new employer; gloves off FIRST.

Then do you put on clean gloves? How do you prevent the virus from touching your fingers if you touch anything else with bare hands then?

[LadyFree28, BSN, LPN, RN]

Then do you put on clean gloves? How do you prevent the virus from touching your fingers if you touch anything else with bare hands then?

The premise is to remove the most contaminated to least contaminated, then wash the hands to remove any pathogens that may be on the hands. Gloves, in theory are the most contaminated; even if pathogens are on the hands after removing the gown and the mask, it is still less pathogens on the hands then with gloves on.

[Kyrshamarks, BSN, RN]

that theory goes right out he window in real life with a pathogen like ebola. you do not want to expose any uncovered skin and risk catching it. touch your ppe after exposure without gloves is pure insanity.

[joyouter]

The Ebola virus, its epidemiological picture and how and when it can mutate into a source of infection not only from direct contaminiation with fluids but also whether and how long airborn microdroplets may possess the same infectious danger are all questions which demand more in -depth research.

It has always been comfortable to think about diseases such as malaria, plague and Ebola as `over there`meaning that we in western countries should not have to be concerned. The reality are the present dangers and ethical issues affecting all health care persons, caring for infected patients, who can possibly die from such infections.

Hospitals. governments and managers have been about cut, cut cut, nurses in particular, while piling on the tasks, leading to greater burnout, disenchantment and no support for healthcare staff. This is not a simple virus but if ignored or poor decisions made can easily affect a large number of educated trained healthcare staff, all of who are vital to stopping this pandemic.

I do not think that nurses should be expected to go into the front-line knowing full well that they may die without this being addressed. Nursing does not mean sacrifice , it means caring, compassionate, safe delivery both for the patient and the nurse. Nurses today are bullied and maltreated by poor managers so that we lose many nurses to these tactics. it is truly ironic that in the height of skilled incompetent and limited vision management that the Ebola virus outbreak is turning over the rock so to speak and exposing the soft belly of healthcare without realistic, workable solutions. Consider the varying treatments used in the present day Ebola patients, As there is no one valid vaccine available, there have been treatments ranging from blood products from infected person (assuming this to be an attempt to build antibodies in the victim and correct bleeding) to use of research based vaccines which are scarce nor widely or readily available.

It is a frightening scenario and demands first of all that many oil rich African countries such as Nigeria direct their profits to improving healthcare and education among inhabitants- a crucial task so that personnel are not attacked but supported and that people learn how to avoid this through contaminated bush -meat. ie. bats and other jungle animals, carriers of the Ebola virus.

Secondly, economic issues such as the growing disparity among wealthy and poor also be addressed. Poverty rarely means keeping clean, rather the focus is on food, anything to fill gnawing hunger. Better government, sound economics and improved food distribution all assist in viable health and sanitation. This scenario can be seen across the globe and further feeds cross infection.

I could go on etc. but Thanks for listening

[joyouter]

The nurse in Spain is a Nursing assistant who attended to a priest, who died from Ebola.

Just for clarification

[joyouter]

That is great news. How was this measured- and how accurate are these facts. not meaning to be a downer but if these facts are accurate then there is a lot to be learned by many epidemiologists and infection control specialists.

[SandyB]

The premise is to remove the most contaminated to least contaminated, then wash the hands to remove any pathogens that may be on the hands. Gloves, in theory are the most contaminated; even if pathogens are on the hands after removing the gown and the mask, it is still less pathogens on the hands then with gloves on.

Nice theory but with ebola? I don't want any of them on my hands. I've heard it can take ONE viron to infect a human.

So I take off my gloves and touch the gown or mask or booties and get it on my finger which has a tiny tear by the cuticle...and I'm now infected.

This is not the normal bugs we are used to.

[Christy1019, ASN, RN]

Would it make any sense to take off the super contaminated gloves, put on new gloves to take off the rest of the PPE, then remove those gloves? If nothing else, maybe it'll decrease the risk of transmission... Just an idea