Nursing and the Ebola Virus

Nurses COVID

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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 Family Practice, Mental Health.

http://news.nurse.com/article/20141013/NATIONAL06/141013015?sf32476479=1#.VD8WgDe9KSN

Emory Nurses decreased their work hours from 12 hour shifts to 8 hour shifts with a 45 minute break and a shower after 4 hours. The physicians would cover for them while they were on break. The nurse would then return for the last 4 hours and go through 18 steps to apply full PPE.

Note that the comment about it being so claustrophobic wearing a HELMET AND A HOOD for that long......Hmmmmm. I wonder if the Texas nurses had that level of protection?

QUOTE: "Practicing what we had learned during training versus applying it in a real situation were quite different experiences," Hill said. "We had to adapt and customize along the way. We had trained for the nurses to work 12-hour shifts, but we realized that wearing the PPE [personal protective equipment] for that long was not going to work. It can get claustrophobic staying in one room wearing a white suit with a helmet and hood for so many hours."

Specializes in ER.

I am not understanding why the need to stay in a patient room for an extended period of time. Get in, get out, as little time in full PPE, the better and less chance for exposure from an extended time in the patient's room.

Even cleaning the room, drawing labs, obtaining vs are all things that can be done in much less time. Are they providing companionship or something? This seems ridiculous to me.

Specializes in ICU.
I am not understanding why the need to stay in a patient room for an extended period of time. Get in, get out, as little time in full PPE, the better and less chance for exposure from an extended time in the patient's room.

Even cleaning the room, drawing labs, obtaining vs are all things that can be done in much less time. Are they providing companionship or something? This seems ridiculous to me.

I think it's because they have more risk of exposure if they are taking off their PPE more often. Did you watch the video? That PPE is ridiculous - pretty much impenetrable. It's like a space suit. They are safe while they are in it, unless the patient stabs them with a syringe or something. It's when the PPE comes off that they get exposed. With Emory's plan, if they take off their PPE three times, they only risk exposure three times in twelve hours. If that nurse is doing things every hour, like hourly urine/lots of IVBP/etc., they'd risk exposure at least twelve times per shift if they only came in and out when they needed to.

Besides, they said it takes 20 minutes to put on and 20 minutes to take off... can you even imagine? That only leaves 20 minutes free every single hour to get patient care/charting/etc done if you are going in every hour and spending 40 minutes putting on/taking off PPE.

Would I care for an Ebola pt? yes. Ideally, only after training for level 4 bio safety/hazard training and was equipped w/airborne PPE and rubber. I have had the discussion with other RNs... It's been 50/50 yes/no. I think the decision is solely up to the RN and their decision should be respected.

And I DEFINITELY think the gov't is down playing the potential airborne and spread of this. ERs/Hospitals would not be able to sustain themselves w/the influx of pts who think they have Ebola w/flu like symptoms. Which in turn takes resources away from pts with other needs.

They also need to get there sh** together and start treating RNs like Golden Gods, we should be getting anything we ask for in terms of EVD, right now, like yesterday NOW. Bc if this thing really kicks off and RNs (i.e. me) don't feel 100% supported

and safe, the gov't leadership can have a field day cleaning Ebola diarrhea.

One. Time gov't. One time, just this once... Please don't screw this up!

Under the circumstances at Emory I would take care of an Ebola pt as well… at the Dallas Hospital? Well, not unless I was suicidal which I am not… Those poor staff have been denied basic equipment and safety precautions. It is criminal what that hospital did to those nurses!!!

Specializes in RN, CHPN.
I am not understanding why the need to stay in a patient room for an extended period of time.

The biggest risk of contracting Ebola is during the removal of PPE (when your PPE is sufficient to begin with, otherwise the risk is just as great during patient care).

In addition, proper PPE takes time to put on and take off the right way. 10 to 20 minutes for each.

Specializes in RN, CHPN.

The CDC has now admits their PPE guidelines were too lax. Finally! They have issued new guidelines 'based' on those used by MSF, but still not as stringent.

To see photos of old vs new, and read more about the bumbling CDC, read http://www.nytimes.com/2014/10/16/us...-say.html?_r=0

Sean G. Kaufman, who oversaw infection control at Emory University Hospital while it treated Dr. Kent Brantly and Nancy Writebol, the first two American Ebola patients, called the earlier C.D.C. guidelines "absolutely irresponsible and dead wrong."

HOW could the CDC not have known this? It is mind-boggling to me, absolutely amazing and ridiculous. And I feel the new guidelines still fall short, although they are an improvement.

"Ebola kills 50% to 90% of people who become infected, which is much higher than any other infection we are used to dealing with. The 2009 influenza pandemic killed less than 0.01% of those infected, and SARS killed 15%.The price of getting it wrong with flu guidelines might be a week in bed, but for Ebola it is far more likely to be death."

Specializes in ICU,ER,med-Surg,Geri,Correctional.

So we are not stopping or restricting folks from these high risk regions. But some of the major airports are going to have increased screening. At which time they will place those who are suspicious in quarantine. Then if they develop Ebola they get transferred to a US Hospital, where they can receive the best treatment and care?. So if I am sick and I can get to the USA then I have a better chance of tx. As well as not being a financial burden to my Motherland. Time to close travel. . Seems to me that is a hard call. So just monitoring air-travel is not going to be the answer. We must restrict all travel from these high risk regions? We always hear about terrorism that if we don't defeat them over there we will be fighting them here. Well Ebola is the same concept lets defeat over there...

This morning, before we knew that the second RN had called the CDC before flying and told it was safe, was being defamed by the media and internet trolls when it dawned on me that the gov't refuses to ban flights from the three countries in Africa but counting on travelers to "self-report" and go through ineffective, lame airport temperature checks thereby very possibly allowing hundreds of infected people into the country and that's ok while this poor nurse, an American citizen yet, was being called a criminal and that she should go to jail!!!

Crazy!!!!!!

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.

According to CDC it's contagious if you're febrile!

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Someone responded perfectly around page 10 or so. Typical archaic, forceful, threatening attitude that I have encountered far too often in my career...so happy I haven't become that way

Specializes in Family Practice, Mental Health.

Thank You Brimfield Police Department! Very Well Said!

https://m.facebook.com/story.php?story_fbid=930447536984290&id=124800457549006

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