possible ebola patient

[old&improved]

A patient came to the small hospital I work at (100 beds) late one night with vomiting and diarrhea. He had come from west Africa 2 weeks before where he travels frequently in relation to his work. The ED would not let him in the ER for several hours while they tried to get the ambulance to take him to Phoenix. There was a lot of communication between the chief medical officer, doctor and someone in Phoenix- probably an arm of CDC or infectious diseases.

Eventually, he was allowed in the ED and was treated (at first with appropriate PPE) until someone determined he didn't have ebola. He was admitted to my med/surg floor at midnight. There was no order for isolation, he was put in a regular room and there was no communication to the nurse assigned to care for him regarding the process that was used to determine he didn't have ebola or some other infectious disease. The nurse was just supposed to take the ED nurses assurance(via the doctors) that he did not have ebola or some other contagious illness.

his upset many of the nurses working that night because he wasn't even tested for ebola (we are aware results would not have been instantaneous), and there was NO COMMUNICATION to the nurses caring for him about what assurances they would have that he was not contagious. Some of us are very upset with the way our hospital handled this and I wonder what RIGHTS I have as a nurse to protect myself. I felt very bad for this pt because it took a long time for us to decide how to approach his room (we don't have the proper PPE for ebola on the floors), but at the same time I do not feel I should expose myself to something potentially deadly without being properly taught how to protect myself).

The only people at our hospital trained for this were ED nurses, ICU nurses on a different campus and the engineering dept (I don't understand that). In his chart there was no mention of potential for ebola (which I think was intentional); only that he had recently been in West Africa. Can someone out there tell me what my rights are as a nurse, what I can do to address this and what the hospital should have done? (Besides communicate a lot more effectively, I'm sure) I hate to say this but I think if this had happened during the earlier hours the nurses would have been given a lot more information and the communication would have been handled a lot better.

[nurse4ever08]

Sounds like you are at UMC. Look up the hospital policy on Ebola patients. Call the risk management department and ask them. Also call the infectious diseases nurse

[KelRN215, BSN, RN]

There are plenty of countries in West Africa that were not affected by the Ebola outbreak. Unless the patient was in Liberia, Guinea or Sierra Leone and had direct contact with the infected bodily fluids of someone with Ebola, he doesn't have Ebola. Perhaps that's how they determined he didn't have it.

[MrChicagoRN, RN]

Good point. 18 countries to be exact.

But it it does sound like the hospital did a poor job communicating with its staff.

[old&improved]

He was in the Congo. I googled the Congo and it said there was ebola there last August and the last confirmed case that tested negative twice was Nov 21 2014. That is only 3 months ago. So, yes, there has been ebola there very recently.

[old&improved]

Thank you. Yes. I will definitely get in touch with our infectious disease nurse. I think that will do more than addressing admin.

[MrChicagoRN, RN]

He was in the Congo. I googled the Congo and it said there was ebola there last August and the last confirmed case that tested negative twice was Nov 21 2014. That is only 3 months ago. So, yes, there has been ebola there very recently.

So, the Congo has been ebola free for 104 days, and the disease manifests within 21 days. That's not an at risk patient.

[Atl-Murse]

Paranoia is at work here, just because a sick patient is from West African dose not indicate Ebola " direct contact with the infected bodily fluids of someone with Ebola, he doesn't have Ebola. Perhaps that's how they determined he didn't have it."

[Rose_Queen, BSN, MSN, RN]

Hmm… would denying a patient entry into the ER for several hours not be an EMTALA violation? I'm honestly surprised that after all of the media coverage and CDC updates that any facility with an ER doesn't have a policy in place for potential Ebola cases and that the staff hasn't been education about the policy.

[Esme12, ASN, BSN, RN]

Once it was determined he was not in an area that was on Ebola alert and not in contact with anyone it was deemed he was not a riak. No isolation would be necessary.

YOur supervisor that night should have been able to reassure you.

2014 Ebola Outbreak in West Africa - Outbreak Distribution Map | Ebola Hemorrhagic Fever | CDC

[MrChicagoRN, RN]

This particular patient's risk factors end at Step 1.

[KelRN215, BSN, RN]

He was in the Congo. I googled the Congo and it said there was ebola there last August and the last confirmed case that tested negative twice was Nov 21 2014. That is only 3 months ago. So, yes, there has been ebola there very recently.

Well 3 1/2 months ago for the last confirmed case still = ZERO risk. Your patient was there 2 weeks ago, that's 3 months after the last patient tested negative. You have to have direct contact with infected bodily fluids to contract Ebola. And Congo was not one of the countries that was affected by the 2014 outbreak. Congo and the Democratic Republic of the Congo (formerly Zaire) are 2 different countries. There was a small outbreak in the DRC that was contained in October. In no way would this patient have been a "possible ebola patient."