Jump to content

The Tribulations of an Ebola...Trainer

Disasters Article   (5,019 Views | 5 Replies | 1,038 Words)

Bridgid Joseph is a BSN, MSN, APRN, CNS and specializes in Surgery,Critical Care,Transplant,Neuro.

3 Followers; 16 Articles; 51,076 Profile Views; 67 Posts

You can never be too prepared for Ebola. Training staff to protect themselves in the face of an outbreak, with all of the information from the CDC regarding "best" practice for healthcare workers changing frequently, is not only stressful for staff, but intensely stressful for the trainers. We train people to prepare them, and we can only hope that they take the training seriously and learn despite their trepidations. What I noticed about the training sessions, once I got over my fear for the safety of my colleagues based upon my training, amazed me. Healthcare workers never cease to surprise me, and I think that we can all learn from one another, and have a really positive impact on our hospital cultures because of the Ebola outbreak.

The Tribulations of an Ebola...Trainer
Share Article

My hospital has been preparing for Ebola for months; a multidisciplinary workgroup, all experts in their areas, created policies and procedures to put into place in case they were needed. Procedures from the door of the Emergency Department to inpatient care were created and tested, and a small group of critical care staff that volunteered to care for the patient were drilled. The first trainings went well and staff reported feeling comfortable with the policy/procedures and ready to care for a possible patient.

Shortly thereafter, we had a patient admitted for a possible infection. In line with Murphy's Law, it happened on a weekend when most of the training Safety Officers (who are the experts and leaders) were not in hospital, but they went in on their days off (and stayed in hospital for 48 hours until the Ebola tests returned negative) to assure that policies and procedures were followed, and that staff felt comfortable. We had 24/7 coverage of Safety Officers in place, to ensure staff felt supported, despite the added stress and new policies. Everything went right along with policy and procedure....and the patient, thankfully, ruled out for Ebola. Staff reported a positive experience and would repeat the experience (which is all you can hope for!) When the workgroup debriefed the event, some areas for improvement were highlighted: the specialty groups that may respond for an emergency and all of the off-shift covering MD groups weren't fully trained, and extra support for training was needed.

I was not a part of the workgroup, and not originally trained, but when it became apparent we had around 100 staff that needed immediate training, and the two Clinical Nurse Specialists that stayed in the hospital for 48 hours, until our patient ruled out, needed help, a colleague and I were asked to assist. I'm a team player, truly both of us are, and when I saw that my colleagues were physically and mentally exhausted, and I know that feeling well, I said I would assist. We were told that we would be fully trained before having to run any training sessions. My concerns started during my training: reading a powerpoint (it was not even a week from last edit and already outdated due to daily CDC changes) and going through a training session myself with the true experts....then I was considered an "expert". I didn't feel like an expert and I started to feel stressed out about the high stakes of training staff without the confidence that I normally have.

Honestly, I have been in nursing for 14 years, and working with Trauma/Critical Care patients, I have seen a lot, and I was always known as a bit of a "cowboy"; I did what needed to be done for patients and was always willing to take on a challenge. This is the first time that I have been worried about my own safety and wanted to stay far away from a challenge. Not only that, I am very well versed in training staff to respond to emergencies, and I take the fear factor out of "coding" a patient for staff, which is really easy for me, because when I get an adrenaline rush, I see clearly and it's when I work best. This was different, I felt like a fraud relieving their fears and reservations, when I had my own. I worried about training them according to the policy, which far outweighed the original CDC recommendations (are in line with the current recommendations), that have a high likelihood of changing. I would have loved to answer everyone's questions with assurance: "What exact type of Decon showering are we going to use?" "Why do the CDC healthcare workers wear better suits than ours?" And the simple answer was "I don't know," which doesn't offer a vote of confidence. And in the back of my head, I was thinking: What if they weren't able to follow the procedures? What if they didn't buy into it?

My hospital spared no cost at training; everyone was trained using the actual PPE, in hour long sessions, and what I learned was not what I expected to learn through those training sessions.

Once I got over my hesitations, and in true form I was able to use some humor to break the tension (mostly by doffing akin to a flight attendant doing their safety talk on an airplane), I finally was able to see beyond my stress during these sessions. I started really watching the interactions of the randomly paired staff members and I was surprised. I found that in our two-person process, while one person supervises the other to don and doff PPE, the person supervising felt so much responsibility for the safety of their colleagues that the process was taking longer than we had expected, in a good way; staff were showing true caring for each other, validating each others fears, and reassuring one another. No matter what disciplines I saw, they were all scared, saw the importance in the training and really invested in it, and took the welfare of their co-workers seriously as well. They all took accountability for the safety of one another, and the community as a whole, and understood the complexity of caring for these acutely ill patients that really need us.

I saw rooms full of light and caring during a dark time in healthcare, and I felt proud to work with these staff; instead of letting our fears pull us apart, it brought us together. While I don't wish for an Ebola patient to test our training and the system we put in place, I am very confident that we have the best possible structure in place to care for the patients, and I know that our staff will follow policy (even if there are changes) with the support of our true Ebola experts, if not for their own safety, but for the safety of the whole of us. I am hopeful this can be the norm for all healthcare workers, and all hospitals worldwide as we learn from one another.

Have you seen the same in your hospital setting?

Clinical Nurse Specialist, Emergency Cardiovascular; Specialty: Surgery,Critical Care,Transplant,Neuro

3 Followers; 16 Articles; 51,076 Profile Views; 67 Posts

Share this post


Link to post
Share on other sites

141 Posts; 3,288 Profile Views

Nice article, thanks for sharing!! What hospital in Boston?

Share this post


Link to post
Share on other sites

Bridgid Joseph is a BSN, MSN, APRN, CNS and specializes in Surgery,Critical Care,Transplant,Neuro.

3 Followers; 16 Articles; 67 Posts; 51,076 Profile Views

I work at the Beth Israel Deaconess Medical Center. Where are you located? Have you experienced Ebola training at all?

Share this post


Link to post
Share on other sites

noyesno has 10 years experience as a MSN, APRN, NP.

829 Posts; 17,998 Profile Views

We only have meetings about increasing patient satisfaction.

Glad to see your hospital's prioritizing the safety of it's staff.

Share this post


Link to post
Share on other sites

sirI has 30 years experience as a MSN, APRN, NP and specializes in Education, FP, LNC, Forensics, ED, OB.

16 Followers; 19 Articles; 13,373 Posts; 142,598 Profile Views

Thank you. Very good Article.

Share this post


Link to post
Share on other sites

traumaRUs has 27 years experience as a MSN, APRN, CNS and specializes in Nephrology, Cardiology, ER, ICU.

165 Articles; 21,045 Posts; 195,183 Profile Views

I'm in central IL (not hospital based) and we too have gotten the YouTube and PPP.

Thanks for the nice article. Humor WILL get us thru.

Share this post


Link to post
Share on other sites
×

This site uses cookies. By using this site, you consent to the placement of these cookies. Read our Privacy, Cookies, and Terms of Service Policies to learn more.