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Two Epidemics and Nursing

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While I am not an expert on Ebola, or on epidemic diseases, I am a registered nurse. As such, I feel that I along with many other nurses are positioned to be considered on the front lines of patient care. There have been many articles on this topic already. However, I would like to remind us of a past epidemic, and draw a comparison to today and the Ebola scare.

Two Epidemics and Nursing
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In the year 1952, the United States had the worst outbreak of polio in its history. Polio is defined by the CDC as "A crippling and potentially deadly disease. The virus spreads from person to person and can invade an infected person's brain and spinal cord, causing paralysis." There were around 58,000 reported cases of polio in 1952, with 3,300 people killed. No-one knew how this disease was transmitted, or how to cure it.

Entire communities were panicked because of polio. Because no one knew how this disease was transmitted, children (and parents) were often told to stay home. Bodies of water were avoided, as this was thought to contribute to polio. Many children were getting sick, and their parents did not know if they would survive. In a June 2014 article by the Omaha Magazine, Dr, Byron Oberst, who is a retired pediatrician is quoted as saying "1952 was one nightmare after another. We were working 26 out of 24 hours a day. We got maybe a few hours of sleep. There were so many sick children, it made your heart sick." (This has similarities to what we have seen of Ebola caregivers in West Africa).

Often paralyzed patients had to be placed in iron lungs, which were machines that breathed for them. Doctors and nurses had to care for patients during these times, in spite of the fear of the disease.

One town, Hickory, North Carolina, became known as "Polio City" when it had an earlier but just as serious polio epidemic in 1944. An emergency hospital was formed in Hickory, with doctors and nurses coming in from across the country to aide and fight polio. The dedication that the doctors and nurses demonstrated against this polio epidemic in Hickory is something to be admired by medical professionals today. They were truly on the front lines of this epidemic, and research by the reader will provide how they rose to the occasion.

In fact, it was a nurse, a Sister Kenny, who was the originator of one of the treatments for polio; she developed warm moist compresses to ease muscle spasms instead of the use of braces. Her methods were controversial, but seem to have demonstrated success for recovery from polio.

We are all aware of the eventual positive outcome of poliomyelitis-the discovery and widespread use of the polio vaccine. Thankfully today polio is hardly a concern, at least in developed nations were the vaccine is readily available for children.

Fast forward to today, the year 2014. I do not think that it is a stretch to draw some comparisons with past polio epidemics and the Ebola outbreaks.

The widespread concern among communities about Ebola is not dissimilar to the panic that was found in communities during outbreaks of polio. The difference up to this date, however, is the difference in actual cases seen, at least in the US. We are not at this time like the families of the polio generation, whose neighbors,fellow church-goers and coworkers had family members afflicted by this disease.

Ebola, like polio, is a scary disease. It is scary because it is still a mystery. Like polio, how the virus is transmitted is really not well understood. The West African outbreak of Ebola has been terrible, with the CDC reporting 2705 deaths out of 4665 reported cases in Liberia.

But what we must remember is, at the time of this writing, according to the CDC, there have been 3 reported cases in the US, with 1 death. Also, as we are hopefully well aware, protocols are almost daily being developed here in the US to fight against Ebola. And we, as health care professionals and as nurses are on the front lines of this epidemic.

We need to be sure that we are not giving into the Ebola panic. Our patient population is already panicked enough. We need to be sure to exercise professionalism and good assessment skills during our patient interactions. We need to be careful with our patient's health care histories. We need to not immediately assume that everyone coming to our hospitals has Ebola just because some of the symptoms are the same. At the same time, we do not want to automatically discount Ebola. If we do have a patient with symptoms such as diarrhea, nausea, vomiting or any other symptoms, we need to be sure that we are asking about their travel history. We need to respect and fear the potential of Ebola in our communities but we also need to not let that fear cloud our judgment when obtaining a patient's medical history.

This is an exciting and also a scary time to be a health care professional in the United States. We as nurses should have the utmost respect for Nina Pham and Amber Vinson for caring for Thomas Duncan. We should be grateful that they are at this time doing well, and that because of them, how to handle this disease is being addressed. We should take heed of the death of Thomas Duncan, and realize just how dangerous this disease is and how much we have to learn.

Historically, how to deal with a disease in epidemic proportions is often a case of trial and error. There has been much blame cast on many different areas about Ebola being in the U.S. I believe that if anything is to be blamed it is the disease itself, and the time it takes to develop a solution. It took time for the polio vaccine to be developed. It will take time to learn how to deal with Ebola. Meanwhile, we should all do our part, becoming educated, and using every precaution during these times.

I hope that we can balance caution with good judgment. I hope that we don't have to deal with Ebola on a massive scale. And if we do, I hope that we and our families are kept safe.

We need to rise to the occasion, like the medical professionals did about polio in Hickory in 1944 and 1952. We need to maintain a swift and efficient response to this disease. It comes down to caring one patient at a time to the best of our professional ability. And if I know nurses, we are up to the task.

I wish us all the best in our daily practice going forward.

Resources:

Sister Kenny: Confronting the Conventional in Polio Treatment

Polio Panic of 1952

Global Health - Polio

I am a RN. I enjoy my job. I actually really like it. Some days I want to scream, other days I want to laugh, every now and then I want to cry. I have to write for stress relief. Writing is better than a bunch of bad habits...http://sarahleeregisterednurse.wordpress.com/

12 Articles; 32,371 Profile Views; 116 Posts

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lifelearningrn has 6 years experience as a BSN, RN and specializes in School Nursing.

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It is scary because it is still a mystery. Like polio, how the virus is transmitted is really not well understood

This was a great article, but I disagree that this virus isn't well understood. Ebola has been studied for nearly 40 years. We know it's spread through vomit, feces, blood and body fluids once a pt is symptomatic. We know that people who get it are people who have been in direct contact with sick patients. We know outbreaks originate with infected meat. This is not a mystery disease.

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12 Articles; 116 Posts; 32,371 Profile Views

Thank you for the input. I should have said that how the virus is "treated" is not really well understood. :)

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To newhospicern:

Well viruses evolve over time, what may have been the case 40 years ago may not be sufficient today.

It is very well still a mystery. Why do you think it has been so difficult to deal with in a hospital setting? There are so many factors to consider, I'm sure. Microorganisms, deadly ones, can be so complex and difficult to grasp completely. Yes we know how it is contacted, but are we sure who the primary reservoirs are? Do we know how to properly dis-contaminate infected items properly? Are we sure we are doing everything in our power to be safe as healthcare professionals? It is our duty to keep doing research and not just settle.

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