Will you work during a Pandemic?

[Goju]

admin note: we just added a poll to this thread today, april 25, 2008, please take a second and vote in the poll so we can have a graphical representation of the responses. thanks

scenario:

h5n1 (the bird flu) mutates to become efficient at transmitting human to human causing a pandemic, with a case fatality rate of 60% and with 80% of the cases in the 0-40 year old age range.

see:

http://www.wpro.who.int/nr/rdonlyres/fd4ac2fd-b7c8-4a13-a32c-6cf328a0c036/0/s4_1113.jpg

hospitals will be quickly overrun. hospital staff shortages are 50%. the government orders all nurses to work. there is not enough personal protection equipment (n95 masks, gloves, goggles, tamiflu, vax, etc)

home quarantines become common (in the fed plans).

your family is also quarantined in your home. you are running out of food and the government promises you will be "taken care of" if you report to work.

will you go?

[indigo girl]

I have been in govt service also.

I do not know anything about what the future scenario will look like. I do not

believe that the OP's scenario is how it will look, but I do know that my workplace

is not defensible, and that there will not be enough PPE. I will work somewhere,

but not in that hospital at that time.

I would suggest not labeling any posts on any thread. You might believe

that what you are reading is not within the realm of possibility, and can

say so, but labeling can be insulting, and personal though you probably did

not mean to attack gr8greens by your description of her actions.

Here is the definition of hysteria.

hys-ter-i-a (h-str-, -stîr-)

n.

1. Behavior exhibiting excessive or uncontrollable emotion, such as fear or panic.

2. A mental disorder characterized by emotional excitability and sometimes by

amnesia or a physical deficit, such as paralysis, or a sensory deficit, without an

organic cause.

[New Latin : hyster(ic) + -ia1.]

The American Heritage® Dictionary of the English Language, Fourth Edition

copyright

Hysterics do not prepare in advance. They become paralyzed by fear.

This no more helpful than denial. I can not speak for the OP, but I think

that this thread was initiated to help HCW to think about their personal

situations in advance. Pandemic education is ongoing across the globe.

Global populations need to be aware of the history of pandemics as

natural and recurring global health problems.

http://www.cidrap.umn.edu/cidrap/files/87/countryinfo.pdf

Many possible problems are being thought of in

advance such as what to do about special groups at high risk. This is

practical even necessary.

http://tinyurl.com/26fj5g

The US govt is sending over 1 and a half million dollars to just one province

in Indonesia to fight bird flu there before it comes here. This is not hysteria,

and it sure isn't charity. It is self-preservation.

It is commonsense to prepare in advance, not hysteria.

They are buying us time because there is no vaccine, and no immunity

against a disease with an over 60% case fatality ratio that prefers humans

under age 40.

http://crofsblogs.typepad.com/h5n1/2008/04/indonesia-us-fu.html

The physicians, nurses and others in the following link are not hysterics.

They are practical people as are most health care workers, and the majority

of ordinary people. The public health officers at Effect Measure likewise are not

hysterics.

If we are to be dealing with a severe pandemic in our lifetime, we must

begin talking about preparing the places that we work in for our own safety.

This is commonsense. If our workplaces can not protect us, we should

consider this in advance for the best possible personal outcomes.

http://www.newfluwiki2.com/showDiary.do?diaryId=2315

All we are suggesting is that people here consider the possibility that this may

well happen. The US govt is preparing for it and spending millions here and

across the globe. The govt has already said that it can not help us. Do not

expect them to do so.

This is the govt plan for us given our current situation with no vaccine, and

not enough antiviral to treat most of the population of the US. This is all

there is. And, because this is all there is, there is a grass roots effort going

on to educate the public to prepare.

http://www.pandemicflu.gov/plan/community/mitigation.html

We are not fatalists. There is a lot that can be done to lessen morbidity and

mortality but not if people do not understand the need to prepare. Preparing

families for any life threatening emergency is commonsense.

[Perpetual Student]

It is because it is hysteria

The avian influenza threat fear may be hyped up excessively, but it is highly likely that there will be SOME type of pandemic in the relatively near future. It is better to prepare in a broad manner that is applicable to many eventualities than it is to get caught unprepared for what is highly probable.

The fact that some states are passing laws to force HCWs to work against their will in settings that they have not been previously oriented is quite frightening. I can say without hesitation that there's no way I'd comply with such edicts. I haven't prepared myself, my family, and my friends to survive a calamity only to go and commit suicide by working in what amounts to a concentration camp for HCWs.

[YOUTUBE]

[/YOUTUBE] -- No thanks, I won't go. I honestly fear the potential irrational reactions of the government and population during a pandemic much more than I fear any pathogen.

[BeachBayNurse]

If I am already at work, I would stay. But if not, I am staying at home, not that it would be any help, as I live in a condo and I am sure I am "sharing" the air with my 300 "neighbors"!

[indigo girl]

Protecting the Healthcare Workforce in Pandemic Influenza

http://www.youtube.com/watch?v=rGk-ELKFHto&feature=related

(hat tip flutrackers/florida1

The University of California at Berkeley produced this excellent video.

They have put some thought into what problems healthcare workers

would be facing including caring for their families at home during a

pandemic situation.

With H5N1 now endemic in wild bird populations on the three continents

of Africa, Asia, and Europe, it is smart to look ahead and plan for the

possibility of the appearance of the virus on this continent. There is much

that we can do in advance. UC, Berkeley is at the forefront of pandemic

planning in healthcare.

[kbswife]

Well..... If the government is going to "take care of me", I guess I should consider going to work... Okay, I considered it... NO!!!!!!!!!!!!!!!!!!!!

[Ayrman]

Norovirus has broken out in my hospital, apparently brought in by a patient admitted for an non-related complaint. Since then the virus has spread to other areas of the hospital and all staff have been strongly advised to stay away from work for a minimum of 48 hours after symptoms subside, and to leave even if in the middle of a shift if they experience onset of nausea, vomiting and diarrhea.

The medical-surgical floor is believed to the the start point for the outbreak. Rather than close the floor they continue to pack it with as any many patients as they can find beds for, even if it means unsafe staffing levels.

Other than cautioning staff the only other active precaution is implementing a policy of terminal cleaning of infected bed areas, and even that is questionable as to how well it is being done, with at least one housekeeper refusing to carry out a full terminal clean "because they aren't doing it in the ER."

I should add that half the beds on the affected floor are in double rooms, with only a curtain seperating the patients. The presumptive index case was in such a room with another patient, who apparently was also infected during their stay.

In checking the net for reports of other Norovirus outbreaks in the US I find that a common response is to close the floor, restaraunt or even summer camp as in one case, so that comprehensive cleaning can take place.

As pointed out above they did not close the floor but instead continued to pack it with every patient they could find in an attempt to make up for a census load that hasn't reached this high for over a year. As a consequence one nurse (from another floor no less!) was hospitalized, and another nurse had to leave the floor in the middle of her shift because of the debilitating nature of her illness. Also affected was a CNA who likewise had to leave during her shift, and a unit secretary who normally does not come into contact with patients nor visit their rooms.

Staffing levels during this time were below safe levels, with nurses on day shift assigned as many as 8 patients across the board - including the Charge.

If this is an example of how my particular facility handles in infectious disease outbreak that spreads to staff and patients alike can anyone be blamed if they would refuse to work during a real pandemic such as we are discussing?

[Brian, ASN, RN]

admin note: please note, we just added the poll to this thread (4-25-08), so please take a second and vote in the poll so we can get a graphical idea the responses. thanks

[inflight]

I think many of us realize our administrators and infection control personnel are painfully unprepared for even a few days of high census without the added stressors of a potentially fatal infectious disease pandemic. This really speaks to a lack of efficiency and overall lack of concern for the front line worker. I would go to work because this is the career I've chosen (for now), however, I'm sure that my supervisors both direct and on up would be getting some "guidance" from me on what I expect.

[flygirl43]

No!!!! My family didn't sign on to be a nurse. They are more important to me than my job!

[Chaya, ASN, RN]

Tending toward yes if my family is ok.

[mymom]

Yes I would go to work during a pandemic. Current research suggests if you have had the flu vacine every year you will likely be the survivorof a pandemic. Didnt anyone take care of sars r/o patients ?

[AgentOrange]

Current research suggests if you have had the flu vacine every year you will likely be the survivorof a pandemic

I would be ROTFL if not for the seriousness of this issue. The flu vaccine barely protects people against the regular flu, there is no reason (or evidence that I've seen) to think it will offer any kind of protection against a deathly flu. The reason a pandemic will start is precisely because of the failure of the normal flu vaccine.