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?

[grace90, LPN, LVN]

absolutely not... with or without proper ppe.

i would definitely be at home taking care of my kids.

me, too! i have a severely mentally disabled son and all help we get with caring for him would be stopped. he would need both parents.

my children only have one mother, and that's me and that is where i would need to be. :redbeathe i'm a mother/wife first and foremost. :redbeathe

if needed, i would tear up my license on the spot. it would make good kindling, anyway.

if that all makes me less of a professional, then so be it.

[grace90, LPN, LVN]

No question, I would be there. With the currenjt shortage of nurses, not going is not an option. If the government says they will take care of me and my family or not. this is when true professionalism come out. If you don't want to put yourself or family in harms way you should not be a nurse!! A typical shift in the ED exposes me to HIV, TB, MRSA meningitis, pneumonia, staph etc.. If you don't change your usual practice standards, you will be OK. Change clothes before leaving work or outside your home, if you want. I can NOT believe the other posts I'm reading from these "professionals." If you are so slow to respond that a govenment mandate is what it takes to get you into action, get out now!!!!! Remember, we are here for the patients. I love my family and would do anything to protect them. I'll bet the patients we would be caring for would feel the same way!!

[eltrip]

I suggest that the government stock up on PPE because I'm not working without it. Further, my first responsibility is to my family. If my family is quarentined at home, they will need me and that's where I'll be. I'll see to our food supply.

[casi, ASN, RN]

I wouldn't work without PPE. If they offered me PPE I'd be doing all I could do to help.

BUT: Nowhere in my job description does it say I have to give up my life to save others.

[sailornurse]

my other hope is that suddenly it will occur to them that they need to involve nurses in planning for a solution, and that they will finally get around to meeting with us, and brainstorming with us

locally they have failed to do this, they are planning but all the planning will be for nothing if they do not have 'workerbees" (nurses) to do patient care. all the grand schemes and they are not including nurses in the plans. they are talking to people who have no actual patient care experiences. (phd's in public health/social work)

as for me- having being deployed during gulf war on usns comfort (one of 2-1000 pt bed hospital ships)- gee i am very familiar with how the goverment will "take care of me" like the mopp gear (ppe) that was for a medium male (5'6 170# 7 i was 5' 2' 125#) & the gloves that went with the gear were medium, ( i wear sz 6 surgical gloves) so it would not have protected me or the gas mask that was too big for my small face- but that's all they had and when i finally got a gas mask that did fit-they did not come with the straw adaptor for drinking fluids so i would have died from dehydration??? don't get me started on the va takes care of it's vets-they will take care of me when i am homeless and penniless, thanks usa for my 3 years active duty plus my time in the gulf war combat zone!!!

how are they taking care of the guys/gals in iraq when they do not have the bulletproof vests/armored hummers???

so h3ll no, i won't go, gonna keep working on stock piling food/water etc[ hmm maybe start collecting some ppe's n95's gonna check out ebay:twocents:/color]

[Laidback Al]

. . . I fall in the older age group,too, which has a high fatality rate. . .

While this may be true for regular influenza, this is not correct for H5N1. The fatality rate among all age groups hovers around 60%, older people are NOT more likely to die from H5N1.

What is important is the infection rate. Only 28 people out of about 350 people worldwide that have contracted H5N1 are OLDER than 40 years old. If H5N1 becomes the next pandemic strain, children and young people will be the most affected. Older individuals will most likely be taking care of sick and dying younger individuals.

This also relates to a previous comment in this thread. Current influenza vaccinations are probably not effective against H5N1, and given the vaccination rates in countries where H5N1 is now occurring, it can not explain why older people are less likely to become infected with H5N1. The low infection rate for adults over 40 years old seems to be related to some kind of cross immunity that has evolved over a lifetime of exposure to regular influenza viruses rather than immunity built up over time through vaccinations.

It will be older people, including nurses and other HCW, that will have the burden of caring for the ill during the next pandemic.

[Jacksdad]

I've been following the news concerning H5N1 for a couple of years, and I've been prepping for a pandemic for about a year now. That means laying in enough supplies for a long period of isolation for myself and my family. Most of us have no personal experience of anything as devasting as the 1918 outbreak, so it's difficult to imagine life as we've come to know it being turned on it's head by something as simple as a flu virus.

The truth is that in the event of a major pandemic, we'll be on our own. If you doubt that, consider the following quote from Mike Leavitt, US Secretary of Health and Human Services,

“Any community that does not prepare locally will be sadly disappointed with the Federal Government.”

The inference is simple - there will be no federal cavalry coming over the horizon. The government has told us as plainly as it can - fail to prepare on a personal level at your peril as your family will not be looked after by the authorities.

The virus in it's native avian form kills at an alarming rate - near 100% in chickens within a day or so, and in humans (even with early diagnosis, Tamiflu and respirators) it's increased it's lethality from about 50% in 1997, to over 70%. In a pandemic we could see absenteeism rates over 50% or more, due to a combination of people falling ill and social distancing. Think how that would affect the running of the power grids, water treatment plants, food production and deliveries. I work in dialysis, and we need a constant supply of power, clean water, and medical supplies - if we lose one we're shut down. How would your facility cope long term? And will you have heat and light at home in such an eventuality? If food supplies were disrupted and the shelves started to empty at the stores, how long could you feed your family (assuming you could cook without power)? The panic buying in many parts of the country following the media coverage of rice shortages should give us a little insight into we could realistically expect in the days and weeks following a major outbreak. If it happens we'll have little warning - the US government has modeled an H5N1 pandemic using current population densities and travel patterns and estimates it'll take about 21 days to become global. The UK government believes it will reach Britain in four weeks after the first human patient fell ill in Hong Kong. We do know that pandemics have been a part of human history for a long time - to the best of our knowledge, there have been 12 in the past 400 years. Do the math - three per century, and it's been 40 years since the last one. If H5N1 doesn't mutate to a H2H (human to human) form, history has shown us that something else will.

In 1918, most of the population of the States lived in rural communities (or in a city close to one) where food was available. We live in a very different world today - we officially became an urban species this year as over 50% of the world's 6.6 billion people now live in cities. In 1918, isolation was often a fact of life - people simply lived further apart - and crops were grown without the reliance we have today on hybrid crops, pesticides/ chemical fertilizers, and fuel to drive just about every piece of farm equipment imaginable. Food, water and electricity are supplied to city residents (over three billion people) by a fragile and interconnected series of systems. Eliminate one and the system fails. No power, water and food, and within a short time riots will happen. Look at New Orleans post Katrina and imagine every US town and city in the same (or worse) shape. If the feds couldn't do their job then, how do you think they'll cope in a pandemic? Do you think they'll be there to help?

Sorry to sound alarmist, but even if this thing goes H2H and drops it's lethality to Spanish Flu levels, the death toll will be greater than anything we've ever seen before. Pandemics come in waves - usually two or three. The second wave is usually the deadliest (in 1918, over 90% of the estimated 80-100 million worldwide fatalities died during the second wave). The global population in 1918 was approximately 1.6 billion - if we extrapolate the clinical attack rates and case fatality ratios they saw back then to our current population, we could expect to see 360 million dead in a few months. That's right - no typos - over a third of a billion dead in a few short months.

I don't think it'll be a case of deciding whether to go to work - in many cases there won't be a job to go to.

[rnheart]

Very eloquently put, I think You are absolutely correct

[425april, ASN, RN]

hmmm. After that description I would have to say "no". I agree that I cannot do much to help without PPE. My clients come first, however, I have a family that needs me also. That would be futile, given that info on percentages.

[nanyanga]

Surely with a pandemic nurses are supposed to work because nursing is a noble profession.The biggest challenge is the protection of the nurse making them exposed.Improving nurses remuneration so that they can buy themselves the protective gear can be very handy.:redpinkhe

[hbgwan, LPN, LVN]

if i already had 'RN' after my name, you better believe i'd be there!

[flygirl43]

I worked in Toronto during SARs. We had 1 N95 mask on our trauma unit, and a Dr took it. Are you kidding. If that's the type of protection they offer us (and its what theyve done in the past) Im staying home andd watching tv