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?

[susan cr]

If I'm not proected what good will I do anyone? What is the plan, just keep ordering nurses to work to replace the ones that are sick and/or dying? Where is the PPE, etc going if there isn't any for healthcare workers? POLITICIANS probably....

[lamazeteacher]

This may be an opportunity for a rant, but posters should calm down, as the example given was hypothetical. However,:

1. Any facility has had plenty of time to order PPE, in quantities for their community's population.

2. {rotocol forbids giving nursing care without PPE, to anhyone in Respiratory/Droplet Isolation. If you ran out, family members or good friends would have to help with the patient's ADLs

3. This wave is very mild, so few people need hospitalization, whose health wasn't already compromised, or high risk case.

I doubt that politicians would give nursing care in hospitals, so at the most, if they did abscond with PPE, they'd take one box of masks, no gowns or goggles.

The masks are being held, in some areas for professionals' use only. Drug stores didn't get any.

[Dragonnurse1, ASN, RN]

This may be an opportunity for a rant, but posters should calm down, as the example given was hypothetical. However,:

1. Any facility has had plenty of time to order PPE, in quantities for their community's population.

2. {rotocol forbids giving nursing care without PPE, to anhyone in Respiratory/Droplet Isolation. If you ran out, family members or good friends would have to help with the patient's ADLs

3. This wave is very mild, so few people need hospitalization, whose health wasn't already compromised, or high risk case.

I doubt that politicians would give nursing care in hospitals, so at the most, if they did abscond with PPE, they'd take one box of masks, no gowns or goggles.

The masks are being held, in some areas for professionals' use only. Drug stores didn't get any.

Protocol FORBIDS :thnkg::eek:giving nursing care without PPE??? How in the world did we (humans) survive all the horrible diseases of the past(ie.. typhoid, plague, small pox, cholera, polio, tuberculosis and malaria - just to name a few) and how did caregivers and nurses and doctors manage to care for the sick. There was no PPE then and at some point in the future we will be unable to obtain enough equipment to care for every sick person during a pandemic. what would you have us do? Are nurses to quit caring for the sick just because of a protocol. Immunity often comes from exposure. I was the one nurse on nights in our ER that got to take care of all shingle patients. I am immune. Have been since I was a child. In fact I spent the night with any child that had chickenpox. I never contracted chickenpox but I digress:offtopic:. I am sure Florence Nightingale :nurse:would be proud of all the nurses that say me first then maybe I will care for the public that I said I would help.:smackingf

You say that posters need to "calm down" as the scenario was "hypothetical". I say that the scenario is closer to reality and knowing where the posters stand can help others plan what they may do in the future to be ready to care for a public that some nurses have decided to abandon WHEN the pandemic hits full bore.:thnkg:

:crash_com

[lamazeteacher]

protocol forbids :thnkg::eek:giving nursing care without ppe??? yes, the ic manuals all state that respiratory/droplet isolation requires that. so if ppe is scarce, it needs to be conserved, making as few entries into those patients' isolation rooms as possible (which i suspect is the norm, anyway). friends/relatives who were exposed to patients before their admission should be encouraged to stay with them, unless they are at high risk. oh, i see how elderly nurses can be employed to care for isolation patients as, for once, they're not the ones at high risk........

how in the world did we (humans) survive all the horrible diseases of the past(ie.. typhoid, plague, small pox, cholera, polio, tuberculosis and malaria - just to name a few) and people stayed in their homes while sick, more; and thestrong of mind and body, survived! throughout history, that was the story regarding survival. a lot of people died!

there was more respect for authority, and when people were told by officials that they were under quarantine, they "stayed put". now we may need marshalls on every block to contain those exposed.......

the reason women gain excessive weight durng and after pregnancy is a natural way to preserve their lives during famines, so that babies would be fed, i think. so hormones kick in to react to undereating......

how did caregivers and nurses and doctors manage to care for the sick. there were far fewer professional caregivers/capita in days past, especially at the turn of the 20th century, when the population in the usa was exploding - especially in cities. mothers and oldest sisters were the caregivers (think "little women").

there was no ppe then - necessity was the "mother" of invention. handwashing was the new method of preventing the spread of disease following semelweiss, and the promotion of it was impressive. also, in the old days, there were no tampons, pads, etc., and fabric that was scrubbed after use, happened.

and at some point in the future we will be unable to obtain enough equipment to care for every sick person during a pandemic. what would you have us do? are nurses to quit caring for the sick just because of a protocol. you seem to be in favor of dropping theory and practise that you've been taught. i wonder why, rather than creating substitute measures for possibly missing ppe (a long shot). this is the ppe manufacturers' christmas, after all!

i didn't suggest abandoning flu patients, rather enlisting others to assist, who seem to have some immunity, as they're well and have been exposed to the flu patient for 3 - 7 days without catching it (possibly having had something conferring it, earlier. also, the ppe we have is made of paper, which is not ecologically sound..... so in the future, perhaps reusable gowns will come back, and an insert of several layers of filter-like material made from bamboo (a resource that could never run out. i have it behind my condo, and it grows 15" an hour in the summer), could be placed in a mask cover.......

immunity often comes from exposure. true! i was the one nurse on nights in our er that got to take care of all shingle patients. geez! why do you think you're immune? i am immune. have been since i was a child. in fact i spent the night with any child that had chickenpox. i never contracted chickenpox but i digress:offtopic:. how did you spend the whole night with one patient, working in the er? and why was the patient kept there, exposing possibly non-immunized children to it?

i am sure florence nightingale :nurse:would be proud of all the nurses that say me first then maybe i will care for the public that i said i would help.:smackingf welcome to modern thinking, a reality born of having too much, i think.

you say that posters need to "calm down" as the scenario was "hypothetical". i say that the scenario is closer to reality i think that lack of ppe wasn't reality. it might be necessary to check with your infection control nurse to see if extra ppe is on hand, lots of ppe. it doen't get outdated when kept in its plastic wrapping, so if purchasing departments balk at the expense, they need to know that it will be utilized eventually, if it isn't used in the pandemic. when i was the ic nurse at a county hospital, i was always butting heads with purchasing, especially during the implementation of "universal/standard precautions", in the '80s; and sharps containers!

and knowing where the posters stand can help others plan what they may do in the future to be ready to care for a public that some nurses have decided to abandon when the pandemic hits full bore.:thnkg:

it is disappointing to see how many nurses shy away from challenges without working out solutions/substitutes for ppe, or a method of obtaining enough.

:crash_com

innovation is part of being a nurse, and more people need to rise to substandard situations! (is that a contradiction in terms?)

[Dragonnurse1, ASN, RN]

Geez and I thought I was a stick in the mud and not willing to change............:dzed:

I am that OLD NURSE! I did not say that I took care of the same patient all night. I said that I took care of EVERY patient with shingles that came to the ER on nights. Why - because I am immune and it spared the other nurses the exposure. You know the ones that were pregnant or had never had chickenpox.

You miss my point however, at some point in time PPE will be unattainable and/or everyone will run out. Then how do you think we - medical personnel - will care for the sick? It is so easy to justify the way things were done in the past and today the medical field is much more high tech but that very standard will be the undoing of all of us. Why are more people susceptible to illness? Because of the very habits that now make us civilized.

I think it is amazing that the older generations survived until adulthood given the way we grew up, jumping into swimming holes, riding bikes without helmets, running barefoot through the neighborhoods and in playgrounds, sharing drinks with each others and eating the same hotdog or ice cream. The cars did not even have seat-belts and nurses did not even wear gloves.

However, I guess that I am as antiquated as my ideals. But when the pandemic comes my husband and I will be willing to care for all those ill and we will do it with or without PPE.:deadhorse

:w00t:

[mianders, RN]

Not without PPE! I would do no good to anyone if I am infected.

[caewelike]

No glove... no love.

[Woodenpug, BSN]

While most of the posters would choose not to work. Almost two thirds of the people answering the pole would work.

No glove means most other perishable supplies would we exhausted. RN's would not be anymore useful in direct patient care than laypersons without those supplies.

[ssing45]

I won't work without PPE.

[tellteri]

DragonNurse...I'm very happy that YOU ARE still around!!! I'm an Oldie but a goodie and I start nursing school on July 23rd. I currently work in a LTC facility as a CNA and have worked in a teaching hospital before. AS a kid, I spent alot of time in the hospital as a patient and that's where my dream of being a nurse came from....

The nurses in the 60's and 70's were very different from the nurses I work with today. CARING and SERVICE were the norm back then; today, I get excited when I work with a nurse who takes the extra step or takes the time to be creative and problem solve with me. I'm not bashing nurses; I know the workload is heavy and the hours are long, BUT...that's what we signed on for...there's no glory, no money, no fame, there's CARING, HELPING and solving problems.

We live in a country where we have the freedom to CHOOSE to be whatever we want to be. With every choice, there is responsibility. Government is made up BY the people....our government will only be as good as we are....we criticize the politicians who will RUN and HIDE if a pandemic breaks out...well, just read most of these posts? He/SHe is just like many of us who think of ourselves first and run and hide.

Someone said that nurses wouldn't be much better in direct care than lay people without PPE...I haven't even gone to school yet but I know alot more about caring for the sick than the "lay" people I know..PPE is a tool...nurses have knowledge and skill. Before PPE, there were still nurses and they worked caring for the sick

The one detail in the hypothetical that "gets" me is the average age of the victims...0-40....that means ALOT of children. Children who won't get the care they need to perhaps survive and have a life of their own...I don't think I could turn my back on them. I'd hope that there would be people willing to care for my own children and grandchildren...I'd make sure my family had what they needed at home to be safe, then I'd say my prayers and go help the people who need my skills and caring. I'd work as smartly as I could with what I had on hand. (make my own makeshift mask...may not be up to standards but it's better than nothing!)...exercise as much caution as possible...wash my hands constantly, not touch my eyes, nose, etc. . I'd pray for the sick and for all the other responders....and be grateful that there were people who were willing to help.

[ssing45]

As an aside to why I won't work without PPE, I feel that I need to clarify my choice. I have a handicapped son who needs my presence. Also, I am taking medication that causes immunosupression.

For those of you willing to die for the cause, more power to you. My dying (while more likely than yours due to immunosupression) will cause extreme hardship for my son. Sorry, but I don't feel have the right to hurt him for the sake of others.

[tellteri]

As an aside to why I won't work without PPE, I feel that I need to clarify my choice. I have a handicapped son who needs my presence. Also, I am taking medication that causes immunosupression.

For those of you willing to die for the cause, more power to you. My dying (while more likely than yours due to immunosupression) will cause extreme hardship for my son. Sorry, but I don't feel have the right to hurt him for the sake of others.

Yours is a unique situation...and there's no need for apologies. There are always some situations where the heart and mind wants to do something, but there are true reasons why you can't. My choice would also be different given your circumstances...I wish you and your son good health always....