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?

[azhiker96, BSN, RN]

Well, my choice will be to work. When someone's child need's an appendectomy or broken limb repaired, there will be at least one PACU nurse on duty.

[SICU Queen]

I am glad for you that you're so dedicated that you would walk away from whatever family/loved ones you have that may need you at home.

I, however, am not.

Maybe you don't have a family? No children?

[Mulan]

No offense, but losing the public's trust is the least of my concerns.

:yeahthat:

[fins]

OK, I think that WAY too many people have watched the Mad Max films. Take a look at the Spanish flu pandemic of 1918. This is a pretty good model for a worst-case pandemic. Transmission rates of up to 50%. Mortality rates of 2-20%. Total dead worldwide 50-100 million. And yet we didn't have lawless bands of nomads wandering across some post-apocalyptic wasteland. Read the wikipedia article if you want details.

A pandemic on the order of 1918 would be bad, yes. It would certainly have far reaching consequences on the economy. But get a grip people - Lord Humungus is not coming for your oil.

[Elvish, BSN, DNP, RN, NP]

Except that bird flu has had mortality in humans running from 40-60%.

[pagandeva2000, LPN]

I hate to say it, but I probably would not go. But, the conflicting thing is that my husband works at my job and he would probably go there. But, I have a son that is very important to me and my first priority is to be with him. I trust no government body.

I have often thought of other situations, such as natural disasters, since Katrina. My first goal would be to get out of dodge with my husband and son intact by my side. If we did decide to go to my hospital for shelter, we would be there as a family. As long as one of them are not there, I would go out and get them first before I would even think of working at that place.

When 9/11 occurred, my son was at school a few blocks from where I worked (at the time, I was an aide at my clinic). I heard of the second plane, then, the pentagon, and the first thing I did was go tell my nursing supervisor that I was going to get my son. I ran down the block and saw the smoke from the Twin Towers and was able to see them burning (and I was in another borough). I got him from school (there were SO MANY parents doing the SAME thing). I thought that WWIII was happening. Then, I brought my son to the hospital and just as we went to one of the floors to see what was happening, we witnessed the first building crumble down. What a Horror!! I held my son close to me and then, called my husband to see where he was, then all of my loved ones. Nope, no pandemics for ME or MINE.

[bigjim]

OK, I think that WAY too many people have watched the Mad Max films. Take a look at the Spanish flu pandemic of 1918. This is a pretty good model for a worst-case pandemic. Transmission rates of up to 50%. Mortality rates of 2-20%. Total dead worldwide 50-100 million. And yet we didn't have lawless bands of nomads wandering across some post-apocalyptic wasteland. Read the wikipedia article if you want details.

A pandemic on the order of 1918 would be bad, yes. It would certainly have far reaching consequences on the economy. But get a grip people - Lord Humungus is not coming for your oil.

The mortality rate for bird flu is very different. The distribution of the population is very different. The welfare state was nonexistent on any large, federal scale in 1918. The level of self-sufficiency among people is ungodly different. How many people would start to be hungry if they could not go to a store/restaurant for two or three days? How many people will not even have the money to go to the store, or restaurant, which is not open, if all the "entitlement" checks don't go out one month, or two months? Where will the money to even write the checks come from if the number of people working and paying taxes is so sharply curtailed?

Call me paranoid, but I will not have to leave my house if something like this happens, and anyone who tries to force their way in better have eaten their Wheaties that morning.

[Scrubby]

If there was a huge pandemic i would not go to work.I'd probably pack my things and head out bush somewhere and wait for the crisis to be over.

[nyapa, RN]

If there was a huge pandemic i would not go to work.I'd probably pack my things and head out bush somewhere and wait for the crisis to be over.

Love it Scrubby!

I really can't answer this question. I know when they ask us every year whether we are willing to come in or stay at work during a cyclone I am hesitant to do so.

Let me ask: once you come into a hospital, you are effectively in isolation? You can't leave? You may never see your family again?

Will those with money be more likely to receive treatment? Would we be more likely to be looking after those who can afford treatment, as opposed to those who can't, as stocks become scarce? Australia has a public health system, but we still do have private hospitals. What about the US though.

I know if I was coming into hospital just to look after ppl who had the money to receive the treatment then I would definitely be more likely to stay at home, and work in some sort of community capacity, if that were possible. Think it would be better to stay home full stop!!!

[azhiker96, BSN, RN]

I am glad for you that you're so dedicated that you would walk away from whatever family/loved ones you have that may need you at home.

I, however, am not.

Maybe you don't have a family? No children?

I do have family but feel I am supporting them best by helping maintain a healthcare system. If I abandon my post to stay home, what do I do if my family gets ill? I don't have sufficient meds or equipment (O2, suction, etc.) to give them supportive care. Suppose my granddaughter breaks her arm, gets a serious cut or develops appendicitis. I don't have the materials or expertise to handle that at home. I'm happy for you that you can handle that for your family. If not, I'll be there to help them if you bring them in. :)

[indigo girl]

I do have family but feel I am supporting them best by helping maintain a healthcare system. If I abandon my post to stay home, what do I do if my family gets ill? I don't have sufficient meds or equipment (O2, suction, etc.) to give them supportive care. Suppose my granddaughter breaks her arm, gets a serious cut or develops appendicitis. I don't have the materials or expertise to handle that at home. I'm happy for you that you can handle that for your family. If not, I'll be there to help them if you bring them in. :)

azhiker, I understand your feelings about this. I agree with you. I hope that HHS, CDC, or some govt agency out there, will read this thread, and realize that it really is representative of what many nurses are going to be thinking across the country. We are sending a strong message here. But will the planners read

this, and will they act on it?

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 as they have with other groups across the country. I think that we deserve this, and I am NOT speaking from a sense of entitlement but rather from a deep belief that if you ask people to do a dangerous but necessary job, you should have the decency to sit down with them beforehand, and talk to them, get to know their needs and concerns, and be involved with them. We are not in the military, and most of us have not signed any contracts saying that we will show up for work. We have the choice not to come, and we are a very, very large group.

I do not think that anyone can speak for us as nurses except nurses. We are a hugh group of caregivers, and I would include the CNAs to be represented in this group also if they want to be. They will be at the bedside with us if they choose to come. Planners can talk to hospital systems, health departments, and the administrators and doctors that represent them, but until they actually speak to the group of people that perform the care, they will get no where. I do not want an administrator or doctor speaking for me. They could never do what I do, and they are not going to be there with me as I tend to the sick and dying. I want nurses speaking for me, and I want the govt to send me a strong message of support before this happens. And, while some nurses belong to unions, the majority of us do not, and therefore union leaders should only be a portion of those who might represent us, and should not be the only speakers involved. I mean no disrespect to unions, but representation should reflect the reality of how we work.

We are lumped together with all the ancillary staff that support facilities, and we know that they are not coming either. We are considered as just another commodity to the health care systems. It is assumed that we will report for duty because we always have even in the most dire or despicable of circumstances, but this time we have some foreknowledge of what is coming, and we have said that most of us are not going to be there. Has the message gotten through or will it be ignored with the govt and the public assuming that we are going to show as we always have?

Why can't some group like Trust for Americas Health go around the country, and brainstorm with us? Why not? The country is depending on us for God's sake. I propose that we are stakeholders in the business of providing healthcare. They have met with other groups of stakeholders. We are equally as important and necessary.

The definition of a stakeholder from Black's Law dictionary is as follows: a "person who has an interest or concern in a business or enterprise, though not necessarily as an owner."

Here is another definition from Webster, "a person or group having a stake, or interest, in the success of an enterprise, business, movement, etc."

I propose that we are stakeholders, and as such we merit consideration, but we have never bothered to ask for it, and it has not been offered to us, and until it is, this country is at a terrible risk of having few caregivers available simply because the problem was either not recognized or ignored.

There are solutions. This is a wealthy country. Maybe some have already been thought of by the planners, but they should not count on us as part of the package until they come around and meet with us. I strongly suggest that they do so, and that it should be with groups of us around the country. Again, they have done this already with business and other groups, and we as stakeholders require the same serious consideration because this is a grave problem, and it requires serious deliberation. It is very foolish of them to disregard nursing in the national planning. I am well aware that just meeting with us, may not solve anything, but it is a first step towards a solution. They need to recognize that the country is at risk of not having caregivers, and go from there.

And now I will get off my soapbox, but I had to get this off my chest first.

And please don't anyone bother flaming me for my suggestions. I am only suggesting the first steps. You do not have to agree with me, but until you come up with something better, don't be part of the problem, and try to shoot me down for trying. Besides I have developed an asbestos hide after studying this problem for the last year and a half...

[EmmaG, RN]

Well said. I agree completely except for one point. You are speaking from a sense of entitlement because we are entitled, as you so eloquently explained.