In my last blog post, I neglected to mention my nursing background. I was in a hurry that day and so just copied and pasted it from a Facebook post. So here are my qualifications, in case anyone is wondering (I know I would be): I have a Bachelor’s of Nursing from Arkansas State University. I’ve worked as as nurse for almost 7 1/2 years, doing stints in ICU, Pediatrics, Urology, and Cardiac Telemetry. I’ve worked in the Emergency Dept for the past 3 1/2 years (almost 4 now), but the vast majority of my experience prior to that is with Cardiac and Medical-Surgical patients. I’ve taken care of a LOT of isolation patients.
So now we have another poor soul afflicted with the deadliest disease since the Black Plague – only it’s worse, because it doesn’t need rats and fleas to spread it around. If it did, most of us in the United States would be safe. I say deadliest disease because its kill rate is approximately 50-70%. To turn that statistic around, that means a survival rate of 30-50%. Those are not good odds.
This morning’s report from Fox News gives us this fantastic line from Dallas Mayor Mike Rawlings: “It may get worse before it gets better.” If you listen to things like congressional debate or recorded discussions at the U.N., you might notice that they speak differently than the rest of us. The language is more formal, but it is also understated. When I see the President (any of them) threatening other nations with sanctions or military action (on TV), they never sound the way I want them to: “We are going to KICK your ASS.” It simply isn’t politically correct. Therefore, my translation of Rawlings’ statement (assuming that it is, in fact, understatement), is “Be prepared, because this will get worse.”
Another thing I’d like to point out is that we’re all probably frustrated with the lack of information provided by hospitals on their staff members. There are two reasons we’re not going to get as much information as we like. #1, HIPAA, the Health Insurance Portability and Accountability Act, which makes it illegal for anyone to reveal anything about a patient without their consent. Violating HIPAA comes with a 1.5 million dollar fine and possible jail time. #2, the hospital is going to protect its nurse, for a variety of reasons. Yes, it’ll cover its ass as much as possible, but also, there aren’t enough nurses to go around already. A nursing shortage has been the norm in this country for decades. We can’t afford to lose any nurses. For that matter, we can’t afford to lose any nurses’ aides, either, nor physicians.
Another interesting thing I’ve noted is that of the “70 others who treated Duncan,” none of the healthcare workers are currently working. They’re still employed (probably having to use their own PTO, but I digress). I’m really glad to hear this, because the last time I checked (about 3 weeks ago), the CDC site said that any healthcare worker exposed to Ebola could continue taking care of patients as long as they came to the health facility for “twice daily temperature checks.” I’m ecstatic that the hospital in Dallas is smarter than that.
Fox mentions that “the second case pointed to lapses beyond how one individual may have donned and removed personal protective garb.” I have spoken with many fellow nurses on Facebook (there are at least 50) from both hospitals in my area, and none of them think that the personal protective equipment we currently use is going to protect us from Ebola. The ER dept at my place of employment has a decontamination room (for disasters like chemical spills), and I’m pretty sure we have biohazard suits, but nobody that I work with knows how to use one. In three years, I’ve been provided one opportunity to learn about it, about two years ago.
Honestly, I’m in triage and if someone with Ebola comes in, the only things I have quick access to are gloves and an N95 mask. All the other protective gear is on the other side of the ER. Quote: “The Ebola virus is transmitted when a person comes in direct contact with an infected, symptomatic Ebola patient’s bodily fluids, such as blood, sweat, saliva and tears.” Even HIV doesn’t transmit in sweat and tears. I work in a room that is approximately 8 ft wide by 12 feet deep, and if people start barfing in the trash can or coughing in my face (as they so often do), there is little I can do to protect myself. (Note to self, put goggles in triage with the mask and gloves).
Apparently the “largest U.S. nurses’ union charged that Duncan’s caregivers worked for days without proper protective gear and faced constantly changing protocols.” That they changed protocols constantly I have doubt. As Duncan’s status deteriorated and blood started splattering around the room, I bet they were doing anything and everything to keep from getting exposed. In addition, the union stated that trash in the room was left to pile up for days. I believe this also, mainly because it happens in hospitals now, and also because getting it out of the room would expose more people. The thing is, few hospitals in the U.S. would have a method in place to dispose of such waste. Yes, we have red bags and proper disposal for isolation waste, but as we’ve seen with the PPE, I imagine that the current methods were deemed insufficient. Therefore, the waste piles up.
As for the contaminated lab samples traveling through the pneumatic tube system (we have one, too) – well, it has to get there somehow. You can either tube it, or carry it down by hand. Is carrying it down by hand really less exposure to others than the tube? The hospital’s comment was that “the facility had not received similar complaints”, which I take to mean that the nurses didn’t complain about it. In my experience, nurses don’t complain much to management, because 95% of the time we’re told that things won’t change and
to just suck it up “We’re not discussing that.” As a nurse, I definitely do not feel like part of a hospital family, unless its a dysfunctional one where the parents rule with an iron fist. So, big surprise that nurses didn’t complain.
As a side note, I rather dislike how the media refers to nurses as “heroes.” Soldiers in the Army have a cynical outlook on heroes, noting that they usually end up dead. There are more soldiers who won the Medal of Honor dying in the line of duty than surviving. So don’t give me that hero garbage. If I truly thought that I’d have to deal with something like Ebola in my line of work, I’d have stayed a graphic design major. I still have a minor child at home. I also have a granddaughter, and I’d like to see her grow up.
As far as I’m concerned, it’s just been “lucky” so far that neither of these women lived with families. If a nurse who’s been exposed to Ebola sleeps with his/her spouse husband all night and then wakes up with a fever, then guess what – the spouse has been exposed. I cannot imagine what it must be like to wake up, note that I have a fever, and have to tell my husband and children that I have to go to the hospital immediately. Then, I would have to leave everyone behind without a kiss or a hug, tell them I love them from as much distance as I can get, then go to my quarantine where I could possibly die without ever touching a loved one again. Then I will get to sit in quarantine for an unknown and unpredictable number of days while my family stays home hoping and praying that I’ll come home alive. Even moms with cancer still get to tuck their kids in at night. Moms and dads with Ebola won’t.