Ebola.


I have been very busy with real life recently; my oldest son and his wife whom I haven’t seen in two years came to visit and to be present at my middle son’s wedding. But of course the topics in the news came up during our conversations.

My son lives in a town with a genuine Level 4 containment facility. But here’s the problem: even the staff that are assigned to that area state that they aren’t adequately trained to work in it! Why? Because it costs money, a lot of money, to have the supplies ready to use in doing the training necessary to keep people not just minimally competent but proficient at such a methodologically demanding task.

It’s something similar to Magnet status for hospitals — they all like to promote that they have magnet status, but most of them don’t live by the ethics and level of staffing a magnet status requires — they just up the staffing for the original certification and the recertifying. In between? Just like everywhere else, overworked and under staffed. I know, I used to work for a magnet hospital. And having a level 4 containment facility gets them extra government money just like magnet status does, but they don’t spend the extra money toward what it’s supposed to go toward: maintaining appropriate staff levels and training to back up those special status items.

Dear oldest son said he thinks hospitals are going to have to make a decision on whether they will care for Ebola patients or care for the community; he thinks any hospital that admits an Ebola patient is going to become ‘toxic’ to the rest of the community, especially if other patients get infected from exposure at the hospital, and they will either have to close to the public to care for Ebola patients or they will have to turn them away to Level 4 facilities if they want to take care of the rest of the revenue generating patients they would normally see.  I think he may be right.

I made a comment on another site I visit every so often on a post about Ebola. I said something to the effect that, if it did in fact become an epidemic in the US, that nursing staff were going to begin refusing to care for those patients. Or even refusing en masse to even come to work.  While I haven’t gotten any real negative feedback and plenty of “likes” for the comment, I did get a response that ended with the statement “ebolaf@#kyou I ain’t afraid.” Or something to that effect.  I am, quite frankly, much too lazy to go and actually look up the comment; it wasn’t phrased in an insulting way.

I took that to mean the author of the response thought I was afraid of Ebola, or that nurses were, and that fear is a bad thing. So I crafted this response:

I have been in medical services since 1994. First as an EMS person then as a nurse. I am used to putting my life on the line in service to others. I used to be the one who ran into the burning house you all ran out of. I’ve fallen through floors, been in flashovers, broken bones from collapsing gear, been puked on by contagious patients, been stuck by contaminated broken glass, had exposures to tuberculosis, meningitis and hepatitis among other things. It is part of the job. You just keep working, whiners need not apply. HOWEVER.

I was trained in how to deal with all of the above, and I was given the tools to do my job properly and safely. My supervisors took my safety seriously. I was trained to recognize the symptoms/signs of danger in the situations I faced and encouraged – required even – to take appropriate action to minimize the dangers to myself and my crew.

This is not the case when it comes to Ebola. Hospitals aren’t capable of handling this, just ask any nurse or doctor in a facility near you – off the record, of course. There is no training and no real plans for training. No facility is going to waste the money to purchase the gear and then waste a lot of it in training staff how to safely don and doff it, unlike the training offered to me in HazMat, fire fighting, and EMS training. It’s just not going to happen.

You want people to not be afraid? Then they need to be trained to recognize early symptoms, to be ready to err on the side of safety, and to be aggressive about taking defensive actions. Nurses in particular are held up as these Florence Nightingales with lanterns sacrificing their lives in service to unwashed humanity (even the male nurses among us).

Do you really think, when health care has become a multimillion dollar business, that image is going to be the reality? When what the WHO and the CDC say about transmissibility differs in not insignificant and potentially deadly ways? When Sanjay Gupta can’t doff protective gear without contaminating himself on live TV?

My husband also works in the health care field and had a conversation with a doctor about Ebola. The doctor said straight up that if it became an epidemic he wasn’t going to be bothering to come to work, he was going to be home caring for the safety and health of his family where he belonged. That’s the reality. It’s not pretty, it’s not what the public wants to hear, but reality is a harsh mistress.

I’m not afraid, at least not blindly so. I think one must take precautions, and protect oneself, and be able to assess risk. I have a lot more chance of getting a Norwalk type virus than I do of getting Ebola, thankfully, because one involves 3 days of wishing I were dead and one involves the likely possibility I will in fact die. It’s all in assessing risk.

This whole idea that nurses are, and should be, held to a “higher standard” than the likes of the rest of the great unwashed humanity…?  Bunk.  We’re people just like the rest of you.  Nurses are obese, smokers, diabetics, drug abusers, alcoholics, codependent, crazy, in possibly much greater numbers than the rest of the population as a whole.  As I said in my original comment, I have a license and a calling, not a death wish.

Enough said.