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Why We Shouldn’t Be Surprised a Nurse Contracted Ebola in the U.S.

tonydokoupil

Note: I have intentionally not linked to NBC’s post about Nina Pham, RN’s nursing experience. Critical care nurses must meet exacting requirements prior to receiving critical care certification. Critical Care certified nurses have already put in the time. Please reference this FAQ from the American Association of Critical Care Nurses

Anyone making comments about the nurse who contracted Ebola and her competence or her thoroughness needs to read this article. If you are a nurse or physician or other healthcare provider who does not work in a biohazard containment facility, you need to rethink. Remember: people who are experts with this clothing get Ebola. Are we surprised that people who are not experts could contract it? The issue is training and skill level. We should not be surprised that people who have never been around Ebola are not experts at containing or contracting Ebola.

(update added at end of post)

I’ve known for years (and I think a lot of people have) that Ebola would get to the U.S, but I still haven’t been afraid of it because you remain more at risk of being shot by a police officer or security guard even if unarmed in the United State than of catching Ebola. Even as a nurse. You are at higher risk to die of diabetes, the flu, or by a drunk driver than you are from Ebola. You have this risk simply because you live in the United States.

But what I DO know… due to my burn scar, I can’t wear a traditional TB mask. I have to wear a PAPR hood. However, I’ve never worn one. I don’t even know how they work. Still, if I had a TB patient, I’d be expected to learn how to care for the hood as well as the patient. I’ve never worn one. That’s…. not comforting. (In addition, workers at Texas Presbyterian were not given Hazmat suits until a positive Ebola test was received).

I think it’s time hospitals,  nursing, and medical schools started adding biohazard PPE training to their regimens. I think the United States should fund this. I think they can do it by reversing the decision to slash the Hospital Preparedness Program from $515 million to $255 milllion in 2014 and the Public Health Emergency Preparedness Program from $900 million in 2005 to $610 million this year. (Links found from “Ebola Highlights Public Health Crisis“)

The United States has thousands of hospitals, all staffed by medical professionals who have dedicated years of their lives to careful education and preparedness for the care of any individual who may be hurt or ill. Is it too much to ask that the United States not ask for actual years off of our lives?

 

Edit:

After initially posting this, I came across this article from Oregon Live  that states, according to records obtained by the AP, Texas Presbyterian did not place it’s staff into Hazmat suits until Duncan’s Ebola test was positive.

 

So:

 

Patient from Liberia: Check

With explosive diarrhea: Check

Vomiting: Check

High fever: Check

Hazmat suits? Let’s wait for blood results.

 

I really hope that article is wrong, but I don’t think it will be.

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Bribery

It’s happened to nearly every nurse I know. You work your ass off for a patient, and at the end of the day, the patient or family member try to give you a large cash sum in thanks for your work. I’m not talking about a $5 gift card to Starbucks, I’m talking about a gift of over $50 cash, or of a great deal of worth.

I remember caring for a woman who had emergency surgery but also had Alzheimer’s. She was traumatized to be out of her nursing home. She refused to eat anything. I worked with her for 3 days, helping her walk, making sure she didn’t fall, bathing her, and ordering different foods until I found something she would eat. It involved calling the nursing home and finding out from their staff what her favorite foods were.

I became close to her family over this time. Her son repeatedly thanked me for all my work, which was really nice. He nearly cried when his mom started to eat a peanut butter and jelly sandwich, cut into perfect squares. Every morning when he arrived and saw her clean and cared for, he knew his mom was safe.

At the end of my third shift with this pleasantly confused and challenging patient, her son pulled me into a corner and tried to give me $100. “Take your husband out to dinner.” I politely refused, and told him his thanks was more than enough. He insisted he wanted to give me a gift, so I suggested he send the floor a fruit basket, something we could all share. He begged me to take the money, but I told him it wasn’t right, because caring for his mother was my job. He said I did more than my job, but nurses know, I may have gone a little bit above and beyond, but not far. I politely said no a third time, and told him to take his own wife out and relax now that his mother’s health crisis had passed. He finally agreed.

After the patient was discharged home, multiple fruit baskets arrived for night and day shift, for each side of our unit. Everyone was really happy about that.

Not taking money from patient family members is one of the basics of nursing ethics. It could be construed as a bribe to give one patient better care than another, which I just won’t do. You get care based on how much care you need, not how much care you can afford.

So imagine how I feel every time I hear about a politician taking bribes for things like hot tubs, home repairs, vacations, etc.

It makes me want to vomit. Consider Bob McDonnell, who has been accused of taking multiple bribes. He makes enough money. He didn’t need those things. If it comes out to be true, it’s going to be horrible.

I am always amazed at the frenetic energy the wealthy or well-to-do spend on BECOMING MORE WEALTHY. You already can support yourself in luxury. The governor gets free food! A mansion! After he’s done, he’ll have speaking opportunities, book opportunities, maybe a pension (I don’t know what happens to Virginia governors after they leave office). Before this bribery scandal, even becoming Vice President was a realistic option. Instead, he had to take money and services from people.

Shame on Bob McDonnell, and shame on every politician who takes bribes. I’m not even talking about funding for political campaigns, I’m talking about out and out bribes. Shame on you. I would never solicit bribes from a patient or family member, how dare you do this to your constituents, who look up to you.

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