It's Tuesday night, my bladder is full, and the emergency department is poppin'. 11.5 hour into a 12 hour shift that consisted of multiple heart attacks, strokes, and a motor vehicle accident, just to name a few patients seen tonight... When a patient with nausea, vomiting, and abdominal pain is triaged into my care, the first question I immediately asked is, "Have you made any recent travels within the last 21 days?" Of course the patient rudely snaps, "I don't have Ebola; I just ate something bad."
As an emergency room nurse, my primary focus is on the immediate safety, whether that be for patients, the community, or on a good day, caring for myself. Nursing is a selfless job, and it is very bothersome when patients are rude to the person who is caring for them, essentially saving their life. But, that's human nature, I guess, and nurses have learned to deal with it.
I'm sure many of you have heard about the Ebola outbreak in Dallas, and if you haven't, you probably live under a rock. If that's the case, stay under the rock, it's most likely safer. With recent media coverage, the infected nurses from Dallas are receiving a lot of backlash for improper technique. However, the truth is that a majority of us are not equipped to care for Ebola. According to the Centers for Disease Control and Prevention (CDC), personal protective equipment (PPE) should suffice against the spread of the virus. However, Ebola is a creature in itself.
Lets put this into prospective. The CDC precautions for the Ebola virus are contact and droplet, which consist of the following PPE: gloves, a disposable gown, mask, and goggles. I agree with the CDC that this is the normal protection against contact and droplet illnesses, but my question is...
Is the Ebola virus normal?
I mean the virus ONLY kills 50% of it's victims compared to the 1-2% influenza (flu) does. Oh, and by the way, Ebola and the flu are spread the same way--surprise! However, non-like the flu, Ebola has no FDA-approved vaccination or medication; care is focused more on symptom management rather than treating the disease (e.g. intravenous fluid resuscitation, electrolyte balance, oxygen preservation, and hemodynamic stability). Recovery relies on supportive care and the patient's immune system. With a virus of this magnitude, so easily spread, and no cure, why are nurses risking their lives being equipped with only standard PPE. And, why does the CDC get to wear the full Hazmat suits? But, of course then when a nurse contracts Ebola, it's their fault--no ifs, ands, or buts about it.
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Healthcare professionals care for many patients each day, several with curable illnesses and some that are not treatable. Ebola is unpredictable, and many of us are ill-prepared and not equipped to care for the virus. Believe it or now, healthcare professionals are humans too; we are not perfect. I'll be the first to admit that I make mistakes. But, with that said, we are doing everything we can do to be near perfect, including staying up to date on our skills and on illnesses such as Ebola. As the Ebola virus continues to spread and affect more lives--and it will--it is going to be a challenge for nurses and patients. However, the care and treatment development will only continue to evolve. In the meantime, please have faith in us, nurses. We really do know more than you think we do. We are not as incompetent as the CDC or the news anchor--reading cue cards--would like you to think.
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Signs and Symptoms of Ebola:
- Fever (greater than 38.6 degrees C or 101.5 degrees F)
- Severe headache
- Muscle pain
- Weakness
- Diarrhea
- Vomiting
- Abdominal (stomach) pain
- Unexplained hemorrhaging (bleeding or bruising)
