Wednesday, October 15, 2014

Ebola: As a patient advocate and as a nurse I have to make a stateement about this poor nurse in Texas who contracted Ebola. Spreading of an infectious disease When health care professionals put on those special isolation gowns and gloves this is part of “INFECTION CONTROL”, not infection eradication. Of course the goal is to eradicate but the point is to control the spread of the infection while caring for the ill patient. Part of controlling the spread of infection is educating the people visiting about the immediate risk to themselves and others and what protective gear they should be wearing. This is not about being politically correct it is about safety. With the shift in health care to be more “patient centered”. We have gotten away from the ultimate goal patient safety and infection control. We now have rugs in waiting rooms. Can you really clean a rug. Children are permitted on the nursing units. When I was at the hospital recently, young children were crawling all over said rugs? How can that be sanitary? The treatment of the nurse who contracted Ebola by the media The initial response from the media was that the nurse broke protocol? The problem is the guidelines set forth and provided were standard infection control protocols. I am glad the local nursing union stood up and said give us specific protocols to address this infectious disease and permit us to ask questions to the experts. Permit being the operative word. You can write up a protocol and no matter how clear it seems, there is room for interpretation. This is why dialogue needs to occur. The difference between Ebola and other infectious diseases that we may see in the hospital is the virulence and the risk to life. Logically, would this nurse break protocol knowing the risks? I find that highly unlikely. Nurses are at higher risk for contracting infectious diseases due to the proximity to the patient and the time spent with the patient. In the critical care setting the nurse to patient ratio is, generally one to two patients. Based strictly on these numbers, the day is spent with the patient. The longer you are in contact the higher the risk of contracting the disease. This is a logical deduction. No other health care worker spends this much time in close contact with a patient with an infectious disease. The doctor examines the patient and leaves. The nurse has more contact with the immediate area of the patient. The immediate area includes surfaces that may have inadvertently become contaminated Nurses are taught about infection control practices during our training. Nurses are also taught about the consequences of breaching policy and procedure as well as the consequences to our health as well as the health of our family and loved ones if we fail to follow proper infection control practices. Other health care workers come in contact with the patient and may touch surfaces after they have come in contact with the patient. Is it possible that someone other than the nurse did not follow proper procedure, proper hand washing, proper decontamination, absolutely. Previous blogs of mine discuss dirty hands doctors, a pastoral care professional that touched my skin wearing gown and gloves. All health care workers must be trained to effectively provide infection control. I wonder had the health care professional that contracted Ebola in Texas been a doctor would the media have treated him or her differently? When the story broke o 10/13/14 on CNN consistently reporters stated that the nurse broke protocol? Yet the following day CNN and other news networks stated quietly, that the nurse states she did not break protocol and now they are saying they are unsure what occurred. The physician consultants for the news networks explain about general infection control practices and Dr. Sanjay Gupta makes a good point that the key here is that this infection is virulent and less forgiving. All health care workers must be trained and retrained in proper infection control and the specifics of the disease they are working with. It is a shame that the first statements from the media was, “what did the nurse do wrong?”