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Reuters Report: U.S. Nurses Say They Aren’t Prepared to Handle Ebola Patients

How do you clean an infected elevator?

The Centers for Disease Control and Prevention (CDC) has repeatedly said that U.S. hospitals are prepared to handle Ebola patients, and many infectious disease experts agree with that assessment.

According to a report from Reuters, however, U.S. nurses say they are untrained and unprepared to handle patients arriving in their hospital emergency departments infected with the virus.

Texas Health Presbyterian Hospital in Dallas, which is now caring for the first Ebola patient to be diagnosed in this country, had completed Ebola training just before Thomas Eric Duncan arrived in their emergency department on September 26. But despite being told that Duncan had recently traveled from Liberia, hospital staff failed to recognize the Ebola risk and sent him home, where he spent another 2 days becoming sicker and more infectious.

“The Texas case is a perfect example,” said Mickey Samios, a triage nurse in the emergency department at Medstar Washington Hospital Center in Washington, D.C.

“In addition to not being prepared, there was a flaw in diagnostics as well as communication,” Samios said.

Nurses argue that inadequate preparation could increase the chances of spreading Ebola if the hospital staff fails to recognize a patient coming through their doors, or if personnel are not informed about how to properly protect themselves.

Samios said she and other members of the emergency department staff were recently trained on procedures to care for and recognize an Ebola patient, but not everyone was present for the training, and none of the other nursing or support staff was trained.

“When an Ebola patient is admitted or goes to the intensive care unit, those nurses, those tech service associates, are not trained,” she said. “The X-ray tech who comes into the room to do the portable chest X-ray is not trained. The transporter who pushes the stretcher is not trained.”

If an Ebola patient becomes sick while being transported, “How do you clean the elevator?”

In a survey of approximately 400 nurses in more than 200 hospitals in 25 states, more than half (60%) said their hospitals were not prepared to handle patients with Ebola, and more than 80% said their hospitals had not communicated to them any policy regarding the potential admission of patients infected by the Ebola virus.

Another 30% said their hospitals had insufficient supplies of eye protection and fluid-resistant gowns.

Unlike influenza or the common cold, which can be spread by coughing and sneezing, Ebola is spread only by contact with bodily fluids from someone who is actively sick. That means the risk to the average person is low, but for health care workers, the risk is much higher.

As of August 25, more than 240 health care workers have developed the disease in Guinea, Liberia, Nigeria, and Sierra Leone, and more than 120 have died, according to the World Health Organization. Many of these infections occurred when health care workers were removing their personal protective gear — masks, gowns, gloves, or full hazmat suits used to care for the patients.

Nurses say hospitals have not thought through the logistics of caring for Ebola patients.

“People say they are ready, but then when you ask them, ‘What do you actually have in place?,’ nobody is really answering that,” said Karen Higgins, a registered nurse at Boston Medical Center.

Higgins, an intensive care unit (ICU) nurse, said hospital officials have been teaching nurses on one of the regular floors how to care for an Ebola patient.

“I said, ‘Well, that’s great, but if the patient requires an ICU, what is your plan?’,” she said. “They looked at me blankly.”

Source: Reuters; October 3, 2014.

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