Hours after a nurse in Dallas was diagnosed with the Ebola virus, nurses’ unions in Sacramento and around the country began warning that the government guidelines on caring for Ebola patients are inadequate, and hospitals aren’t giving their members adequate training and protective equipment.
Diane McClure, a nurse at Kaiser Permanente South Sacramento Medical Center, said Monday that Kaiser and other health care providers aren’t doing nearly enough, and the guidelines issued to hospitals by the U.S. Centers for Disease Control fall short of what’s needed to prepare hospital staff who could be on the front lines should Ebola patients start to arrive.
McClure is a member of the powerful California Nurses Association and National Nurses United, an umbrella organization for CNA and other nurses’ unions. On Sunday, National Nurses United staged a rally in front of a Kaiser facility in Oakland.
“We’ve been going for weeks being told it’s fine, and it’s not fine,” McClure said. “It’s scary when you’re worried about potentially dying, and you work for a hospital that could give you proper protection and it doesn’t appear they’re doing it. They’re going by the CDC guidelines that from the beginning weren’t strict enough.”
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The union call to action came following news of a Texas Health Presbyterian nurse who was infected with the disease during extensive contact with Ebola patient Thomas Eric Duncan, who died last Wednesday. The worker had been considered low risk because she was wearing protective equipment.
While an investigation into how the nurse became infected is ongoing, CDC Director Tom Frieden blamed a lapse in the protocol health care workers are advised to follow.
Nurses say lack of protocol is more likely to blame.
In recent weeks, National Nurses United said it has surveyed nearly 1,800 nurses in 46 states about emergency preparedness. Eighty-five percent of those who responded said their hospitals have not provided the type of education on Ebola that allows them to ask questions. Thirty-six percent said their hospitals lacked sufficient supplies of fluid-resistant gowns for a potential outbreak, and 39 percent said their hospitals did not have plans in place to equip isolation rooms with plastic-covered mattresses and pillows, and to discard all linens after use.
Zenei Cortez, a Kaiser Permanente South San Francisco nurse and vice president of National Nurses United, said Sunday’s Oakland rally was a “call for preparedness,” and an effort to provide a venue for missing voices. The organization has also organized a national call on Wednesday, during which nurses can ask questions and pose concerns.
“We’ve been saying this long before the outbreak in Texas,” Cortez said. “We knew it was just a matter of time until it would show up in the U.S., and sure enough, it showed up. We need to say that this needs to happen now. We cannot wait any longer.”
Contacted by The Sacramento Bee on Monday to talk about their preparations for Ebola, Kaiser, UC Davis, Dignity Health and Sutter Health did not make officials available for interviews. In emailed statements, Sutter and Dignity said they are following the protocols issued by the CDC. According to these protocols, hospitals should take an inventory of their personal protective equipment including gowns, gloves, shoe covers, eye protection and face masks. They’re supposed to review plans for special handling of linens and supplies and conduct refresher training courses for health care personnel.
McClure said she has not received any training from Kaiser. The only communication from the hospital has been a single sheet of paper with basic information dispensed Friday, she said.
Dr. Stephen M. Parodi, infectious disease specialist and director of hospital operations for Kaiser Permanente Northern California, said in an email Monday that Kaiser has distributed updated educational materials to facilities and Tuesday will release a safety video demonstrating the proper use of protective equipment. Training for personnel in emergency departments, outpatient medical facilities and call centers began Monday, Parodi said.
“We recognize the concern among the public and health care workers everywhere,” he said. “As we have been doing all along, we will continue to engage with our staff, monitor our practices and take all necessary steps to ensure that our patients are getting the best up-to-date care, and that our staff are prepared and informed.”
Laura McCasland, spokeswoman for the Sacramento County Public Health Office, said the county is working closely with hospitals to ensure that the CDC protocol is followed, just as it was with a possible Ebola case at Kaiser Permanente South Sacramento in August. At that time, Kaiser staff suspected a case of Ebola and reported it immediately to the public health office, which worked with the hospital to send a specimen to the CDC for testing. The specimen came back negative, but McCasland called the event “an exercise of what would happen in any suspect case.”
McClure said she’s not reassured. The patient’s presence at the south Sacramento facility only caused confusion among the nurses, she said, and made them even more aware of the lack of protocol. “People were not sure about equipment. I think the nurses were just taken aback because they weren’t sure what to do.”
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The personal protective equipment health workers wear while treating an Ebola patient must be donned and removed a specific way. What the Centers for Disease Control and Prevention instruct them to do:
▪ Gloves: Grasp outside of glove with opposite gloved hand; peel off. Hold removed glove in gloved hand. Slide fingers of ungloved hand under remaining glove at wrist.
▪ Goggles/face shield: To remove, handle by “clean” headband or earpieces. Place in designated receptacle for reprocessing or in waste container.
▪ Gown: Unfasten neck, then waist ties. Remove gown using a peeling motion; pull gown from each shoulder toward the same hand. Gown will turn inside out. Hold removed gown away from body, roll into a bundle and discard into waste or linen receptacle.
▪ Mask or respirator: Grasp ONLY bottom then top ties/elastics and remove. Discard in waste container.
▪ Hands: Perform hand hygiene immediately after removing all equipment.
Source: Fort Worth Star-Telegram