Sunday, November 2, 2014

Walking on the edge: in support of nurses


I know this whole recent news story in Maine about the nurse who has been fighting quarantine has brought out a lot of criticism of her.  Actually that's putting it lightly.  I've seen some of the most horrific, rude, and hateful statements on social media against this woman.  She’s been bashed by fellow nurses, although I have seen some voice of reason in the postings as well.   I truly believe that social media brings out the worst in people who can hide anonymously behind their statements, and call people names like “idiot” and worse, without having to debate an issue in an intelligent manner.

My personal opinion is people really didn't like to see a woman, and a nurse, be so verbally adamant and outspoken about the issue, added in with the fact that we don’t think we fully understand Ebola.  I think she's someone who is willing to put herself on the line (because she's certainly been vilified) to make a statement and to point out the problems with mandatory quarantine.  People keep saying, "what's the big deal, it's 21 days, deal with it."  The big deal is that it sends the wrong message about how Ebola is spread and how we should be dealing with it.  The American Nursing Association (the professional nursing organization in the US) has put out a statement in support of Kaci Hickox and the current CDC guidelines, which she is following, and has been willing to follow.  She simply did not believe a state-imposed quarantine is the right answer.  

I’ve been truly horrified at how nurses have been portrayed in the recent events surrounding the Ebola crisis.  Nurses are people like everyone else, and none of us are perfect.  And just like every profession, there are some nurses who are better than others.  There are those who strive for excellence, and there are those who just want to get through the day.   But I believe at least 90% are in the first category!  You don’t go into nursing to make money (it’s a comfortable living, but you’ll never be wealthy).   Nurses work incredibly hard to earn that money too.  There’s very few professions where a hard day at the office means you lost a life.  Working with very sick patients, exposing yourself EVERY DAY to illness, blood, urine, feces, vomit, and sometimes deep sadness, it’s not a job for everyone.    Nurses choose their profession based on an affinity for science, and a passion to help others.   

Why would anyone think that a nurse who volunteered her time and energies to go work with the sickest, most infectious patients in the world right now, in a third world country, where there aren’t clean shiny hospitals with every piece of equipment you need at your fingertips, but makeshift tents in the heat of the African sun, would really be a person who just “wants 15 minutes of fame” or is “looking for money.”   I can’t even fathom someone having those two aspects to their personality.    What I can understand is a nurse who is not only passionate about her work and her patients, but also her belief in science and the proper approach to a disease that she knows better than 99.9% of those of us who sit back and judge her, based on the little that we have learned over the last 4 weeks.  
Nurses are my heroes.  They do things every day that go the extra mile to help their patients, to comfort the families, to ensure their safety.   No, hospitals are not perfect. Doctors are not, and nurses are not.  But guess what?  We’re on the front lines in ANY epidemic.   To me, when the two nurses in Texas became ill after caring for the man from Africa, it was quite concerning, because I thought in America we would be fully protected.   It became clear we have much to learn and to prepare for in case of having such a patient.   The mistakes made in Texas could have been made anywhere, because very few hospitals were really ready.  Ebola was a distant possibility, not a reality that would walk into the ER.  Now we know differently and are working to be prepared.   But the truth is, without constant preparation and training, any staff in the US would be challenged to care for such a patient.   The best plan would be quick recognition and transfer to a center that trains all the time and understands the protocols intimately. 

I’m not scared of Ebola.  There have been less than 10 cases treated here, and only 2 that were contracted here: the two nurses who cared for Duncan when he was at his very sickest.   The fact that his own family did not develop the disease, should put everyone who is freaked out about being on a subway, plane, or in a bowling alley with a potentially infected person, at ease.   I’m more scared that people are not vaccinating their children and horrific communicable diseases that we thought we had eradicated are coming back like pertussis, measles and mumps.  The recent outbreak of Enterovirus in children that has made them so sick is much more of a threat right now.  The flu season is coming and I know many people have not bothered to get a vaccine because they either think they won’t get the flu, or they think it gives them the flu.  And yet the flu kills thousands of people per year.  But we don’t quarantine people with the flu. 

This is all a long-winded way of saying that I hope people can put this in perspective, and try to understand the distinctions between isolating someone who is sick (right thing to do) and someone who may have been exposed.   And the operative word is MAY.  Most healthcare workers who have been overseas do NOT become sick.  The CDC guidelines do stratify overseas workers into a different category than healthcare workers in this country who may work with one or two patients.  I think their guidelines make sense and are reasonable, and will keep people safe.  Under those guidelines, Kaci Hickox falls into the "Some Risk" category (NOT High Risk) and would be directly monitored (meaning someone is checking in on her daily) so that if she develops a fever at all, it would be immediately detected and she would be isolated.   That makes sense and that’s what she’s been fighting for.  http://www.cdc.gov/vhf/ebola/exposure/monitoring-and-movement-of-persons-with-exposure.html#table-monitoring-movement

 I admire her.  I think people who stand up for what they believe is right, and put themselves out on a ledge that most of us never will, because of the fear of being attacked by the masses, are pretty amazing people  Because that’s not selfish.  That’s bravery.