Don the mask, pump the alcohol and care for the person
by Jess Morton. Last modified: 01/11/14
There is much talk about Ebola at the moment, hence why I thought it was not appropriate to add to the hype. However, those close to me will know that I am not always appropriate. Thus, I am sharing my thoughts anyway.
The majority of comments surrounding ebola in my newsfeed have centred around the Personal Protection Equipment (PPE) for those caring for a patient with either suspected or confirmed ebola as well as the often unsubstantiated panic about “what if” my country, hospital or I come into contact with it.
Have the general public become so concerned with the “What if?s” and toying with the miniscule probability that Ebola may ‘break out’ in Australia that we let the images of fellow Mums, Dads & children suffering & lying dead & abandoned in streets awash over us. Have we become so immune to tragedy, suffering, injustice & health inequality that we have lost the instinct to reach out to others first? Or is it simply assessing our danger & risks first & foremost just as with any other DRSCAB scenario? Is it ok to be embarrassed of the Australian politician who was quoted in regards to the Australian nurse who returned from working with the Red Cross in an Ebola hospital and sensibly self-quarantined at home & contacted health authorities about her low-grade fever.
“One person’s moral and humanitarian ambitions are being carried out at a very grave cost to Australia.”- (Bob Katter)
Is it really only “one persons” ambitions? Shouldn’t it be the moral ambitions of Australia, the UK, the US, Canada? Shouldn’t we all have the same ambitions to help the ebola-affected areas as much as possible and work together to find a cure and care for those who are already sick? Take note of the language and terminology I used: “Help”, “care for” and “sick”.
Australia’s response to the Ebola epidemic is increasingly and unnecessarily mean-spirited. < ahref="https://twitter.com/Sydney_Uni">@Sydney_Uni https://t.co/GdCm096ztO
— The Conversation (@ConversationEDU) October 28, 2014
We really need to be thinking of the Ebola outbreak as a humanitarian disaster rather than a disease outbreak, and talking about it so.
— Carl H (@CarlosDenWA) October 26, 2014
My second point of consideration is in regards to the level of public co-operation in regards to infection control. Never in my 10 years of working in health care have I ever seen such a public interest in the PPE of healthcare workers. Sure, I remember the avian influenza (birdflu) making headlines in 2003-2004 & then again in 2012 when it hit China. Pictures of everyday folk walking down the street in both Sydney & China donned with duckbill masks made the newspaper each day. We know that nosocomial infections exist. We know that community acquired infections exist and typically, nurses, paramedics & doctors will go between many patients, relatives & other staff in one shift. Bring the infection control principles back to your ground level.
- Help stop unnecessary infections entering the hospital by advising sick relatives not to visit.
- Help stop our hospital bugs going back to the community by asking relatives to wash their hands & don any appropriate PPE when visiting. It is important to assure them that those measures not only help to protect themselves, but also to protect the loved one they are visiting or by taking home bugs to their grandchildren or friends at home.
- Wash your hands and use alcohol solution in between patients & before & after care just as religiously as when you were a student being assessed
- WASH YOUR PATIENTS HANDS AFTER THEY HAVE BEEN TO THE BATHROOM.Yes, It is obvious. But many clinicians still forget or are too lazy to assist their patients to wash their hands after going to the toilet.
Yesterday: Patients rarely wash hands after using toilet. Today: Patients wearing masks in triage. Hand hygiene remains unchanged.
— jeremy faust (@jeremyfaust) October 24, 2014
Gowning up is a pain, we all hate it, admit it! Especially to just hook a new IV line up or to do a set of observations. However, as I have seen more deaths from nosocomial infections & the spread of Norovirus shut down whole hospital wards over the years and keep over twenty nursing & medical staff at home, I have become more and more vigilant with infection control policies.
My 3rd and final point. We have all been guilty of referring to the patient in cubicle 1 as “bed 1, or when we handover, we will say “she is MRSA”. But even if the person that is unwell in cubicle 1 does have an MRSA infection, that person has a name, a story & their diagnosis is not their definition. Similarly to mental illness, infectious diseases carry their own stigma. MRSA, VRE, ESBL, Norovirus, RSV, influenza, Shingles, scabies, sometimes pertussis & more. We see these all the time. Some nurses begrudge being allocated those four isolation rooms with varying infectious diseases.
I have heard paramedics lament having to be in close proximity to the patient with infectious diarrhoea and vomiting and do not hide their disdain as they may need to touch contaminated waste from the patient. However, we realise that it is part of our job. We have committed to caring for the sick & injured and it is only on rare occasions would someone refuse. But can that commitment reach a point where clinicians can back out?
A local ER did an unannounced Ebola sim. >90% of the ER nurses refused to care for the "Ebola patient." Disheartening.
— movinmeat (@movinmeat) October 18, 2014
With no reference or evidence of this mock drill, I still put the idea forward as to whether a line can be drawn. Should clinicians have the option to refuse to care for a patient who has the Ebola virus? Is it the stigma of the disease that creates this apprehension or fair reason?
It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has. –William Osler
— Mark Reid, MD (@medicalaxioms) October 26, 2014
Lastly, remember that the person who has a PE, depression, CCF, VRE or even ebola has eyes. They can see your body language, they can hear your words and can sense your displeasure in being allocated their care.
Place yourself in that isolation space and consider how you would wish to be treated.The following two tabs change content below.
Jess MortonStudent Paramedic.I am an Australian undergraduate Student Paramedic. I study part-time as I am also Mum to 2 beautiful boys. I am passionate about Friendship, Family & #FOAMed. I am keen to get more experienced as well as student Paramedics into the FOAM world to enable better access to education to result in better patient care. My interests include photography, thick shakes and sleeping in past 6am.
Don the mask, pump the alcohol and care for the person
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