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Dallas had no protocols. They certainly were not using Doctors Without Borders protocols at first. That is a breach.
Quote:
Originally Posted by Katiana
I think Hyperthetic said it well. And I am not able to make any further determination of how those two got infected. The head of the CDC did not blame Dr. Spencer or Dr. Brantly before him for a breach in protocol, just the nurses! Heck, Brantly was considered a hero when he walked off the plane. Frieden's remark was a totally unnecessary slam on the nurses, probably meant (unwisely) to reassure the public that the risk is only for people who so break protocol.
And I have read nothing that says Dr. Frieden blamed the nurses either. That is strictly the way some people are choosing to interpret his remarks. And before someone asks why he apologized, that was strictly because of the abuse that was being heaped upon him. Do you believe either of them got infected without a breach in protocol? You can't have it both ways, Kat. You cannot insist that neither nurse had a breach in protocol and not have an alternative theory.
"“I was still seeing patients in the emergency room and on the ward,” [Brantly] said. He was evaluating suspected cases without wearing full protection. And he was interacting with family members – hugging the bereaved, shaking their hands. Ebola doesn’t pass through casual contact with someone who doesn’t have symptoms, but many patients he saw may have been in the early stages.
'You never know who is walking around with a fever who took some Tylenol to make themselves feel better,' Brantly said."
“ 'I know there were times when I didn’t have full protection,' he said. 'There were enough opportunities outside the isolation unit.' ”
I suspect that Dr. Spencer was in a similar situation. Both of the doctors had ample opportunity to be exposed while not wearing PPE.
If either of the nurses was in contact with Mr. Duncan without proper PPE, she could have also been exposed that way. However, in Dallas such an exposure should not have happened, because Duncan was already suspected of having the disease.
Like it or not, protocol was breached in Dallas. We will never know whether lack of proper equipment or an error in using it was the cause of the breach. If the former, the hospital is to "blame". It would be naive to say that a nurse could not have made a mistake, though, especially with the apparent chaos at the hospital when Duncan came back the second time and the fact that neither nurse had actually used PPE in an Ebola patient care scenario before.
I have seen nowhere an actual statement that could be construed as "blame", which to me suggests that someone is saying the nurses were negligent or incompetent. The "blame" is being inferred from a simple statement that a breach in protocol happened, and it must have happened unless we are to alternately infer that the PPE was defective.
What we know is that, at least initially, the PPE used in Dallas, was either lacking or ineffective. That is a breach in and of itself.
The media just hopped on the "blame the nurse" bandwagon.
Do you really think anyone would officially say Dr. Spencer "breached protocol" after the reaction to saying the nurses "breached protocol" created such an uproar?
I have read mountains of material on Ebola over the last few weeks. My personal conclusion is that PPE, properly donned and properly removed, provides protection against the wearer coming down with Ebola. If a health care worker who used PPE gets sick, unless he is exposed to the disease while he is not wearing PPE, then there has been a breach: torn glove, defective gown, insufficient gear (uncovered skin), or accidentally touching skin or face. Accidentally touching the face can be due to an unconscious gesture that the person never realizes he made.The experience in Africa suggests that accidentally touching the face is a big, big problem. That is why the buddy system was implemented.
Very, very capable people (nurses and doctors) who worked with many patients with Ebola have gotten sick with it in Africa. They were not incompetent, and I do not believe either the two Dallas nurses or Dr. Spencer are incompetent. It is this implication of incompetence that has folks complaining about "blaming the nurses."
Nancy Writebol has repeatedly said she has no idea how she was infected, because she was not involved in direct patient care. (Which made a lot of people believe Ebola is airborne.) However, in an interview she recently disclosed that she helped doctors remove PPE. Dare I say that a breach in protocol caused her to get infected? All it would take would be a touch of a doctor's contaminated PPE. Would that be "blaming" Ms. Writebol? I consider it a likely explanation of how she got infected, nothing more, nothing less. It does not mean I think she is stupid or careless.
IIRC, no one speculated on how Dr. Brantly got Ebola, either. It was totally unnecessary speculation period, to discuss how the two nurses got Ebola with the general public. Did it need to be "explained"? Shouldn't we have cared more about their health than how they got infected? Of course, one would hope further infections could be prevented, and for that reason investigate what happened, but Dr. Frieden was not on-site there in Dallas, and had no reason to start idle speculation. It's nice he has unfailing belief in his protocols, which he changed after the nurses' illnesses. And he certainly had no business saying Amber Vinson shouldn't have traveled when his own organization gave her the OK to do so. The fact that he may not have known that does not absolve him of throwing her under the bus in that manner.
We can all argue semantics from now till h*ll freezes a six foot crust, but saying they got it through a breach in protocol does put the blame on them, not the protocols, as in they did something wrong, because the protocols are perfect. I also find it distasteful that it's sometimes said, "they just weren't trained right" as if to mean it wasn't really their fault, they just didn't have the "training". Most nurses don't like the term "training", like nurses can't think and therefore need to be "trained". Prior to their illnesses, the CDC was referring people to a website for "training".
I've read plenty about Ebola too. I'm not so certain about the PPE stuff. And I totally do not buy the argument that since no one at the NIH, Emory or University of NE got Ebola taking care of patients, that the PPE protocols work perfectly, every time. The patients at those hospitals were much less sick than Thomas Duncan, and as I said above, they were brought in under controlled circumstances and already diagnosed.
Last edited by Katarina Witt; 10-26-2014 at 03:38 PM..
I think we are actually in agreement. Like I said, the implication was made (yes by the media) that the nurses were to blame but they were basing those opinions on the words of Dr. Freidman. I think by saying 'breached protocol', it led to that line of thinking and opinions by the media. As I said before, it was primarily in the wording. For example, you said that it was the PPE either lacking of being ineffective that was likely to blame in Dallas. The connotation is quite a bit different than saying breached protocol, even though, as you illustrated, it really does mean breached protocol. This is why people who are spokesmen have jobs. They know how to carefully wade through these word minefields. In a perfect world, there would be no such misunderstandings but in the 24 hour news cycle world, it is the bread and butter of their ratings.
IIRC, no one speculated on how Dr. Brantly got Ebola, either. It was totally unnecessary speculation period, to discuss how the two nurses got Ebola with the general public. Did it need to be "explained"? Shouldn't we have cared more about their health than how they got infected? Of course, one would hope further infections could be prevented, and for that reason investigate what happened, but Dr. Frieden was not on-site there in Dallas, and had no reason to start speculating. It's nice he has unfailing belief in his protocols, which he changed after the nurses' illnesses. And he certainly had no business saying Amber Vinson shouldn't have traveled when his own organization gave her the OK to do so. The fact that he may not have known that does not absolve him of throwing her under the bus in that manner.
We can all argue semantics from now till h*ll freezes a six foot crust, but saying they got it through a breach in protocol does put the blame on them, not the protocols, as in they did something wrong, because the protocols are perfect. I also find it distasteful that it's sometimes said, "they just weren't trained right" as if to mean it wasn't really their fault, they just didn't have the "training". Most nurses don't like the term "training", like nurses can't think and therefore need to be "trained". Prior to their illnesses, the CDC was referring people to a website for "training".
I've read plenty about Ebola too. I'm not so certain about the PPE stuff. And I totally do not buy the argument that since no one at the NIH, Emory or University of NE got Ebola taking care of patients, that the PPE protocols work perfectly, every time. The patients at those hospitals were much less sick than Thomas Duncan, and as I said above, they were brought in under controlled circumstances and already diagnosed.
In the case of using PPE for Ebola, training appears to be absolutely 100% necessary. Do nurses not "train" in how to do CPR? How do they learn how to do other nursing procedures, such as in the OR. Do they not practice them? Do ERs not have disaster drills?
CDC even has a three day course for domestic Ebola treatment units:
The PPE works. The people who use it are not perfect. That includes the two nurses in Dallas. I cannot say they personally "broke protocol", as opposed to not having better PPE, but you cannot say neither of them made a mistake, either.
In the case of using PPE for Ebola, training appears to be absolutely 100% necessary. Do nurses not "train" in how to do CPR? How do they learn how to do other nursing procedures, such as in the OR. Do they not practice them? Do ERs not have disaster drills?
CDC even has a three day course for domestic Ebola treatment units:
The PPE works. The people who use it are not perfect. That includes the two nurses in Dallas. I cannot say they personally "broke protocol", as opposed to not having better PPE, but you cannot say neither of them made a mistake, either.
It's more of a semantic thing, which maybe people not in nursing wouldn't understand. For years, nurses' education was called "training". Nurses went to training school. It was like they weren't being taught, they were being trained like animals to perform functions.
Nurses are educated like other professionals. And just because the CDC calls something a "training" course, that doesn't make it so. Do you not think a person could better function if they knew why they were doing something, instead of just performing a rote role as someone "trained" would do? No, I've never heard CPR called "training". It's called going to a CPR class. In fact, the whys are explained in CPR. Of course nursing skills are practiced, but you have to know why you're doing something to be able to do it well, sometimes to be able to do it at all. I've never worked in an ER; I don't know what kind of drills they do.
I don't really give a flip what Emory did. Their patients weren't as sick as Mr. Duncan, either, they knew they were coming, already diagnosed with Ebola.
As for the Dallas nurses, there is no evidence they "breached" anything except probably the limits of their patience with all the crap that's been said about them. It's idle speculation.
Cuomo and Christie are both politicizing this, just to take take the spotlight away from their other investigations. Both of them have presidential aspirations, and they are using Ebola to gin up fear. It's disgusting.
I hope that nurse sues Christie, if she has grounds, as he continually states "“But you know I feel for her,” Mr. Christie said. “I hope she recovers quickly and we’re going to do everything we can in New Jersey and in our public health system to make sure that she does.”
Problem is she is not sick.
I think it's funny the same folk would throw a fit if the government infringed on their right to have an arsenal of weapons are the same folk that think its ok to keep her quarantined when she has no symptoms and no fever.
I'd like to remind people that Cuomo is a Democrat
and Christie is a Republican
so it is not just a republican vs democrat issue
and shall i remind you people she is a CDC employee?
also to reiterate.
knowing how DR Spencer got it is a precaution to be added to the protocols to be followed.
as they said themselves they don't know how they got it.
which is a going concern especially if the virus can be spread in other ways.
they just do not have enough data and analysis is needed.
also nurses have been asking for HAZMAT SUITS for a while not.
CDC should be providing hazmat suits as asked
especially since the nurses whom were protesting for just that.
News is out that nurses are calling in sick because they do not want to care for Mr. Spencer because they have no
Hazmat suits eg equipment to deal with the problem and only
CDC equipment.
sorry CDC give it to them already. complainer CDC employee took down her linkedin profile because she was exposed.
for intentionally making this political.
unfortunately Obama overturned both the Governor's decisions.
thanks for intentionally putting others in danger.
You wont lead and refuse to let others lead...
and just want to go on stage and trying to be popular instead of telling us the truth.
I'd like to remind people that Cuomo is a Democrat
and Christie is a Republican
so it is not just a republican vs democrat issue
and shall i remind you people she is a CDC employee?
Not sure why you bolded democrat. It doesn't change my opinion. I never made a distinction, they are both idiots! I am tired of the ignorance. Lets see what we know.
No one who flew with Duncan, or nurse Vinson has been infected.
No one who came in contact with Duncan, even when he was SYMPTOMATIC was infected. ( his girlfriend, ambulance drivers, etc)
The only people who have contracted Ebola either have 1) gone to west Africa and been in contact with Ebola patients at the final stage of the disease 2) have been caretakers here in the us of someone in the final stages of the disease.
The rest is politics and hysteria. This nurse is fully capable of monitoring her temps and reporting them, just like dr spencer did. When he had a fever he notified the proper authorities.
It's sad that we are nearing flu season and now every ER is going to flip out as soon as someone comes in with a fever.
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And I am not able to make any further determination of how those two got infected. The head of the CDC did not blame Dr. Spencer or Dr. Brantly before him for a breach in protocol, just the nurses! Heck, Brantly was considered a hero when he walked off the plane. Frieden's remark was a totally unnecessary slam on the nurses, probably meant (unwisely) to reassure the public that the risk is only for people who so break protocol.
