Nurses Say U.S. Hospitals Aren't Adequately Prepared To Handle Ebola Patients

Any hospital with a private room and bathroom is technically adequate for isolating and treating an Ebola patient, according to the Centers for Disease Control and Prevention. But to truly remove the risk of contracting the deadly virus among health workers requires meticulous work and years of repetitive drills and practice, according to nurses on the ground who also say that they are not receiving the proper training to protect themselves and their communities.

"We’ve been asking for training for protocols and we have not gotten it,” said Katy Roemer, RN, a nurse at Kaiser Oakland and a member of National Nurses United. "Pieces of paper are being handed to us with minimal instructions on it, and it’s not adequate to deal with a virus like Ebola.”

Roemer’s experience is reflected thousands of times over in a survey conducted by NNU, which asks more than 2,000 nurses if their hospital has adequately prepared for Ebola. Seventy-six percent say their hospital hasn’t told them about any admission policy for Ebola patients. Eighty-five percent say their hospitals haven’t provided a forum for nurses to ask questions about their Ebola protocols.

One day after confirming that nurse Nina Pham contracted Ebola through her work caring for Dallas index patient Thomas Eric Duncan, CDC Director Dr. Tom Frieden admitted that hospital staff training and protocols needed to change.

“We have to rethink the way we address Ebola infection control, because even a single infection is unacceptable,” said Frieden during an Oct. 13 press conference. The CDC is conducting a detailed investigation to figure out how Pham could have become infected. “If this one individual was infected and we don’t know how within the isolation unit, then it is possible for other individuals to be infected as well,” he concluded.

Pham is now in isolation at Texas Health Presbyterian Hospital Dallas, and the CDC is working with staff there to figure out exactly what went wrong.

Disturbingly, a portion of nurses also described U.S. hospital conditions that mirror conditions that prevent developing countries from defeating Ebola. Thirty-seven percent say they don’t have enough eye protection supplies, 36 percent say there aren’t enough fluid resistant gowns, and 39 percent say their is no plan in place to stock isolation rooms with plastic covered bedding or discard linens after use.

Public health officials are looking to one of the only programs that has gotten it right: the Biocontainment Unit at Nebraska Medicine that treated Ebola patients Dr. Richard Sacra and NBC cameraman Ashoka Mukpo.

The Nebraska facility is one of only four hospitals with a biocontainment unit built especially for receiving patients with infectious diseases and bioterrorism victims. Nebraska's unit is the largest in the country, with features like separate doors for entrances and exits, a staff decontamination shower, a negative air pressure system that prevents air in the patient’s room from escaping to other parts of the hospital (although Ebola isn’t an airborne virus), and a laboratory within the biocontainment unit itself, so that infectious samples need not travel long distances to labs throughout the hospital.

Their efforts have been led by nursing director Shelly Schwedhelm, MSN, RN, who offered some advice during her own Oct. 13 press conference. While she acknowledges that other hospitals may have the equipment needed to safely treat Ebola patients, they may not have the human resources required to keep all healthcare workers safe.

For instance, Schwedhelm said one of the most important safety measures at Nebraska Medicine are full-time staffers solely dedicated to supervising healthcare workers put on and take off personal protective gear like gowns, gloves, and face masks.

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