Monday, October 13, 2014

What If Healthcare Employees Refuse?


So we have another case of a nurse contracting Ebola from her patient while she was supposedly completely protected. I guess they are saying the one in Spain did not have adequate protective gear or something but I am betting she thought she did or she would have insisted on it.

At this point it is looking like either someone's idea of adequate biological protection is way off base or this Ebola thing is spread much differently than they are thinking.

Whatever the case maybe I find myself wondering just how many "oops we were wrong" incidents it will take before healthcare employees, from doctors and nurses to aides and janitors, flip them the bird and walk away?

I am sure there are more than a few genuine hero types that will stay until they drop but I doubt it will be many overall.

I also wonder how the government would handle such a situation. Would they try and force em into working like air traffic controllers? I am assuming they can do such a thing them being considered emergency personnel but honestly I truly don't know.

What do you think?

Keep Prepping Everyone!!!

 

27 comments:

  1. I doubt its a situation any of them would want to be in. I guess they have to trust the system a bit. if they refuse I doubt they'd get paid, maybe suspended so many wouldn't be in the situation to turn it down.

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    1. Kev - Yep the slavery of debt might make force them to. Personally I have never been one to use debt much but some (most) are up to their eyeballs.

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  2. They will call in sick and have doctors that will sign the notes.
    Maybe Obama will do a photo op with a group of ebola victims since it is so hard to transmit the disease. That would lift my spirits!

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  3. If there were a widespread Nursing walk out the government already has a plan in place. A federal judge WILL order them back at work. Anyone not showing up on time would instantly be made an example, with federal contempt charges and long imprisonment without trial. If the walk out was massive with all or most staff involved, federal and most state governments will simply send the NG to the homes of the staff members, heard them up in trucks and hold them at work at gun point , the "leaders" or "resistors" will simply be shot in front of the others. If you think I have a tin foil hat then you better re-think as this is all actually taken from a published government Bio-War response manual from the '60s. IMO, "isolation zones" will very ,VERY quickly morph into death camps, ether intentionally or by accident . Just look at what happened after one week with healthy people shut up in a stadium after Katrina. Now think what government will do with a compound full of sick they cannot treat, feed, guard, or safely move. A "walkout" is just the least of the problems government is about to create---Ray

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    1. Ray - Interesting. I can see the gov guys wishing for that kind of power but it does beg the question what if the guard refuses as well.

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    2. Ray, I was a teenager during Vietnam. I remember watching how some of my female relatives in the medical profession who had desired skill sets were "enlisted" much as my male relatives were drafted. I do not recall what the term was they used, but it was pretty much compulsory service in the military, just as if they had been drafted. I watched & learned. That is one of the major reasons why I am a retired NICU RN, and not an ER RN, ICU RN, etc. My skill set is of no use to anyone over the age of 30 days of life. During wartime, the OBs & the pediatricians pretty much hold down the fort at home, because their skill set is not useful for combat.Same with the nurses.

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    3. Marivene - That is a very interesting and helpful insight. I never knew about that turn of events nor thought on the specialty side of nursing etc.

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  4. My contact at UAMS, where all of Arkansas' Ebola patients will be hospitalized tells me that there is a lot of grumbling about the ward that the directors of the hospital have selected. It is small, and there are other better equipped wards (think: negative air pressure and decontamination areas) to handle the patients. My contact told me that a lot of the nurses will simple walk out and quit because "they don't get paid enough and RN jobs are easily obtained".

    Staffing will be a problem. The mobile radiographers have also expressed the same sentiment, except that the jobs are not as readily available. I imagine that the feeling will trickle all the way down from the RNs, doctors, PTCs, x-ray techs, lab techs, and every other person involved. IDK what the ratio is, but I imagine that it is about 50-75% of the staff will quit rather than work with the infectious Ebola patients.

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    1. Oh, and I've also seen plenty of nurses get very complacent about not follow protocol.

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    2. K - What would be the chance of them including those like you or even clerical staff and demanding/ordering them to act as aides?

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    3. Legally, a hospital in the US cannot make you work outside of the limits of your license. A "nurse" has to have a nursing license, or be certified as a medic or EMT, etc. A clerical person cannot be made to give patient care, unless they hold a license to do so - - like a clerk who happens to also be an EMT or a CNA. Many unit clerks in hospitals are required to be CNAs or EMTs, for that very reason - - so they can give patient care.

      It is not the same in other countries. In some of them, an RN is an RN & they can send a nurse from the pediatric floor into the OR if they have a shortage, but not here.

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    4. Marivene - Good points all. But could they simply ignore the specialty restrictions and force nurses to other departments? Could they expect clerical people and techs to act as non-certified aides or orderlies?

      Would they?

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    5. PP, the restrictions are not on the license for an RN, they are in your certifications. Every area requires certain certification to work there. In NICU, common requirement are BLS, STABLE (a transport certification), and NRP ( a resuscitation protocol). Adult ICU, ER and MedSurg often require ALS, etc. In addition, every Jan-Mar, US hospitals spend an insane amount of $$ making all the nurses take online courses. Ours were called "Healthstream", and were universally hated. If a nurse did not complete the online courses by the deadline,they could not work until the courses were completed. To then try to force individuals to work in an area outside their documentented "competencies", would be to throw open the doors & put up a sign that said "sue here". The hospital could lose its certification, at which point the doctors would depart.

      However, in most hospitals, RNs are required to "float" to other areas with common competencies when their "home area" census is low, if the other area needs an RN. For NICU, we could float to post partum, taking babies only, or to peds, taking children less than 1 year old, (and those areas were floated to us when our census exploded), UNLESS we had previously worked in an area where we had adult competencies that were documented, or unless we had requested to be "cross trained" to another area. I foresee mandatory "cross-training", then floating as a requirement after the training. Small rural hospitals already do this. If one were of a mind to depart, the time to do so would be BEFORE completing the cross training.

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    6. Marivene - I see. Thanks for explaining that. I guess what I wonder is though how bad does something have to get before necessity throws all the red tape to the wind.

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  5. PP,

    Biggest problem I see is we are dealing with a BSL-4 agent. But almost all the medical staff, both here and in Africa are using BSL-3 gear in trying to deal with this. The consequence is infections among the medical staff. Damn! I wonder why????

    Add in the CDC is lying through their teeth about the severity of this virus. The maroon spokesman says "there was a breach of protocol." Well, no shit, Sherlock, we are dealing with a highly infectious level 4 biological agent. Too bad the CDC cannot figure this out. US hospitals have almost zero capacity to deal with level 4 agents.

    Then I have to add in the .gov holds a patent on the virus and since natural organisms cannot be patented that tells me we are dealing with a GMO organism at best or a weaponized virus at worst. PLUS the CDC holds the patents on vaccines for Ebola and Hark, such magic...they are ready for human testing. I damn sure smell a horde of rats here.

    Oh, lest you think I am blowing smoke here, I earned a PhD in Microbiology and worked several years in viral infections.

    Winston

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    1. Winston - So you think this is an event that has gotten out of control? On purpose? If it was genetically made wouldn't they know what level was needed for sure or maybe it got out of control and mutated?

      You present some interesting questions.

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    2. Winston gives good details. This is the story as I have come to understand it as well. We don't really have the capability of dealing with Ebola or any other class of diseases that require these precautions at the general hospital level. Your talking germ warfare research levels of protection.

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  6. How exactly do you force people to care for other sick people? If a nurse or doctor decides they place more value of their own life than that of the sick person, what can the govmint realisticly do? They cannot force anyone to think or act except at the point of a gun. That seems somewhat self defeating. Even soldiers can and most likely will simply sat no. Heck, I would raher be alive to face the music rather than listen to it from my body bag. If a mass refusal actually does occur, stand back and get your tyvec suit on, it will lead to total SHTF. JMHO

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    1. Anon - I imagine one way to force most people would be the threat of immediate financial repercussions. The government loves to start soft and then go hard like requiring all staff to stay on location and then the next morning finding themselves barb wired in with guards or something like that. Not saying it will happen nor will it be legal but....

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    2. Anon, without a license, a nurse or a doctor cannot work. The powers that be can pull that license. For a nurse, the operative phrase would be "for unprofessional conduct". Those updates every year or two to keep your license current are mailed to your house, so they know where you live. In both UT and ID, it is a requirement to keep the DOPL (Dept of Prof Licensing) informed of your current address, if you hold a Professional License of any kind. As PP pointed out in a response higher up on the thread, if they jerk your license, you have no way to pay your bills... even, so, I would imagine a small number of individuals would change clothes & manage to make it outside. It's not like nurses are famous for parking in the employee parking lot.

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  7. Several months ago, I saw "The Hot Zone" on a library sale shelf, bought it, and read it. I highly recommend it. It is nonfiction. Little did I know at the time, what was described in the book would be coming here.

    Right at the beginning, the procedure for going from outside to Level 1, 2, 3, and finally 4 is detailed.

    Ebola is a Level 4 agent. Shortly after Duncan was hospitalized, I read somewhere that the hospital was following Level 2 protocols, which are completely insufficient for Ebola. All I can figure is that they were doing what the CDC told them to.

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    1. Miss M - Sounds like a good read I will try and find it. I believe you are right the CDC has been underplaying it and the hospitals listened.

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  8. Anon - The government thinks it can do whatever it wants because it has not been sorely tested in recent years. Not sure how long they could control such a task if people were dropping like flies around them though. Still you do have a valid point.

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  9. From what I read today ( which I don't believe much of anything I hear, see, or read these days) but Duncan was vomiting and having the major squirts before they were even treating him for Ebola and protecting themselves from Ebola. I hope that is true and they just royally screwed up :/

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    1. Kelly - They more than likely were buying into the line that it couldn't come here. Trusting governments will get ya killed.

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