Most RNs Say Hospitals Still Not Done Proper Training, Education for Confronting Ebola

In the tragic wake of the death of Thomas Eric Duncan in Dallas from the Ebola virus, registered nurses who would be among the first to respond and interact with other patients possibly infected still say their hospitals are lagging, according to survey responses from more than 1,700 registered nurses across the U.S.

National Nurses United says all U.S. hospitals should immediately upgrade emergency preparations for Ebola in this country -- and nurses and the public are also asking why there are only two hospitals in the U.S., one in Atlanta and one in Nebraska, that appear to be fully capable of caring for patients infected with the Ebola virus.

“Nurses know that what is critical now in the face of this deadly disease is to spread readiness, not fear. It is Ebola today, but other infectious diseases are not far away. All hospitals need to take steps now to protect patients, frontline caregivers, and public safety,” said Bonnie Castillo, RN, who directs NNU’s disaster relief program, Registered Nurse Response Network.

Several weeks ago, National Nurses United began surveying registered nurses across the U.S. about emergency preparedness.  Most of the nurses are telling NNU that they remain unaware of proper preparation for the Ebola virus.

As of Wednesday morning, more than 1,700 RNs at hundreds of hospitals in 35 states have responded to the NNU national survey.  Notably, the number of RNs responding has nearly quadrupled since the news of the Dallas case – and yet the overwhelming number of RNs voicing concern over lack of preparedness at their hospitals has showed virtually no improvement.

Current findings show:

• 76 percent still say their hospital has not communicated to them any policy regarding potential admission of patients infected by Ebola
• 85 percent say their hospital has not provided education on Ebola with the ability for the nurses to interact and ask questions
• 35 percent say their hospital has insufficient current supplies of eye protection (face shields or side shields with goggles) for daily use on their unit; 36 percent say there are insufficient supplies of fluid resistant/impermeable gowns in their hospital
• 39 percent say their hospital does not have plans to equip isolation rooms with plastic covered mattresses and pillows and discard all linens after use; only 8 percent said they were aware their hospital does have such a plan in place

NNU is calling for all U.S. hospitals to immediately implement a full emergency preparedness plan for Ebola, or other disease outbreaks. That includes:

• Full training of hospital personnel, along with proper protocols and training materials for responding to outbreaks, with the ability for nurses to interact and ask questions.
• Adequate supplies of Hazmat suits and other personal protective equipment.
• Properly equipped isolation rooms to assure patient, visitor, and staff safety.
• Proper procedures for disposal of medical waste and linens after use.

 “Handing out a piece of paper with a link to the Centers for Disease Control, or telling nurses just to look at the CDC website – as we have heard some hospitals are doing – is not preparedness. Hospitals can and must do better, and we should have uniform national standards and readiness,” Castillo said.

The Dallas case, where the infected patient was sent home after arriving at the hospital, hardly provides any reassurance, said NNU.

Media reports have indicated that the Dallas patient’s exposure was not properly communicated to hospital staff.  But, Castillo added, it’s not just a failure to communicate, but also a reminder that hospitals should not just rely on automated protocols with computerized scripts for interacting with patients.

“It’s time to move from the electronic computer plan to a national healthcare action plan,” said Castillo. “We have the expert nurses and physicians, we have to train and drill with the whole team, from triage to treatment to waste disposal.”

“As we have been saying for many months, electronic health records systems can, and do, fail. That’s why we must continue to rely on the professional, clinical judgment and expertise of registered nurses and physicians to interact with patients, as well as uniform systems throughout the U.S. that are essential for responding to pandemics, or potential pandemics, like Ebola,” Castillo said.

NNU is also calling for significant increases in provision of aid, financial, personnel, and protective equipment, from the U.S., other governments, and private corporate interests to the nations in West Africa directly affected to contain and stop the spread of Ebola.