GetMeOuttaThisMess Posted October 2, 2014 Share Posted October 2, 2014 Dallas is getting to play the Ebola game now and this raises a question that I've always wondered about. If there were an actual epidemic outbreak in your locale, would you show up to work and assume the personal risk? For myself, I'm old enough to be able to say that it's been a good life, my family is taken care of should something happen to me, and for me personally, this is what I signed up for. Would I be happy about it? No, but again, I knew the potential consequences when I made the decision. It really isn't any different than enlisting in the military during an active conflict in my mind. For those wanting to enter the field of medicine, you really need to think long and hard about this, IMO. Link to comment Share on other sites More sharing options...
Acebecker Posted October 2, 2014 Share Posted October 2, 2014 My wife will likely have something to say about it, but yes. Yes, I would still show up to work my scheduled shifts. I would wear lots of PPE, but I would be there. I think the bigger question is this: do any of us have any idea how to stem the spread if a patient has suspected ebola? Our local critical access hospital has 2 rooms CDC rated to handle ebola. None of them are in the ED. So, do we set up a special tent city in the parking lot if it gets to that? These are the things we're working through - even we small communities need to have a plan if it shows up on our doorstep. Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted October 2, 2014 Author Share Posted October 2, 2014 These types of issues are covered in the federal government disaster life support classes, BDLS, CDLS, and ADLS. To answer your question, typically if resources allow, patients would be triaged through an outside structure (tent) and then processed through into the ED in a controlled environment manner. These classes are actually interesting, and with ADLS you get to fully gear up and go through mock casualty situations. The one time I took it we had a drill outside a community college campus with bodies lying everywhere. Link to comment Share on other sites More sharing options...
Acebecker Posted October 2, 2014 Share Posted October 2, 2014 That's awesome. I would definitely feel more prepared if I could get that kind of training. Link to comment Share on other sites More sharing options...
UGoLong Posted October 2, 2014 Share Posted October 2, 2014 For those of you who were there at the onset of HIV, you'll remember that some of the same questions were asked. I was just starting in EMS at the time, before gloves, when medics still stuck dirty, unretractable needles into seat cushions, and we sometimes did mouth-to-mouth on kids while waiting for our equipment to show up. Clearly things had to change and change they did. Now we have decent Hazmat training and carry full PPE on the truck. The hospitals where I work as a PA have emergency procedures, vaccinations, stand-by prophylactic antibiotics, etc. My family would expect me to take precautions and not throw myself on a grenade, but I'd show up. Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted October 2, 2014 Author Share Posted October 2, 2014 Same here. Gloves? Who needs gloves? Put your hand with gauze over it and apply pressure. The early 90's HIV explosion had everyone concerned in EDs. Wasn't even in my lectures in school because we didn't know of it yet (early 80's, when we were "assistants"). Link to comment Share on other sites More sharing options...
Moderator True Anomaly Posted October 2, 2014 Moderator Share Posted October 2, 2014 I live and work in the middle of Dallas, and yes I showed up for my shift yesterday. No, I didn't go haywire with mask and gown, but I always wear gloves with every patient encounter anyway, and clean my stethoscope between each patient with those sanitary wipes- I did this long before the Ebola patient checked in down the street. And no, I haven't yet had any known/possible exposures show up to me. Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted October 2, 2014 Author Share Posted October 2, 2014 I was actually asking more about a hypothetical XYZ disease that appears on our doorstep with widespread illness. I was curious if in this situation others would actually show up to provide patient care? Link to comment Share on other sites More sharing options...
Acebecker Posted October 2, 2014 Share Posted October 2, 2014 Have you seen contagion? I think in an apocalyptic disease state, I would be at work initially. As things degraded, however, isolating myself would probably occur at some point. Link to comment Share on other sites More sharing options...
PACdan Posted October 2, 2014 Share Posted October 2, 2014 As long as the supplies and equipment were still there, I'd come in. If you show up and the cupboards are bare (no PPE, no sanitation/trash service, linens, etc.) it's time to book it. You're no longer "safe" and neither is anyone you attempt to treat. That would be a very drastic scenario. Link to comment Share on other sites More sharing options...
myironlung Posted October 3, 2014 Share Posted October 3, 2014 hell no, my job is not worth my life Link to comment Share on other sites More sharing options...
cinntsp Posted October 4, 2014 Share Posted October 4, 2014 The movie Outbreak, which was loosely based on ebola, was the first thing to get me seriously interested in science and medicine. I wanted to be a virologist for a long time afterwards. I guess it would be lame of me to not tackle this situation head on. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted October 4, 2014 Moderator Share Posted October 4, 2014 I would go to work just like I did in the 80s when HIV was new. We used to take care of HIV+ pts in the E.D. because no one would see them in the office. took care of a bunch in the early 90s as well when I was a medic and we still didn't know much about it. I may actually go to africa and volunteer there if I can swing it. see my ebola thread today. Link to comment Share on other sites More sharing options...
CAtchall Posted October 5, 2014 Share Posted October 5, 2014 Several things. If I had my current position, tech on medsurge, no I would not show up. I would be the one responsible for cleaning up all the linens and accompanying body fluids. The nurses would show up and give mess then roll out-like now. On a side note: I would likely show up begrudgingly. Every time we have had TB, lice, shingles, flu, or insert random disease I've shown up. At least from what I've seen at my current hospital, housekeeping and materials management would be the first people to bug out. Even mid week they don't have enough people show up to stock linens, let alone servers or anything else. Lastly, as a PA I would show up. Weird I know. Showing up as a pa means that people will actually receive care. Providing care is a huge reason that I'm becoming a pa, since you never know the difference that every person saved can make. Link to comment Share on other sites More sharing options...
PACdan Posted October 5, 2014 Share Posted October 5, 2014 Several things. If I had my current position, tech on medsurge, no I would not show up. I would be the one responsible for cleaning up all the linens and accompanying body fluids... ...Lastly, as a PA I would show up. Weird I know. Showing up as a pa means that people will actually receive care. Providing care is a huge reason that I'm becoming a pa... Changing linens IS providing care. It doesn't have all the glory of dx and tx, but it's still care and in many cases just as important to the pt. Never forget that. Link to comment Share on other sites More sharing options...
CAtchall Posted October 5, 2014 Share Posted October 5, 2014 Changing linens IS providing care. It doesn't have all the glory of dx and tx, but it's still care and in many cases just as important to the pt. Never forget that. While that is true, it does not mean that I don't resent some of the nurses who never help with any of those tasks or adls. As written, I would show up Bc I know how much every bit counts. It just sucks being so low on the ladder and not getting any help. Link to comment Share on other sites More sharing options...
PACdan Posted October 5, 2014 Share Posted October 5, 2014 While that is true, it does not mean that I don't resent some of the nurses who never help with any of those tasks or adls. As written, I would show up Bc I know how much every bit counts. It just sucks being so low on the ladder and not getting any help.I feel you on that. Some thought they were above such a lowly task. I see providers who think the same. I never want to develop that kind of thinking. Link to comment Share on other sites More sharing options...
CAtchall Posted October 5, 2014 Share Posted October 5, 2014 I feel you on that. Some thought they were above such a lowly task. I see providers who think the same. I never want to develop that kind of thinking. Agreed. I think that is a strength of the pa profession. From my experience it cultures more of a team attitude as opposed to a ladder of delegation. Link to comment Share on other sites More sharing options...
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