I'm a nurse and I took the Nightingale Pledge.

[Avalux]

"I solemnly pledge myself before God and in the presence of this assembly, to pass my life in purity and to practice my profession faithfully. I will abstain from whatever is deleterious and mischievous, and will not take or knowingly administer any harmful drug. I will do all in my power to maintain and elevate the standard of my profession, and will hold in confidence all personal matters committed to my keeping and all family affairs coming to my knowledge in the practice of my calling. With loyalty will I endeavor to aid the physician, in his work, and devote myself to the welfare of those committed to my care."

I have these plane tickets and really want to go visit my family and not be stuck here alone with all this time off. Chances are, I won't get ebola. I mean, it's probably safe to go, no one is insisting I stay home and isolate myself. But -- I watched a person succumb to ebola infection and I know how horrific it is. I will do whatever I can to help stop it in it's tracks. If there's even a remote chance I might be infected with ebola, I won't risk exposing others to it, even if I might be personally inconvenienced. For the good of all.

[Avalux]

5. It's what I would have done, in the same situation.

I would have stayed put.

[FarPoint]

105. Absolutely!

I posted a few days ago that Amber knew in her heart that she should not go...her clinical instincts alone were telling herself just that, don't go, stay put. A real clue was how she contacted the CDC several times ..sort of needed repeated validation that she could leave while her instincts said don't do it.

[MoonRiver]

2. If only....

[uppityperson]

3. Are you one of the nurses in Dallas who worked with MrDuncan?

I am not sure of what you are saying here. Thank you.

[Avalux]

4. No I am not.

My post is in response to another, which tries to explain Vinson's reason for traveling in the first person; as I have done here. I was offended by it; as nurses (or any healthcare professional) should never risk the public health for personal reasons.

[uppityperson]

7. Gotcha, thanks.

[w0nderer]

11. -strike nurses- -insert good citizen/population-

A good citizen/person of population/human race shouldn't go to contagion spreading spots if they believe themselves to be carrying or in extreme cases 'could potentially carry' a disease even down to and including flu.

respects to you!

not healthcare worker but i _care_ about the _health_ of people i work with and contact frequently (store clerks, strangers and so forth included)

[Avalux]

24. Thank you.

If everyone thought this way, it would be easier to contain disease outbreaks. I'd want you on my team!

[w0nderer]

41. Makes sense though doesn't it?

even just with cold or flu

1 person comes in on nyquil / dayquil (still spreading it) and self running at less than 50% capacity

vs...stay home a few days more (or call doctor)

respect vs selfishness

*bows* if i had the training i'd be honoured to be on that team

edit :::
did not mean to compare ebola (or other major diseases) to flu (although having read the wonders of spanish flu ...)

it's one of those personal responsibility vs 'i can do what i want' things

[PuraVidaDreamin]

60. We get counciled if we call in sick

And this is placed in " our files" we are told.
Management has never been more punitive and
We nurses have never felt so threatened, even having
A union. The union doesn't have the strength it once had,
And this just tickles management.

They don't care if you have the flu!
Show up! They don't care if you have a sick
Family member, just get your ass to work.

Me, I don't care if I get counciled, or they put a letter into my file.
But most of my other co-workers are scared to death.

[uppityperson]

83. I had influenza yrs ago and was told to come to work and just wear a mask, while taking care of

a quadriplegic kid on a vent. I refused and almost lost my job. Better my job than giving it to my patient. I hope more employers realize the trouble this can cause, and allow people sick days.

[w0nderer]

111. respects! i hope so too

lack of sickdays will eventually lead to problems in the US

good on you for refusing to risk patient

actually (outsider/insider) view (legal resident)
lack of sickdays OR lack of access/stigma of 'free access' (imagine 1 homeless person being given a dollar bill from an ebola symptomatic person) they won't ask for help, they won't show up on 'radar' but they do take care of their own (spread it)

[w0nderer]

110. Not doubting, that's ridiculous though

then again my boss wants me to do the same

wonder if written orders would work?

please give me a written order to come in , and spread contagion to immunity damaged people

funnily in most countries of this world a nurse refusing to spread contagion would be 'applauded'

[moriah]

16. Then why aren't we quarantining health care workers who work on Ebola patients?

If you're so offended by the ***CDC*** telling her she could visit her family, when she dutifully reported her symptoms and her "fever" (99.5 is not a clinical fever, which as a nurse you should know), and by her acting based on the instructions of the #1 health authority in the US, then maybe you should start advocating for that.

Would you stay 21 days in an isolation ward to protect the populace? Because really, that's the only way to stop the threat of nosocomial infection of medical staff infecting the rest of the country.

[Avalux]

19. Where? In Africa? And yes I would.

I'm not sure what your last sentence means.

[moriah]

34. What I meant is, medical workers catching Ebola in the hospital from hospitalized patients...

.... and potentially spreading them.

The only way to stop it would be to have every person who comes into contact with an Ebola patient, or their lab samples, or their biohazardous waste, isolated for 21 days after care stops.

Otherwise, people are going to go to the grocery store, may not report their fever correctly, may be told by stupid agencies that they're cleared to travel, etc.

[Avalux]

40. There's definitely risk involved without enforcing quarantines.

Unfortunately, a lot of things went wrong in this particular situation with Mr. Duncan and Texas Presbyterian Hospital.
Docs without Borders have treated thousands with a rare transmission; but they are absolutely vigilant when it comes to infection control. I really hope this can be a learning experience.

[moriah]

72. Patients w/ Ebola really need to be quickly moved to hospitals with people trained in dealing with..

.... suiting up properly, de-suiting, handling lab samples correctly, etc.

The ward at Emory was designed for exactly such infections, and I'm glad this nurse is there.

[Avalux]

74. Here's the problem with that.

We have four facilities in this country that are fully equipped to handle patients with an RG4 infectious disease....combined, there are only 8 beds TOTAL. Emory has a 2 bed capacity, I believe.

Part of the problem is what to do with the waste from these patients. It's such a messy disease, and clean up amasses a lot of material. Just having one patient, where everything including waste must be autoclaved, takes a tremendous amount of resources and manpower.

[KMOD]

80. Indeed! Great post and point! n/t

[moriah]

108. Then train health care workers better. And right now, we have less than eight cases.

At least one hospital in each state should have trained their people on the full procedures long before this, and if nothing else, should be drilling health care workers now. Have cases transferred to that trained hospital.

If DWB can do the proper suiting/desuiting protocol with primitive facilities, we should be able to train workers in modern facilities to do the job. But expecting untrained workers to suit up perfectly, and get out of their protective gear safely, is unrealistic. It's a danger to the workers that needs to be addressed, and a danger to the rest of society as well since they aren't being quarantined as an alternate precaution.

Sure, it's money to train people. It's more money to build a wing in a hospital in each state designed to handle RG4 diseases. But I think the training, at least should be given, and drills conducted, at at least one hospital in each state. In mine, it'd likely be the University of Arkansas for Medical Science, our major state-funded hospital and medical school.

[FarPoint]

106. Me too! I felt a twinge of embarrassment.

I am a health care provider.

[enough]

6. "For the good of all." The defining concept of civilization.

But unfortunately, not the world in which that young nurse has grown up. She has grown up in a world where the most powerful voices in society are telling her that "the good of all" is a concept only for communists and chumps. She has worked in an environment where "the good of all" is so totally subordinated to "profit for some" that it may well be she cannot even understand what "the good of all" means.

I don't say this to denigrate her, or to argue with you.

[calimary]

9. God, enough, you just made a really profound AND foundational statement.

This absolutely cuts to the heart of our collective plight in this country:

"But unfortunately, not the world in which that young nurse has grown up. She has grown up in a world where the most powerful voices in society are telling her that 'the good of all' is a concept only for communists and chumps. She has worked in an environment where 'the good of all' is so totally subordinated to 'profit for some' that it may well be she cannot even understand what 'the good of all' means."

We've been deliberately and pointedly indoctrinated with this for more than THIRTY YEARS... being told that "the good of all" is a "concept only for communists and chumps." And I would add the ever-popular "lazy moochers" to that equation, also.

http://reclaimdemocracy.org/powell_memo_lewis/

[DiverDave]

20. If I could rec a post, yours would be

Spot on, nailed it, use any other you can think of.
I have been called a chump simply for doing the
Right thing, returning money for a survey on a car
We ended up taking back as the baby seat
wouldn't fit, giving food and money to people
that others deemed "scammers"
Things that would make me a poor fascist

[Avalux]

22. Good post, thank you.

It is unfortunate. We are reaping the ill effects of a world based on competition, not cooperation.

[Tumbulu]

91. So well said!

[w0nderer]

42. +1 (n/t)

[Eleanors38]

112. ^^^ Health care workers are like good soldiers:

They head into danger, not away from it.

[magical thyme]

8. I presume that means that after you cared for Mr. Duncan, you refused orders

to go care for other patients in the hospital, possibly carrying even a micron of infectious body fluid to an immunocompromised patient. Correct?

And that as a result, you were fired after you refused to care for other patients after leaving Mr. Duncan's room?

And I also presume that when you were told to self monitor and report any fever, you did so. And that when you were assured that your 99.4F temp was not a symptom of Ebola so not to worry, you figured you know more than the state authorities you were reporting to and turned yourself in immediately to the ED, correct?

I understand your point. I also understand that the nurses involved were given very mixed messages about the risks involved and were working in horrendous conditions. They were provided with totally inadequate PPEs for days, required to care for other patients in the hospitals after leaving Mr. Duncan's room, collecting specimens and sending them through the pipeline without any special precautions thereby potentially contaminated other patient specimen containers, and more.

[Avalux]

10. If I had been given a totally inadequate PPE, I would have quit.

Because if I knew that, I would not have been able to care for Mr. Duncan, then other patients as well, because I might have been exposed. And knowing that, I would not be able to quit and remain quiet. I would have spoken up - LOUDLY.

I am not blaming the nurse; we've never been in this territory. But it's always best to err on the side of caution when the unknown is a matter of life or death, and not just take orders.

[Texasgal]

14. How do we know what Amber's mind set was?

I personally believe that she traveled before hearing about her colleagues prognosis and then became concerned once she heard and had already traveled. She did the RIGHT thing or so she thought by calling the CDC to be find out if she was cool to travel.

This nurse bashing has gotten out of control! Ebola is not something anyone here has dealt with and she was given the wrong tools and the wrong info in order to protect herself. She also VOLUNTEERED to care for Mr. Duncan. I can not think of anything more gracious.

If anything I have the up most respect for these nurses... more so than any of the other doctors or administrators that didn't protect her.

If you are a Nightingale oath-er than you should be FURIOUS at how she has been treated!

[Avalux]

17. Read my other posts in this thread.

I applaud her for volunteering to take care of Mr. Duncan, she has a good heart and I'm not bashing her. BUT, she doesn't have any common sense. I would never have traveled after caring for him with inadequate equipment.

[KingCharlemagne]

62. Ah, but would you have cared for other (non-Ebola) patients after caring for Duncan with

inadequate equipment?

That's what the management directed her to do, in the process delivering a message that she really had nothing to worry about, just as everyone else was saying.

[Avalux]

68. As I stated above, I would have quit.

I don't care what they ordered me to do. I would have quit and sounded an alarm. People in end stage ebola infection are MESSY. Without the proper equipment and not just that, but proper training and vigilance when donning and taking off the equipment, infection can happen, and infection can be spread.

[Texasgal]

93. Common sense is not an issue here.

She was NOT trained by her administrators. Dammit! Put the blame where it belongs!

What hospital in the USA had any "common sense" or ANY training on Ebola??? Only a few...right?

[Avalux]

96. Sorry, but I won't blame the adminstrators and absolve her.

There's plenty of unfortunate decisions to go around. The information about ebola, how it is transmitted, and the necessary precautions are not a secret that only the administrators could pass along to her. If all people do is follow orders, there really is no hope.

[Texasgal]

98. what orders did she not follow?

Seriously, she was not given the correct gear to protect herself. What training should she have followed??

[Avalux]

100. Perhaps she could have used her critical thinking skills to find out for herself.

I would have researched the hell out of it on my own to ensure that what I was given to wear was correct. Wouldn't have been hard to do.

[Yo_Mama]

109. She didn't know it was inadequate PPE

It conformed to CDC guidelines. Look, everyone at the top level kept saying this could not happen.

She did go on that trip before the first nurse's infection was announced. That announcement came as a shock to her, and then when she contacted authorities, she was STILL told she was okay.

None of this - NONE OF THIS - was the nurse's fault. Nurses care for acutely ill patients with severe and contagious infections all the time. They were told - EVERYONE was told - that standard, contact, and droplet precautions were sufficient.

She would not have taken care of other patients had she believed she was potentially infectious, and she would not have gone to her family, friends and fiance if she suspected it. Further, she knew that the first providers (first ER visit), the ambulance personnel and the family weren't showing signs of infection. It was logical for her to believe that the personnel using infection precautions were at a lower level of risk than they.

Everyone looking at this is using what they know now as a risk filter. Yeah, CDC shouldn't have told her to fly. But they did. And if a nurse can't trust the federal agency who sets the guidelines as to protect the public, then a nurse has NOTHING in which to trust.

If she hadn't gotten on that plane and instead had gone to a local ER, the odds are high that she would have been turned away without being tested. Because the local ER would have also made the same calls, and one would have to assume that they would have gotten the same response. Because, on that day, and even now, the official CDC guidelines are that a health care worker exposed to an Ebola patient while using standard, contact and droplet precautions HAS NO RISK.

[magical thyme]

15. I agree with you. Especially as both nurses seem to have had good support systems

behind them.

But we weren't there, we aren't steeped in that hospital's culture and we don't know what they were being told or what threats were made. We do know that all the nurses have been threatened to remain quiet and those that did speak out, did so anonymously with the help of the nurse's union, except for one who just went public I think yesterday.

And it's easier for me to say that now, at age 61, because I've learned not to trust "authorities" the hard way and I'm so close to being able to collect social security that I'm finally giving up and saying fuck it. I don't know what I would have done at 29. I was a lot more gullible back then. And I know that even at my age I've put up with more crap than I should have because I needed the money to keep a roof over my fur-family's and my heads.

So I can't call her an idiot or selfish or anything else other than very misguided. My understanding is that she reported her plans and temp to the state official, that the state official went to the CDC and then called her back and told her she was cleared to travel.

[Ilsa]

18. Suddenly quit? In Texas, a nurse might be threatened

with patient abandonment, even though it isn't true and doesn't meet the strict legal test. But the employer might threaten it. You'd have to be prepared to do battle.

[Skittles]

12. THANK YOU AVALUX

the people defending that plane trip are CLUELESS

[Avalux]

13. I think they don't have an understanding.

There's a level of personal responsibility unique to being a healthcare worker, it's not just a job. You know that your actions could adversely impact the health of others. Maybe those defending the plane trip don't understand that.

[Skittles]

21. in their zeal to demonize the hospital management and the CDC

(VERY much deserved) they relieve the lay folk of the duty to behave in a responsible manner - if anything has been learned it is that some people will do no such thing - the idea this gal really had to continue with her out of state wedding plans is utterly ridiculous

[Avalux]

25. I agree with you completely.

There are also people who decide to be a nurse (or a doc for that matter) for the sole reason of good pay and they can usually always get a job. But that's a discussion for another time.....

[Skittles]

101. I always saw being a nurse, like being a teacher, a calling

not something you can just do for other reasons

me, I've donated 50 gallons of blood products but get squeamish watching medical shows

[MissDeeds]

23. You are an angel on this earth

Thank you for your service to the sick and those in need.

[KMOD]

26. I get what you're saying,

and I'm sorry you were offended.

Going by everything we know about Ebola, and how it is transmitted, do you believe she exposed anyone? She was still asymptomatic when she flew. Unless you believe something about the Ebola virus has changed.

I understand there is a certain panic with this situation, and because of that, some have taken the abundance of caution to almost an absurd extreme. Geez, it seems everyone has gone from no biggie, to OMG at the CDC in their contact tracing.

We still haven't found that ''in between'' mode that is so desperately needed.

[Avalux]

27. There were two decision points.

The first, making the decision to fly to Cleveland in the first place. The second, having a low grade fever and making the decision to fly back to Dallas (after the ok from a person on the other end of the phone who wasn't able to TAKE her temp).

So at either of those times, she could have decided to not go. If I had cared for an ebola patient with questionable equipment and then started to get a fever, I would have called the CDC, told them where I was, and to get someone there immediately. But I wouldn't have gone in the first place.

[KMOD]

28. She reported her low-grade fever

to the CDC via the Dallas Health Dept., multiple calls I believe. The Cleveland Clinic is also right there.

But again, I'm asking, do you believe she exposed anyone based on what we know about Ebola transmission?

[LisaL]

30. Fever is a symptom. She was symptomatic.

[KMOD]

35. heh, this could change to another discussion

What is the fever threshold for Ebola. It's been lowered I understand, but her low-grade fever was still below the "new threshold".

[Ms. Toad]

81. Since 13% of Ebola patients do not run a fever at all,

Any fever is cause for concern.

[KMOD]

84. Yes, of course n/t

[Avalux]

31. I really can't say, because I don't have the facts.

We don't really know anything. All we know is that she was self-monitoring her temp, made a phone call and got on a plane. We don't know if she's being truthful about her temp, or if other symptoms were present.

In the absence of that information, all I can say is this - if no other people on that plane came in contact with her body fluids, then no.

[LisaL]

32. Authorities now think she might have had symptoms as early as Friday.

"New information received by the CDC Thursday indicates the latest Ebola patient– Amber Vinson– may have experienced symptoms as early as Friday, Oct. 10 — the day she flew into Cleveland."

http://fox8.com/2014/10/16/cdc-nurse-may-have-had-ebola-symptoms-earlier-than-originally-thought/

[Avalux]

33. Like I said, all we have is her word.

It's looking like she wasn't initially truthful.

[LisaL]

36. She didn't have typical symptoms even when she was diagnosed.

Sounds like her presentation of Ebola is atypical, making it hard to figure out when exactly she started to have symptoms.

[KMOD]

38. Is Ebola no longer spread from vomit, diarrhea and blood?

Is that where we're going.

This is getting crazy.

[LisaL]

45. Your forgot other body fluids, such as saliva, sweat and urine.

[KMOD]

48. Yes, you are right that I did not mention all of the bodily fluids

Are you saying Lisa, that you believe her sweat, if she did sweat, was exposing folks to Ebola on that plane? Really?

[LisaL]

49. Yes, really.

Obviously cdc thinks that there is some risk that somebody was exposed. Or there would be no need to monitor all the people that flew with her.
Even if the risk is low.

[KMOD]

52. Well, ok then. Thank you for your honesty.

I believe they are just doing an excessive abundance of caution due to the concern, but if you are certainly entitled to believe otherwise.

[KMOD]

37. Thank you for your response.

I admit as well, that we don't know everything.

I won't question her honesty in her temperature, since she is the one who felt the need to double check with the CDC. We also know that she was not emitting any body fluids, the airline crew has also stated this.

Unless people believe that the virus has changed, I don't believe she exposed anyone.

[LisaL]

43. Ebola is spread by all body fluids.

"When an infection does occur in humans, the virus can be spread in several ways to others. Ebola is spread through direct contact (through broken skin or mucous membranes in, for example, the eyes, nose, or mouth) with
•blood or body fluids (including but not limited to urine, saliva, sweat, feces, vomit, breast milk, and semen) of a person who is sick with Ebola
•objects (like needles and syringes) that have been contaminated with the virus
•infected animals
•Ebola is not spread through the air or by water, or in general, by food. However, in Africa, Ebola may be spread as a result of handling bushmeat (wild animals hunted for food) and contact with infected bats. There is no evidence that mosquitos or other insects can transmit Ebola virus. Only mammals (for example, humans, bats, monkeys, and apes) have shown the ability to become infected with and spread Ebola virus."



http://www.cdc.gov/vhf/ebola/transmission/index.html?s_cid=cs_3923

[KMOD]

50. I'm quite aware of this, but thank you

The virus is at it's most virulent form during the death cycle though. Was the nurse dying on the plane?

[magical thyme]

54. It is still contagious. It's on a continuum, depending on viral load but also

depending the type and length of contact, the type of body fluid, and one ingredient repeatedly left out of discussion... on the immunocompetency of the exposed person.

[KMOD]

59. on the immunocompetency of the exposed person.

Ah yes, and that is a concern as well, and could also wharf into a separate discussion.

Regarding the viral load, do you believe the nurse exposed anyone of the flight, magical thyme?

[magical thyme]

63. I doubt it.

If I were sitting next to her, I'd probably be quietly monitoring my temperature and watching the calender. But I'm a worrywart. I always figure god hates me.

[KMOD]

69. lol

honestly, I probably would too. I think fear is our natural first instinct. Then we become rational.

[magical thyme]

76. I went into the urgent care lab the other day

donned my lab coat and gloves and started cleaning all the surfaces with clorox wipes.

The lab assistants immediately, and I mean immediately, started laughing at me. They immediately knew why I was suddenly cleaning like crazy. MT's worried about Ebola

Anyway I had to explain to them that in school we were taught to always assume the prior tech had spilled something and failed to clean it up completely. And that was good practice, but of course we didn't usually have time at the hospital and would arrive and just dive in. and I was trying to get back into good practice.

Deep down, though, they're worried too. But they can't afford to think about it, so they keep it buried except occasionally bursting out with "just ban the flights and don't let them in...." statements.

I then told them about my classmate who used to work nights at the hospital and how she rigorously stuck to that cleaning practice and how it drove us crazy because the ED would be overflowing and she would be in her own little world cleaning all the benches. And accidentally disconnecting instruments from host computers and starting timers all over the lab , so not only would the 2nd shift person have to run around handling all the ED specs, I'd be running around trying to re-connect the hosts and running up and down the lab as alarms would randomly start beeping all over the place for an hour or so after she arrived.

So yesterday our lab manager just sent out an email, and they are cracking down on everything due to Ebola. And even though it's extremely unlikely that I'll ever be any closer to an Ebola case than I am now at the other side of the country, getting back into good practice now will keep me from getting written up later.

[KMOD]

82. :) You're on top the of curve MT

It is nice to see that our health care systems are starting to take this more seriously.

[RiffRandell]

39. She exhibited more symptoms in Cleveland before flying home.

I don't know what the Uncle qualifies as feeling sick; was she vomiting and/or had diarrhea on Tuesday when she went to the hospital?

Her uncle, Lawrence Vinson, said Thursday night that his niece didn't feel sick until Tuesday morning, when she went to the hospital with a temperature of 100.3 degrees (which is still below the CDC's Ebola threshold).

Yet a federal official with direct knowledge of the case gave different information to CNN's Elizabeth Cohen, relating that Vinson said she felt fatigue, muscle ache and malaise while she was in Ohio. She did not have diarrhea or vomiting while in that state or on the flight home.

http://www.cnn.com/2014/10/16/health/us-ebola/index.html

[KMOD]

47. She felt "funny''

That's according the a top official at the CDC.

I don't take much stock in Elizabeth Cohen's interpretation of a conversation she had with an unknown federal official.

[RiffRandell]

66. I don't take much stock in what anyone says right now.

I'm not panicking and I doubt she infected anyone on those flights but I still think it was a bad move, and it was beyond stupid for the CDC give her the okay.

[KMOD]

70. That's cool n/t

[LisaL]

29. She was already symptomatic when she flew back to Dallas.

She had a fever, and wasn't feeling well for several days prior. So yes, it's possible she exposed people.

[Avalux]

44. I see you provided details above. She did not have diarrhea or vomiting, say 3rd party sources.

If that is the case, then she probably didn't infect anyone.

[LisaL]

46. Her symptoms are listed in post 39.

And diarrhea and vomiting are not the only ways to spread Ebola.

[magical thyme]

51. post 39 quotes a federal official on her earlier symtpoms

saying she was feeling muscle aches and general malaise as much as 4 days prior. That is not an atypical presentation, though. Muscle aches and general malaise are both early symptoms, along with headache and I remember reading Brantly had a sore throat.

Personally, I've felt they should never have used a threshold fever as a required criteria. Just any one or two symptoms if you've had exposure. But that's just my take...

[LisaL]

53. CDC seems to think her Ebola presentation was atypical.

"Braden said Vinson did not have typical Ebola symptoms even when she was diagnosed with the virus Tuesday."


http://www.cleveland.com/akron/index.ssf/2014/10/ebola_patient_amber_joy_vinson.html

[magical thyme]

55. meh. CDC thought 101.5F was an appropriate threshold criteria. CDC thought it was ok to

wear droplet precautions. And then when they shifted to biohazard suits with 2-3 layers of protection, with double hood and filtered air supply...that it was ok to leave the front of the next completely exposed.

CDC has been way off the mark on a lot of things. I'm sticking to my own reading and conclusions at this point.

[LisaL]

73. Well, that's true.

My guess is her viral load was high for the symptoms she was exhibiting.
We were told Nina's viral loads were low.
We were not told that about Amber.

[magical thyme]

77. Nina's first symptom was a low grade fever, and she came in immediately

Amber's first symptom was general malaise and body aches, so she didn't come in until 4 days later when her temp hit 100.3 or 101.3 or something like that.

4 days is a lot of replication time for a virus. Amber drew blood and catheterized him. A lot of opportunity for exposure there.

[LisaL]

86. Well, it's just a guess.

CDC says her symptoms were atypical. They haven't said her viral loads were low. My guess is they were expecting more symptoms than she had for the viral load that she had.

[magical thyme]

87. I'm not going to try to parse their statements down to that level...

Emory may not have given them her viral loads yet.

Nina has been in treatment for longer and they may have been watching the loads closely to see how she responded to Brantly's plasma. They probably tested viral loads before the transfusion and then at some point after to see if there was a measurable decline and how much. NIH is a research facility, so they probably are studying her as well as treating her.

Oh, yeah. I just remembered that CDC made statements after Duncan died about how nobody had ventilated or done dialysis on an ebola patient and hinted that may not have been a good idea, back when they were trying to back off the protocol breach/blame statements, when in fact both those supportive treatments were used at Emory and/or Nebraska to save patients. So I'm really not going to try to parse their statements, lol.

[KingCharlemagne]

56. After she provided care to Mr. Duncan, Vinson provided care to other

non-Ebola patients at the direction of the hospital management. Were you in her shoes, would you have refused to do that and put your job at risk by so doing? Would you have presumed to know better than the CDC what to do?

You know what? I'm glad she flew to Ohio to see her family. At least she had one last chance to visit with her family and loved ones before being condemned by a cruel and capricious system and disease. Odds are high, based on what I've read here on DU, that she infected no one on that flight. I'll bet if she infected anyone it was one of the non-Ebola patients she provided care to after caring for Mr. Duncan.

[LisaL]

58. Well, her family members are now in quarantine.

Numerous people are not working, and children are not going to school.
You don't know if she infected anyone or not, until incubation period passes.
So being glad she flew is ridiculous.

[KingCharlemagne]

65. So does that mean the CDC employee who cleared her for travel (via the TX

Dept. of Health) was wrong? If so, has that person been named and disciplined for placing the public at risk?

Speaking of 'ridiculous'.

Kiss up, kick down is alive and well.

I know that I'm extremely pissed that a worker is being scapegoated for the MANIFEST failures of management and government.

And on a nominally Democratic board, no less. If that's ridiculous, so be it.

[LisaL]

67. Of course CDC were wrong to allow her to travel.

I have no control over CDC employees being disciplined.

[Lars39]

75. Management and government have made bad decisions. She did, too.

It's not one or the other. It's both.

[KingCharlemagne]

88. Fallacy of false equivalence. Hindsight is always 20-20. The decisions she

made at the time she made them made and make perfect sense, given the information and messaging she and all of us were receiving AT THE TIME.

Why wouldn't she fly from Texas to Ohio when management had allowed her to provide care to non-Ebola patients after having provided care to Mr. Duncan and repeatedly assured her and everyone that the appropriate protocols were being followed when the reality is that NO PROTOCOLS WERE BEING FOLLOWED OR THEY WERE BEING MADE UP FROM HOUR TO HOUR?

Question: How many managers or government employees have been fired because of this? Answer: Exactly the same number who were fired for allowing 9-11. That would be a great big goose egg.

[Lars39]

90. She made the choice to put herself in places

that would be problematic if she developed symptoms. That choice of hers has possibly put others at risk.

[KingCharlemagne]

94. Um, you do know the CDC cleared her to fly back from Ohio to Texas, right? So after

she out of an abundance of caution called the CDC and was cleared to fly, she possibly put 'others at risk'? OK, then why hasn't anyone at the CDC been fucking fired or even arrested for endangering the public health????

[Lars39]

95. If you go back and read the OP, you might learn

why many here are objecting to her decision to fly.

[KingCharlemagne]

97. But apparently not objecting to the management of the hospital ordering

her to care for non-Ebola patients AFTER caring for Mr. Duncan.

Thus illustrating La Rochefoucauld's maxim that hypocrisy is the tribute vice pays to virtue.

[Lars39]

99. Not so!

Goes against even basic training.

[Skittles]

103. thank you LisaL - you get it

it was not a wise decision no matter how much it is spun

[RiffRandell]

78. That's sounds horribly spiteful.

I stated before I doubt she infected anyone, but I don't know anyone that is 'glad she flew.'

[KingCharlemagne]

92. It may be the last time she gets to see her family and loved ones after having

volunteered to treat Mr. Duncan. I think it is despicable the way she has been treated and is being treated, not least on this board. Hence my 'spite,' as you put it.

[tavernier]

57. I am a nurse who was infected with

pneumocystis pneumonia during the initial outbreak of AIDS, before the hospital deigned it necessary to protect the staff (and patients) with an appropriate level of care. In those days the protocol swung from the ridiculous to the absurd; either total denial, or shoving a pizza under the door and run for your life. ( I exaggerate a bit, but not much.)

Although I was extremely ill for weeks, my immune system was not compromised so I pulled through. Sadly my patient didn't, but he deserved a much better level of compassion, and with the proper isolation techniques, would have had an easier death.

I think that once the panic settles down and we are intelligently equipped to care for these patients, it will no longer be at the bogey man stage that AIDS once was.

I continued to work with my patients, but with proper tools and knowledge, for many years. My new staff members would ask me, from time to time, how to avoid transmission. Should they be in the same room? Should they avoid conversation? Etc. Etc. my answer was always the same... Follow the proper protocol for isolation... and be careful who you sleep with. I always got a chuckle with that.

I know that this disease is different and the same rules don't apply, but these are still human beings, and they still deserve the best care we can give, physically, emotionally, and spiritually. The sooner we stop the panic, the sooner we will find an intelligent and appropriate way to deal with this disease.

[KMOD]

61. The sooner we stop the panic, the sooner we will find an intelligent and appropriate way to deal

with this disease.

Exactly!!!!!

[Avalux]

71. Interesting that you contracted PCP with a healthy immune system.

It's rare; I'm sorry that happened to you. I was working with newly diagnosed HIV positive patients at that time, and it was nothing short of crazy...I remember docs refusing to treat AIDS patients. I worked with my patients for 20 years and was always careful....but my family didn't like it much. I met a lot of truly wonderful people....and lost a lot of them too.

[tavernier]

79. Three of us contracted it.

I had a very high fever for several days, but recovered after after a couple of weeks, although I couldn't shake a lingering cough and flu like symptoms on and off for months. At one point my husband was terrified that I was going to die. I think for me it was a combination of things... Over worked, over tired, and this particular patient was extremely ill and "juicy" in the end stage. We were suctioning with gloves, but I don't remember being required to mask.

Things were so different in those days. For one thing, everyone smoked in the hospitals, even at the nurses station. And back 40 years ago when I did my training, gloves weren't even available, or if they were, we were taught that a patient would think it demeaning if a caretaker wore gloves to touch them. Crazy, huh? And not so long ago.

[RiffRandell]

85. Sounds like you're a great nurse, not to mention very

intelligent and compassionate.

Thank you for caring so well for your patients.

[tavernier]

89. The sad part is that

you always remember your mistakes and bad judgements, rather than the thousands that you've helped. I think it's an occupational hazard shared by many caregivers. Probably why there are no Oscars or Golden Globe ceremonies for health care workers. We would all be on stage apologizing for not doing enough!

But I will accept your kind words for the others in my field of work.

[ZombieHorde]

102. Am I the only one who finds that pledge a bit offensive?

So fucked up.

[ecstatic]

104. The 77 workers were not considered an at risk group. Period.

They were not monitored at all, nor were they given any indication that protocol was breached. Thankfully, Ms. Pham was smart enough to second guess the BS spewing from the hospital and the CDC, and proactively took her own temperature daily. By the time Pham was diagnosed, Vinson was already in Ohio.

[LisaL]

107. She was in OH but she still had to fly back.

She already had a fever, and by that time CDC knew these nurses were at risk group.
Yet she was still allowed to get onto the plane.