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Do Nurses Have the Right to Refuse to Treat Ebola Patients? Featured On FOX TV Today

10-17-14-VARNEY-&-COMPANY

Wednesday I was on “Street Smart” on Bloomberg TV and yesterday on “The Real Story with Gretchen Carlson” on FOX NEWS to address the rising fear among RNs of treating Ebola patients without adequate training, preparedness and appropriate PPE.

Today I’ve been asked to appear on FOX Business Network’s Varney & Co. show on “A nurse’s right to refuse to treat an Ebola patient.”

I invite you to join me today, October 17, 11:30am ET on FOX Business Network.

P.S. Comment and wish me luck.

13 thoughts on “Do Nurses Have the Right to Refuse to Treat Ebola Patients? Featured On FOX TV Today

  1. You are doing a great job voicing the nurses’ views and concerns. Thanks for caring so much.

  2. Excellent Vickie, I will be watching. You represent all of us so well.

    Can a nurse refuse to take care of a patient DX with Ebola?

    Refusal is not about Ebola, it is about any patient’s condition that exceeds the nurse’s scope of practice and training. In a word, my position is “yes”, we can and must refuse.

    With that said, the refusal must have a strong argument. Based on my 30 years in pre-hospital and facility experience, and designated as a “float” and “agency” nurse in critical areas, the qualifiers to refuse would include and are not limited to:
    1. The nurse is pregnant;
    2. The nurse states she is not qualified to render the rights of the patient to receive the best care, evidenced by ………….
    a. The nurse’s lack of training in a high level infection risk patient;
    There must be an infection risk level system, e.g. algorithm if you will, that also addresses the appropriate management of the infection risk. We nurses love algorithms, it is our decision tree. Create it, evaluate it, improve on it and provide continuous measure of outcomes. These people do not understand our “nursing process.” Let’s educate them (even the nurses who haven’t used the NP in years, but are admin. and supervisors, etc.)
    b. Inferior equipment;
    c. Inadequate precautions, especially attire, to prevent cross contamination nurse/patient
    d. Inadequate staff support system such as ancillary personnel also trained in the process of
    containing infection, disposal of infected items, etc.
    e. Inadequate supervisory resources for consultation (and carrying a clip board around doesn’t qualify).

    Above is my opinion and based upon my experience:
    a. ICU nurse floated to an ED to manage ICU patients in an area inadequately equipped area; an ICU nurse does not make an area ICU. When the refusal was made to the ED supervisor the reply was “we have always done it this way.” My reply, “then shame on you. I will find you a list of what we need before I take any ICU patient, and the ratio will be no more than 2:1. We must have more nurses.”
    b. As an Adult ICU nurse directed to “float” to a “PICU” and assigned a two-week old infant DX: failure to thrive and expected to place a feeding tube without a seasoned PICU nurse present. Supervisor rationale – “you have so much experience, taking care of peds will be no different for you.” I cannot share my reply to that.
    Above are just a few examples.

    I respect the whistle-blower in the present issue. She would have more credibility if she had refused based on some of my opinion above. She is young, was possibly intimidated. Still – good for her.

    As you have reinforced for us Vickie, ignorance is not a defense. Once a nurse takes an assignment, she is responsible for the whole package.

    Not to mention, infection at all levels of transfer and degree has been around for hundreds of years. For goodness sake, why hasn’t this wheel been made by the CDC, WHO, NIH already? Monetary cuts have nothing to do with it. It is about their inability to implement our simple Nursing Process. Black and White.

    Thank you so much, Vickie. You look amazing and poised as always.
    Linda Waidelich

  3. First, Vickie I know you will be great and have the many nurses’ backs you are speaking for on this issue! Secondly, it is my opinion that nurses do have the right to refuse treating Ebola patients. They are dealing with lack of appropriate equipment for their safety much less the possibility of spreading this vicious infection to others, i.e. family. Thirdly, I think the solution is facilities that specialize, have the equipment needed, and training to treat the people they are serving. Treating others and not being equipped physically and mentally would do a disservice to those they are treating.

  4. Thanks Vickie, again you were spot on in being the voice of nurses.

  5. Vickie, I was able to watch both interviews. Excellent job! Thank you for all you do.
    Deborah Amato

  6. My sentiments, exactly. Thank you for your imput and discussion, Vickie.

  7. Saw you on TV. Very nicely done.
    So far though, nobody is mentioning how the staff should dress to staff the ER without exposing themselves. I think it means boots, hoods, bonnets, masks and gloves to see just about anybody up close. But nobody is addressing that. Maybe sending each person to an isolation room, using robotic care and cameras would be the solution in the ER, if technology has finally gotten to that point.

  8. Thank you Vickie, for standing up for nurses on the front-line! This is serious business!

  9. I still work 3 12-hour shifts and just completed my hospital’s mandatory training for Ebola. This was all on the computer and took about 90 minutes. The PPE we were shown does not cover all of the skin and we have no isolation rooms with ante rooms to disrobe. The process of doffing the PPE appeared to miss some important points in removing the gloves safely and as one was removing the PPE inside of the patient room, it seemed unsafe in several aspects. Since the symptoms include vomiting, diarrhea and bleeding, the outer gloves will become contaminated while cleaning up the patient and flushing the toilet will aerosolize the virus plus a lot of other problems not addressed in the training are obvious to me.

    1. Orrene, good points on your experience at your own hospital, yikes!

      I used to teach nurses PPE, donning and removal. I splashed blue died water on those students to demonstrate why it is so important in safe removal, and it is still not guaranteed 100% safe. Gloves on last and off first- since most body fluid handing will be the gloved hands. The problem I found during removal is that the hands are exposed for the rest of the PPE removal. In this case with Ebola, there would have to be another person with full gear to assist with removals – there is a dilemma of the last person assisting, on their own safe removal.
      We could see how the blue water splashed all over the place, some spots had to be viewed under a microscope. You ought to suggest this technique and have the lab bring a microscope to class.

      The other concern with Ebola is hand washing and use of aerosol based alcohol for hand cleaning. The CDC uses watered down chlorine.

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*The opinions and statements made by Vickie Milazzo, the founder of Medical-Legal Consulting Institute, Inc. are based on her experiences and expertise, should not be applied beyond the specific context provided, and do not guaranty or project actual results. Vickie Milazzo is no longer involved in the operations or management of the business, but is involved as an independent education consultant.

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