Ebola outbreak - general thread #9

[MyBelle]

Actually, neither the hospital nor the CDC released Duncan's name. They were very careful not to release any personal information about him. It was like that for several days before his sister went to the press and disclosed his name and other info. (I just reread the first Ebola thread).

I don't recall who disclosed Nina's name, but if it was the hospital they were definitely in the wrong.

ETA. just skimmed back over Ebola thread 5. It looks like the relatives released the names of the nurses as well, not the hospital. The hospital did release a number of statements on behalf of Nina, actually on hospital letterhead. I didn't think anything of it at the time, but in retrospect I find it odd. Who thinks of issuing a public statement when they are isolated in the hospital, sick with a deadly disease? Quite possible, IMO, that the statements were... encouraged, perhaps, in some way.

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It could be the statements were encouraged because there was a lot of public attention that could have easily become panic at the time. I have no doubt the names would have been released by the gov't. after they were officially diagnosed.

JMO

 

[Wyle_E_Coyote]

It could be the statements were encouraged because there was a lot of public attention that could have easily become panic at the time. I have no doubt the names would have been released by the gov't. after they were officially diagnosed.

JMO

You might want to reread the first and fifth threads. All three were diagnosed, confirmed Ebola, but their names were NOT made public by the authorities. In all three cases, the names were publicized by relatives days later.

And if the statements were coerced in any way, as the lawsuit alleges, she has a good case IMO.

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[nrdsb4]

You might want to reread the first and fifth threads. All three were diagnosed, confirmed Ebola, but their names were NOT made public by the authorities. In all three cases, the names were publicized by relatives days later.

And if the statements were coerced in any way, as the lawsuit alleges, she has a good case IMO.

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I'm thinking that rather than "coerced" in the traditional sense of the word, the hospital may have gotten permission from a sick and vulnerable person who didn't have the strength at the time to put up resistance to some "let's show some team spirit" pressure.

co·erce
kōˈərs/Submit
verb
past tense: coerced; past participle: coerced
persuade (an unwilling person) to do something by using force or threats.
"they were coerced into silence"

More
obtain (something) by using force or threats.
"their confessions were allegedly coerced by torture"

 

[Wyle_E_Coyote]

I'm thinking that rather than "coerced" in the traditional sense of the word, the hospital may have gotten permission from a sick and vulnerable person who didn't have the strength at the time to put up resistance to some "let's show some team spirit" pressure.

You say "coerced" so much nicer than I did! . LOL[emoji6]

 

[murphy3k]

I'm thinking that rather than "coerced" in the traditional sense of the word, the hospital may have gotten permission from a sick and vulnerable person who didn't have the strength at the time to put up resistance to some "let's show some team spirit" pressure.

RSBM. Let's not forget this permission was obtained from a patient who was unable, in the hospital's view, to make end of life decisions for herself. When I read that section within the complaint my jaw dropped. The hospital cannot have it both ways. JMO.

 

[nrdsb4]

RSBM. Let's not forget this permission was obtained from a patient who was unable, in the hospital's view, to make end of life decisions for herself. .

Yeah, that's pretty much what I was saying.

Rather than coerced, which implies threats, I think this sounds more like taking advantage of someone in a vulnerable state.

I think THS should take care of both nurses. Not necessarily because legally they should, but I think it would be a good thing to do. These women were failed by a system not ready for the inevitable. IMO the CDC shares a good bit of the blame here, but I don't think any help will be forthcoming from that quarter.

That said, I'm not anti CDC. They've done a lot of good. But they are not perfect. Fortunately they seem to be willing to change their protocols and such when evidence proves them imperfect.

 

[Wyle_E_Coyote]

The definition of coerce is broader than just using force or threats. It also includes using authority, fear, intimidation, etc. See dictionary. Com definition below.

coerce
[koh-urs]
verb (used with object), coerced, coercing.
1.
to compel by force, intimidation, or authority, especially without regard for individual desire or volition:
They coerced him into signing the document.
2.
to bring about through the use of force or other forms of compulsion; exact:
to coerce obedience.

verb (used with object), coerced, coercing.
3.
to dominate or control, especially by exploiting fear, anxiety, etc.:.
The state is based on successfully coercing the individual.

 

[nrdsb4]

We shall see. Nina is stating that she didn't give permission, period. PHD says she did.

I'm hoping to see the legal documents, though I suppose we won't if they settle.

 

[MyBelle]

You might want to reread the first and fifth threads. All three were diagnosed, confirmed Ebola, but their names were NOT made public by the authorities. In all three cases, the names were publicized by relatives days later.

And if the statements were coerced in any way, as the lawsuit alleges, she has a good case IMO.

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She has to prove her statements were coerced and I doubt she will be able to do that but we will see. afaik, specific details about her medical condition were never released by the hospital. But a person's identity can be released if it is in the public interest to do so. Even her dog was in the news and was in quarantine.

JMO

ETA: As I suspected, the family released her identity because the news media had already figured it out. The public right to know trumps her right to privacy.

Health officials have not released the nurse’s name, but Yahoo News identified Pham through public records and a state nursing database.

JMO

http://news.yahoo.com/nina-pham-ide...bola-165521689.html?soc_src=mediacontentstory

 

[Wyle_E_Coyote]

She has to prove her statements were coerced and I doubt she will be able to do that but we will see. afaik, specific details about her medical condition were never released by the hospital. But a person's identity can be released if it is in the public interest to do so. Even her dog was in the news and was in quarantine.

JMO

If she was hopped up on pain meds, which medical records would show, it would be very easy for her to show she couldn't have consented.

Moo

 

[MyBelle]

If she was hopped up on pain meds, which medical records would show, it would be very easy for her to show she couldn't have consented.

Moo

The media would have released her name whether she consented or not. The public had a right to know.

JMO

 

[murphy3k]

The media would have released her name whether she consented or not. The public had a right to know.

JMO

Having her name released does not give the hospital the okay to release her medical information. Only she can authorize that. If she never gave consent for medical release, or even withdrew consent, at any point, the hospital has a problem. JMO.

 

[nrdsb4]

I can't even remember if the hospital did release any medical information, other than the video, which is a big deal imo. That's a major HIPAA violation if she didn't sign a release.

 

[MyBelle]

Having her name released does not give the hospital the okay to release her medical information. Only she can authorize that. If she never gave consent for medical release, or even withdrew consent, at any point, the hospital has a problem. JMO.

I don't know that the hospital released anything about her medical condition without her permission. There was a video released and most videographers will not record someone on private property without a signed release.

 

[MyBelle]

If she was hopped up on pain meds, which medical records would show, it would be very easy for her to show she couldn't have consented.

Moo

Good luck to her in proving it.

JMO

 

[SCHMAE]

http://finance.yahoo.com/news/real-...c=mediacontentstory&soc_trk=fb&fb_ref=Default

 

[nrdsb4]

http://finance.yahoo.com/news/real-...c=mediacontentstory&soc_trk=fb&fb_ref=Default

My first reactions to this is that as suspected, that video should never have happened.

Secondly, I fully believe she had never been trained in ebola care. With the exception of the four specifically dedicated units, I doubt any US nurses had been trained for care of a disease which had never ever been seen on US soil.

BUT: for her to say she had "never" had any training at all for any contagious disease is ridiculous. If that's the case, she had no business working as a nurse in an ICU. We all get education and training on various precautions in nursing school, as well as in the course of working as a nurse. I find it next to impossible to believe she had no training whatsoever in infectious disease, yet touts herself as an accomplished ICU nurse. Nurses in Texas are required to get continuing education to keep our licenses. She should have sought out classes for this if she felt inept. Our continuing education is our responsibility to obtain, not the hospitals', though most hospitals will provide opportunities to get their CE's on campus. This sounds like lawyer talk to me.

Lastly, the lawsuit almost implies that nurses in general are asked to volunteer to take patients, or that they regularly have the option to refuse to care for various patients. When you work as a nurse, you are given a patient assignment. You do NOT get to say "Well, I'm sorry. I don't take care of AIDS patients because I'm afraid I might get a needle stick." When you arrive in the ICU for your shift, you do not have the notion that you will be deciding who you will or will not care for.

In this instance, ebola was a totally different animal, and a nurse could have conceivably asked for a Safe Harbor exemption due to the fact that she felt it was out of her scope and knowledge. Occasionally I would be floated to the open heart ICU. I had no experience with a fresh heart, so I would have had a huge problem with being assigned such a complicated patient. It never happened, of course, because my hospital didn't do that and was always just thrilled to have the extra body, so they only gave me day 2 post op patients. In this situation, however, there was not a nurse in the entire hospital who would have had ebola experience.

I just don't like the implication here that hospitals who don't ask their nurses permission before making assignments are doing anything wrong or out of the ordinary.

 

[MyBelle]

http://finance.yahoo.com/news/real-...c=mediacontentstory&soc_trk=fb&fb_ref=Default

Duncan had not been diagnosed but she claims she should have had a choice about whether to care for him? I think it is a tad unrealistic for a nurse assigned to the ICU to expect to have a choice in caring for any ICU patient.

JMO

 

[nrdsb4]

Duncan had not been diagnosed but she claims she should have had a choice about whether to care for him? I think it is a tad unrealistic for a nurse assigned to the ICU to expect to have a choice in caring for any ICU patient.

JMO

In general I agree, except to say that a nurse should not accept an assignment which she knows she is not competent to take. For example, a floor nurse who's great at taking care of general med surg being asked to take care of a fresh open heart. Or a neuro ICU nurse being asked to take care of a patient with a femoral sheath that she's had no exposure to or education about. Usually these situations don't come up, though.

In the Presby incident, there was likely NO ONE there who had experience of this type. Somebody had to take that patient. PHD could not refuse to care for the patient; he was entitled to care. How they made assignments, I have no idea. But every day I walked into the ICU I was aware that today could be a *****, and that I could have a patient who would stretch me to my limits. Granted, no one expects ebola.

 

[MyBelle]

In general I agree, except to say that a nurse should not accept an assignment which she knows she is not competent to take. For example, a floor nurse who's great at taking care of general med surg being asked to take care of a fresh open heart. Or a neuro ICU nurse being asked to take care of a patient with a femoral sheath that she's had no exposure to or education about. Usually these situations don't come up, though.

In the Presby incident, there was likely NO ONE there who had experience of this type. Somebody had to take that patient. PHD could not refuse to care for the patient; he was entitled to care. How they made assignments, I have no idea. But every day I walked into the ICU I was aware that today could be a *****, and that I could have a patient who would stretch me to my limits. Granted, no one expects ebola.

BBM. No nurses in the U.S. to my knowledge, even at the four designated centers, had ever actually cared for an Ebola patient prior to the arrival of the health care workers from Africa last summer long before Duncan arrived. The protocols were in place then. The health care workers, including doctors, were exposed even though they were wearing protective gear in Africa.

Dallas Presby is a huge teaching hospital and not for a minute do I buy her story that she was just handed something off the internet and nobody picked up biohazard waste. That's simply not believable. If Duncan had been the first patient to be treated in the U.S. it would be different but he wasn't.

JMO

Dr. Philip Smith, medical director of the University of Nebraska Medical Center’s Biocontainment Patient Care Unit, said there isn’t sufficient information to say that there was a major breach in technique at Presbyterian.

If a worker follows the rules, he said, “the chances of getting Ebola are small, but not zero.”

http://www.dallasnews.com/news/metro/20141012-probe-launched-into-how-nurse-was-exposed-to-ebola.ece