‘Ebola Care is Nursing Care’

    • November 10, 2014
Ebola worker donning protective wear.

The Ebola outbreak is shining an international spotlight on the critical—but often unseen—work of nursing in the United States and abroad, nurse leaders say.

Nurses are mounting the main caregiving response to the deadly virus in West Africa and in the United States, according to Sheila Davis, DNP, ANP-BC, FAAN, a Robert Wood Johnson Foundation (RWJF) Executive Nurse Fellow (2012-2015). Davis is chief nursing officer at Partners In Health, a nonprofit organization that is working with other groups to train health workers, identify sick patients, and deliver quality care to patients in West Africa. Davis, who recently returned from Liberia and Sierra Leone, is overseeing her organization’s multi-faceted, on-the-ground response to the disease.

Because there is no cure for Ebola, most of the care patients are receiving is supportive nursing care, Davis said. Nurses are doing the difficult and dangerous work of providing intravenous hydration and oral nutrition, managing diarrhea and nausea, cleaning and feeding patients, and monitoring their overall status. Ebola care is, in short, nursing care, she said, adding: “Nurses are the ones who are providing the care in Ebola tents and who are wearing those space suits you see on TV.”

In addition to providing direct care, nurses are also influencing national health policy, said Cole Edmonson, DNP, RN, FACHE, NEA-BC, an RWJF Executive Nurse Fellow (2012-2015) and chief nursing officer at Texas Health Presbyterian Hospital in Dallas, where Thomas Eric Duncan was treated for Ebola. In October, Duncan, a Liberian citizen, became the first person ever to die of Ebola in the United States, and two of his nurses contracted the disease while caring for him. “The nurses at Texas Health Dallas have helped shape the national care and personal protection guidelines and protocols related to Ebola and are now sharing their learnings,” Edmonson said.

But that’s not all nurses are doing. They are also helping the public understand how the virus is transmitted and fighting panic with information in the United States and abroad. They are speaking out in radio and television news programs on channels like CBS and NPR, writing guest editorials and appearing in stories in newspapers ranging from the Washington Post to the Baltimore Sun to USA Today, and taking other steps—including threatening legal action—to raise awareness about the disease and defend the rights of nurses and other caregivers.

On October 2, for example, Lillian Rivera, PhD, MSN, RN, an RWJF Executive Nurse Fellow (1999-2002) and administrator of the Miami-Dade County Health Department in Florida, fielded questions about the virus on a CBS news program in Miami. On Oct. 16, Lynn Babington, PhD, MN, RN, an RWJF Executive Nurse Fellow (2013-2016) who is senior vice president for academic affairs at Fairfield University School of Nursing in Connecticut, co-authored a media advisory in response to a suspected—but negative—case of Ebola at Yale-New Haven Hospital.

And on Oct. 26, four nurses who treated Duncan at Texas Health spoke at length about what CBS correspondent Scott Pelley described as their “heroic” work to care for Duncan in the days before his death in a segment on CBS’ 60 Minutes. “As frightened as I was, I didn’t allow fear to paralyze me,” Sidia Rose, one of the nurses who treated Duncan, told Pelley. “I got myself together. I’d done what I needed to get myself prepared mentally, emotionally, and physically, and went in there and did what I was supposed to do.”

Defending Caregivers’ Rights

Maine nurse Kaci Hickox, meanwhile, has spoken out in the news media on behalf of the rights of nurses and other caregivers who are treating patients with Ebola. After returning from West Africa, she successfully challenged a quarantine that had been imposed on her by the state even though she had tested negative and showed no symptoms of the disease. “I remain really concerned by these mandatory quarantine policies for aid workers,” she told reporters. “I think we’re just only adding to the stigmatization that, again, is not based on science or evidence.”

Dallas nurses Nina Pham and Amber Vinson made international headlines when they contracted the virus while caring for Duncan. Both recovered—and in so doing educated the public about the disease via the news media. One widely publicized photo showed President Obama hugging Pham; that gesture helped ease fears about the virus.

Raising awareness is “an important role for nurses to help reduce public fear and decrease stigma associated with patients and caregivers of patients diagnosed with Ebola,” Edmonson said. And that work, Davis added, will minimize prejudice against caregivers and encourage more health care workers to volunteer to combat the virus in West Africa—the key way to prevent its spread to the United States and other countries.

Moreover, nurses who speak out in the media also have an opportunity to educate the public about the broader—but often invisible—role nurses play in health and health care, and about the need for more nurse leaders and for more collaborative, interdisciplinary health care, Davis said.  “If people were more aware of the role nurses play in health care, they would understand that we have to have nurses at the table to make decisions about funding and strategy.”

The Ebola virus, Edmonson said, has catapulted nursing into the national spotlight. “Positive or negative, the current press has begun a conversation that needs to continue within the profession and inter-professionally about the role and the future of our great profession. The importance of having the best educated and prepared nursing workforce has never been more apparent.”