EBOLA ALERT!

DOCTORS, NURSES, SCIENTISTS, CLEANERS Because you are at the forefront.... NURSES AT THE FORE FRONT N.B Applying Universal Safety p...

DOCTORS, NURSES, SCIENTISTS, CLEANERS Because you are at the forefront....

NURSES AT THE FORE FRONT

N.B Applying Universal Safety precautions would save you
But this note is not about universal precautions.
Let's look at the bad habits that welcome Ebola:

Establishing rapport with your patient: that handshake you are accustomed to giving can be skipped. Now, the most important part of your rapport is asking how widely travelled the patient is, his west African experience, his guests, his visitation habits, his sick relatives, the loved ones he's buried, the travel behavior of his lovers etc.....all before you get down to the reason he came. That way you can establish your population at risk. If u have a waiting area, they can fill the compulsory questionnaire while awaiting their turn to see the doctor. . If feasible, the receiving nurse does this rapport at the nurses station while taking vitals. The earlier the patient is isolated, the better. This is important at this stage to help u quickly isolate the patient for further questioning and then allow your further kit up.

During examination, all that checking for pallor, temperature and axillary lymphadenopathy with bare hands should be left in the Pre-Ebola era. If u use nylon gloves, this message is not for u. I don't know how to address your case. You are wicked to yourself. That said if your normal wrist sized latex gloves are not protective enough please use your money and buy elbow length gloves..
Note that I'm not telling you to tell government to buy, or to tell your CMD or ur medical director in ur PP because it gets to a time you have to take charge of your life. No one would fill out your life assurance.....you would.

So you are done with examination and you go back to your table to document your findings postponing washing your hands till when the patient goes out....help yourself. A word is enough for the living. Wash those hands before you return to your seat. And then splash some Jik on the faucet handle when you are done.
If your office is one of those that warrant your dipping hands into the drum to fetch water, please use your own money and buy a bucket with a tap that u can use. That N500 for buying it would save government the N5000 that would be given to your family for your effort.
When the patient leaves the examination bed, ensure the mackintosh that must have been placed there beforehand is doused with alcohol, bleach or original spirit....(not all those 'I dey kampe spirit'.....ofcourse if your bleach has been open for more than 30days, it belongs to the sewage tank). After the patient leaves the consulting room before the next patient, wash your hands again.

Now for the doctor managing the obviously ill patient, there is no time for sme sme. If you are in a designated Ebola ward, u would need an appropriate PPE that is impermeable to fluids, light enough to wear for long periods, permeable to air slightly, and should be worn over your boots. Do not tuck them into your boots, wear elbow length gloves over the PPE. Safety googles and head covers would be necessary. Before removal of this outfit, efforts to decontaminate the material should be made as removal may pose exposure to skin. Spray the body with a medium pressure bleach solution, avoid using high pressure as this may aerosolise the organisms. As much as possible, these should not be reused. While in these outfits, business is strictly business, minimise contact with other staff. Comport yourself as if sterile for a surgical procedure. You can't be giving a handshake to another kitted person when u r both loaded with the virus, you can't be leaning on a surface fully kitted in PPEs, you expose other staff not working directly with the virus and even expose yourself at a later time. If you need to pause or socialise then you need to leave the vicinity after removing your outfit.

In the pre-Ebola era, your patients vomitus could splash around and the average doctor would still smile at u, now, how dare you not hold your shit together as a critically ill patient? If u can't ensure you as a patient protect me to the best of your ability then we are not on the same page. So yes, patients, if you are reading this, accept this advanced apology for anything that comes as a sequelae to you being knowingly careless with your waste. Doctors please educate your patients to restrict their movements to their bed...you cannot stroll around checking up on other patients or environment. We recognise that you are really ill so promise to handle all you need by your bed including getting your pu....no sweats. You cannot not use the bucket we have provided for you for vomitting, or use it and keep it carelessly being prone to spillage. Thou shalt use your diaper if need be.

Signing against medical advice: please do not go away with that wrong assumption that if a person DAMAs, you have one less patient to worry about. When that patient leaves, that patient would not tell people back at home what he or she has, that patient would go back home, and act the part to the best of their ability, 'abi Cholera is also around, my own is not Ebola. It's cholera'. For every Ebola patient you allow go back home, 8more would come back, maybe not to your hospital, but just maybe their tertiary contacts may find their way back to you. In my opinion, if need be, force should be applied in any measure to restrain any patient that threatens to leave.
If you decide to turn away Ebola Patients deliberately, how well would you sleep at night? Just picture going back home and seeing your wife hugging the patient....(she happened to be her close friend and she remembered her close friend had a husband doctor so thought to drop by for private visit....hahaha).

Nurses, your task is by no means easy! From vital signs measurement (something has to be done about how we measure blood pressure) to cleaning up patients, to managing waste, to changing bedding....you must like the doctors arm yourself with appropriate barrier PPEs

Research scientists, virologists n lab scientists, my heart goes out to you working in this nation where availability of bio safe labs is probably a criminal offense. You would be dealing with probably the highest concentrations of these viruses....you need to be appropriately kitted. The random sample you get may just be a potential Ebola case. Avoid cluster in your labs, make access to your labs restricted. Reducing the traffic in the labs would reduce the risks of accidents, spillage and distractions. Ensure your lab is fitted with a shower. It may come in handy. Decontaminate your tables every hour, it would save you.

To our dear cleaners, without whom we would not have the fairly clean environment we have. Sometimes I wonder about what your own hazard allowance could be, if doctors earn a paltry N5k. I feel better armed in that I know what I'm dealing with and wonder as to whether you knew what you fully got yourself into when you applied for a cleaning job. Did anyone really tell you the kind of materials you would be dealing with? I once saw a cleaner emptying a safety sharp box into a refuse bag and in shock called her to order....in her defense, she said she had been working in admin department and was only sent to the wards to cover a shortage. No one thought to educate her. She didn't even have gloves on whilst emptying bin after bin of contaminated material beside each bed.
Cleaners, you are so important in the control of this disease. We would rely on you for safe removal of contaminated material, for decontamination of surfaces we work on and have to come in contact with. This would not be the usual eye service work, we would need to trust you with this huge task whilst we ensure you are protected by making sure our wastes are disposed properly into the bins

Are you one of those whose hands are married to their faces? You are permanently itching your eyes, nose, scratching, or you even suck your biro in thought? This Ebola era would be a good time to make an Ebola resolution....
Are you one of those who have the bad habit of leaving your clinical coat for the gods at home or hanging off that fancy rack like a trophy? Please, now is the time to make sure your clinical coats are functional enough to act as a barrier, to be your first defender. If you can, having a bath Before you leave work would be a good idea.
When you are done for the day, peel off your coat and put in a bag n tie for daily washing. If daily washing is not feasible, please leave the coat in your hospital, don't carry no infections home, your household did not swear no oath with you. When washing your coat, preferably use a washing machine, (and no, I don't mean the LG excuse for a machine). Put the temperature at 60C which would be enough to kill Ebola virus, the washing machine also serves to minimize your contact with the virus. Do not dry in the house, dry under sunlight especially if u hand washed. If you have to wash yourself, I'd suggest you use those gloves laborers use, yes the heavy duty ones to first decontaminate the gown in bleach before you can wash the gowns with your hands. If you don't do your laundry yourself, please don't be a devil, tell who ever does it what the outfit has been exposed to, so the person can protect himself, (anyway if you allow your cleaner or laundry person catch Ebola, nemesis and Karma would be too far fetched to describe what would happen to you).

The only true success is when we record no transmission of the virus to healthcare workers. While we have recorded casualties, it's still not too late to tell a new story.



WE CAN'T DO NOTHING.
WE CAN'T TURN OUR EYES AWAY FROM THE SICK.
WE CAN'T BE SILENT WHILST WE DIE.
WE HAVE TO SAVE US FOR US.
WE MUST DEFEND OUR LAND

Likita Kent for Ebola Alert
Follow @EbolaAlert
visit ebolaalert.org to learn more and to volunteer

Location: United States

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