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Analeissa Gut
Rombawa

a
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Ethic
Treating patients with Ebola presents an ethical dilemma for health care
workers. They want to help, but place themselves and their families at risk by
doing so.

The 2014 Ebola Epidemic is the largest in history according to

the CDC. It has two imported cases including one death and
two locally acquired cases in healthcare workers that have
been reported in the United States. Health professionals face a
moral dilemma when asked to help in an outbreak such as the
one occurring. A nurse caring for patients with Ebola, knows
that they may, with one slip of a glove, get it, and now they
have compromised themselves and compromised their
families is an extremely difficult ethical decision that we as
nurses will face on a daily basis when we are asked to care for
those who have an infectious disease.

?
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E
P
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o
G
The CDC has revised PPE guidelines
and there is a tremendous awareness of
the Ebola virus, yet it is improbable that
every hospital, ambulatory care clinic,
and physician practice in the Unites
States has been trained to a level of
automatic competency, obtained the
correct PPE resources, and established
the proper protocols for nursing staff,
custodial staff, supervisors, and
healthcare managers.

y
t
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i
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Re

Yes, it is the nurses job and

responsibility to care for patients,
but its also the nurses job and
responsibility to care for
themselves, by accepting or
rejecting an assignment that they
are not equipped or trained for
and the needs of the patient are
beyond the qualifications and

Ebola
hemorrhagic
fever

Severe disease with high case fatality

Absence of specific treatment or
vaccine

Transmitted by direct contact

Bodily fluids (Blood, saliva,
mucus,vomit, urine, feces, sweat)

Standard, Contact, Droplet

precautions

How long does Ebola live outside the

body?
Ebola on dry surfaces, such as doorknobs and
countertops, can survive for several hours
Virus in body fluids (such as blood) can
survive up to several days at room
temperature.

Signs and Symptoms

Initial: Fever, chills, myalgias, malaise,
anorexia
After 5 days: GI symptoms- nausea,
vomiting, watery diarrhea, abdominal pain
Headache, conjunctivitis, hiccups, rash,
chest pain, SOB, confusion, seizures
Hemorrhagic symptoms

Protocol
Patient placement

Hand Hygiene
Environmental
Proper/Adequate
Infection Control
Facilities
Safe
Injection
Patient Care
practices
Equipment
Monitoring,
PPE
Management, and
Adequate Training Training of Visitors

E
P
P
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Guidan
1. Prior to working with Ebola patients, all healthcare workers involved in

repeated training
and have demonstrated competency in performing all Ebolarelated infection control practices and procedures, and
specifically in donning/doffing proper PPE.
the care of Ebola patients must have received

2. While working in PPE, healthcare workers caring for Ebola patients

should have no skin exposed.
3. The overall safe care of Ebola patients in a facility must be overseen by
an onsite manager at all times, and each step of every PPE
donning/doffing procedure must be supervised by a trained observer to
ensure proper completion of established PPE protocols.

g
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E
PP
Donning N95 Respirator
1. Engage Trained
Observer
2. Remove Personal
Clothing and Items
3. Inspect PPE Prior to
Donning
4. Perform Hand Hygiene
5. Put on Inner Gloves
6. Put on Boot or Shoe
Covers
7. Put on Gown or Coverall

8. Put on N95 Respirator

9. Put on Surgical Hood
10.Put on Outer Apron
11.Put on Outer Gloves
12.Put on Face Shield
13.Verify
14.Disinfect Outer Gloves

g
n
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PP
Doffing N95 Respirator
1. Engage Trained Observer
2. Inspect PPE
3. Disinfect Outer Gloves
4. Remove Apron
5. Inspect Apron
6. Disinfect Outer Gloves
7. Removed Boot or Shoe
Covers
8. Disinfect and Remove Outer
Gloves
9. Inspect and Disinfect Inner
Gloves
10.Remove Face Shield
11.Disinfect Inner Gloves

12. Removed Surgical Hood

13.Disinfect Inner Gloves
14.Remove Gown or Coverall
15.Disinfect and Change Inner
Gloves
16.Remove N95 Respirator
17.Disinfect Inner Gloves
18.Disinfect Washable Shoes
19.Disinfect and Remove Inner
Gloves
20.Perform Hand Hygiene
21.Inspect
22.Scrubs
23.Shower
24.Protocol Evaluation/Medical
Assessment

e
c
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Bene
Protect
Yourself
Your family
The patient
Limitations in experience and knowledge may not require refusal
of the assignment but rather an agreement to ensure patient
safety. If no accommodation for limitations is considered, the nurse
has an obligation to refuse an assignment for which she or he
lacks education or experience. ~American Nurses Association

e
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Et
- Refusal to take care of patient
- Inadequate staff
- Overworked/Tired nurses
- Responsibility

Code of Ethics

Responsibility for nursing

judgment and action (4.3)
Responsibility refers to the specific accountability or
liability associated with the performance of duties of
a particular role.
Nurses accept or reject specific role demands based
upon their education, knowledge, competence, and
extent of experience.
Individual nurses are responsible for assessing their
own competence. When the needs of the patient are
beyond the qualifications and competence of the
nurse, consultation and collaboration must be sought
from qualified nurses, other health professionals, or
other appropriate sources.
Educational resources should be sought by nurses
and provided by institutions to maintain and advance
the competence of nurses.

http://youtu.be/qGB6DJIz5RU

.
.
.

e
c
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c
Your

Nurses have the right to refuse to

care for the patient...If the hospital
or clinic does not provide the
proper PPE, training, and
education.

Z
I
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Q
K
C
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Q
WHOS RESPONSIBILITY IS IT TO PROVIDE THE
PROPER PPE, TRAINING, AND EDUCATION?
A) NURSES
B) HEALTH CARE FACILITY
C) SECOND GRADE SCHOOL TEACHER
D) PATIENT

Z
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Q
K
C
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Q
I WOULD CARE FOR A PATIENT THAT HAD EBOLA
IF I DID NOT HAVE THE PROPER PPE, TRAINING
OR EDUCATION?
A)TRUE
B)FALSE