Nurses: Michigan not prepared for Ebola

Karen Bouffard
The Detroit News

Nurses in Michigan and nationwide charged Wednesday they are not adequately prepared to care for Ebola patients, lacking both the training and proper equipment to deal with the deadly disease.

The Michigan Nurses Association called on Gov. Rick Snyder for greater leadership, even as state agencies and the Michigan State Police stepped up efforts to prepare for a possible outbreak.

Snyder spokesman Dave Murray said the administration is pushing the group for details about the complaints because its "statements are very general and broad."

The state Department of Community Health said Wednesday it continues to follow the situation in Texas.

"The governor was 100 percent correct when on Oct. 9 he said all hospitals were equipped to do isolation work per the Centers for Disease Control requirements at that time," department spokeswoman Jennifer Smith said.

"As this is a rapidly evolving situation, we are adapting to what has been learned from the situation in Texas and will continue to work with hospitals, health departments, physicians, nurses and other health care providers to ensure the health and safety of our residents and health care workers."

Detroit health systems said they're taking aggressive measures, including drills. At Oakwood Hospital in Wayne, personnel donned full protective gear Wednesday to treat fictional travelers during a simulated exposure at Detroit Metro Airport.

Dr. Marcus Zervos, director of infectious diseases for Henry Ford Health System, said the system's four hospital are prepared.

"We have done an extensive amount of training on identification of suspect patients, what is the proper protective gear and isolation, how a patient should be treated and managed," Zervos said. "In many ways, we've gone beyond the recommendations of the CDC."

Nurses fears were heightened by Wednesday's news that a second Dallas nurse tested positive for the virus after caring for Ebola patient Thomas Eric Duncan at Texas Health Presbyterian Hospital.

The 185,000-member National Nurses United union argues the second case supports nurses' claims that they are not getting proper training and often lack even the correct protective gear — charges echoed by the Michigan Nurses Association.

"Even the hospitals that are trying (to prepare) are struggling to keep up with this situation and may be falling short," said Dawn Kettinger, spokeswoman for the Michigan Nurses Association. "What we're hearing from nurses is that in general they don't feel 100 percent prepared.

"(Hospitals') policies don't match what the CDC says, they don't have the equipment on the premises. We want to see drills at every hospital."

The Michigan nurses group has endorsed Snyder's Democratic challenger, Mark Schauer, in the Nov. 4 election.

Earlier this month, Snyder told The Detroit News editorial board he was in almost daily contact with state health and emergency management officials to ensure hospitals are ready for a possible Ebola-stricken patient.

"I may be overstating this, but I think almost every hospital in Michigan is equipped to do the isolation work that we need to do," Snyder said.

Located near Detroit Metro, Oakwood is the designated receiving hospital for travelers flagged by Centers for Disease Control and Prevention health workers at the airport. The CDC has a presence at Detroit Metro because it is one of 12 U.S. airports that receive international flights.

"Because of the longstanding relationship we have with the airport, there's an agreement that if anything happens (at Detroit Metro) involving infectious diseases they will be brought to Oakwood," said Martin Levesque, manager of infection prevention and control at Oakwood-Wayne.

Hospital personnel knew there would be a drill Wednesday, but didn't know details, such as what tasks they would perform and how many patients there would be. Starting at 2 p.m., they practiced putting on protective suits, as well as removing them following exposure to patients.

Henry Ford Community College student volunteers arrived in several ambulances, acting out the scenario that they were possibly exposed to the virus on a plane by a vomiting fellow traveler.

Dressed in the highest level of protective gear — including hazardous materials suits, head coverings and goggles — nurses interviewed the fictional travelers to determine their level of exposure. The volunteers then were led to decontamination tents where they were hosed down with disinfecting solution.

"Exposed" volunteers were led to a holding area, while the volunteer playing the part of the infected traveler was wheeled directly into an isolation ward through an a door entirely separate from the entrance to the Emergency Department.

The Governor's Office issued a press release last Thursday outlining a comprehensive effort to prepare for a possible Ebola case in Michigan, including weekly communications with the CDC and constant updates to health care providers on the CDC's evolving treatment protocols.

Snyder has ordered an immediate statewide inventory of personal protective equipment required for an Ebola response. He also ordered the State Emergency Operations Center to activate in the event of an outbreak, and to conduct exercises and drills to test their preparedness.

But the Snyder administration is not working fast enough or providing strong enough leadership, Kettinger said.

"(Snyder) was doing an inventory of hazmat suits in the state, and a week later we haven't heard the results of that," Kettinger said. "What we're hearing (from nurses) is that there is not the equipment that is needed in most places — so where's that assessment? We need concerted leadership at the top."

Asked if the union's charges could be political, two weeks before the Nov. 4 election, Kettinger noted that only 20 percent of the state's nurses are unionized.

"Ebola doesn't care if you're a Democrat or a Republican," Kettinger said. "That's not what we're interested in. We need for our health care workers and residents to know they're safe."

At Henry Ford Health System, Zervos said "It's understandable that people would be concerned and we also are concerned."

"We feel we have enough protective equipment," Zervos added. "The biggest issue is getting more control over the epidemic in Western Africa itself."