Issue link: https://nnumagazine.uberflip.com/i/417543
of the CNA/NNOC Board of Directors. "That is not going to work. We cannot blame the healthcare providers who are on the frontlines who are risking their lives to provide care for patients. It's not okay. We are here to spread readiness, not fear." As of press time, the World Health Organization reports there have been almost 14,000 Ebola cases, with about 5,000 people dying from the disease, concentrated in the West African countries of Liberia, Sierra Leone, and Guinea. An unusually high rate of infection is occurring among healthcare workers, largely the result of lack of personal protective equipment, and more than 400 health workers have contracted the virus, with more than 230 dying of it, as of early October. In Liberia, Ebola is grimly nick- named the "nurse killer" disease. Before announcement of Pham's infection, a nurse's aide in Spain was also confirmed to have con- tracted the disease. "We have the resources in this country, but we have hospitals pick- ing and choosing what to do," said Bonnie Castillo, RN and director of the NNU-affiliated Registered Nurse Response Network, which raises funds and sends RN volunteers to disaster zones. "Unfortunately, they are not stepping up to their responsibility. And we are not going to be silent. We will be in front of our hospitals, letting the public know if they are ready or not ready. Far too many are not ready." Because of NNU's outspokenness on the issue of preparedness, Castillo received a critical phone call days later. Some of the registered nurses who work with Pham at Texas Health Presbyterian wanted NNU's help to let the news media and public know what conditions were really like at the hospital while treating Duncan, but they needed to stay anonymous for fear of retaliation and termination. After vet- ting their story, NNU called a press conference on Oct. 14, where NNU leaders read a statement written by the Dallas nurses describing exactly the situation RNs across the country had been warning against: Lack of preparedness naturally led to chaos and confusion and needless exposure of healthcare workers to the Ebola virus. The nurses described how, because nobody was sure what to do, Duncan was not immediately isolated and had been left for hours in an area of the emergency room with seven other patients. They described how when they called the hospital's infectious diseases specialists, the unit did not have answers and said they would need to "get back to them." They described how the personal protective gear that they were using at the time left a large triangle of skin on their necks—an area very close to their mouths—exposed. Nurses had to devise a makeshift solution: wrap medical tape over that gap. Ebola waste in some places was piled up to the ceiling. The list goes on. "Were protocols breached? The nurses say there were no proto- cols," their statement reads. On Oct. 15, the same day as a scheduled international conference call for RNs on Ebola, news broke that a second RN, Amber Vinson, had also tested positive for Ebola. The urgent need for full-body haz- mat suits, powered air-purifying respirators, hands-on training and drilling, and enough RN staffing so that nurses could watch one another don and doff the suits and have sufficient time to take care of patients was never more apparent. On the conference call, registered nurses from across the country shared how their facilities were not ready. Yadira Cabrera, an RN in El Paso, Texas, said her hospital claimed to be ready, but nurses in reality had only had 10 minutes of education and were given a flyer referring them to CDC website links. John Armelagos, RN and pres- ident of the Michigan Nurses Association, said his hospital had no hazmat suits, only equipment and gloves made of cheap materials, and the gowns they were told to use were too short. Karen Wild- burger, a Florida RN, described how she was suspended from work just because she independently contacted the CDC to ask for infor- mation and educational materials since her hospital had done noth- ing. (Wildburger, thanks to her union, was later reinstated.) "It's a mess. We need help," said Washington, D.C. RN Donna Fleming Cobey, summing up the situation. That day, NNU sent President Obama a letter asking him to exer- cise his executive powers to mandate that every hospital provide healthcare workers with the optimal level of personal protective equip- ment that CDC staff and staff at other hospitals specializing in infec- tious diseases use, and teach them how to properly utilize the gear. The next day, one of the Dallas nurses who had originally approached NNU went public with her story. Briana Aguirre, an RN who had taken care of colleague Nina Pham, described many of the same details NNU had released previously with the national news media. "We could not be more proud of Briana, are grateful for her contacting us, and join with nurses and the public everywhere in praying for her safety," said DeMoro. At this point, it was pretty obvious that all U.S. hospitals should be stocking the equipment NNU nurses were demanding, and teaching all staff—not just certain units—how to use the gear. The CDC updated its recommendations to reflect just that on Oct. 21. But the vast major- ity of hospitals were still not complying. And the CDC's recommenda- tions are just that—suggestions, not rules. Nurses also worked on the state level to win the Ebola safety standards they deserved. Massachusetts nurses were outraged when their Legislature's Joint Committee on Public Health convened a hearing Oct. 16 to discuss Ebola preparedness, but did not let front- line RNs testify. They showed up to share their stories with the media anyway. And in meetings with Gov. Jerry Brown and the state 14 N A T I O N A L N U R S E W W W . N A T I O N A L N U R S E S U N I T E D . O R G S E P T E M B E R | O C T O B E R 2 0 1 4