On Monday November 17, experts from the School of Nursing, the School of Medicine, and UNC Health Care came together to discuss the realities of the Ebola crisis in Africa and how health care workers in the United States are preparing to care for people who contract the virus.
The evening began with remarks from Dr. Mary Tonges, PhD, RN, FAAN, Senior VP and Chief Nursing Officer for UNC Health Care. Treating Ebola patients requires strong collaboration between all members of the health care team, she said, even though the supportive care these patients require is traditionally associated with nursing. “Ebola has launched nursing into the national spotlight,” she said. “But as I said in the beginning, quality health care is a highly collaborative interprofessional team effort.”
During the first half of the town-hall style event, the panelists shared their own experiences and observations on the Ebola crisis. Dr. William Fischer II, MD, an assistant professor at the UNC School of Medicine (SOM), immediately dispelled one of the most common myths about Ebola—the myth that contracting the virus is a death sentence.
“With aggressive supportive care, we can drive down case fatality rates,” he said. “And this can be done in a safe manner.”
Dr. Fischer also pointed out that it is a misconception that most Ebola patients die from the profuse bleeding associated with the virus. According to him, most patients are likely to die from the intense response of their own immune systems.
He supported his assertions with data and his own experiences treating Ebola patients in Gueckedou, Guinea. He said he was initially very nervous about his assignment, but once he arrived, he realized his fears were exaggerated. “I instantly calmed down as soon as got to the Ebola treatment center,” he said. “I realized these patients look just like the patients we take care of in critical care units here.”
The focus of the discussion switched to preparation in the United States as Drs. Carol Durham, EdD, RN, ANEF, FAAN, a clinical professor of nursing at the SON, and Benny Joyner, MD, MPH, an assistant professor of pediatrics and anesthesia at the SOM, shared details about the simulation they created with their health care partners to prepare providers for caring for patients with Ebola. As directors of simulation programs at each of their schools (Education-Innovation-Simulation Learning Environment at the SON and the Clinical Skills and Patient Simulation center at the SOM), they have a wealth of experience developing simulations that encourage teamwork.
Ebola, they said, requires an even higher degree of teamwork because of the steps health care providers have to take to protect themselves and each other from the virus. The procedures include a buddy system in which team members partner up to prevent each other from doing things out of habit (like rubbing their eyes) that could expose them to Ebola. Dr. Durham said even if UNC Health Care never has to use these procedures, the work they have done on the simulation has established a new collaborative learning structure. “We hope that we are using these resources for naught,” she said. “In actuality, this work will never be for naught because the lessons we have learned from designing an interprofessional simulation for a high risk, complex patient care environment have prepared us to face future crises with enhanced communication and collaboration.”
Dalton Sawyer, Director of Emergency Preparedness and Continuity Planning at UNC Health Care, spoke about the steps (in addition to the simulation training) UNC Health Care has taken to prepare for delivering high-quality care to an individual with Ebola while also protecting their employees and patients. The UNC Health Care approach can be summed up in three words, he said, “Ask, isolate, and call.” They have established procedures so that providers know to ask the right questions, isolate the sick individual from others, and call the right people to assist.
The screenings UNC Health Care has instituted are designed to minimize fear and encourage people to speak up. Yet, as Dr. Rumay Alexander, EdD, RN, FAAN, demonstrated in her portion of the program, public reaction can vary widely. As director of the SON Office of Multicultural Affairs, Dr. Alexander used her keen insight on culture and diversity to describe the roots of fears about Ebola. “The Ebola crisis has created its own flavor of fear,” she said. “When things that are supposed to keep you safe— like national borders and national authority, seem porous and ineffective – it’s under these circumstances that skepticism about authority turns into corrosive cynicism and people seek to build walls.”
The second half of the evening was dedicated to tackling questions from the audience. Students, faculty, and other members of the community peppered the panelists with questions about everything from the technical details of how the Ebola virus survives to broader inquiries about the steps policymakers are taking to screen and monitor individuals returning from affected parts of Africa. The experts addressed students’ questions about training, provided advice to a mother whose son was preparing to travel to an Ebola-affected area, and addressed the questions posed by a man whose wife who is planning to offer her services as a nurse to Ebola patients in Africa.
Interim Dean and professor Donna Havens, PhD, RN, FAAN, concluded the evening with a few reflections on the evening’s discussion. She noted the crisis has led to changes in how health care providers are educated and how they collaborate in the workplace. “This event was a true interprofessional effort,” she said. “I think we need to watch this group [of speakers] because all of the people up here tonight are going to take these efforts to the next level.”
Additional Links and Resources
- Video about Ebola shown during the Town Hall
- Ebola information guide from the UNC Health Sciences Library
- UNC Health Care Ebola Update
- NC Health Info Website
- NC Department of Health and Human Services Ebola Page
- MedlinePlus Ebola Page
- UNC-Chapel Hill Department of Environment, Health, and Safety
- Pictures from the Town Hall