# 1947
While bird flu news may be slow right now, an essential debate continues among health care workers (HCWs) over whether they will work during a pandemic. Their concerns are numerous, and quite frankly, justified.
Here are just a few:
- Few hospitals are aggressively stockpiling enough PPE's (Personal Protective Equipment: Masks, gowns, gloves) to last their staff through a 12 week pandemic wave. Most will run out in less than a month, and resupply during a pandemic is doubtful.
- Many facilities, and governments, appear to believe that cheap surgical-type masks, instead of the more protective N-95 (or N-100) masks, will suffice for their personnel in a pandemic.
- With few exceptions, antivirals for HCW prophylaxis are not being stockpiled.
- Hospital security will be a huge issue, and is one that many facilities do not appear to be addressing. Angry crowds demanding medical care for loved ones will constitute a real and present danger for HCWs.
- Many HCWs have children or other dependants whom they could not leave unattended during a pandemic. No matter how dedicated they might be, for most HCWs, family comes first.
- With 40% absenteeism (and probably higher), combined with patient overload, those that do work could quite literally be `worked to death'. Long shifts, stress (physical & psychological), and fatigue will be major factors, and could well breed fatal mistakes.
- Some HCW's fear that their facility will be `locked down', and they may quarantined, and not permitted to leave; cut off from their families and friends for the duration.
- And of course, the ultimate fear is, if they are permitted to travel back and forth to work that they would carry the virus to their families.
While a certain number of HCWs won't be willing to work even with proper PPE's, polling data indicates that once PPE's are gone, or adequate security vanishes, that the majority of HCWs may leave their jobs.
I've covered previous polls here, here, and here.
About 10 days ago, after a six-month-long conversation in a thread called Will you work in a pandemic? on allnurses.com, a new poll was begun, asking if HCW's would work without proper PPE's in a severe pandemic.
I presented early results in a blog back on April 26th, where roughly 50.5% said they would work, while 28% said they would not, and 21% said they weren't sure.
As of today's writing, 579 HCWs have answered the poll, and the percentage of those that would refuse to work has gone up, while the percentage of those who would agree to work has gone down.
(click to enlarge)
The comments in this thread, now approaching 250, are most illuminating and should be read by every hospital administrator, health care worker, pandemic planner, and government official in the country.
If adequate provisions are not made for the protection of HCWs and their families, half of them may elect not to work in a pandemic. To this we must add the inevitable absenteeism due to illness, burn out, or caring for loved ones stricken with the disease.
Officials that blindly assume that HCWs will endanger themselves and their families during a pandemic are likely to find themselves greatly disappointed.
I urge them all to read all the comments in Will you work in a pandemic? and to take them seriously.
These are your troops, the ones you will need to battle a pandemic, and right now they are greatly demoralized by the lack of pandemic preparation they are seeing. If you ignore this issue, you do so at our nation's peril.
No one expects a firefighter to run into a burning building without bunker gear, and no one should expect a health care worker to expose themselves to a deadly infectious disease without proper protection.
This is an issue near and dear to me, as through the years some of my best friends have been HCWs. I intend to bang this drum loudly, and often.
One of the nurses on allnurses.com, Indigo Girl, who has been a tireless advocate of educating HCWs about pandemic issues, put it better than I possibly could.
I'm sure she won't mind if I quote her.
I hope that that the CDC and HHS are noting the responses in this thread.
The public will assume that nurses are going to be working.
The govt assumes this also.
Homeland Security, are you reading this?
When will you sit down and talk with us? We are not just statistics.
We are real individual people with families that depend on us.
This is an avoidable tragedy. But only if we face it head on, and do something about it now, before a pandemic strikes.
