Why the nurse is not to blame for the Ebola “mistake”
There is a lot of talk about why the man diagnosed with Ebola at Texas Health Presbyterian Hospital was sent home from the emergency room not having been tested for Ebola despite telling the triage nurse he had been in Liberia.
Because they let him go, he came in to contact with up to 20 people including a handful of school aged children. According to CNN, “Hospital officials have acknowledged that the patient’s travel history wasn’t “fully communicated” to doctors” (CNN article). CNN also reports that “‘A travel history was taken, but it wasn’t communicated to the people who were making the decision. … It was a mistake. They dropped the ball,” said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.”
“They dropped the ball”. I certainly hope Dr. Fauci is not talking about the nurse.
Don’t get me wrong, internal communications, or lack thereof, is a very serious problem in healthcare today. And the common patient is often unaware of this. To the patient, if you tell one person, they will tell the others. Unfortunately, as we all to well know, this isn’t always the case.
The nurse was following a check list which asks about foreign travel as a part of the history taken on each patient with infectious symptoms. He or she must have documented this in a computer chart but they must not have verbally told the doctor. To be completely safe, a patient presenting with these symptoms with a travel history from Liberia who had contact with someone who died of Ebola should have been immediately put on contact isolation pending testing. But for this, we should not blame the nurse.
Each doctor is supposed to take their own history as a part of the examination of the patient. The fact that the emergency doctor or doctors did not take a thorough history is not the fault of the triage nurse. In fact, this isn’t a “communication” problem at all. It is an examination problem. For reasons unknown, because it hasn’t been addressed in the media, the doctor simply failed to ask the right questions.
This was a mistake, and hopefully not a deadly one. 80 people are now being monitored for signs and symptoms of the disease for the next 21 days, the incubation period of Ebola. They likely will be just fine. It is an unfortunate circumstance. BUT, lets not default to blaming the nurse.