By Sylvia Foley, AJN senior editor
“It is extraordinarily difficult to establish an IV line in a dehydrated patient by generator-powered light while double gloved, with one’s goggles fogging.”—Deborah Wilson
In one of this month’s CE features, “Inside an Ebola Treatment Unit: A Nurse’s Report,” author Deborah Wilson offers readers a rare look from the frontlines of the 2014 Ebola epidemic. Her stories about her patients and colleagues are as compelling as they are informative. Here’s a short overview of the article:
In December 2013, the first cases of the most recent outbreak of Ebola virus disease (EVD; formerly known as Ebola hemorrhagic fever) emerged in the West African nation of Guinea. Within months the disease had spread to the neighboring countries of Liberia and Sierra Leone. The international humanitarian aid organization Médecins Sans Frontières (MSF; known in English as Doctors Without Borders) soon responded by sending staff to set up treatment centers and outreach triage teams in all three countries. In August 2014, the World Health Organization declared the outbreak an international public health emergency.
In September 2014, the author was sent by MSF to work as a nurse in an Ebola treatment unit in Foya, Liberia for five weeks. This article describes her experiences there. It provides some background, outlines the practices and teams involved, and aims to convey a sense of what it’s like to work during an Ebola outbreak and to put a human face on this devastating epidemic.
Responding to the challenges. As Wilson notes, there is no cure for EVD. Current standard treatment is aimed at providing “‘aggressive’ supportive care, which consists of oral and IV medication, oral and IV rehydration, nutritional supplementation, and psychosocial support.” But meeting this standard can be challenging in places where even basic resources are limited or absent and fear runs high. And when the international community is involved in a local response, transcultural issues arise. At Foya, open and ongoing discussions between the international and Liberian health care workers proved essential to incorporating Liberian cultural values and fostering “creative thinking and mutual support.” Wilson also details the coordinated strategies necessary for effective intervention at the organizational and national levels.