Returning Nurse from Africa Describes Her Ebola Screening & Mandatory Quarantine

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Published on: October 27, 2014

American health care workers and those from foreign nations who care for Ebola-stricken individuals in West Africa have a personal responsibility to self-quarantine for the World Health Organization recommended period of 42 days before resuming their normal activities upon returning home, either here or abroad. However, there have been 3 known individuals who have not followed any recommendations by either the Center for Disease Control (CDC) or the World Health Organization (WHO), which has exposed numerous Americans, placing them at risk. Any health care worker who does not exercise personal responsibility after being potentially exposed has been determined, by this former registered professional nurse, to be negligent, derelict in their duty and responsibility, and criminally responsible if they develop symptoms and potentially infect others.

Some health care workers may not agree with this position. In fact, one nurse who just recently returned from Ebola stricken West Africa penned an article for The Dallas News detailing her arrival in New Jersey. As you may recall, New Jersey is one of six states that has been charged with “the burden of Ebola screening.” Kaci Hickox, a nurse holding degrees from the University of Texas Arlington and Johns Hopkins University, returned to find herself being under “mandatory quarantine.” Ms. Hickox stated, “This is not a situation I would wish on anyone, and I am scared for those who will follow me.”

Ms. Hickox relayed the treatment she, as a health care worker, received upon declaring she had been to Sierra Leone with Doctors Without Borders. She stated, “I am scared that, like me, they will arrive and see a frenzy of disorganization, fear, and most frightening, quarantine.” Hickox described her “ordeal” in detail and assessed her treatment as “being made to feel like a criminal or prisoner.” Hickox described briefly how she cared for Ebola-stricken individuals, maintaining their dignity and humanity. Regarding the treatment of US health care workers returning from Ebola stricken areas, Hickox stated, “The US must treat returning health care workers with dignity and humanity.”

While the work in which Ms. Hickox engages is worthwhile, it does not preclude her from her responsibility from ensuring she “does no harm” to others. All individuals should be treated with dignity, respect, and humanity – not just returning health care workers who cared for Ebola-stricken individuals in West Africa. Probably unknown to Ms. Hickox is the fact that the federal government has charged six states with Ebola screening and monitoring of individuals entering the country from West African nations; and each state is charged with developing their own set of guidelines on what to do regarding quarantine and isolation. In other words, there are no set standards for the states to follow and no one has seen it necessary to develop any. Therefore, disorganization and confusion would be the order of the day.

Because the federal government has been derelict in its duty, the duty has now fallen to six states who are allowed to implement guidelines independent of each other without any continuity. It was a potential situation that was pointed out previously in another article. However, there still remains a 30% gap in the number of individuals entering this country from West African nations, as only 70% arrive through the six states charged with the monitoring and screening. Still, nothing has been addressed regarding this gap.

Hickox stated she went hours without food or drink and was only given a granola bar and water. She stated her temperature was taken with a forehead scanner, and she was sent to the hospital when it read 101 F. Her temperature had been taken orally before, and was recorded at 98.6 F.

As someone who has been labeled “anti-technology,” the forehead scanner for taking temperatures is the most inaccurate of all the methods. The oral method is more accurate, but even scanning the ear would have produced better results than the forehead scanner.

Leaving any individual without food or drink for four hours after a flight is unacceptable. Considering that it appears her entire ordeal, by her account, lasted seven hours, a granola bar and glass of water is totally unacceptable once being placed in a quarantine/isolation situation. Because it appeared there was no one in charge or any type of procedure to follow, Ms. Hickox relayed that very little food or hydration were offered to her, which means others probably went lacking as well.

These are the types of situations that occur when there are no set standard guidelines and each state is allowed to develop its own when it comes to monitoring and screening of individuals returning or entering the country from West African nations, regardless of being a health care professional or not. Measures hurriedly established and implemented because of the federal government’s negligence in its duty produces gaps in areas that might have been addressed had more time been given to develop standard guidelines for all states. It is a travesty and an example of inept leadership at the federal level.

While the article by Ms. Hickox is moving (as it is intended to be to draw outrage at monitoring and screening), it does not address the responsibility health care workers have regarding self-quarantine and isolation upon/before returning from West Africa after caring for Ebola-stricken individuals. Neither does Ms. Hickox address this situation as being a result of a derelict federal government. It is her personal, tunnel visioned account of her experience without giving one thought as to the root of the problem.

There is no health care professional who can attest that for 100% of the time they follow the protocols and guidelines 100% correctly. Anyone who can claim that is either so self-arrogant they believe themselves incapable of an accidental error or that being tired would not affect their performance, or they are essentially “perfect” and incapable of a mistake. Additionally, one would also have to believe these guidelines established for personal protection are based on medical science knowing “all there is to know” about Ebola. It is better to err on the side of caution by asserting that it is possible, despite all the precautions taken, that one has been exposed to Ebola while caring for Ebola patients. Under this assumption, personal responsibility would dictate a self-quarantine and/or isolation for the recommended period of time by WHO.

Six states would not be responsible for instituting monitoring and screening measures for individuals entering/returning from West African nations had a travel ban/restriction been implemented by the federal government – the only entity, by the way, that can implement such a policy. This government can ban travel to Israel because of some “political” game but cannot implement a travel ban/restriction because of a deadly, contagious virus. Something is very amiss here.

If the federal government had performed its duty, Ms. Hickox may not have been in the situation she experienced in New Jersey. By virtue of being a health care professional, Ms. Hickox was well aware of the dangers and responsibility she herself claimed when “choosing” to work in West Africa with Ebola stricken patients. She accepted by virtue of her choice any “extraordinary” measures that would be implemented to prevent a possible pandemic of this disease in America. While her “dignity and humanity” may have been violated, it is her duty to not potentially be a “walking carrier of disease” to any innocent individual with which she may come in contact.

Instead of railing about her “dignity and humanity,” maybe Ms. Hickox could support restricted travel to Ebola-stricken West African nations to essential medical personnel only and a ban of commercial, recreational, and business travel to those nations. But, her concern is more for the “dignity and humanity” of returning health care workers when faced with the monitoring and screening process, which is, admittedly, atrocious because of returning from these Ebola stricken West African nations. Where is the concern to not infect innocent individuals and the recognition that a possible exposure to Ebola occurred? Where is the acknowledgment of personal responsibility, the duty she possesses as a nurse to others?

Her article indicated her blood tests for Ebola returned negative. Can anyone be sure that the negative tests for Ebola are truly negative without follow up testing closer to the end of the incubation period? After all, there is a certain threshold of virus that must be present in order to trigger a positive result.

A wise nursing professor once said, “Anyone can nurse, but it takes a special someone to be a nurse.” Nursing, for most, is a career choice; but to be a nurse, one is called into service. It is a higher calling than just caring for the sick and infirmed, comforting the dying, and supporting those who have no support. It is a calling from God to be in his service to the sick and infirmed, the dying, and those without support. It is sometimes being called to make a sacrifice when others will not. It is a willing choice – a choice one makes without complaint – and a choice to suffer consequences, either good or bad, because of that calling. There is a science and art to being a nurse, but there is also the spiritual aspect as well—an aspect that brings with it tremendous personal responsibility and accountability.

Because being a nurse entails more than just education, science, and art, those individuals who are nurses should remember this when choosing to enter an area where great service and sacrifice will call for much more than just education, science and art.

However, Ms. Hickox’s rant against measures instituted by one of the states “charged” by the federal government with screening, monitoring, and dealing with individuals who have potentially been exposed to Ebola has produced results; it gained the attention of a well-known civil rights attorney. According to a report by The Blaze, Hickox has planned to file a lawsuit in federal court alleging violation of her civil rights. Norman Siegel, attorney for Hickox, stated “We’re not going to dispute that government has, under certain circumstances, the right to issue a quarantine. The policy is overly broad when applied to her.” Additionally, New York Governor Andrew Cuomo has indicated the strict guidelines for mandatory Ebola quarantine will be dropped. In New York, returning health care workers will be allowed to quarantine in their own homes for the “21 day” incubation period while being monitored by New York Department of Health and Mental Hygiene, who will conduct at least two unannounced visits to ensure compliance with the state quarantine measures.

Hickox’s attitude and actions resound with narcissism, arrogance, and selfishness. She acts like a child who has had her favorite “blankie” taken away. Her civil rights are more important than another individual’s right to live, in her eyes. Because of her unwillingness to exercise professional, civic, and personal responsibility and comply with needed health mandates, she is going to file a federal lawsuit alleging civil rights violations. Ms. Hickox has probably not been made aware of the three health care professionals who have contracted Ebola and exposed innocent individuals because of their lackadaisical attitude and “I’m perfect in performance” arrogance. But if she was, would she even care in the first place? Probably not, because in her eyes she could not possibly have Ebola, as she followed guidelines for personal protection perfectly 100% of the time.

This “nurse” is a disgrace to the profession, and so are other medical professionals who refuse to exercise personal and professional responsibility. She should not tout and “brag” about her “sacrifice” to travel to West Africa and care for Ebola infected individuals if she is unwilling to make a sacrifice to ensure that individuals in the US do not become infected by following a mandatory quarantine in the place determined by the state charged with instituting measures to ensure health safety.

America has witnessed medical professionals not performing their professional duty and personal responsibility for whatever reason. When individuals declaring themselves “medical professionals” refuse to act professional and responsible, it is up to others to ensure their lack of ethics and morals do not contribute to a health care disaster in our society. If Ms. Hickox doesn’t like that, then maybe this “nurse” should consider another career as she is not an individual who can “be a nurse.”

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