Shiloh
Editor, Senior Moderator
Source: http://www.canada.com/globaltv/national/health/story.html?id=61ac9a20-d08d-4cd4-a1e8-990253f03a19
No one ready for next crisis, nurses warn
Workers and system unprepared for outbreaks, disasters, researchers told
Joanne Laucius, Ottawa Citizen
April 16, 2008
Almost five years after SARS, a broad-ranging University of Ottawa study that asked front-line health workers about their ability to cope with large-scale health crises found that many still don?t feel prepared to respond.
And many have little confidence in the system?s ability to handle a public health emergency.
The study, to be released today, began about two years after the SARS outbreak of 2003 claimed 44 lives in the Toronto area. It took more than three years to complete and included five focus groups comprised of 100 registered nurses, registered practical nurses and nurse managers. The sessions were conducted in Ottawa, Toronto, Vancouver and Halifax between November 2005 and February 2006.
The study also included a web-based survey of 1,500 emergency and critical-care nurses.
About half had worked during an outbreak of an infectious disease, such as C. difficile, since the SARS outbreak.
The study?s range was from coast to coast, but perceptions were the same across Canada, said lead researcher Carol Amaratunga, a professor with the Institute of Population Health.
The study found that while almost three-quarters of the workers said they were ?a little? or ?somewhat? prepared for an infectious disease outbreak, 18 per cent were ?not at all? ready. Meanwhile, 21.1 per cent were ?not at all? prepared for a natural disaster; 69.4 per cent for a chemical weapons attack and 69.5 per cent for a biological weapons attack.
?Three years post-SARS, they really didn?t know what was happening, even in their own institutions,? said project co-ordinator Patricia Thille.
The findings are important, because there will be another public health crisis like SARS, she said. ?It?s just a question of when.?
During a crisis, the health of front-line workers must be protected to meet ?surge capacity? needs.
If it?s not, the health care workforce will shrink due to illness, quarantine and refusal to work, the study found.
But the nurses surveyed said they were already working at maximum capacity. ?The terrible secret is that there is no surge capacity,? one participant told the researchers.
Among the issues identified:
- Of three emergency rooms examined by researchers, none had a plan or requirement for regular fit testing of masks and other safety equipment such as gloves, gowns and face shields. One nurse commented that most workers had been fitted for a mask, but the testing certificate had expired six months ago.
- While doctors are provided with ?scrubs? in most hospitals, nurses have to provide and launder their own. Wearing uniforms out of the hospital and bringing them home to be laundered poses a risk to the public and workers? families, the study noted.
- Support for quarantined workers was an issue, especially the delivery of food, medications, masks and other protective equipment to workers who have no family member to bring them these items.
?One person was quarantined and had no groceries, no one to walk the dog,? said a participant.
- Workers also reported getting conflicting orders.
?I was in quarantine, called Friday afternoon and had a three-way phone conversation. Under no circumstances should I come in,? said one nurse.
?Someone would contact me from Public Health. Didn?t happen. Said they would send food. Didn?t happen. Next day called and asked me to come in.?
- More than 27 per cent of the workers reported having multiple jobs. Many nurses work on contract and as casual and part-time workers and have no guarantee that they would be compensated for lost time if they get sick.
?I am part-time. I have no benefits,? said one participant. ?Should I put myself at risk? What if I get sick for a long time??
- About 90 per cent of nurses in the field of emergency and critical care are women, and many found their duty as parents and spouses conflicted with their duty as nurses.
About 53 per cent of the workers in the study had dependent children living with them. Many were caught between their duty to care for patients and personal and family safety.
No one ready for next crisis, nurses warn
Workers and system unprepared for outbreaks, disasters, researchers told
Joanne Laucius, Ottawa Citizen
April 16, 2008
Almost five years after SARS, a broad-ranging University of Ottawa study that asked front-line health workers about their ability to cope with large-scale health crises found that many still don?t feel prepared to respond.
And many have little confidence in the system?s ability to handle a public health emergency.
The study, to be released today, began about two years after the SARS outbreak of 2003 claimed 44 lives in the Toronto area. It took more than three years to complete and included five focus groups comprised of 100 registered nurses, registered practical nurses and nurse managers. The sessions were conducted in Ottawa, Toronto, Vancouver and Halifax between November 2005 and February 2006.
The study also included a web-based survey of 1,500 emergency and critical-care nurses.
About half had worked during an outbreak of an infectious disease, such as C. difficile, since the SARS outbreak.
The study?s range was from coast to coast, but perceptions were the same across Canada, said lead researcher Carol Amaratunga, a professor with the Institute of Population Health.
The study found that while almost three-quarters of the workers said they were ?a little? or ?somewhat? prepared for an infectious disease outbreak, 18 per cent were ?not at all? ready. Meanwhile, 21.1 per cent were ?not at all? prepared for a natural disaster; 69.4 per cent for a chemical weapons attack and 69.5 per cent for a biological weapons attack.
?Three years post-SARS, they really didn?t know what was happening, even in their own institutions,? said project co-ordinator Patricia Thille.
The findings are important, because there will be another public health crisis like SARS, she said. ?It?s just a question of when.?
During a crisis, the health of front-line workers must be protected to meet ?surge capacity? needs.
If it?s not, the health care workforce will shrink due to illness, quarantine and refusal to work, the study found.
But the nurses surveyed said they were already working at maximum capacity. ?The terrible secret is that there is no surge capacity,? one participant told the researchers.
Among the issues identified:
- Of three emergency rooms examined by researchers, none had a plan or requirement for regular fit testing of masks and other safety equipment such as gloves, gowns and face shields. One nurse commented that most workers had been fitted for a mask, but the testing certificate had expired six months ago.
- While doctors are provided with ?scrubs? in most hospitals, nurses have to provide and launder their own. Wearing uniforms out of the hospital and bringing them home to be laundered poses a risk to the public and workers? families, the study noted.
- Support for quarantined workers was an issue, especially the delivery of food, medications, masks and other protective equipment to workers who have no family member to bring them these items.
?One person was quarantined and had no groceries, no one to walk the dog,? said a participant.
- Workers also reported getting conflicting orders.
?I was in quarantine, called Friday afternoon and had a three-way phone conversation. Under no circumstances should I come in,? said one nurse.
?Someone would contact me from Public Health. Didn?t happen. Said they would send food. Didn?t happen. Next day called and asked me to come in.?
- More than 27 per cent of the workers reported having multiple jobs. Many nurses work on contract and as casual and part-time workers and have no guarantee that they would be compensated for lost time if they get sick.
?I am part-time. I have no benefits,? said one participant. ?Should I put myself at risk? What if I get sick for a long time??
- About 90 per cent of nurses in the field of emergency and critical care are women, and many found their duty as parents and spouses conflicted with their duty as nurses.
About 53 per cent of the workers in the study had dependent children living with them. Many were caught between their duty to care for patients and personal and family safety.
