The nurses complained that they were not provided with adequate personal protection equipment and were not well-informed on how much to use.
Texas Health Resources, however, said that all staff members treating Duncan wore appropriate personal protective equipment recommended by the CDC at the time, which included a gown, shoe covers, a face shield and an optional N-95 mask. When the CDC later said leg covers were required, Texas Health provided them, according to the statement. Nurses who were classified as “no known exposure” or “no risk” per CDC guidance were allowed to treat other patients, Texas Health said.
The CDC guidelines for personal protection equipment—which have changed over the past week—currently call for gloves, a fluid-resistant or impermeable gowns, eye protection and face masks, which can double as eye protection. The CDC also recommends double-gloving, disposable shoe covers and leg coverings in situations where copious amounts of body fluids are present. Though nurses expressed concern that skin was exposed by isolation gowns, Texas Health claims that they were directed to pinch and tape exposed areas, as recommended by the CDC. The system has since ordered hoods.
Texas Health Resources confirmed that the pneumatic tube system was used on Duncan's initial visit to the Dallas hospital, before he was diagnosed with Ebola, but specimens were in sealed bags inside plastic carriers that never leaked or spilled in the system, according to the statement. When Duncan returned to the hospital, the tube system was not used. Lab specimens were hand-carried in sealed containers according to protocol, and some routine labs were done in his room via wireless equipment, the health system said.
The nurses, who the union said feared losing their jobs if they identified themselves, spoke through an NNU leader. The union refused to describe how many nurses were included in the group, claiming that doing so would reveal their identities to their supervisors. NNU does not represent the nurses. The Texas affiliate of NNU has collective bargaining agreements at several Texas hospitals but none owned by Texas Health Resources.
Before Duncan arrived at the hospital, the nurses told NNU, they were not aware of a protocol for dealing with patients with Ebola-like symptoms. Rather, they were told to call the hospital's infectious disease department. The Texas Health statement did not respond specifically to allegations that nurses were ill-prepared.
The nurses also told NNU that some personnel moved freely in and out of the isolation area without wearing proper equipment and that the hallways between the isolation pod and other areas were not properly cleaned. These claims were also not addressed.
News reports Thursday claimed that some Texas Health Presbyterian nurses were considering a walk-out in protest of the company's handling of the situation.
Follow Adam Rubenfire on Twitter: @arubenfire