A Retrospective on Nursing During the 2014 - 2016 Ebola Outbreak

Abstract

The 2014-2016 Ebola virus disease (EVD) epidemic in West Africa was one of the most severe global health crises of the 21st century. Nurses, as the largest group of direct care providers, faced extraordinary risks and responsibilities during this outbreak. This document explores the multifaceted role of nurses in EVD management, emphasizing the dangers they faced, the leadership they provided, and the public's shifting perception of their work. The document also addresses how Ebola's transmission dynamics and containment measures affected nursing practice, and how the epidemic evolved into a complex humanitarian emergency (CHE).

Through analysis of documented experiences, media coverage, and global responses. This document illustrates the essential contributions of nurses during the EVD crisis and underscores the need for better support and recognition of nursing roles in future epidemics.
The Role of Nurses in the Ebola Virus Disease Epidemic:

Introduction: Nurses on the Frontlines

Nurses are the largest group of healthcare professionals providing direct patient care, placing them at heightened risk of workplace-acquired infections. During the 2014-2016 Ebola epidemic in West Africa, the lack of information on proper personal protective equipment (PPE) usage and isolation precautions created widespread fear. This fear prompted many nurses and other healthcare professionals to leave the workplace altogether (Etienne et al., 2015).

Understanding Ebola Virus Disease and Transmission

EVD is caused by the Ebola Virus (EBOV), a highly virulent pathogen and one of five known species of Ebola viruses. EBOV is primarily transmitted through direct contact with the bodily fluids of infected individuals, including blood, semen, saliva, feces, and breast milk. Although transmission is mainly contact-based, EBOV can also be spread through droplets, though the full extent of this mode remains unclear. Transmission risk decreases with distance, but droplet precautions remain essential for healthcare workers (Judson et a1., 2015).

Patient Care and Safety Protocols

Caring for EVD patients requires strict biosafety and isolation protocols. Staff must be trained in specific competencies to ensure containment of the virus and to maintain a safe healthcare environment (Feistritzer et a1., 2014). The implementation of such protocols is vital to ensure both patient outcomes and healthcare worker safety.

Nurses leading the Fight Against EVD

Nurses in West Africa played a pivotal role in preventing disease spread and maintaining public health during the outbreak. Severely understaffed healthcare systems struggled to respond effectively to the crisis, making nursing leadership crucial. Nurses helped coordinate response efforts, protect frontline workers, and provide essential care during the epidemic (Sagar, 2015).

Humanitarian Implications: More Than a Disease

The Ebola epidemic represented more than a viral outbreak, it was a complex humanitarian emergency (CHE). The crisis intersected with broader issues such as health, politics, environment, and security. The epidemic destabilized West African societies and exposed their systemic vulnerabilities. Nurses were among the global responders addressing not just the disease, but its wide-ranging societal impacts (Downes, 2015).

Public Perception and Media Portrayal

Public understanding of the nursing role during the epidemic was shaped heavily by the media. Hall and Kashin (2016) conducted a document and content analysis of 234 articles, 125 of which were analyzed in depth regarding the portrayal of nurses during the 2014-2016 Ebola epidemic. Their findings revealed that the public largely misunderstood the nurse's critical role. As the outbreak progressed, media portrayals of nurses shifted from positive to negative, reflecting changing public sentiment and media narratives.

Courage in the face of Fear

Despite the danger, many nurses showed unwavering commitment. British nurse Will Pooley volunteered in Sierra Leone and became the first British citizen diagnosed with EVD. His efforts, along with those of countless others, illustrated the courage and resilience of the nursing profession during this crisis. Organizations like the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) mobilized global support to assist healthcare workers on the frontlines (Newland, 2014).

Conclusion

The 2014-2016 Ebola epidemic in West Africa highlighted the crucial role of nurses in global health emergencies. From frontline care and infection control to leadership and advocacy, nurses not only responded to a deadly virus but also to a complex humanitarian crisis. Their contributions, though often misunderstood or underrepresented, were vital to the international response to EVD. Recognizing and supporting nursing roles in future public health emergencies will be essential to improving global preparedness and resilience.

Conflicts Of Interest

The author declares no conflicts of interest present in this paper.

References

Downes E. (2015). Nursing and complex humanitarian emergencies: Ebola is more than a disease. Nursing outlook, 63(1), 12-15. https://doi.org/10.1016/j.outlook.2014.11.010

Etienne, N. L., Burns, C., & Conlon, H. A. (2015). Ebola Virus Disease. Workplace health & safety, 63(12), 551-553. https://doi.org/10.1177/2165079915607874

Feistritzer, N. R., Hill, C., Vanairsdale, S., & Gentry, J. (2014). Care of patients with Ebola virus disease. Journal of continuing education in nursing, 45{11), 479—481. https://doi.org/10.3928/00220124-20141027-12

Judson, S., Prescott, J., & Munster, V. (2015). Understanding ebola virus transmission. Viruses,
7(2), 511-521. https://doi.org/10.3390/v7020511

McGillis Hall, L., & Kashin, J. (2016). Public Understanding of the Role of Nurses During Ebola. Journal of nursing scholarship : an official publication of sigma Theta Tan International Honor Society ofNursing, 48(1), 91-97. https://doi.org/10.1111/jnu.12182

Newland J. (2014). Ebola: the power of nursing overcomes fear. The Nurse practitioner, 39(12),
7. https://doi.org/10.1097/01.NPR.0000456399.15780.34

Sagar P. L. (2015). Nurses leading the fight against Ebola virus disease. Journal oftranscultural nursing : official journal of the Transcultural Nursing Society, 26(3), 322-326. https://doi.org/10.1177/1043659615574326