General Discussion

That is why truck drivers are required to take breaks.

Hell, I can be fairly fried by hour 8 of day 4 of my job in any given week, and I work (nominally) 8 hour days at a far less stressful and hectic job than nursing.

And let's not even mention the way the DOCTORS are pressured to "process" patients in the least possible time. I'm sure the ER is much worse than scheduled appointments.

I refuse to blame the nurses or doctors. I blame the failure of the US populace to insist on the implementation of a high quality, standardized electronic health record system that could easily be updated to flag patients based on certain information. As a programmer I know what is possible, and I also know something about what is and isn't happening in the EHR world. It's disgraceful. Like almost everything else in this country, it is being driven by capitalist theory and profit motive, rather than what is best for society. Thus we have a multitude of disjointed, difficult to use EHR systems that probably make it impossible for the CDC to rapidly apply a new protocol for an emerging epidemic. (Let's imagine for the moment that we aren't discussing ebola, but something far more contagious by being airborne or having more prevalent animal hosts.)

It would be fairly simple to program the EHR to flag the record based on the content (or missing content) in certain responses, and popup a bright red warning message when someone tries to mark the record to be discharged. Probably this hospital has already attempted to do that, now, after this incident. But what about every other hospital in the country? We are relying on every hospital or hospital system with a discrete EHR software instance, to ask their IT staff to apply a change like this. Which will get done when the IT staff gets to it. Which may only be after the first ebola patient comes through that hospital's ER. And that's only the hospitals ... what about doctor's offices? Other clinics?

Anyway, in short, the blame belongs to the demands of capitalism and profit motive being applied to a supposed "health care" system.

(I do want to be clear that I don't think everyone involved in health care and EHR development are "evil profiteers". I think most are well-meaning people trying to do good, but trapped in an evil profiteering and counterproductive system that has unfortunate consequences for patients and society in general.)