Discussion – week 15

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    Rachel Vargo

    1) Dr. Evans benefitted from the protocol that New York planners had created after seeing the arrests made from Memorial. She had the foresight to study the guidelines on how to allocate ventilators in a severe respiratory pandemic, likely because she saw what happened in New Orleans. Questions remaining include how do we let patients know that they would not get power outlets and what if someone had been willing to give up their outlet for someone else had they been asked.

    2) The emotions Sheri felt were likely surreal. She spent a lot of her professional career studying all the things that went wrong in New Orleans, and then she is in New York watching some of the same mistakes take place. The mayor had made an identical evacuation call as the mayor of New Orleans did, which saw hospitals stranded without help if their generators went out. She says herself “after everything that should have been learned about those horrific days in New Orleans, another hospital in a major city now found itself without power, its staff fighting to keep alive their most desperately sick patients”. Experts tried to find out what guidelines they could set to minimize damage and to do the most good possible. They recommended ways to stretch their supplies and New York purchased a bunch of extra ventilators. Ontario experts created the SOFA system and Pou fought to create immunity laws for practitioners working through emergencies.

    3) Maryland allowed the general population to take part in planning instead of just “expert opinions”. They educated the public about how a scenario like this happens and what difficult decisions have to be made during it. However, this makes it harder to come to a conclusion because everyone argues over what is best. I think Fink means that science is great at giving black and white answers, but the issue of triage during an emergency has nothing black or white about it, it’s all gray. With something so morally questionable, maybe science isn’t appropriate for making our choices and we can rely on our values and ethics.

    4) I feel like the AMA does a good job of supporting doctors and nurses in a difficult profession. When many issues arose that the AMA didn’t have guidelines for following Katrina, they quickly addressed them and made appropriate decisions. It’s unfortunate to see how corrupt the justice system can be in America. How Foti and many others wanted Pou and the nurses behind bars more than anything else but weren’t worried about all the murderers walking free on the streets. I think having medical cases reviewed by medical professionals alongside the attorneys and judges to help clarify things the average person without medical knowledge wouldn’t understand, could be very helpful for future cases.

    5) When Bernier states this he is referring to the fact that we always defer to professionals and experts when faced with a tough ethical decision, and we never step back and ask what the general population would want. I agree that the general public should be able to voice their opinions, but when dealing with certain medical issues, I think it’s better to defer to professionals who have devoted their lives to answering questions like this. Unfortunately, experts can be extremely partisan or not see a situation how someone else may see it, and may still make the “wrong” decision.

    6) Education can teach you how to use critical thinking and be able to prioritize things when an emergency or disaster occurs. This book highlighted how not being prepared or having a plan makes disasters 10 times worse. I know how much responsibility will be added when we become nurses, and I can have this book in the back of my head as a reminder to always be prepared. I will try to learn from emergency situations as I encounter them and figure out exactly what went well and what could go better next time, along with how to implement it.

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