Managing SARS quarantine measures in Taiwan: ‘Experiences of public health nurses’

Introduction
            The article ‘Confidence in controlling a SARS outbreak: Experiences of public health nurses in managing home quarantine measures in Taiwan’ is a 2006 publication authored by Chih-Cheng Hsu, Ted Chen, Mei Chang and Yu-Kang Chang and published in the American Journal of Infection Control, volume 34, issue 4. This article examines the level of confidence and the reasons behind the state of confidence in controlling the 2003 severe acute syndrome (SARS) epidemic among nurses in Taiwan. Hsu et al (2003) identify that the level of confidence depended on how serious the epidemic was perceived, daily reporting of the epidemic as well as the number of infected persons in a particular community.
Critique

            Public health nurses in Taiwan have portrayed professional confidence in the past as evidenced by their participation in eradicating malaria and implementing contraception policies. Nevertheless, the 2003 SARS epidemic met the nurses unprepared thus their professional confidence was at task. This was more so in ensuring that the home quarantine policy instituted by the National department of Health was successful yet health center nurses were not involved in coming up with the policy. With public health nurses being in contact with SARS infected patients and SARS suspected cases, most of them were greatly challenged since they lack the experience to handle the outbreak. In this study, Hsu and colleagues (2006) identified that a great majority of nurses (up to 72%) did not have confidence that the epidemic would be controlled in a short time. It was also evident that there were challenges encountered in the process of implementing the SARS quarantine policy. In specific, the nurses were concerned that they did not have enough protection against the virus. In addition, the public was not cooperative in the SARS control efforts not to mention that there was a communication breakdown between control agencies as well as non-existent standard operating procedures.
            While the Taiwan’s Department of Health responded promptly to the SARS outbreak, the measure did not consider the welfare of the public health nurses who were to have hands on job in the quarantine process. The safety of the nurse is paramount to ensuring that effective care is delivered (Cherry & Jacob, 2005). By failing to provide enough safety measures, nurses had to develop a pessimistic attitude towards success of containing SARS in Taiwan. In addition, it is notable that effective implementation of any policy depends on the participation of all stakeholders (McQueen, Jones & Jones, 2007). In this scenario, the public’s failure to adhere to quarantine procedures discouraged nurses from effectively handling the epidemic. While the public is to be blamed, the government and the quarantine program directors are mainly to blame due to poor communication concerning the seriousness of the outbreak. Furthermore, outdated information relayed to nurses failed to be in tandem with the situation on the ground.
            In controlling this epidemic, the Watson nursing model provides suggestions that can be effective. By recognizing that “caring can be effectively demonstrated and practiced only interpersonally” (Nursing Theories, 2010, para 2), the SARS quarantine policy would have focused on promoting the relationship between the nurse and the quarantined individuals. Due to the severity of the epidemic, provision of enough protective materials would have boosted nurses’ confidence to interact with the patients. Lack of confidence is indicative of lost faith and hope among nurses. Unfortunately, this is transmitted to the patient in the relationship between the patient and care giver. By focusing on building faith and hope in nurses and the public through provision of accurate and up to date data, nurses would have gained confidence on controlling SARS outbreak in Taiwan.

References
Cherry, B. and Jacob, S. R. (2005). Contemporary nursing: issues, trends, & management. 3rd Ed. ISBN 032302968X: Elsevier Health Sciences.
Hsu, C., Chen, T., Chang, M. and Chang, Y. (2006). Confidence in controlling a SARS outbreak: Experiences of public health nurses in managing home quarantine measures in Taiwan. American Journal of Infection Control, 34(4): 176-181.
McQueen, D. V., Jones, C. M. and Jones, C. (2007). Global perspectives on health promotion effectiveness. ISBN 0387709738:
Nursing Theories. (2010). Jean Watson’s philosophy of nursing. Retrieved 16, Aug. 2010 from http://currentnursing.com/nursing_theory/Watson.html