At the Texas hospital where a Liberian Ebola patient died last week, nurses complain that they were given little guidance on how to treat the severely ill man, contrary to assertions by US health authorities.
The head of the US Centers for Disease Control and Prevention (CDC), Thomas Frieden, said earlier this week that a "breach in protocol" by health workers led to a nurse becoming infected with the potentially fatal virus.
But a national union speaking late Tuesday on behalf of the Texas nurses rejected the assertion that protocols were breached.
They told reporters at a telephone news conference that clear treatment guidelines for Ebola were all but non-existent at the Texas hospital.
"The CDC is saying that protocols were breached, but the nurses are saying there were no protocols," said Roseann DeMoro, head of the group National Nurses United, in a phone conference from California.
The nurses' union shared the revelations from workers at Presbyterian Hospital Dallas without disclosing their names, because many were afraid that their candor could cost them their jobs.
The first time that the patient came to the hospital he was sent back home, despite having told nurses that he had been in Ebola-stricken Liberia -- information that authorities now say should have been a clear tip-off that he could be infected with the illness.
- Duncan exposed 'for hours' -
When the patient, Thomas Eric Duncan, returned a few days later, feverish and visibly ill, he was made to sit for hours in an emergency room waiting area, exposed to other patients.
The nurses said that after he was admitted, there were no guidelines on how to discard the Liberian patient's soiled towels and linens.
During much of his hospital stay Duncan was overcome with bouts of vomiting and diarrhea, and the nurses said they had received no clear-cut guidelines about how the toxic mess would be cleaned off the floor, or who would do it.
After Duncan's death, authorities confirmed that Nina Pham, a nurse at the hospital who took care of him after he was admitted to the hospital, has been infected with Ebola.
A newly-minted nurse with just a couple of years' experience under her belt, Pham cared for Duncan for more than a day but is not aware of any problem with her protective gear, DeMoro said.
Still, she somehow became infected and now is being treated for the illness at the same hospital where she contracted the disease.
DeMoro expressed outrage that anyone caring for a patient with Ebola would be made suspectible to contracting the illness, and said the young nurse was failed by the medical establishment.
"That is not protecting our nurses," an outraged DeMoro said.
"It should not have happened to anyone. And there are a lot of culpable people in this paradigm."
Deborah Burger, the NNU's co-president, said Duncan's lab samples were sent in the hospital tube system "without being specifically sealed and hand delivered," Burger added.
"The entire tube system was potentially contaminated," she said.
"There was a lot of confusion about (gear) protocol, and frequent changing of instructions."
The nursing staff said that they were directed to wear standard or generic hospital gowns that are flimsy and could be permeated or ripped.
They also complained that they were advised to use surgical masks, not the plastic welder-type shield mask considered a best option.
And while they wore protective gloves, parts of their heads and necks remaine exposed, she explained
DeMoro pointed the finger not just to the Texas hospital where Pham worked, but at the US health care overall.
It "is a chaotic system," she said.
"The federal government should mandate optimal standards so that nurses are protected," she argued.
She also blamed corporate interests and lobbies for opposing national medical spending that could address pandemics smoothly.