Don’t Panic, Prepare: Edgy Moment for H1N1

September 29, 2009

By Shawn Kennedy, MA, RN, AJN editorial director & interim editor-in-chief

'Nuff Said by ElektraCute / Elektra Noelani Fisher, via Flickr.

'Nuff Said by ElektraCute / Elektra Noelani Fisher, via Flickr.

While many people (including nurses) remain relatively unworried about the coming flu season, others, it seems, are on high alert. I do wonder about the millions of dollars being spent (and being made) in the name of H1N1 (swine flu). I’ve heard of several seminars touting “must-know” facts and bearing titles that might make hospital administrators feel negligent if they don’t send staff (at hefty registration fees). Many companies, including mine, are distributing bottles of hand sanitizer to employees. And I can’t even imagine how many N95 respirators have sold since the Institute of Medicine (IOM) recently recommended their use by health care workers caring for patients with pandemic (H1N1) 2009 influenza.

Take it seriously. Still, as a former emergency nurse, I’m all for being prepared for disasters. This influenza should be taken seriously. As of September 20, the World Health Organization reports there have been 3,917 deaths and more than 300,000 confirmed cases worldwide, although the actual number of cases is probably much higher.  The latest surveillance report from the Centers for Disease Control and Prevention indicates widespread flu activity throughout much of the United States already this year.

Mandated vaccinations for health care workers. The unusually high number of U.S. cases last spring—not typically flu season in the northern hemisphere—have some asking whether we’re in for a more severe and more deadly flu season, which officially begins on October 4. Concerned not only about preventing outbreaks but also about having enough health care workers to care for those who do contract it, the New York State Department of Health has mandated that health care workers who provide direct patient care must receive the flu vaccine.  (Comments on recent Off the Charts posts discussing health care workers’ reasons for declining the vaccine reveal what a controversial issue this is.)

Los Angeles ER a sign of things to come? Last week the IOM released Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations to guide facilities in the event that health care systems are overwhelmed with patients—a timely release, as it turns out. On Saturday, the Los Angeles Times reported that Los Angeles Metropolitan Medical Center “voluntarily closed its four-bed emergency room Sept.18 after a surprise visit by state health inspectors, who found two of three emergency room nurses were out sick [with the flu] . . . Hospital officials improved backup staffing plans and now expect to meet with state inspectors to reopen the emergency room” this week.

How will your hospital cope if many physicians, nurses, aides, lab workers, and support staff don’t show up because they’re either already sick or afraid to venture out for fear of getting sick? What if there are too many patients and not enough beds or medication or mechanical ventilators?  Scary stuff, indeed, and I hope it remains something we only talk about. But if your facility hasn’t started talking about these possibilities, you should.

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