Archive for the ‘H1N1 virus (swine flu)’ Category

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Mid-October Rainy Thursday Web Roundup

October 15, 2009

By Jacob Molyneux, blog editor/senior editor

The nursosphere is thriving and Change of Shift, the always interesting compendium of what’s new on nursing blogs, is up over at Emergiblog.

The health care reform process creeps slowly but surely toward an end someone somewhere can surely envision. One crucial question many are still asking is whether insurance companies might serve consumers a bit more readily and agreeably if they were forced to face a little competition from a public option. After all, isn’t competition supposed to be a good thing?

Most experts don’t expect the H1N1 vaccine to pose any more danger than the seasonal flu vaccine; even so, many Americans (and nurses commenting here, or taking our poll about the mandatory vaccine) continue to be wary, prompting public health officials to engage in especially aggressive surveillance measures in order to quickly detect any possible negative reactions to the vaccine: “Government Keeps Close Eye on Swine Flu Vaccine.”

AJN clinical editor Christine Moffa posted here a while back about how meditation might help cranky or exhausted or overworked nurses stay focused on what matters during the workday. Today the NY Times has a related piece on “doctor burnout” and meditation.

The role of social media in health care is constantly evolving as we all find our way. Its use by hospital workers is at issue in a recent post at Running a Hospital, about one hospital’s decision to ban social media from all its computers. And here’s something else on this: blogger Not Nurse Ratched wonders if social media policies in the workplace are going too far. How are Facebook, Twitter, etc., being used at your hospital?

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AJN Vaccine Poll Results

October 13, 2009

Update: Oct. 21: Thanks to everyone who took part in the vaccination poll (interestingly, only a fraction of those who visited the poll actually answered the simple yes/no question). The poll is now closed. The results: approximately 170 respondents (nurses?) answered the question “should the H1N1 vaccine be mandated for nurses?” Of these, 77% answered “no” and 23% answered “yes.”

Judging from comments we’ve received in response to other posts (here, here, and here) about the H1N1 vaccine, we surmise that not every nurse who answered no is actually opposed to getting the vaccine. They just don’t want to be told they have to get it. Others, of course (as some of the strongly worded comments left in response to this poll show) are entirely against it, whether it’s mandated or not. And others are wholeheartedly for it, firm believers that decisions made by experts using available evidence usually, if not always, lead to benefits for us all.

But there’s obviously a lot more to say on this topic, and we’ll be posting about it soon.

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Marketers Honing In On Online Nurses

October 2, 2009
Internet Splat Map (jurvetson/via Flickr)

Internet Splat Map (jurvetson/via Flickr)

Nurses, you’re being watched: a marketing Website has an article on the growing influence of nurses online. Let us know what you think. Here’s an excerpt:

. . . Manhattan Research recently released a report about nurses online noting that approximately three out of four U.S. nurses recommend health websites to patients. The study notes that the average nurse spends eight hours per week online for professional purposes, which is just as much time as physicians, and almost all of them use the Internet in between patient consultations. Nurses are also proactive in researching medical product information specifically online – over eighty percent have visited a pharma, biotech, or device company website in the past year.

In addition to the prevalence of the Internet as a research and patient communication tool, nurses are continuing to find their unique voices online through a growing number of prominent nursing blogs such as Codeblog and Emergiblog which both share powerful stories of healthcare from the nurses’ point of view.

Also found today on the Web: Read the rest of this entry ?
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Mandating Flu Vaccines for Nurses

September 30, 2009

By Diana J. Mason, RN, PhD, editor-in-chief emeritus

Yesterday, nurses and other health care workers from New York State went to the state capitol in Albany to protest a regulation issued by the New York State Department of Health mandating that all health care workers get vaccinated for both the seasonal flu and for the pandemic H1N1 2009 influenza by November 30th or lose their jobs. Deborah Gerhardt, RN, who was interviewed by USA Today, says she may have to lose her job because she doesn’t have confidence in the safety of the new H1N1 vaccine: “Just because the FDA approved the H1N1 vaccine ‘doesn’t mean it’s safe in my book.’”

mandatingflushotsNew York State Commissioner of Health Richard Daines, MD, disagrees, and followed up an open letter to health care workers released on September 24th with a press conference to defend the new policy. The New York State Nurses Association, which urges nurses to get vaccinated but is against mandatory vaccinations, wrote their own open letter in response.

Citing one study of health care workers during a mild flu season that showed that 23% of the workers showed evidence of having had the flu that season but that 59% of these said they didn’t have the flu that year, Daines said that his concern is that workers are carrying the virus and exposing at-risk patients without realizing it. When challenged on whether family members and other visitors represent an equally great threat to patient safety, Daines noted that some hospitals would close their doors to visitors if an infectious disease were spreading.

Should we have a choice? Does our health and safety come before that of our patients?

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For more on the ethics and safety of getting vaccinated, see these recent blog posts as well:

Nurses Express Safety Concerns About H1N1 Vaccine
Is It Ethical for a Nurse to Decline the H1N1 Vaccine?

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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. Read the rest of this entry ?

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Shortage of School Nurses Means Greater Student Vulnerability to H1N1

September 28, 2009

By Alison Bulman, AJN senior editorial coordinator

the school bus routine by woodley wonderworks, via Flickr.

the school bus routine by woodley wonderworks, via Flickr.

On Friday the New York Times reported that a shortage of school nurses is making students more vulnerable to the pandemic (H1N1) 2009 virus, stating that  “[m]any districts have few or no nurses to prevent or respond to outbreaks, leaving students more vulnerable to a virus that spreads easily in classrooms and takes a heavier toll on children and young adults.”

The article acknowledges the key role played by school nurse Mary Pappas, who we interviewed for this blog shortly after she’d helped identify the first U.S. cases of H1N1 at a school in Queens. As AJN reported in June, school nurses  have been and will continue to be on the front lines of efforts to prevent or manage outbreaks. But the school nursing shortage is acute, with just one nurse for every 1,155 students nationally, a ratio that the American Federation of Teachers has called “dangerous.” With a new school year underway, the Times reports, school districts are relying more heavily on non–health care personnel to identify and isolate sick kids and monitor absences.

For more on issues related to school nurses and nursing, see these recent posts:

Can School Nurses Help Prevent Heat Stroke Fatalities in High School Football?

Nurse Organizations Oppose Move to Allow Non-Licensed Personnel to Give Insulin to Students


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Nurses Express Safety Concerns About H1N1 Vaccine

September 9, 2009

By Jacob Molyneux, blog editor

Nurse blogger Not Nurse Ratched has written a post on her decision not to get the H1N1 vaccine shot until she is more convinced of its safety.

I’m just urging caution against the knee-jerk fear reaction that is, no doubt, going to make hordes of people swarm out to clamor for this vaccine. I’ll be watching for more data on it and might modify my decision, but for now I’m going to just say no.

Judging from responses to a recent post we ran on the topic (“cancel my subscription” appeared more than once), the loudest clamor may be from those who are driven by fear of the vaccine rather than fear of the H1N1 virus. In the post in question, Doug Olsen, a nurse ethicist, examined the ethical side of the question of whether or not nurses should get vaccinated. 

(Whether or not you agree with Olsen’s guarded conclusion in favor of vaccination, his post demonstrated how a professional ethicist uses a set of concepts as tools—not to come up with a definitive answer that can be called “right” or “wrong” but instead to examine the moral dimensions of a decision. We hope that some of the concepts he used will be seen as tools to help nurses make their own informed decisions.) 

By way of update, here’s an addendum we received from Olsen that addresses some of the concerns about vaccine safety expressed in the various comments:

Any obligation of nurses to protect the patient by getting flu vaccine depends on trust in the science and in the system for doing and reporting the science. Reasons for not trusting the system run the gamut from easily dismissed conspiracy theories to healthy, well-founded skepticism. Read the rest of this entry ?

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Is It Ethical for a Nurse to Decline the H1N1 Vaccine?

August 26, 2009

By Douglas Olsen, PhD, RN. Olsen is an AJN contributing editor who co-coordinates the journal’s Ethical Issues department and a nurse ethicist with the National Center for Ethics in Health Care at the Veterans Health Administration in Washington, DC. The views he expresses here are meant to stimulate discussion of this topic and not to serve as pronouncements guiding what nurses should or shound not do. The views are his alone and should not be construed as representing those of AJN or of the National Center for Ethics in Health Care or the Veterans Health Administration.

MailOnlineFluJabScreenshotPublic health experts advocate widespread flu vaccination for people who give direct care to patients. However, in the past less than 40% of health care workers have been vaccinated for flu, and in a recent Nursing Times survey from the UK 30% of nurses said they would decline H1N1 vaccine and only 37% said “Yes” they would take the vaccine. Here are some thoughts on how to sort out the question from an ethical perspective.

Nurses, as patients, should be accorded the same respect for their decisions about health care, including the right to refuse a treatment, that is due to all patients. In ethics this is called respect for patient autonomy.

Professional obligation. However, nurses have a professional obligation to do as much as is reasonably possible to care for their patients. This includes incurring a certain amount of personal risk in giving care. Nurses incur risk on the job all the time from infections, violent patients, and many other sources.

In 2006 the American Nurses Association (ANA) put out a position paper that gives some guidance on the degree of risk that’s reasonable for nurses to accept in giving patient care: “[t]he benefit the patient will gain outweighs any harm the nurse might incur and does not present more than an acceptable risk to the nurse.”

Risk versus benefit. And so, the question is whether the degree of benefit expected for patients outweighs the degree of risk from the vaccine.  Read the rest of this entry ?

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H1N1 Update: Nurses Protest Unsafe Handling of Swine Flu Patients; Tamiflu’s Risk for Children May Outweigh Its Benefits

August 10, 2009

More than 100 nurses gathered on the steps of the University of California at San Francisco Medical Center today to protest what they say are unsafe practices in the handling of swine flu patients. (Read more.)

The protesting nurses pointed to understaffing as a potential contributor to the unsafe practices.

And Nursing Times has this, regarding new research on the use of Tamiflu (oseltamivir) in children:  “Risk from Swine Flu Drugs Outweighs Benefits in Children”

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CDC Advisors Make Recommendations for Use of Vaccine Against Novel H1N1

August 7, 2009

AJN received this advisory earlier this week from the CDC:

swineflu2In July 2009, CDC’s Advisory Committee on Immunization Practices (ACIP) made recommendations on who should receive vaccine against novel influenza A (H1N1) when it becomes available, and which priority groups should be vaccinated first if the vaccine is initially available in extremely limited quantities. Five key populations were focused on by the committee to help reduce the impact and spread of novel H1N1. The key populations include those who are at higher risk of disease or complications, those who are likely to come in contact with novel H1N1, and those who could infect young infants. The committee recommends that when the vaccine becomes available, the following groups, accounting for approximately 159 million people in the United States, should receive the vaccine first:

• pregnant women,
• people who live with or care for children younger than 6 months of age,
• health care and emergency services personnel,
• persons between the ages of 6 months through 24 years of age, and
• people from ages 25 through 64 years who are at higher risk for novel H1N1 because of chronic health disorders or compromised immune systems.

The committee does not expect that there will be a shortage of novel H1N1 vaccine, but availability and demand can be unpredictable. There is some possibility that initially the vaccine will be available in limited quantities. In this setting, the committee recommended that the following groups receive the vaccine before others:

• pregnant women,
• people who live with or care for children younger than 6 months of age,
• health care and emergency services personnel with direct patient contact,
• children 6 months through 4 years of age, and
• children 5 through 18 years of age who have chronic medical conditions.

The committee further recommended that once the demand for vaccine for these prioritized groups has been met at the local level, programs and providers should begin vaccinating everyone from ages 25 through 64 years. Current studies indicate the risk for infection among persons age 65 or older is less than the risk for younger age groups. Therefore, as vaccine supply and demand for vaccine among younger age groups is being met, programs and providers should offer vaccination to people over the age of 65.

The committee also stressed that people over the age of 65 receive the seasonal vaccine as soon as it is available. The novel H1N1 vaccine is not intended to replace the seasonal flu vaccine. It is intended to be used alongside seasonal flu vaccine to protect people. Seasonal flu and novel H1N1 vaccines may be administered on the same day.

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