Don’t Panic, Prepare: Edgy Moment for H1N1

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

'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 […]

2016-11-21T13:22:05-05:00September 29th, 2009|nursing perspective|0 Comments

Shortage of School Nurses Means Greater Student Vulnerability to H1N1

By Alison Bulman, AJN senior editorial coordinator

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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2016-11-21T13:22:07-05:00September 28th, 2009|Nursing|1 Comment

Nurses Express Safety Concerns About H1N1 Vaccine

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 […]

Vaccine Wars Ensue as H1N1 Mutates – Just Alarmist Sci-Fi Fantasy?

Picture this: in early September of this year, the novel H1N1 influenza virus mutates into a strain that can quickly lead to wracking fevers, violent vomiting, respiratory failure, dehydration, and death. It is also highly resistant to existing antiviral agents. The first cases of this new strain are identified after a spate of deaths in a Kansas City nursing home as well as among members of a church choir in the same city. The new strain quickly shows up in a number of major metropolitan areas in the U.S. and then in several European countries. As hospitals are swamped and the number of deaths rises unabated, borders are sealed between countries—but it's too late to stop the new strain from spreading as the fall and winter flu season gets into full swing.

CDC Guidance for Nurses on the Swine Flu

 

Photo by AlphaTangoBravo/Adam Baker, via Flickr. Photo by AlphaTangoBravo/Adam Baker, via Flickr.

The following comes to us from the Centers for Disease Control and Prevention (CDC):

 

Swine Flu Guidance for Clinicians & Public Health Professionals [as of April 29, 2009, 1:45 AM ET]
http://www.cdc.gov/swineflu/guidance/
Clinicians should consider the possibility of swine influenza virus infections in patients presenting with febrile respiratory illness. If swine flu is suspected, clinicians should obtain a respiratory swab for swine influenza testing and place it in a refrigerator (not a freezer). Once collected, the clinician should contact their state or local health department to facilitate transport and timely diagnosis at a state public health laboratory.

Interim Guidance for Clinicians on Identifying and Caring for Patients with Swine-origin Influenza A (H1N1) Virus Infection [as of April 29, 2009 2:00 AM ET]
http://www.cdc.gov/swineflu/identifyingpatients.htm
Interim guidance is provided here for nurses and clinicians who might provide care for patients with swine-origin influenza A (H1N1) or suspected swine-origin influenza A (H1N1) virus infection. It will be periodically updated as information becomes available.

Transmission
Transmission of swine-origin influenza A (H1N1) is being studied as part of the ongoing outbreak investigation, but limited data available indicate that this virus is transmitted in ways similar to other influenza viruses. Seasonal human influenza viruses are spread from person to person primarily through large-particle respiratory droplet transmission (e.g., when an infected person coughs or sneezes near a susceptible person). Transmission via large-particle droplets requires close contact between source and recipient persons, […]

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