Friday, February 7, 2014

20140207 Current Events Mandatory Flu Vaccinations for Nurses

This article on medscape tells about a pregnant nurse who was fired for refusing the flu vaccine.  I find this situation to be very interesting.  I really want to side with the nurse.  I want to be able to say that I believe that should have been her option.  I want to say this because, in other cases, I myself would like the right to refuse a vaccination if I feel that it is not safe.

However, this is the flu vaccine.  I myself have never received it, but I do get it for my children every year, and when I begin nursing school, I will begin taking the shot.  I simply do not take it because I have never had the flu and I do not currently work with an at-risk population.  Since my children's immune systems are immature, I feel incumbent to vaccinate them.  Because the flu is so contagious, I do believe that anyone working in a hospital, long term care facility, or, really, anywhere where there is a concentration of people (such as a school) should receive the vaccination if they do not have a solid reason not to.

This nurse was pregnant, and she feared that the vaccination could put her baby at risk.  Her anxiety over this was so great that she was able to get a physician's note saying that the stress from worrying about this was putting her baby at risk.  However, this just is not fact-based.  While no group of pregnant women is assembled as part of a study of effects on pregnancies before the vaccine is released, data from after the vaccine is released shows that receiving the vaccine may actually lead to lower incidence of pre-term birth.

In an age of evidence-based practice, do we want a nurse who won't use the evidence?

And then, I do see her side.  How do we know what is true?  But anecdotal stories of things going awry are hard to critically examine, since they don't really give us enough information to prove causality.  In some cases, it is less clear. With a disease so easily spread as the flu, I just don't think there is enough evidence against the vaccine. Could her employer have given her some tasks away from patients until after she had the baby, or after flu season? It is possible, but would that be her job? I am all for being flexible, and I think employers should be flexible. But I can also see how they wouldn't want her in the building, and also that there might not be another job suited to her with minimum patient contact. It could truly be a dangerous precedent.
letter to the editor regarding nurse demands in a strike; nurses being overworked; quality of care

This is a letter to a paper editor, spurred by a patient's observations about nurse scheduling and overtime, as well as an impending strike. The patient appreciates the competence demonstrated by her nurses and expresses dismay at the focus on profit rather than patient outcomes. 

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