Sad but not surprising response to mandatory vaccines
Posted: 04 January 2013 12:56 PM   [ Ignore ]
Sr. Member
Avatar
RankRankRankRankRankRankRankRankRankRank
Total Posts:  2018
Joined  2007-04-26

THIS article on Yahoo refers to a hospital where some nurses were fired for refusing mandatory flu vaccines. Its not the first time this has happened. We had a similar issue at our own hospital when the H1N1 flu epidemic was in progress and silly rumors circulated about the vaccine being untested. A small but significant portion of the nursing staff and other support personnel revolted.

The sad thing about the article is the responses afterward. It seems that more than 90% of the responders support the nurses decision. It just shows the persistent ignorance concerning vaccines. What is extremely frustrating as a physician is that these cases only strengthen public misconceptions. When people see medical professional like nurses voicing concerns it gives those concerns undue credence. Im not really sure what the solution is.

Its truly difficult to sympathize with the nurses for several reasons.

1) When you work in the health professions the job you sign up for requires you to put the patients health first. If they are concerned about some small risk form the vaccine then they really should find a different job. Its unethical to put patients at risk because of your own fears. The “staying home when you’re sick” approach is an ineffective way of protecting patients because considerable viral shedding begins a day or more before symptoms develop.

2) All staff in patient care positions are required to get vaccinated for measles , mumps, rubella and a number of other things before they will be hired at any health care facility. Strangely there is no resistance to this requirement. Its inconsistent to take a stand against the flu shot when these same individuals already agreed to a different set of mandatory vaccines.

3) These people are health professionals. The risk benefit ratio for flu vaccines is unquestionable. They should know better. If their medical decision making is as poor as this on the vaccine issue, what sort of decisions are they making on other medical issues that affect their patients?

Physicians and nurses have a long tradition of putting their own lives at risk over the centuries to take care of the sick and dying. Allowing some individuals to do this and be lauded in the media for it sets a bad precedent. This behavior is nothing to be praised. It should be called what it is, cowardly.

 Signature 

For every complex problem there is a solution that is simple, obvious,.... and just plain wrong

Profile
 
 
Posted: 04 January 2013 02:31 PM   [ Ignore ]   [ # 1 ]
Sr. Member
Avatar
RankRankRankRankRankRankRankRankRankRank
Total Posts:  7641
Joined  2008-04-11

When talking to fellow nurses, I am always surprised to hear the level of mis- information about vaccination. There were some who wouldn’t get vaccinated for one silly reason or the other. With mandatory vaccination, everyone got theirs. This is the first time it has happened in my unit—to my knowledge. I have not heard of any problems in the rest of the hospital.

 Signature 

Church; where sheep congregate to worship a zombie on a stick that turns into a cracker on Sundays…

Profile
 
 
Posted: 04 January 2013 03:23 PM   [ Ignore ]   [ # 2 ]
Sr. Member
Avatar
RankRankRankRankRankRankRankRankRankRank
Total Posts:  573
Joined  2007-08-21
macgyver - 04 January 2013 12:56 PM

3) These people are health professionals. The risk benefit ratio for flu vaccines is unquestionable. They should know better. If their medical decision making is as poor as this on the vaccine issue, what sort of decisions are they making on other medical issues that affect their patients?

I especially agree with that!

 Signature 

Vi veri veniversum vivus vici

Profile
 
 
Posted: 04 January 2013 05:44 PM   [ Ignore ]   [ # 3 ]
Moderator
RankRankRankRankRankRankRankRankRankRank
Total Posts:  5187
Joined  2010-06-16

Hmmm.  Next time I need to go to the hospital, I’ll request that only nurses who didn’t refuse vaccinations attend to me.  LOL

Occam

 Signature 

Succinctness, clarity’s core.

Profile
 
 
Posted: 05 January 2013 06:57 AM   [ Ignore ]   [ # 4 ]
Sr. Member
Avatar
RankRankRankRankRankRankRankRankRankRank
Total Posts:  2018
Joined  2007-04-26
Occam. - 04 January 2013 05:44 PM

Hmmm.  Next time I need to go to the hospital, I’ll request that only nurses who didn’t refuse vaccinations attend to me.  LOL

Occam

That’s actually a good idea Occam. Our hospital handled the problem by forcing all workers to wear masks full time if the have patient contact and do not get the flu shot. At first I thought this wasn’t a great solution since masks may only have a marginal effect on transmission. I changed my mind after a while though. Wearing a mask can be cumbersome and uncomfortable. It also marks you like a scarlet letter. Many of the workers who had initially refused eventually gave in and took the vaccine to avoid the burden of wearing a mask all day.

While that worked i think the hospital really needs to do more education than coercion. I am sure there must have been occasions where patients asked the nurses or other workers about the masks. On some occasions these individuals may have expressed their views and poisoned the patients minds about vaccines. It would be better i think if the infectious disease dept held required seminars and then had breakout discussion groups where people could voice their concerns and they could be educated so they would understand why those ideas are flawed. It wouldn’t convince everyone and there would be an expense but those who still didn’t agree to be vaccinated could then be forced to wear the mask. It might be better also if all health care facilities had new employees sign a something when they are hired stating that they understood mandatory annual flu vaccines where a condition for employment.

 Signature 

For every complex problem there is a solution that is simple, obvious,.... and just plain wrong

Profile
 
 
Posted: 05 January 2013 07:17 AM   [ Ignore ]   [ # 5 ]
Sr. Member
Avatar
RankRankRankRankRankRankRankRankRankRank
Total Posts:  2018
Joined  2007-04-26
asanta - 04 January 2013 02:31 PM

When talking to fellow nurses, I am always surprised to hear the level of mis- information about vaccination. There were some who wouldn’t get vaccinated for one silly reason or the other. With mandatory vaccination, everyone got theirs. This is the first time it has happened in my unit—to my knowledge. I have not heard of any problems in the rest of the hospital.

I have always been frustrated by this. Its not just the vaccine issue but many other medical concepts where various medical personnel have strange misinformed ideas about things. I’m not sure if its the education they get. I think as they say “a little knowledge is a dangerous thing”. Some of them know just enough to get the thought process going but not enough to prevent it from going astray.

Its as though there is a medical conspiracy going on and only the nurses, PA’s etc no the real truth. It’s obviously not all of them or even a majority. Most are very intelligent and roll their eyes at the one’s who spout these ideas but there are enough of them to keep this subculture alive over the years. Just last week I heard a nurse telling a friend not to let her father have cancer surgery because the tumor was small and once you open the abdomen and the “oxygen hits the tumor it will spread like wildfire”.

The problem has been largely ignored by the medical profession and the hospitals because most of this goes on underground but I’m beginning to wonder how much damage is being done due to the spread of misinformation by medical professionals that the public respects.

 Signature 

For every complex problem there is a solution that is simple, obvious,.... and just plain wrong

Profile
 
 
Posted: 05 January 2013 07:35 PM   [ Ignore ]   [ # 6 ]
Sr. Member
Avatar
RankRankRankRankRankRankRankRankRankRank
Total Posts:  7641
Joined  2008-04-11

My training was pretty straightforward and mostly evidence based. I blame a lot of it on the BS CEUs that are allowed to be taught in the place of real evidence. Jim Underdown did a great job of calling out the CA BRN about this.  In a lot of hospitals and units, nurses aren’t encouraged to be critical thinkers. In the ICU, I could call for tests I knew needed to be done in an emergency situation (like a CXR or ABG on a patient in sudden respiratory distress or an EKG for arrhythmias), while I am calling the doctor, who would then write the order to cover me, and it saves time. I nearly had my ass handed to me in my current unit when I called for an ECG on a patient that had gone into a second degree heart block, while I have the clerk call the doctor STAT. Because I called for the ECG, we were able to capture and document the rhythm before it converted, something the doctor eventually admitted was a good idea. But he was still pissed at me for calling before HE ordered it. Nurses seem to be susceptible to woo, and I don’t know why. It drives me crazy. I was taking ACLS once and we were doing our mega-code. The ‘patient’ coded, and I asked the nurse why she wasn’t starting CPR, and she told me it was because the doctor hadn’t told her yet *facepalm*, I explained that SHE could initiate CPR, it is covered by our practice, and she would lose critical time if she waited for permission to do CPR. UGH…
*stepping off my soapbox*

 Signature 

Church; where sheep congregate to worship a zombie on a stick that turns into a cracker on Sundays…

Profile
 
 
Posted: 06 January 2013 06:39 AM   [ Ignore ]   [ # 7 ]
Sr. Member
Avatar
RankRankRankRankRankRankRankRankRankRank
Total Posts:  2018
Joined  2007-04-26

I hear you. I’ve been witness to plenty of these episodes over the years. Luckily things usually function well in most cases and this sort of stuff doesnt happen that often. The problem usually develops when you have insecure individuals on either side of the interaction. Either you have a physician who is insecure and is threatened if he/she feels someone encroaches on his/her decisions or you have a nurse who is insecure and refuses to do anything that isn’t explicitly spelled out for him/her.

Most of the time things seem to work well. When everyone knows what they’re supposed to do, is confident in their abilities, and respects the abilities of the rest of their team, patients get better care, there is much less friction and a lot more respect among all the parties. Its a tough thing to fix when you have a dysfunctional team member like the doctor you worked with. Sometimes its just a matter of maturing and gaining confidence but other times you have to try and change a lifetime of insecurity which isn’t so easy to do. The bottom line is that you do what you know is right to take care of the patient. Let the chips fall where they may and hopefully you have supervisors you can count on to support you.

 Signature 

For every complex problem there is a solution that is simple, obvious,.... and just plain wrong

Profile
 
 
Posted: 06 January 2013 01:28 PM   [ Ignore ]   [ # 8 ]
Sr. Member
Avatar
RankRankRankRankRankRankRankRankRankRank
Total Posts:  7641
Joined  2008-04-11
Occam. - 04 January 2013 05:44 PM

Hmmm.  Next time I need to go to the hospital, I’ll request that only nurses who didn’t refuse vaccinations attend to me.  LOL

Occam

You are very lucky to live in CA where the flu vaccines are mandatory. Any nurse not vaccinated by 10/31 must wear a mask at work, the entire shift for the entire flu season. There is also a sticker given to us to put on our badge as proof of current vaccination. You can ask to see it. The other vaccinations, such as pertussis, measles, mumps, chickenpox are a requirement of my employment. You have to have your titers drawn regularly, to make sure you are still immune. Even though I am of an age (ahem!) to be immune to most of these, if my titers fall, I would be required to be immunized. We also get yearly TB testing.

 Signature 

Church; where sheep congregate to worship a zombie on a stick that turns into a cracker on Sundays…

Profile
 
 
Posted: 06 January 2013 01:31 PM   [ Ignore ]   [ # 9 ]
Sr. Member
Avatar
RankRankRankRankRankRankRankRankRankRank
Total Posts:  7641
Joined  2008-04-11
macgyver - 05 January 2013 06:57 AM
Occam. - 04 January 2013 05:44 PM

Hmmm.  Next time I need to go to the hospital, I’ll request that only nurses who didn’t refuse vaccinations attend to me.  LOL

Occam

That’s actually a good idea Occam. Our hospital handled the problem by forcing all workers to wear masks full time if the have patient contact and do not get the flu shot. At first I thought this wasn’t a great solution since masks may only have a marginal effect on transmission. I changed my mind after a while though. Wearing a mask can be cumbersome and uncomfortable. It also marks you like a scarlet letter. Many of the workers who had initially refused eventually gave in and took the vaccine to avoid the burden of wearing a mask all day.

While that worked i think the hospital really needs to do more education than coercion. I am sure there must have been occasions where patients asked the nurses or other workers about the masks. On some occasions these individuals may have expressed their views and poisoned the patients minds about vaccines. It would be better i think if the infectious disease dept held required seminars and then had breakout discussion groups where people could voice their concerns and they could be educated so they would understand why those ideas are flawed. It wouldn’t convince everyone and there would be an expense but those who still didn’t agree to be vaccinated could then be forced to wear the mask. It might be better also if all health care facilities had new employees sign a something when they are hired stating that they understood mandatory annual flu vaccines where a condition for employment.

Great idea. Yes, I’d make sure the person leading the conference was an ID specialist or immunologist.

 Signature 

Church; where sheep congregate to worship a zombie on a stick that turns into a cracker on Sundays…

Profile
 
 
Posted: 07 January 2013 12:21 PM   [ Ignore ]   [ # 10 ]
Moderator
Avatar
RankRankRankRankRankRankRankRankRankRank
Total Posts:  4052
Joined  2006-11-28

Our hospital offers free flu vaccinations. We have 25 doctors and about 100 support staff. We use about 15 vaccines a year. Unfortunately, I’m not convinced education will change this. I print out and distribute the relevant information from CDC (or sometiems Mark Crislip, who’s less gentle) every year, but even nurses I respect and have worked with for years still refuse to get vaccinated. While our patients aren’t susceptible, we still work with the public, and we are still medical profesisonals, so there’s really no excuse. But there’s no chance of any coercive measures in our environment, and sadly that seems to be the only thing that works.

 Signature 

The SkeptVet
The SkeptVet Blog
Militant Agnostic: I don’t know, and neither do you!

Profile
 
 
Posted: 07 January 2013 12:30 PM   [ Ignore ]   [ # 11 ]
Sr. Member
Avatar
RankRankRankRankRankRankRankRankRankRank
Total Posts:  573
Joined  2007-08-21
mckenzievmd - 07 January 2013 12:21 PM

Our hospital offers free flu vaccinations. We have 25 doctors and about 100 support staff. We use about 15 vaccines a year. Unfortunately, I’m not convinced education will change this. I print out and distribute the relevant information from CDC (or sometiems Mark Crislip, who’s less gentle) every year, but even nurses I respect and have worked with for years still refuse to get vaccinated. While our patients aren’t susceptible, we still work with the public, and we are still medical profesisonals, so there’s really no excuse. But there’s no chance of any coercive measures in our environment, and sadly that seems to be the only thing that works.

What are their reasons for not getting vaccinated?

 Signature 

Vi veri veniversum vivus vici

Profile
 
 
Posted: 07 January 2013 08:49 PM   [ Ignore ]   [ # 12 ]
Sr. Member
Avatar
RankRankRankRankRankRankRankRankRankRank
Total Posts:  7641
Joined  2008-04-11

Our vaccines are all free through employee health.

 Signature 

Church; where sheep congregate to worship a zombie on a stick that turns into a cracker on Sundays…

Profile
 
 
Posted: 07 January 2013 08:51 PM   [ Ignore ]   [ # 13 ]
Sr. Member
Avatar
RankRankRankRankRankRankRankRankRankRank
Total Posts:  7641
Joined  2008-04-11
morgantj - 07 January 2013 12:30 PM
mckenzievmd - 07 January 2013 12:21 PM

Our hospital offers free flu vaccinations. We have 25 doctors and about 100 support staff. We use about 15 vaccines a year. Unfortunately, I’m not convinced education will change this. I print out and distribute the relevant information from CDC (or sometiems Mark Crislip, who’s less gentle) every year, but even nurses I respect and have worked with for years still refuse to get vaccinated. While our patients aren’t susceptible, we still work with the public, and we are still medical profesisonals, so there’s really no excuse. But there’s no chance of any coercive measures in our environment, and sadly that seems to be the only thing that works.

What are their reasons for not getting vaccinated?

They listen to Dr Oz-the quack, and believe his BS.

 Signature 

Church; where sheep congregate to worship a zombie on a stick that turns into a cracker on Sundays…

Profile