Hospitals illegally firing nurses for refusing flu vaccines

elkpark · Jan 30, 2013

I for one think it's ridiculous that so many people in this forum agree with the policy of getting terminated if you don't get the injections.

I don't know that it's a matter of so many of us agreeing with the policy -- we're just saying that, as far as we know, healthcare employers are within their legal rights to choose to set the policy and enforce it.

CrunchRN, ADN, RN · Jan 30, 2013

Yawn. This debate can go on forever and not get anywhere like the last 9 pages. There is no right or wrong, but only personal opinion based on a bunch of different factors.

The bottom line is that since nurses are a dime a dozen employers can dictate anything they wish. Unless you fight that issue the rest is irrevalent.

Is it really worth throwing yourself on your sword for though? I would never put my ability to pay my mortgage at risk over this issue. Just take it if you have to and then find a new job at your leisure. I mean reality is sometimes in life you just have to suck it up and do stuff you do not wish to.

Or, finally band together, and do something to limit the excess supply of nurses that allows employers to dictate this kind of stuff.

elkpark · Jan 30, 2013

But I guess my main point with this comparison would be that washing your hands has been proven to work 100% of the time.

Could you please cite some source that supports the statement that "washing your hands has been proven to work 100% of the time"? "Work" how? To get your hands visibly "clean"? How are you defining "clean"? Are you claiming that handwashing is guaranteed to prevent transmission of infection "100% of the time"?

olddragger · Jan 30, 2013

Wow.

Just because I am not in favor of a mandated flu vaccination means I am willing to risk infecting a patient?

per your post--" it is surprising that those so willing to sacrifice patient safety to make a questionable supported point about personal autonomy managed to graduate from Nursing School".

So are you saying that if a nurse doesnt receive the flu vaccination then they shouldnt have graduated from Nursing School?

Do you think that the flu vaccination protects you from getting the flu?

Do you think that nurses that come to work with congestion, maybe a slight cough--or just not feeling good are willing to risk infecting their patients?

Or what about those Nurses that do not care for patients, but work in other areas of the hospital--like in medical records, research, or telephonic nursing? Do they need the flu shot mandated also?

If you really look this at issue you will discover mandated flu vaccinations for EVERYONE IN THE HOSPITAL has at best a limited benefit. Do you threaten nurses job/profession for something that has only a limited benefit? OSHA doesn't think so, CMS doesn't think so, and many other well respected organizations dont.

Now lets look at handwashing --since you have focused on that comparison. Now granted, I do not know what the handwashing policies are at the facility you work in, but at our facility our policies mimics CDC's recommendations.

Those being: http://www.cdc.gov/mmwr/PDF/rr/rr5116.pdf

skip down to page 32 if you dont want to read the entire thing--its long.

Now once you have read this if you can say that your facility mandates handwashing and monitors such consistently -then all I can say is your facility is the first one I have heard of that does that.

I mean--do they have someone watching people all the time? Because that is what it would take.

Now short version of the cdc recommendations--means that the length of time for proper handwashing is 40 secs to 1 minute--each and every time. Before patient contact ( even taking a blood pressure for example), after patient contact, after touching your face/hair, after touching any inanimate object, after eating, going to the bathroom etc etc. Now IF I remember correctly a study was done on a typical floor nurse handwashing requirements following these strict guildlines and it was not workable. A floor nurse that had 5 patients to care for would need to wash their hands an estimated 100-200 times a day. Thats approx 1.5-3 hrs a day of handwashing.

I quote: 9/17) An update from GE’s Scott Gallagher: “Our research has shown that nurses may have as many as 200 opportunities for hand washing per shift. A more typical range is 100-120, and most use an alcohol-based gel that quickly sanitizes and dries while moving on to the next task. Even so, it’s not difficult to understand the challenge of washing so often every day. Our work has focused on not just changing behavior to improve compliance, but to understand what changes in workflow & processes can help reduce that number.”

Effectivness? How about this: per cdc

[h=3]What kills influenza viruses?[/h]Influenza viruses can be destroyed by heat (167-212°F [75-100°C]). In addition, several chemical germicides, including chlorine, hydrogen peroxide, detergents (soap), iodophors (iodine-based antiseptics) and alcohols are effective against influenza viruses if used in proper concentrations for a sufficient length of time. For example, alcohol-based hand rubs can be used in the absence of soap and water for hand washing.

I agree with the poster that said that this debate can go on forever. However, I do hope that the learning part of this debate can be of some help to others. Whether each one of us is OK with a mandated flu shot or not, is not as important to me as learning the truth behind why all of a sudden it is mandated, it's true effectiveness , and all the other precautions that also should be in place. We as Nurse have a responsibility to promote health and to be the patients advocate. How can we do that when we are not aware of the facts behind the curtain?

MunoRN, RN · Jan 30, 2013

Wow.
Just because I am not in favor of a mandated flu vaccination means I am willing to risk infecting a patient?
per your post--" it is surprising that those so willing to sacrifice patient safety to make a questionable supported point about personal autonomy managed to graduate from Nursing School".
So are you saying that if a nurse doesnt receive the flu vaccination then they shouldnt have graduated from Nursing School?
Do you think that the flu vaccination protects you from getting the flu?

Yes, it's about 60% effective.

Do you think that nurses that come to work with congestion, maybe a slight cough--or just not feeling good are willing to risk infecting their patients?

By the time symptoms appear you may have been virulent for up to 3 days.

Or what about those Nurses that do not care for patients, but work in other areas of the hospital--like in medical records, research, or telephonic nursing? Do they need the flu shot mandated also?

Mandates are usually limited to "patient care" positions or those that may enter patient care areas.

If you really look this at issue you will discover mandated flu vaccinations for EVERYONE IN THE HOSPITAL has at best a limited benefit. Do you threaten nurses job/profession for something that has only a limited benefit? OSHA doesn't think so, CMS doesn't think so, and many other well respected organizations dont.

CMS does think so, they require you submit you data on influenza vaccination rates among staff, then they publish that data in HospitalCompare.

Now lets look at handwashing --since you have focused on that comparison. Now granted, I do not know what the handwashing policies are at the facility you work in, but at our facility our policies mimics CDC's recommendations.
Those being: http://www.cdc.gov/mmwr/PDF/rr/rr5116.pdf
skip down to page 32 if you dont want to read the entire thing--its long.
Now once you have read this if you can say that your facility mandates handwashing and monitors such consistently -then all I can say is your facility is the first one I have heard of that does that.
I mean--do they have someone watching people all the time? Because that is what it would take.
Now short version of the cdc recommendations--means that the length of time for proper handwashing is 40 secs to 1 minute--each and every time. Before patient contact ( even taking a blood pressure for example), after patient contact, after touching your face/hair, after touching any inanimate object, after eating, going to the bathroom etc etc. Now IF I remember correctly a study was done on a typical floor nurse handwashing requirements following these strict guildlines and it was not workable. A floor nurse that had 5 patients to care for would need to wash their hands an estimated 100-200 times a day. Thats approx 1.5-3 hrs a day of handwashing.
I quote: 9/17) An update from GE's Scott Gallagher: "Our research has shown that nurses may have as many as 200 opportunities for hand washing per shift. A more typical range is 100-120, and most use an alcohol-based gel that quickly sanitizes and dries while moving on to the next task. Even so, it's not difficult to understand the challenge of washing so often every day. Our work has focused on not just changing behavior to improve compliance, but to understand what changes in workflow & processes can help reduce that number."

This is why Handwashing is no longer the standard, Hand Hygiene is the expectation, which includes primarily gelling, which can kill viruses in 15 seconds or less. I'm a little confused by your point here, like vaccinations handwashing isn't 100% effective, that's why we use as many partially effective methods as possible. When they are all combined, that's what lowers risk the greatest.

wooh, BSN, RN · Jan 30, 2013

So those who don't get the flu shot are degenerates who are willing to risk the health of their patients.

So are those who do get the flu shot but refuse to wear a mask to protect their patients from strains not covered by the shot also degenerates who are willing to risk the health of their patients?

Because I'm protecting my patients from ALL flu strains by wearing the mask. Those who got the shot are only about 60% effective. After all, they could be virulent with flu B for days before symptoms show up. Spreading their germs to all their patients. Because they're too lazy to wear a mask. Who cares more about their patients' health?

benjaeli, MSN, RN · Jan 30, 2013

My hospital has the same policy of mandatory flu shots otherwise caregivers have to wear a mask when taking care of patients. I refuse to wear a mask the entire shift.

wooh, BSN, RN · Jan 31, 2013

So you're willing to risk giving your patients flu B just because you don't want to wear a mask?

benjaeli, MSN, RN · Jan 31, 2013

"9:07 am by wooh So you're willing to risk giving your patients flu B just because you don't want to wear a mask?"I'm claustaphobic enough when i have to gown and mask up for someone on contact precautions so I'm only stating that I prefer flu shot rather than use the mask ....my personal preference. On another note my husband who is active duty military is given the flu shot every year...it's mandatory to continue to be active duty...they line up and get the shots as soon as its available for that year.

wooh, BSN, RN · Jan 31, 2013

Here's the thing, I'm Typhoid Mary because I haven't had the flu shot. I don't care about my patients. I'm spreading the flu to ALL OF THEM.

But I'm wearing the mask. Protecting them from ALL the flus.

It's ridiculous to insinuate that nurses that refuse the flu shot are selfish stupid people then not be willing to wear a mask to protect your patients from the flu NOT COVERED BY THE FLU SHOT.

I'm not calling YOU (benjaeli) selfish. To be sure, I don't recall you (benjaeli) expressing an opinion other than to say you don't wear the mask.

Just saying that the moral indignation (from others in this and similar threads) towards those who won't get the flu shot is hypocritical when expressed by those not willing to wear a mask all the time to protect their patients from illness not covered by the flu shot. ESPECIALLY when flu B that's not covered is quite prevalent this year.

benjaeli, MSN, RN · Jan 31, 2013

Here's the thing, I'm Typhoid Mary because I haven't had the flu shot. I don't care about my patients. I'm spreading the flu to ALL OF THEM.But I'm wearing the mask. Protecting them from ALL the flus.It's ridiculous to insinuate that nurses that refuse the flu shot are selfish stupid people then not be willing to wear a mask to protect your patients from the flu NOT COVERED BY THE FLU SHOT.I'm not calling YOU (benjaeli) selfish. To be sure, I don't recall you (benjaeli) expressing an opinion other than to say you don't wear the mask. Just saying that the moral indignation (from others in this and similar threads) towards those who won't get the flu shot is hypocritical when expressed by those not willing to wear a mask all the time to protect their patients from illness not covered by the flu shot. ESPECIALLY when flu B that's not covered is quite prevalent this year.

You are correct. I don't have any problem with anyone that chooses not to get the flu shot or with those who do get it. I think it should be a personal decision. I also do not agree with being terminated for refusal. I'm simply stating my hospital's policy and what I prefer to do. If I wasn't in healthcare I might not have gotten a flu shot in fact before nursing school I never got a flu shot. I just prefer not to walk around with a mask all day and I also couldn't bear the thought of infecting my two small children with anything so I do it...knowing that nothing is ever 100% guaranteed.

olddragger · Jan 31, 2013

I give up. Just--- everyone go take the flu shot. What do we nurses know anyway.