Latest Comments by BostonFNP

BostonFNP Guide 40,795 Views

Joined Apr 4, '11 - from 'Northshore, MA'. BostonFNP is a Primary Care NP. Posts: 4,621 (61% Liked) Likes: 11,102

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  • 1
    NotAllWhoWandeRN likes this.

    Quote from Drphillgood
    I couldn't find anything on a 100% crew Boston, but I was able to find a CDC article that had a crew on a small naval ship and 99% compliance which I think they may have been talking about. It's in my last post.
    Yeah and that one showed that 25 of 102 crew members sought care for ILI of which only 18 were LCIV in the setting of 99% vaccination rate (and only 17/ of the 18 were vaccinated). If you consider a VE of about 60% this seems like the vaccine was fairly effective in preventing illness in the majority of the crew. The strain appeared to be a good match that season, so it is interesting that 17 vaccinated people got LCIV, however they were all vaccinated via either intradermal or mist, not IM.

  • 1
    NotAllWhoWandeRN likes this.

    Quote from r1013
    Approx 2 years ago I was watching an interview with a chemist from a pharmaceutical company that produces the shot. All the typical questions were asked and responses were as expected except one. He was asked if it worked. With a smile and slight laugh he said "well... we can't prove it and we have never seen it work, but the science behind it is sound so we highly recommend it."
    Can you link to this interview, I'd like to see it.


    Quote from r1013
    A US Navy aircraft carrier with 100% flu shot compliance has out break of the flu.
    I don't see any news stories or published papers about this. Can you cite your source for us please?


    Quote from r1013
    I feel like I'm becoming a conspiracy theorist with the flu shot because to me things don't add up. What I have come to the conclusion of, is that it doesn't work. I am still trying to decide 100% but right now I am 90% leaning its all a bunch of bull.

    You can read more here: Flu Shot Remains Most Dangerous Vaccine Based on Injuries and Deaths Compensated by Government
    You are concluding the vaccination is not effective and 90% leaning on some anecdotal evidence and reports from sources like "Health Impact News". You seem to have the right gut reaction: you are becoming a conspiracy theorist, or at very least, a pseudo-scientist.

    Perhaps "things don't add up" because you are asking the wrong question: this is confirmation bias.

  • 2

    Quote from Cheyenne RN,BSHS
    I have to share a recent article on this topic. I have had an opinion that much of the vaccination-mask push is more hype than outright fact. I would appreciate any input from others. I included the link and a few sentences directly from the article.
    Mandatory flu shot policies may be based on flawed research, study suggests

    Mandatory flu shot policies may be based on flawed research, study suggests

    Written by Heather Punke February 01, 2017 |
    While the CDC urges everyone to get a flu shot, some hospitals take it a step further and mandate employees to get a flu shot or face possible termination. These mandatory flu shot policies are rooted in the belief the shot protects both workers and patients from the virus. However, a study published in PLOS says the policies may be built on faulty research. "The impression that unvaccinated [healthcare workers] place their patients at great influenza peril is exaggerated," according to the study.
    Actual study link: Influenza Vaccination of Healthcare Workers: Critical Analysis of the Evidence for Patient Benefit Underpinning Policies of Enforcement

    This was talked about above. Having read it a few times, my thoughts:
    • The analysis is interesting in an academic sense.
    • It presents a competing perspective and a critical analysis on a small part of the extant data.
    • I am not an epidemiologist, so I confess that some of the calculations and assumptions made are above my comfortable understanding, though they seem theoretically sound.
    • It is clear there is a clear difficult-to-describe all-cause mortality result; this has been seen in many other studies and always warrants further evaluation as it is suggestive of selection bias. It suggests the use as a primary endpoint is concerning.
    • The reduction in LCIV (where studied) is significant and more consistent with the predicted data.
    • This was only 4 trials reviewed and no new data was created.
    • There is a lot of data manipulation in this case by the very nature of the analysis.
    • This is not a blinded study and several of the authors have a clear historical bias as well as the funding sources having pending legal actions on the topic.
    • I am still not sure I understand the "generalized" extrapolation nationwide; the numbers don't seem to add up and it is not clear how they arrived where they did and they make a large assumption that the previous study data would be linear.
    • The authors' conclusion is exaggerated.

  • 0

    Quote from mushyrn
    I long for the days nurses are rational enough to realize recreational weed use (off the clock) is no reason to be fired or punished by some tyrannical BON, same as it is now with the much more dangerous drug alcohol.
    Recreational weed is illegal (in most states) and alcohol is not, that's all the BON cares about.

  • 0

    Call your malpractice company right away regarding the med error.

    Consider other legal help for the drug issue.

  • 1
    Riburn3 likes this.

    There is a lot more to consider than straight salary. What was the full benefits package? Hours/wk? Call?

  • 3
    Scottishtape, ICUman, and Jules A like this.

    Quote from ICUman
    I am curious if you would mind sharing your reason(s) behind this? Particularly interested in your response based off your existing experience.
    From a financial investment perspective, independent practice affords NP opportunities that the PA route does not.

  • 0

    It depends on your local DEA office. Normally it is pretty quick.

  • 3

    Quote from mrl3fnp
    Dionne B, Brett M, Culbreath K, Mercier RC. (2016). Limited Effect of Healthcare Worker Influenza Vaccination Rates on the Incidence of Nosocomial Influenza Infections. Infection Control Hospital Epidemiology, 37(7). 840–844. Retrieved from DOI: Potential Ceiling Effect of Healthcare Worker Influenza Vaccination on the Incidence of Nosocomial Influenza Infection | Infection Control & Hospital Epidemiology | Cambridge Core
    I don't disagree with this study, which showed increasing influenza vaccination rates initially decreased influenza rates by nearly 50% prior to plateauing and maintaining the reduced rate. I think we all understand there is a ceiling that is less than 100%.

    What this is not is a citation to a study showing mask use superior to influenza vaccine in the reduction of lab-confirmed influenza virus.

  • 2
    elkpark and NotAllWhoWandeRN like this.

    Quote from mrl3fnp
    I have yet to see an unbiased and financially uncorrupt influenza vaccination study showing the effectiveness at reducing the risk of spreading influenza comparable to that of wearing a mask. If health care facilities were really concerned about patient health and reducing the spread of hospital-acquired influenza why do they not implement a mandatory mask wearing policy for everyone? Especially when the flu vaccination is so controversial and so many health care workers have legitimate objections.
    You haven't seen a "unbiased and financially uncurrupt" influenza vaccination study because you chose to call every study that is at odds with your point of view both of those things. Ironically, while calling the extant data biased, you so excellently demonstrate the confirmation bias that is ripe through the pseudoscience movement. Your arguments use the same logical fallacies that we see all the time from anti-vaxxers, including this ad hominem about author disclosures (thankfully the term "shill" has yet to be played). Tell us, do you support other vaccines?

    I don't inherently disagree with you that if a hospital system truly wanted to prevent disease spread there are potentially better/boarder ways to accomplish that, and I do think there are other factors at play. Truth be told I think that the influenza vaccine has the least amount of supporting data when compared to other vaccines.

  • 2

    Quote from mrl3fnp
    These are the biased, financially corrupt, exaggerated, and mathematically impossible studies the CDC uses to influence hospitals to implement policies that mandate forced influenza vaccinations on health care workers at the risk of getting fired if they do not comply.
    Again, disclosed information about one or more authors does not invalidate a study. In example, the study you just cited was funded in part by the Ontario Nurses Association, which strongly opposes mandatory vaccination of nurses and was in a concurrent legal battle regarding it.

  • 2
    elkpark and NotAllWhoWandeRN like this.

    Quote from mrl3fnp
    De Serres, G., Skowronski, D. M., Ward, B. J., Gardam, M., Lemieux, C., Yassi, A., . . . Carrat, F. (2017). Influenza Vaccination of Healthcare Workers: Critical Analysis of the Evidence for Patient Benefit Underpinning Policies of Enforcement. Public Library of Science, 12(1). doi:10.1371/journal.pone.0163586
    This is an interesting critical review of a small portion of extant RCT data. From a quick read, I think some concerns raised are valid ones. I am not sure I can fully back the authors assumption that just because clinical values are greater than mathematically predicted values that means the clinical values are the result of bias in a non-blinded study design; that being said I am not an epidemiologist by training so I really can comment on the validity of the authors prediction calculations and the assumptions made to calculate them. They superficially seem reasonable, but again (at least for now) clinical data for me trumps calculated-predicted data.

  • 2
    elkpark and NotAllWhoWandeRN like this.

    Quote from mrl3fnp
    Thank you once again for making my point about bias and financial corruption.......
    Your point hasn't been made; you have provided zero evidence perhaps aside for conspiracy theory.

    Quote from mrl3fnp
    The European Centre for Disease Prevention and Control (ECDC) is the European equivalent to America’s CDC and those conducting the research work for the ECDC. Consequently, there is a strong potential for bias and financial corruption influencing the conclusions……….

    So to post this research as if it proves a point isn’t being intellectually honest……….
    Again, cite your evidence that there is any financial corruption or bias by the ECDC or CDC in this peer-reviewed study.

    I don't think many people will be surprised that you have once again posted a slew of opinions as if they are fact without citing a single source. You want to talk about intellectual honesty? Then why don't you cite your source on this statement you made a few posts prior that mask-wearing is "more efficacious compared to the flu shot".

  • 3

    Quote from klone
    (rigor)

    Keep going - I'm enjoying this exchange.
    Vigor. Rigor. Turgor. That's my 7th grade education.

  • 3

    Quote from mrl3fnp
    To argue for or against the efficacy of the flu shot is futile when the other person doesn't recognize or understand statistical power, bias, and financial corruption. But, I regress because my argument is not relating to the efficacy of the flu shot........It's relating to mask-wearing being more efficacious compared to the flu shot and the hypocrisy of nurses and healthcare organizations when it comes to patient safety.
    More sources, less opinions. Can you cite the trial comparing mask use to influenza vaccine in preventing confirmed influenza?

    bin‐Reza, F., Lopez Chavarrias, V., Nicoll, A., & Chamberland, M. E. (2012). The use of masks and respirators to prevent transmission of influenza: a systematic review of the scientific evidence. Influenza and other respiratory viruses, 6(4), 257-267.


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