by JobsearchingRN

I wonder whats really going on these days. Ive got to really wonder whose protecting who when were mandating nurses to take the shots and trying to blame them. How many hospital are not giving the nurses proper equipment and exposing public to H1N1 by not screening. Nurses are required and being told to wear mask and isolation equipment . The public and hospital are demanding we take the shots and stating we need to take the shot because were exposing the public. Recently I receieved a patient headache, difficulty breathing for 3 days, recent exposure to his wife home sick flu, and nausea. No fever. He came to my floor and not tested for H1N1 and no isolation. I called infection control to discuss this with them. Pt was admitted for respiratory distress. Infection control called back and said yes isolate him. I was told on the phone the regular surgical mask on floor were good but we did not need the N95 mask for the flu. I was also told there not testing for H1N1 anymore since it can only acurately screen for 40% of cases. So now were not isolating , not using N95, and I along with many others present have been exposed to this patient (prior to me placing him in isolation). A nursing student told me she was in the city and they were not using N95 on a patient with confirmed case H1N1. They were using regular masks. I even talk to occupational health from another hospital that was giving shots. THey said their hospital is unsure if ok to use mask they got for N1H1 BUT THEY ARE NOT USING THE N95. Wow how much do they really care about nurses? Are we making thing up as we go and to bad for nurses. I would really like to know whats going on in your hospital! Is this common practice? I hear some hospitals are putting nurses at risk demanding they take the shot that are unproven and possibly severe side effect . Its got me wondering how expendable are we? We will not know how many nurses die from H1N1 if they have stopped testing. Our ratios for nurse to patient have increase related to economy and H1N1. How many people know about new panademic rules ? Who gets a ventilator and who does not. If your on and you get so many days someone else can get it. I was told during this debreifing the nurse /patient ratio maybe 30:1. I dont know about the people making the decisions . I know my hospital is definately have alot of family in it. They're all related. I know it takes along time to survive on ventilator if your one of unlucky ones hit hard by it. But I know my charge nurse brags that manager would make sure shes not taken off in 5 days if not better. What are all the nurses seeing out here. The untold facts. How is your hospital dealing with this? Im really confused. Has money and no humanity driven us this far? Maybe we are just a footprint in the sand that is singled out to a meer non existant state . Many of our untold stories , selfless caring acts and being part of the increasing fatalities just doesnt seem to matter .
.

Re: What is happening in your hospital? Not using N95 mask, NO screening for H1N1 ,

Basically the same thing in the hospital I where I work. We are no longer testing for H1N1, if the patient does come back positive for flu, then they are placed in isolation, but we only get standard surgical masks. In our unit meeting today we told if we can get an N95 mask we are to keep it for the entire shift (of course). The big thing is if. We are being encouraged, but not forced to take the new vaccine. I personally have known several people with the flu, but not confirmed H1N1, that have had respiratory complications. Kind of scary, but it is the nature of the business.

Re: What is happening in your hospital? Not using N95 mask, NO screening for H1N1 ,

It doesn't help that USA Today is carrying an article that says a surgical mask is as good as a N95. I was so mad when I saw it. It is on front page in lower left handed corner.

Re: What is happening in your hospital? Not using N95 mask, NO screening for H1N1 ,

We are completely out of n95's and told there is a nation-wide shortage.

Re: What is happening in your hospital? Not using N95 mask, NO screening for H1N1 ,

My hospital is using the rapid influenza test only which we all know and the CDC states is only 10-70% accurate. No N95 respirators, infection control says surgical masks are sufficient. H1N1 shots strongly encouraged but not mandated. It's scary because we not only have flu cases but a lot of pneumonia as well that could very well be a complication of a mild H1N1 case. So a lot of exposure.

From what I have heard, mask manufacturers are claiming that there is not a shortage of masks. I suspect hospitals don't want to put out the costs for N95's and by strongly recommending the shots they can cut down the costs for PPE because you are protected by the shot?

It's a shame health care facilities are putting profits before protection of their employees.

Re: What is happening in your hospital? Not using N95 mask, NO screening for H1N1 ,

Originally Posted by *ac*

We are completely out of n95's and told there is a nation-wide shortage.

BUT! This is a national emergency and they have told us for years (since katrina etc) that they are prepared. HA! Disgusting---they could have at least told us back when to stock pile a few at home. Well if they have no N95s for us, what else don't they have? Tamiflu....gowns....vents....atbs...OH yeah!---HCWs!..?

Re: What is happening in your hospital? Not using N95 mask, NO screening for H1N1 ,

Originally Posted by silvergirl

BUT! This is a national emergency and they have told us for years (since katrina etc) that they are prepared. HA! Disgusting---they could have at least told us back when to stock pile a few at home. Well if they have no N95s for us, what else don't they have? Tamiflu....gowns....vents....atbs...OH yeah!---HCWs!..?

It is the conflicting information that is a pain. Some people will tell you N95 must be used and other's say sugical mask are OK too. Some people say that N95 can't be had and other's say "no shortage". My favorite is "H1N1 vaccine has arrived", to bad nobody has any". Other's say "all HCWs have to be vaccinated," Then we are told there is no vaccine so "never mind". The one thing that I have heard is that the virus is mild to moderate in 97% of the population. Which means only 3% is getting extremely ill. 1% of the people infected will die. That is actually matching what I am seeing with my own two eyes.

Re: What is happening in your hospital? Not using N95 mask, NO screening for H1N1 ,

Pretty much the same thing here- no N95, only surgical masks. We are doing the rapid flu test, but basically everyone who has flu-like symptoms is being treated as a positive with isolation, masks, etc. The problem I have is that it is already getting crazy with the amount of people that are coming in and wanting to be tested. Our hospital has no real plan to deal with the sheer numbers of people that are coming in and wanting to be tested.

Re: What is happening in your hospital? Not using N95 mask, NO screening for H1N1 ,

I thought the flu (all flues) were droplet, not respiratory? Mask with eye shield, not n95.

Re: What is happening in your hospital? Not using N95 mask, NO screening for H1N1 ,

Originally Posted by justiceforjoy

I thought the flu (all flues) were droplet, not respiratory? Mask with eye shield, not n95.

Yes, on the eyeshield to protect you from infection via the lacrimal ducts. But, it is not just droplets, hence the IOM, and CDC recommend the N95 mask based on the latest research. If they are still thinking it is droplets only, then your facillity is not reading the lastest CDC updates.

Respiratory Protection for Healthcare Workers in the Workplace Against Novel H1N1 Influenza A:
A Letter Report

http://docs.google.com/gview?a=v&pid...on%2Fpdf&pli=1

From the IOM, this from pages 16 to 18:

Originally Posted by docs.google.com

This letter is focused solely on airborne exposures that would require respiratory protection. Respiratory particles setle slowly from air and are able to disperse throughout the room. Thus inhalation exposure to respirable particles does not require close contact with an influenza patient, although exposure intensity is higher closer to the patient. Large droplet particles settle more rapidly from air and do not disperse throughout the room. Thus exposure to these particles tends to require close contact with the influenza patient, although there is a continuum of distances traveled from the point of emission depending on particle size.

Evidence from environmental and animal studies has supported the role of airborne exposure in the transmission of influenza virus. the 2008 IOM report reviewed research on airborne transmission including animal studies and observational studies on the effect of ultraviolet light and air circulation (IOM, 2008b). Newer studies published since the 2008 IOM report provide additional evidence regarding airborne transmission. For example, Fabian and colleagues (2008) showed that persons ill with influenza A (and B) emit the virus as respirable-size particles in exhaled breath and in coughs. In a study using stationary and personal sampling and measurement in a healthcare clinic attended by patients with influenza A (and B), researchers confirmed the presence of the airborne influenza virus in various clinic locations and in the breathing zones of healthcare workers, with more than fifty percent of detectable virus particles in the respiratory range (Blanchere et al., 2009). Mubareka and colleagues (2009) found that guinea pigs infected with the influenza A virus (H3N2) can efficiently transmit the infection to susceptible guinea pigs via inhalation, presumably by virus carried on respirable particles. (Mubareka et al., 2009). Other recent studies show that ferrets infected with nH1N1 virus transmitted the infection to susceptible animals via inhalation. Inhalation transmission was less efficient compared to a seasonal H1N1 virus in the study by Maines and colleagues (2009) but was found to be efficient in the second study (Munster et al., 2009).

Current evidence supports airborne exposure as likely being one of the routes of nH1N1 virus transmission in healthcare settings absent appropriate exposure control measures. This does not preclude transmission by the droplet spray, and contact routes absent appropriate control measures. Therefore, the committee concluded that recent animal and environmental studies have demonstrated the importance of airborne transmission of nH1N1 virus, however the relative contribution of each of the possible routes of transmission is yet to be determined. Without knowing the contributions of each of the possible route(s) of transmission, all routes must be considered probable and consequential.