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Can nurses be forced to work during pandemic

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by nursey04 nursey04 (New) New

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azhiker96 has 10 years experience as a BSN, RN and specializes in PACU.

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There is a guideline from the feds, http://www.ahrq.gov/research/mce/index.html#Contents

It doesn't spell out what would be done to force people to work, only that under a declared emergency they may need to change the rules a bit. I bolded and underlined the key bits.

Key Legal and Ethical Issues. The Presidential declaration of a national emergency or disaster, along with the declaration of a public health emergency by the Secretary of HHS, may be the basis for the Secretary to invoke a waiver authority under the Social Security Act, which permits increased regulatory flexibility for home treatment and patient transfers. It is important for the home health care sector to anticipate legal concerns that may emerge during a declared public health emergency and begin to consider potential solutions to these issues in advance.

Legal parameters differ from State to State and may change during a declared emergency. Home health care agencies should consult their State and local governments, professional organizations, or local pandemic influenza planners to learn about laws and regulations that may affect their operations and staff during an influenza pandemic.

  • Allocation of scarce resources. Determine with local planners how to use resources most efficiently and under which priority the agency will be allocated specific patient treatment resources.
  • Scope of practice. Determine whether scope of practice restrictions set forth by the State or political subdivision will be extended to allow, for example, more home health care workers to provide vaccinations or medications.
  • Addressing medical personnel licensure requirements. Determine appropriate legal approaches to adapting normal licensing requirements for volunteer health personnel to more readily support declared emergencies.
  • Reimbursement. Learn who, if anyone, is legally required to pay for services during an emergency.
  • Human resource policies. Policies will need to deal effectively with issues such as failure to report to work.
  • Workers compensation. Determine whether workers compensation carriers will provide the same protections that they provide under standard conditions.
  • Patient release policies. Learn what policies are for releasing patients from standard hospital care to home-based care.
  • Protections for at-risk populations. Learn what enhanced protections are for at-risk populations.
  • Health care worker liability protections. Learn the agency's liability for harms that arise to patients from home health care services during emergencies
  • Patient abandonment. Determine under which circumstances a home health care provider's failure to treat existing patients may result in penalties.

Edited by azhiker96
clarity

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azhiker96 has 10 years experience as a BSN, RN and specializes in PACU.

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Thanks for all the replies. I am referring to the US-currently work/live in Massachusetts. I work in an outpatient clinic currently, but also fear being forced-or even more so as other posters have pointed out "coearced"-into working in a different type of setting to care for the acutely ill if there were to become a need.

The answer to the question is yes, Massachusetts can try to force you to work if they declare a health emergency.

The public health authority may.....require in-state healthcare providers to assist in the performance of vaccination, treatment, examination, or testing of any individual as a condition of licensure, authorization, or the ability to continue to function as a healthcare provider in this state.
from page 33 of 39.

Source: http://www.publichealthlaw.net/MSEHPA/MSEHPA2.pdf

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llg has 42 years experience as a PhD, RN and specializes in Nursing Professional Development.

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For most people who will get this flu, it will not be worse than other cases of influenza ... of which there are many cases each year. People get sick: they get over it. What is particularly bad about this flu is NOT that everyone who gets it is going to become seriously ill, it's that it is highly contagious -- and a higher percentage of the population will get it. People are acting as if this were some science-fiction movie with a deadly virus about to turn us all into zombies or something.

... And as for child care ... EVERY family should have a back-up plan for providing child care regardless of situation. Even in routine times, there is always a possibility that a school will close temporarilty or a regular child care provider will become unavailable, etc. To not have a plan is short-sighted and irresponsible.

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talaxandra specializes in Medical.

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I was at an international conference last year that had several pandemic sessions. The focus was primarily on ensuring support staff (cleaners, cooks, orderlies etc) came in, with an assumption that health professionals wouldn't need the same level of encouragement.

Recognition of the vital role health care providers play was evident in the concensus that health care providers have been nominated by multiple surveys of the general population, and by strategic planning across the board, that this group should be vaccinated as a priority.

In the event of a pandemic or other overwhelming disaster all governments will be more interested in the wellbeing of their population as a whole than the preferences of individuals. I wouldn't bank on just deciding not to come in.

If the 1918/19 Spanish flu is indicative of the next pandemic (which is not necessarily this flu), the differences between usual flu and pandemic influenza include:

- higher virulence/more contagious

- altered victim pattern (young, healthy people)

- higher mortality rate

This means a larger population than normal will be affected, including those people usually relatively safe from becoming seriously affected, and more people will die. It doesn't mean everyone will get sick, that everyone who gets sick will be seriously affected, or that vast numbers of people will necessarily die. but if the majority of the workforce are affected a lot of infrastructure will be affected for the duration of the pandemic, which will have a lot of knock on effects that may themselves cause other issues.

Edited by talaxandra

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twinmommy+2 is a ADN, BSN and specializes in ED.

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I'm wondering-can the government force nurses to work during an emergency outbreak such as a pandemic?

I was just told today that if my family or I came down with this virus the hospital would pay for all of us to have antiviral medication, I think to keep the nurses working where they are needed. I like the idea!:yeah:

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caroladybelle is a BSN, RN and specializes in Oncology/Haemetology/HIV.

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Asa nurse that used to work in Florida, I will tell you that many facilities expected staff to work during the storm, and occasionally be closed in. And there were facilities that fired staff for not reporting to work, in regards to hurricanes.

I worry more from a hurricane than working in a health care facility with PPE for a disease like the flu.

As a healthcare worker, I expect to have to work in a healthcare crisis. I have worked HIV units, back in the early 1980s, and my current employer would expect me to work during a pandemic, within reason. I am safer at work with PPE and most contagious illnesses than I am at the supermarket.

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Most contagious illnesses, yes. And with this current round of H1N1 I'd agree totally. It may be pandemic, but it's not very lethal or problematic. However- would you feel the same if this mutated into a form as lethal as H5N1 with a greater than 50% mortality rate?

Asa nurse that used to work in Florida, I will tell you that many facilities expected staff to work during the storm, and occasionally be closed in. And there were facilities that fired staff for not reporting to work, in regards to hurricanes.

I worry more from a hurricane than working in a health care facility with PPE for a disease like the flu.

As a healthcare worker, I expect to have to work in a healthcare crisis. I have worked HIV units, back in the early 1980s, and my current employer would expect me to work during a pandemic, within reason. I am safer at work with PPE and most contagious illnesses than I am at the supermarket.

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I was just told today that if my family or I came down with this virus the hospital would pay for all of us to have antiviral medication, I think to keep the nurses working where they are needed. I like the idea!:yeah:

That's awesome... :up: ... assuming it doesn't pick up the anti-viral resistance that alot of flu strains have so far..... :idea:

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This flu, yes. However, the concern is that "this flu" is at a high risk of mutation into "another flu" that has a far greater mortality rate.

As to child care- most people do have short term back up plans. However- how many people have long term ones in place for the event of school closings, daycare closings, nannies that come down with a serious pandemic illness or are unable to care for ones child due to enforced quarantine etc. etc. etc. How many of us don't live near family members or those who would be home and willing to care for another child? Or who have special needs children who need special care that requires alot more than just calling that nice SAHM down the street to sit for a bit? Yes- everyone should have a backup plan- but this is quite a bit different than the sort of potential back up plans that most people have in place.

For most people who will get this flu, it will not be worse than other cases of influenza ... of which there are many cases each year. People get sick: they get over it. What is particularly bad about this flu is NOT that everyone who gets it is going to become seriously ill, it's that it is highly contagious -- and a higher percentage of the population will get it. People are acting as if this were some science-fiction movie with a deadly virus about to turn us all into zombies or something.

... And as for child care ... EVERY family should have a back-up plan for providing child care regardless of situation. Even in routine times, there is always a possibility that a school will close temporarilty or a regular child care provider will become unavailable, etc. To not have a plan is short-sighted and irresponsible.

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inthesky has 1 years experience and specializes in behavioral health.

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I'm a psych nurse without med surg experience. I would want to do my civic service, but this would be awkward. Keep me away from critical care patients and IV starts and I'd probably make do with supervision. =P

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lamazeteacher specializes in OB, HH, ADMIN, IC, ED, QI.

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The answer to the question is yes, Massachusetts can try to force you to work if they declare a health emergency.

from page 33 of 39.

Source: http://www.publichealthlaw.net/MSEHPA/MSEHPA2.pdf

Keeping in mind that the document (at the site above) is a model upon which the fashioning of laws regarding the power given state agencies and personnel that will go into effect when an emergency is declared, it should be recognized that it calls for absolute faith and support of government workers who oversee the implementation of it. During the state of emergency declared, until it is lifted, military and state workers will assign duties, the acceptance of which dictate other workers' retention of licensure.

In other words, you do what is required of you by the Governor of your state and his/her appointees, or lose your license. Such servitude hasn't been in place for civilians previously, except when natural disasters strike, and order needs to be reinstated. Trust for those in office will be mandatory, and non compliance punishable. Public needs will supercede individual rights.

From the comments in posts here, it appears that some would like their ordinary responsibilities to take precedence and can hardly believe that they must plan for the care of their children for an uncertain period of time because a higher duty calls them when an emergency such as mass terrorism, pestilence, or war occurs. That is no time to rethink your vocation!

Being there for others, not by choice is a hard pill to swallow, but there it is. It's like the first time you were required to perform a procedure that seemed to be too much for you. "There's nothing to it, but to do it", as the song says. This is a great thread, to help us to recognize all the preparation that we must do to ensure our own families' security. And government workers need to inspire our trust in them, until it must be there. Censure and partisanship need to be dropped, and expectations elevated. Yes, we CAN DO IT!!!

No one can say they weren't warned, after reading these posts!

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Hey- if "they" want to pay the astronomical costs for in-home childcare plus my salary in that situation? Sure- I'll probably do it. Otherwise- they can have my license because yes- my children are my first priority. Everyone else can have my service- and gladly- but ONLY once they (my children) are taken care of. And anyone who thinks that that is somehow a wrongful prioritization is IMO the one who needs to rethink their priorities.

Think about it- if a parent is worried about their child in a situation like that- how focused will they be on the task? If they are not focused on the task- how likely is it that mistakes will be made? If mistakes are made- how likely is it that someone could die?

The way you talk is as if one shouldn't go into nursing if they have children they recognize their responsibility for, and don't have family nearby who can devote an unspecified amount of time toward raising (since in a case like that who knows how long the situation would last or how many hours a day/week one would have to have them do this) or who can't afford the astronomical cost of in-home childcare (in situations like we are speaking of, there is a good chance that childcare facilities would be closed- or does the state have mandates that they are required to be open as well?) Nevermind whatever special requirements those who have children with special needs might face...

As for public need superceding individual right- well- sorry but I think that mindset is a load of crock. But then- I'm not a socialist. I think that the worst that should be able to happen in this situation is that if one leaves a job- they can't go back to that job and expect it to be there. This is healthcare- people are sick and dying every day. Everyone has their limits. People resign now for poor working conditions, family issues etc. A situation like we're talking here should be no different as far as being forced to work.

From the comments in posts here, it appears that some would like their ordinary responsibilities to take precedence and can hardly believe that they must plan for the care of their children for an uncertain period of time because a higher duty calls them when an emergency such as mass terrorism, pestilence, or war occurs. That is no time to rethink your vocation!

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