Flu Shots...Please explain

[pagandeva2000, LPN]

Hello Everyone;

I am a new LPN that works in a clinic at a hospital in NYC that paid my way through school to become a practical nurse. As an LPN, I give immunizations, PPD, injections, and such. Now, with the flu shot, we must have the patients screened by an RN. I was told that this is state law. The flu shot is considered to be a standing order where patients can walk in and receive it as long as they are properly screened by the RN, then, we can administer it.

This backs up the clinic considerably. We are a municipal hospital that accepts patients whether they can pay or not. There are patients that wait more than three hours after seeing a doctor just to get a flu shot, because we have few RNs and they are busy triaging, assessing, doing telephone triage, dealing with emergencies, etc...so it is hard to find the RN that is readily available to screen the patients. It wasn't this way before I attended school...the doctor ordered it, we ALL gave it.

I am not into the LPN-RN debate here. I am just wondering if there is a state law for this in New York, and basically, why is it this way? I feel bad for the patients. I can do everything else, but I have to hand the already irate patient to the RN bin, only for them to wait two more hours before they can get vaccinated. I don't know what to say to the patients, I feel guilty when I have to approach a busy RN 10 times in a row, and it frustrates my day to no end. Thanks, all!

[EricJRN, MSN, RN]

Hmm... weird. Seems like you could do a lot more harm with other vaccinations (like DPT, etc) than you could with a flu vaccine. Have you checked the NY Board of Nursing website?

[txspadequeenRN, BSN, RN]

Never heard of this mess.. Ive been doing Flu clinics now for about 6 weeks this year .. But I started doing them in 2000. We have a Doctors order (standing) but do all the screening and injections. A lot of times in the past I was the only nurse at the clinic . Now they have been staffing better and we have had several nurses at each clinic.. I have no clue who is a RN or LVN cause we do our own thing...oh your asking about specific to NY.. I'm in TX but here is my 2 cents anyway....

[NRSKarenRN, BSN, RN]

yep, its ny reg....will get link.

[color=#990000]nys nursing - immunization guidelines

non-patient specific orders

a non-patient specific order authorizes named rns or rns who are not individually named but employed or under contract with a legally authorized entity, to administer specified immunization agents or anaphylaxis treatment agents for a specified period of time to an entire group of persons such as school children, employees, patients of a nursing home, etc. some health care agencies think non-patient specific orders refers only to giving immunizations to employees. such orders can actually be much broader than this.

some examples of non-patient specific orders are:

• administer influenza vaccine 0.5 ml. im to all incoming freshmen students at x college who are eligible per protocol between august 27, 2001 and december 31, 2001
  
• administer influenza vaccine 0.5 ml im to all employees of x organization who request it and who are eligible by protocol between october 15, 2001 and february 1, 2002.
  
• administer influenza vaccine 0.5 ml. im to all x county residents who request it and who are eligible by protocol between november 1, 2001 and january 3, 2002
  
• administer hepatitis b series to all employees of x organization eligible per protocol between january 1, 2002 and december 31, 2002.

if they've already seen physcian + they order vacination, then lpn may administer but must have written order on chart...check the link.