H1N1 -- in the NICU

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Hi....I realize there is much information online about H1N1, and an enormous amount can be found here at allnurses...a great resource! But I'm finding nothing online specific to the virus in the NICU. I would love to hear how your units are handling the following situations.......nurse with sick family member, nurses floating to Peds or other floors with active flu cases, babies of suspected or confirmed positive mothers, visitors of those babies who will be going back and forth between mom and baby, suspected or confirmed moms visiting their babies. I have read no reports of babies themselves actually becoming ill with the flu....but several cases of mortality / morbidity r/t the premature births caused by Mom's flu have been reported. I think my greatest concern at this time, is the possibility of serious staffing issues if there are large numbers of premature or ill babies coinciding with large numbers of nurses out due to flu.

Our unit guidelines are no different that those for the rest of the hospital for now....they include: surgical mask if taking care of pt with unknown respiratory illness, staff with sick family members are to mask for 7 days from time of initial exposure, staff with flu are to stay home until fever free (although many times this particular flu is presenting without fever), we are pulling staff to peds and they are supposed to be reminded to stay off our unit (no coming over for lunch etc) if caring for respiratory pts.

Is this similar to what you are doing? Have you changed your visiting policies? We do have our manditory scrub in for visitors, of course...and now a sign reminding those with exposure to the flu to ask for a mask.

please take a second and reply! -- thanks!

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Specializes in Neonatal ICU (Cardiothoracic).

When the NYC H1N1 outbreak started, we just screened visitors for s/s illness, had masks on hand, and isolated one infant who had been exposed to the virus from a family member. We just ended up doing droplet precautions...

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Specializes in NICU, PICU, educator.

We will be closing our unit to all visitors except parents, we don't float to peds at all anyways, but we also will not be getting PRN help from there during flu/RSV season. We will screen the parents and have to take their temp...fever or cold symptoms=no entry. All personnel have to get the vaccine, and if you don't you will be fitted with one of those nasty duck-bill masks...I think I would die if I had to wear that for 12 hours a day! If you have had the vaccine, and a family member is sick, you still come to work, no vaccine and sick family member=time off. If you have respiratory symptoms, you will be sent home.

For a baby with mom who is exposed....isolation precautions (droplet) and not visitors unless they can prove they had the vaccine. We are sending out a letter to all parents encouraging them to get vaccinated, and their immediate families also so that they will not get sick and be able to continue to visit their kiddos.

This applies for all maternal child areas.

At the hospital my DH works at not only are the employees getting vaccinated, but they are doing their immediate families for free also.

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Specializes in NICU level III.

If our parents are sick they are not allowed into the unit & this is made clear at the time of admission. We don't float to peds, but if we have to go up there to start an IV we don't start IV's on peds patients that have RSV or other types of respiratory viruses (this is nothing new to our unit).

Our hospital is requiring us to get the flu shot & is encouraging our families to participate in getting vaccinated. If we refuse to get the vaccine then we have to wear masks anytime we set foot on hospital grounds. I'm sure when the H1NI vac. comes out they are going to try to require us to get that otherwise they will probably require us to wear a mask if we refuse as well.

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I realize most parents choose to stay away when they are sick until they start feeling a little better, but you actually deny parents access? Can they not just wear a mask? I can't imagine the way a parent must feel to actually be told they cannot come see their baby.

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Specializes in NICU level 3.

At the hospital I work at we are required to get the H1N1 shot and the flu shot, if we refuse we have to wear a mask for our all of our shifts. Also if we have flu-like symptoms we are required to be off work for 7 days. gonna be scary when we all have flu-like symptoms... very common.

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Specializes in NICU level III.

If parents are sick they can't come in period. Thats how its always been. I dunno if it will change such as if parents have flu like symptoms if they can wear a mask.

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Specializes in Level III NICU.

New York state is now requiring us to get the flu vaccine, and when the H1N1 vaccine is available, we will also be required to get that. We are being threatened with suspension and/or termination if we refuse vaccination. As far as I know, there is no option to just wear a mask. Yet we have no plans to limit visitation at this point, and we have VERY liberal visiting policies. Complete BS, if you ask me. I have always gotten a flu shot, but I'm not too keen on being forced to. FAQs from NYS DOH:

http://www.health.state.ny.us/diseases/communicable/influenza/seasonal/providers/questions_and_answers_-_health_care_worker_mandatory_influenza_immunization.htm#h1n1_vaccine

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How are they handling people who have already had a case of H1N1? (of course, few these days are officially 'confirmed'...so that could be a problem.) Where is the scientific data backing up their plan I wonder?--is this evidence based practice? Because with a liberal unmasked visitor policy, the baby will be exposed to everyone their visitors have been around in the previous week! (the possible incubation time, before symptoms show). This is clearly for their (the hospital's) legal protection, so that no one claims to have gotten the flu from a nurse. If anything, I would think this would set them up for more legal problems. As in, "if you were SO concerned about H1N1 that you MADE the nurses get immunized....how could you be SO irresponsible as to let me bring in Grandma who works at an elementary school or Grandpa who works at Walmart?" Also...are they making ALL employees get the vaccine? Environmental services, administration, chaplains etc? I am very concerned about protecting our patients from exposure, but it's starting to look impossible....with the biggest problem being that of delayed symptoms. I think mandatory vaccines are an extreme attempt to control an almost unmanageable problem. What is the staff response to this requirement?

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Specializes in NICU level III.

I didn't think that they could terminate somebody's positon b/c they refuse to get a vaccination? What are they going to do about ppl that refuse due to religious beliefs?! Hum. . .

I think that if us nurses/hospital workers have to be vaccinated they should make vistiors & parents alike be vaccinated. Hey you want to come in be vaccinated!!! I think they are just as big of a threat if not more to the kids than we are. There is NO difference than me taking care of their child than there is the parents & visitors coming in & touching/breathing on that baby.

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Specializes in NICU Level III.

We have a patient that was exposed by a staff member.. on contact & droplet precaution for a week.

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Specializes in Level III NICU.

Uh, yeah, us staff nurses all think that it's nuts that we aren't limiting visitation. Management just says we offer "family-centered care." Crazy....We say (healthy) parents can continue round-the-clock visiting, have specific grandparent visiting hours, and that's it. Of course, that's kinda what we always want, but at least now we have a legit reason. I see no reason for everyone and their uncle to be parading through an ICU during cold and flu season, ESPECIALLY this year. We are told (and have been told in the past) that if we see someone who has flu-like symptoms we can ask that they leave, and that if we say something like, "you being here with flu-like symptoms is dangerous to the baby you are visiting and all babies here in the unit, and I'm going to ask you to leave," that most people will leave. Yes, most people would leave if told that. I would hope that most people would just use common sense and not visit in the first place, but we all know that isn't true. And of course, there are always those few people that just won't leave. A few years ago, there was a dad who was obviously sick. When the nurse asked him to cut his visit short for the sake of his baby and the other babies in the unit, he became totally irate and threatened her. To the point where she requested an escort to her car each night for the remainder of the baby's stay (luckily not a long one!). Anyway...

According to the link I had posted previously (FAQs from the DOH), there are no religious exemptions to the flu vaccine. Medical exemptions only. The FAQs also cover what employers can do to employees that don't get vaccinated, and while they suggest reassignment in non-patient care settings, my hospital is stating that being vaccinated is a "condition of employment." Just like proving immunity to measles, mumps and rubella is and annual TB screening. And we were told that it could in fact result in termination.

Like I said before, I get a flu shot every year. But it has always been MY decision to. I am nervous about having to receive the H1N1 vaccine, since it is something I have never received before and it is relatively new.

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