Want the flu? Come to the ER.

[Guest219794]

We know the flu thing is likely to get worse, which means a lot more ER visits.

As I have seen so far, we are more a part of the problem than the solution. Even when people call to ask if they should come in, we can't give them consistent accurate advice. Our docs are all over the place regarding who gets swabbed, and who gets Tamiflu. Most get at least fluid and Zofran, re-enforcing the belief that the ER is the place to go if you think you might have the flu.

Our ILI visits fall into 3 categories:

People who have the flu and might benefit from Tamiflu. A small minority.

People who have the flu and won't benefit from Tamiflu.

People who are sick, but don't have the flu.

This last category is probably the majority- people with compromised immune systems. They spend hours in a poorly ventilated waiting room and an ER. Every surface is coated with god knows what, people are coughing and hacking. Other than actually sucking on used flu swabs, I can't think of a better way to get the flu than to come to the ER. We make half hearted attempts with gowns and masks on occasion, but ignore basic hygiene.

In addition, there is the general crowd of ER patients, many, (if not most) are not acutely ill, but tend to be unhealthy in general They are also being exposed.

We have no plan in place to deal with this. There has been no change in staffing models. There has been no change in flow. We will continue to use the same cumbersome system. I will still need to ask a bunch of questions that A- have no bearing on treatment, and B- people lie about. I will still need to do redundant charting etc...All the things I currently waste time doing. Except I will be doing it in the middle of an epidemic. Or pandemic. Or whatever might be on its way.

Assuming this continues to grow, both in reality and public perception, we are hosed. I wish I could say it is unbelievable how unprepared we re, but it is unfortunately completely believable.

Anybody doing a good job preparing and dealing with flu this year?

[Lunah, MSN, RN]

hherrn said:

Other than actually sucking on used flu swabs, I can't think of a better way to get the flu than to come to the ER.

Okay, this made me laugh so hard I almost choked on my coffee. Ha ha! :smilecoffeecup:

All I can say for our ED is that though we've all been exposed over and over and over and over, only a couple of RNs have gotten sick since the onslaught started. Yay for masks and obsessive handwashing! Although it's probably just luck of the draw, overall.

[mamamerlee, LPN]

Separate waiting areas? Like in some Peds offices - 'sick' kids, well kids. Flu, non-flu. Anyone with flu-like symptoms over there, anyone with NO flu symptoms, over here!

But you are correct - ALL the surfaces everywhere are contaminated. In the entire world!!! Every door handle, every knob, every elevator button. Every stair rail, every surface in every public place.

And the vast majority of us will survive!!!!

No flu shots for me - allergic to eggs. Been lucky, never had the flu.

[Nurse Cristian]

Good evening

We are 2 nursing students from Punta Arenas Chile and we were just doing our practice when they detonated the whole issue of the swine flu.

In place of care where primary care practices performed the professional, work more than anything in the prevention so that users do not continue spreading the "Human Influenza, to address mask, using much the" alcohol gel, which was used to disinfect our hands after caring for people, people who are going to meet with respiratory problems they did in a place designed especially for this purpose.

On the issue of the antiviral, there was a very strict control, as it only would prescribe antiviral to the person who was infected, and pharmacies in our country just gave this medicine with a prescription.

Hoping that our experience will serve them we send greetings from the end of the world ...

Cristian Hernandez and Viviana Ruiz

Nursing Students Race

Universidad de Magallanes

[dafp]

Hi

David I am nursing student at the University of Magallanes, Chile.

My country and passing by the incidence of influenza AH1N1 suffer, in the beginning was difficult to face because they had no plans of action against the pandemic. We recommend that you follow the prevention measures like washing hands with soap and water in the home, several times a day, cover your mouth when you sneeze with your forearm or tissue, and that upon arrival to the emergency room will take the temperature immediately 38.5 º and if you can contiagado and make a good detection of the virus in the environment such as epidemiological studies.

Bye, greetings

16 of november 2009

[danyeli]

Hello to all who participate in this forum, we Elisabeth Ponce and Daniela Sanchez, both sophomores Nursing Career in Magallanes (Chile). Our opinion on AH1N1 flu is that it is important to take measures to slow the spread of this and thus reduce the spread, some of the policies adopted by the health service in Chile is to assist health care only in emergencies related Human flu, also called for non-attendance at mass events, was implemented the use of masks and alcohol gel and hand antisepsis measures, as this is one means of further spread of human influenza. We hope that you adopt measures similar to the policies implemented in our country, as they helped us greatly to combat this pandemic.

Thank you very much.

Elisabeth Ponce and Daniela Sánchez

Nursing students, Umag, Chile

[SpaceCoastRN]

Our management's answer to division of the waiting room was separating the last row of chairs (about 14 or so) with fake potted plants, not sure exactly what the isolation advantage the fake plants offer, kind of like us placing an isolation patient in one of the rooms that divides off with a curtain instead of an actual room...I have always loved the 'isolation curtain' with a precaution sign hanging from it....

[Aymese]

With the exception of small children, the immunocompromised, and the elderly...can someone explain to me why it would occur to someone to go to the ER if you have the flu? I feel like I'm missing something or that I'm an ignorant nurse, but I really don't get it. I had the flu last year. It hurt...I missed a week of work...it sucked, but I survived w/ tylenol, gatorade, bedrest, and eventually a quick trip to the doctor's office for antibiotics when a few days later the fever struck again and started to turn into pneumonia. Then...I got better . With the exception of the 3 types of people I listed in the first sentence...what happened to humanity's common sense? When did people become so dramatic and helpless?

I sympathize with the ED nurses who have to deal with the multitudes of those who really do not need to be there. Sorry about my vent, but I think I'm just really sick of hearing about this "pandemic" in the media

[Lunah, MSN, RN]

Some people just relish that "sick" role, or like the attention. I don't get it, either. But many of you probably know the type -- the minute their behind hits the bed, they're texting or calling all their friends to tell them "I've been admitted to the ER!" Big deal ... we take everyone.

[FSK123]

what happened to humanity's common sense? When did people become so dramatic and helpless?

My son (2 yrs) and I both had the swine flu and we have active high fevers for 4 days and low grade fevers for 2 days. He had a 103.9 temp for over 12 hours, that would not break (tylenol/motrin, cool wash cloths, etc....) and he was lethargic so I took him into the hospital for fluids to lower his temp. I am also 7 months pregos and after having a high fever (103.5) and sweating profusely, I noticed my baby was not very active and that I was dehydrated from dripping sweat. So I also went into the ER for fluids and to check on the baby.

That is why people go into the ER, they need medical assitance. I wouldn't say I was being dramatic, but I was helpless and needed medical help. I would say that you are not every empathetic, nor do you apply the holistic approach to nursing if you are this judgemental.

[Lunah, MSN, RN]

FSK123 said:

That is why people go into the ER, they need medical assitance. I wouldn't say I was being dramatic, but I was helpless and needed medical help. I would say that you are not every empathetic, nor do you apply the holistic approach to nursing if you are this judgemental.

I wouldn't call you dramatic, either. I'm glad you benefited from fluids and treatment! You (as in pregnant women) and kids are the people who are being hit hardest by all this flu mess! Glad you're better.

[Aymese]

I would say that you are not every empathetic, nor do you apply the holistic approach to nursing if you are this judgemental.

I would say that you failed to acknowledge my statement about young children or the immunocompromised when you decided to jump down my throat by writing your post about your toddler and pregnant self. Those both qualify as exceptions to my posted question.