Warning: You’re at higher risk for exposure to flu
As an ED nurse, you’re at high risk for being exposed to the flu "like no other group," warns Janice C. Taylor, RN, BSN, CEN, CFRN, an ED nurse at St. Joseph’s Hospital in Bellingham, WA."All I know is, the year I did not get my flu shot, I got the flu. As usually happens, it started on my last day on, which means that for my five days off, I was as sick as a dog," she recalls.
Ever since, Taylor has gotten her flu shot every year. "Yes, my arm may be a little sore the next day, but it is worth it," she says. "If there is anyone that is exposed to the flu, it is ED nurses," says Taylor. "During flu season, I get coughed on, sneezed on, and vomited on by multiple patients a day, especially if I’m triaging," says Taylor.
College students, young adults, the elderly, and children all will wind up in your ED with the flu, says Taylor. "They may have a high fever, and most of the time they are dehydrated, needing IV fluid replacement," she says. "The doctor’s offices are full, and they have to go somewhere." Most of these patients will not be admitted, so nurses in inpatient areas will not be exposed, she explains.
Still, many ED nurses are reluctant to obtain the vaccine, notes Taylor. "Some people are worried that it won’t work, some may think they don’t need it, and others think it will give them the flu," she says. "The one bit of advice that I would give is for the ED nurse to get a flu shot. It’s much better than getting the flu."
According to the Atlanta-based Centers for Disease Control and Prevention, the influenza vaccine is made of killed influenza viruses, which cannot cause infection, and almost all people who get the flu shot have no serious problems with it. However, some people, usually children who have not been exposed to influenza virus in the past, may have fever and body aches after vaccination. These symptoms, if they occur, usually start six to 12 hours after vaccination and can continue for one or two days.1
Know types of flu strains
Here are things to know about the influenza vaccine:
— Increase your knowledge about the vaccine. You must be familiar with the types of flu strains that immunization helps protect against, know the duration of the coverage, how soon to be vaccinated, and when the flu season is estimated to begin, says Anna M. Smith, RN, MSN, director of emergency services at University Of Louisville (KY) Hospital.
According to CDC recommendations, almost anyone would benefit from a flu shot, but it’s especially important for the following groups:
- people 50 years old or older;
- residents of nursing homes or long-term care facilities;
- adults and children with chronic diseases of the heart, lung, or kidneys; diabetes; immunosupression; or severe forms of anemia;
- children and teen-agers receiving long-term aspirin therapy;
- women who will be in the second or third trimester of pregnancy during the flu season;
- household contacts of those in high-risk groups;
- health care personnel;
- breast-feeding mothers;
- travelers.
— Educate patients and colleagues.
Spreading the word about the flu vaccine is of particular importance this year, according to Smith. "Encouraging the public to obtain the flu shot will help prevent confusion of symptoms with anthrax," she says. "We have had a number of people in the community present complaining of exposure." Many of the biological agents, including anthrax, initially mimic flu symptoms, Smith notes. "We are encouraging vaccination to decrease the incidence of flu, thereby decreasing the numbers of people coming to the ED thinking they have been exposed to anthrax," she says. "The public has been very educated to the initial symptoms of anthrax."
As an ED nurse, you should educate patients, coworkers, and family members about the flu vaccine, Smith says. "Explain to the public how the vaccine works, what the vaccine consists of, that it does not cause you to be sick, and that it will not prevent every type of flu," she advises. You also should educate patients about the difference between a cold and the flu, how to treat a cold, how to treat the flu, and when to seek medical help. (To see chart outlining cold and flu symptoms, click here.)
Drive-through’ flu shots
— Volunteer to give vaccines. At University of Louisville Hospital, the public is encouraged to obtain the shot with a two-day "drive-through" program coordinated by the Employee Health and Infection Control department. From 7 a.m. until 2 p.m. on designated days, individuals can drive up to the hospital entrance, fill out a form, and receive an injection without ever getting out of the car, says Smith. "All nurses, including ED nurses, are encouraged to help participate in providing the injections," says Smith. "Last year, we gave over 5,000 injections, and we expect to give even more this year."
Reference
1. Prevention and Control of Influenza, Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 2001; 50: RR-4.
Sources
For more information about the flu vaccination, contact:
• Anna M. Smith, RN, MSN, Emergency Services, University Of Louisville Hospital, 530 S. Jackson Hospital, Louisville, KY 40202. Telephone: (502) 562-3970. Fax: (502) 562-3444. E-mail: [email protected].
• Janice C. Taylor, RN, BSN, CEN, CFRN, Emergency Department, St. Joseph Hospital, 2901 Squalicum Parkway, Bellingham, WA 98225. Telephone: (360) 734-5400. E-mail: [email protected].
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