Saturday, August 2, 2014

Nurses Save Lives by Speaking Up & Advocating for Immunizations #NIAM14

Sister Caregivers by j4p4n - A younger sister holds her older sister in a sisterly embrace. I added a pale pink to this while synthesizing it because it just felt right. I'm not sure why.     Nurses’ primary guiding principal is caring.  Caring can be manifested in many ways, most notably by advocacy for our patients.  Nurses have always operated on a wellness model, seeking to prevent disease and promote health.  Promoting immunizations is a safe and effective way to promote health.  Advocacy for immunizations is supported by the science behind vaccines.  We know that vaccines are safe and effective (DeStefano, Price & Weintraub,  2013; Klein, et. al, 2011), but unfortunately articles continue to appear written by individuals who believe in these discounted theories.  In this age of instant information word spreads especially on the internet with lightening speed.  Nurses must be vigilant in reviewing print materials, television reports, and internet postings about vaccines, and they need to speak out when discounted theories are presented.

Nurses are the most trusted profession (Robert Woods Johnson Foundation, 2014).  So when nurses speak, the public listens.  Individual nurses can do a great deal to increase public confidence in vaccines by rebutting all reports that continue to undermine public confidence in vaccines.  Sensationalism sells.  All of the children who are healthy because of safe and effective vaccines are not newsworthy, but some theory devised by an individual or organization that believes that vaccines are harmful is deemed appropriate for publication.  While we all hope that published stories and reports will support science, that does not always occur.  Reporters can insert just enough doubt in a story in order to be ‘fair and balanced’ so that the piece comes off giving credence to the anti-vaccine side.  Fair and balanced does not mean 50/50 when it comes to vaccines.  Anti-vaccine stories which are often published as pro ‘vaccine safety’ have been discredited therefore they do not deserve 50% of the space in the story.  Nurses can help to stop this biased reporting by taking every opportunity to counter misinformation with evidence-based science that supports safe and effective vaccines.  In journalism the final statements in a piece are what the public remembers.  If a piece ends on a note that plants doubt in vaccines or give the anti-vaccine advocate the last word, nurses need to contact the source of the information and let the press know that nurses are watching and that scientifically unsupported comments about vaccines are not acceptable and that nurses expect this to change.

Announcing by bitterjug - Figure walking and speaking through megaphone. Nurses also need to speak out against misinformed colleagues who do not believe in vaccines for themselves.  According to 2102 data only 77.9% of nurses received influenza immunizations themselves. While this is an improvement over the previous year, 85.6% of physicians were immunized during the same year (MMWR, 2012).  Nurses are governed by beneficence, which means we do something because it will benefit our patients.  We accept immunizations for ourselves, not just to protect ourselves but to protect our patients.   Unpublished data from a large metropolitan city clearly indicate that many hospitals are doing a dismal job of getting their nursing staff to accept influenza immunizations.  Rates for these hospitals ranged from 55-75%.  We need to engage our nursing colleagues to encourage them to accept immunizations.
Refusal of immunizations by nurses is not a personal choice.  A nurse’s personal choice does not just affect that individual nurse, but can also affect our vulnerable patients.  There is clear data that indicates that health care personnel transmit influenza to their patients (Orr, 2012).

     We also need to teach our patients to speak up!  Recently, I was a patient at a hospital known for their excellent nursing care.  The nurse who approached me wore a mask.  I asked her why she was not vaccinated and she informed me that she did not believe in influenza shots and her personal choice was to not accept vaccination.  I told the nurse that her personal choice affected me, her patient, and I had made a personal choice to be vaccinated and expected the nurse who cared for me to do the same.  I informed her that at best the mask only protected both of us for some 20 minutes.  I requested another nurse, and the new one needed to be immunized.  After some resistance on the part of the masked nurse, I was assigned to a new vaccinated nurse.  I was advocating to protect every other patient who came in contact with this nurse and not just myself.

    No other profession advocates for patients more than nurses, so let us do what we do best and stand up and speak out at every opportunity to correct all of the misinformation that is out there no matter where we find it.


References

Centers for Disease Control and Prevention (2012). MMWR. Influenza Vaccination Coverage Among Health-Care Personnel — 2011–12 Influenza Season, United States
September 28, 2012 / 61(38);753-757. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6138a1.htm
DeStefano F, Price CS, Weintraub ES.  Journal of Pediatrics. (2013). Evaluation of immunization rates and safety among children with inborn errors of metabolism http://jpeds.com/webfiles/images/journals/ympd/JPEDSDeStefano.pdf
Klein N, et al., (2011). Measles-Containing Vaccines and Febrile Seizures in Children Age 4 to 6 Years. Pediatrics; 129(5): 809-14.
Orr, P. (2000). Influenza vaccination for health care workers: A duty of care. Canadian Journal of Infectious Diseases. Sep-Oct; 11(5): 225–226.
Robert Wood Johnson Foundation. (2014). Nurses continue to top public trust survey. org/ewww.rwjfn/blogs/human-capital-blog/2014/01/nurses_continue_tot.html


Mary Beth Koslap-Petraco, DNP, PNP-BC, CPNP, FAANP, Member of Nurses Who Vaccinate

Dr. Mary Beth Koslap-Petraco is an assistant professor at Long Island University Post in Greenvale, NY, and a primary care provider. She is a nationally known expert in immunization practice, an advisor for the Centers for Disease Control and Prevention, and served on the Advisory Board of the Immunization Action Coalition, and National Vaccine Advisory Committee. Dr. Koslap-Petraco is the PKIDS on line Advice Nurse and a member of the executive board of Every Child By Two.






August is National Immunization Awareness Month (#NIAM14). The purpose of this observance is to highlight the importance of immunizations, one of the top 10 public health accomplishments of the 20th
Century, according to the Centers for Disease Control & Prevention (CDC). The goals throughout the month highlight the importance of immunizations for a different population each week of the month:
• Week 1: A Healthy Start: (babies from birth to age 2 and pregnant women)
• Week 2: Back to School (children, pre-teens and teens to age18)
• Week 3: Off to the Future (young adults age 19-26)
• Week 4: Not Just for Kids: (adults age 26+)
 For more information, see: http://www.nphic.org/niam
  

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