As anesthetists we are on the front line of patient care. We are trusted with the responsibility to promote wellness and “first, do no harm”. Recently, we have been required to set aside our personal rights in order to enforce a greater good for our patient
population and the question has emerged “should healthcare workers be required to take a flu shot?”
What is driving the push for flu shots? The CDC estimates the number of yearly deaths from flu to be in the thousands; in a bad year like this one, it’s likely to be in the tens of thousands. Older and more debilitated patients are at increased risk of death related to the flu. Since hospitalized patients often encounter up to 50 different healthcare workers per day, it is important that all workers receive the shot.
In an effort to protect patients the Joint Commission and Medicare both require hospitals to have a program for flu vaccinations for their workers and require hospitals to report compliance data. The incentive for the hospital to require vaccination is obvious. The desire for increased compliance has pushed some hospitals to fire workers who refuse to get the vaccination.
In an excellent article by Bob Wachter, MD published in the blog Healthcare Finance News (Making clinicians get flu shots: More important than simply preventing
the flu) the author makes the case for requiring flu shots for ALL healthcare workers. In the blog, the author reviews reasons why workers object to receiving the shot and goes on to describe the advantage to both the patient population and the overall culture of the
institution.
The Wachter blog refers to the
Checklist Manifesto which lists common elements of professionalism to include:
- Selflessness,
- Patient’s expectation of skill
- Patient’s expectation of trustworthiness.
The author suggests that discipline be added to the list. Discipline involves doing the
right thing for the patient regardless of our personal rights. Discipline within the organization transcends the “favored status” that some Doctors and Nurses claim for themselves. The recent push for hand washing is an example of how corporate culture can be changed when care is truly focused on what is best for the patient.
The bottom line is that in a patient centered institution, there are very few valid reasons for refusing the vaccination other than a documented allergy.
Click here to read the blog by Dr Wachter and use the comments box below to offer your opinions.
People don’t like to be told that they have to do something even if it is the right thing to do. Give them the knowledge and opportunity to be leaders in patient safety and they will WANT to get flu shots.
Previous comment is correct. Nobody likes to be told what to do! I will say that I have never been one to get the flu shot- it makes me feel crappy and I hardly ever got sick. However, when I had kids I started getting it to help protect them so our whole family gets the flu shot so it is not too far fetched that hospitals should require it to protect our patients.
My main problem is with a hospital or state requiring people to put something into thier body. Recently, the hospital I work at came out with a statement that they will not hire a smoker! This hospital also required that all get the flu shot. What is next? Should a hospital not provide OB/Gyn services to girl who refuse the HPV vaccine? IF there is ever an HIV vaccine- should all be required to get it? I fear that the flu vaccine requirement is a slippery slope and we need to be careful with what we mandate.
http://www.kevinmd.com/blog/2012/11/physician-takes-flu-vaccine-protest.html
“In their paper titled “Vaccines to prevent influenza in healthy adults” the Cochrane group concluded, “In average conditions 100 people need to be vaccinated to avoid one set of influenza symptoms. Vaccine use did not affect the number of people hospitalized or working days lost but caused one case of Guillane-Barre syndrome for every one million vaccinations. Fifteen of the 36 trials were funded by vaccine companies and four had no funding declaration. Our results may be an optimistic estimate because company-sponsored influenza vaccine trials tend to produce results favorable to their products and some of the evidence comes from trials carried out in ideal viral circulation and matching conditions and because the harms evidence base is limited.” This is hardly compelling evidence.”