H1N1: Creating Dilemma On All Sides

The swine flu and vaccine are presenting some problems for nurses.

In New York state, nurses are threatened with job termination if they don’t get vaccinated against H1N1. The state health department is telling all people who work directly with patients and those with whom they come in contact that they must be vaccinated for both the seasonal flu and the H1N1 virus.

At least one nurse doesn’t like being told that the vaccine is mandatory.

“It's just that we're being forced to take this against our will, without proof that the vaccine will even be effective," Sara L. Rombough, RN, told the Watertown Daily Times. Rombough is a 25-year veteran nurse who works at Massena Memorial Hospital in Massena, N.Y. She says she’ll lose her job in November if she refuses to get vaccinated.

The New York State Nurses Association is taking her side. A spokesman said the association encourages nurses to get the vaccine, but doesn’t think it should be mandatory.

According to the Watertown Daily Times, smaller rural hospitals in New York state may not be able to fire nurses who don’t want the vaccine because dismissing them will cause staff shortages.

The state health department defends its stand on mandatory immunization, saying it wants “herd immunity,” and to achieve that, 95 percent of populations need to be vaccinated. Officials also say that hospital patients need to be protected.

Out West, 16,000 union nurses in 39 hospitals in California and Nevada plan to strike because they say that their employers are not providing enough protections against the swine flu.

The union contends that hospitals should supply disposable N95 respirators to nurses who care for people with swine flu, but there is debate about whether this should happen. One view is that because N95 respirators must be custom-fitted, they are impractical. The Society for Healthcare Epidemiology of America says the masks are not necessary.

The other opinion, fostered by the Centers for Disease Control and Prevention, is that giving N95s to health care workers should be a priority.

A spokeswoman for the California Association of Hospitals said most hospitals would be glad to give N95s to their staff, but the masks are in short supply and many hospitals can’t get them.

In August, a California nurse died of H1N1 because of a severe respiratory infection, according to the California Department of Health Services. The department also reports that more than 3,000 people have been hospitalized in the state because of swine flu; 200 have died.

Should nurses and other health care workers who care for patients with H1N1 be forced to receive the vaccine?

Are nurses who refuse to take the vaccine doing the right thing?

Should hospitals do whatever it takes to protect their medical staff, regardless of cost?

Tell us what you think.