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Friday

NYS Nurses Association Opposes Mandates for Vaccine

Representing over 37,000 nurses, the NYS Nurses Association (NYSNA) has spoken out against a new regulation making flu vaccine mandatory for all people who care for patients in health care...including nurses. Under the new regulations, nurses would be mandated to get a seasonal flu shot as a condition of employment. No shot, no work.

My first thought was: how could anyone be against this?! But, after reading the testimony, I can understand it...moreover, there are a number of Ripple Effect points to consider. After reading all the material, I think NYSNA has a number of valid points.

The first point is: Can this be mandated when no current public health emergency exists? The NYSNA is clear that they fully support and encourage nurses to get flu vaccine. Most would agree that getting a flu shot is good preventative action. When working in health care, what rights do you give up? Consider all the issues the military had mandating Anthrax vaccine not too long ago. Keep in mind you can still decline to get a HBV series and work...

I'll be talking about this in detail on the next Mitigation Journal Podcast (Edition 118 expected release 8/3/09). In the meantime - I've talked about the three best things you can do - now - to prepare for biologic events now, without vaccine...you can hear my recommendations on Mitigation Journal Podcast Edition 117.

Below are the links to the NYS Nurses Association press release and testimony.
Medical News Today story: http://www.blogger.com/post-create.g?blogID=18608016
NYS Nurses Association Press Release: http://www.nysna.org/news/press/072309.htm
NYS Nurses Association full text of testimony delivered by Eileen Avery, MS, RN, Associate Director, NYSNA Education, Practice and Research Program to the State Hospital Review and Planning Council, July 23, 2009, New York, NY.

Tuesday

Paramedic Future

What role will technology play in the future delivery of out-of-hospital care? I once believed that an increased use of technology would increase the scope and duties of paramedics. Today I'm not so sure.

I'm now starting to believe that implementing technology may actually decrease the need for paramedic treatment and, dare I say, speed critical patients treatment.

I learned to read 12-lead EKG's over twenty years ago. It was not common for EMS to "do" a 12-lead and the technology wasn't there to support us doing so. Years later the technology became readily available and is in wide use today. Many seasoned paramedics looked down on the computer interpretation and some, including me, would not read the interpretation until after reading all the leads and making a diagnosis.

Luckily, the technology has grown and become far more trusted. That is trusted to a point where we can question if the middle-man is needed. That middle-man, of course, being the paramedic. I don't know how I feel about this; on one side, any EMT could attach the leads and obtain and transmit the readings to the hospital making 12-lead EKG readily available, sooner. But on the other hand, technology can't consider the patient as a whole and put all the assessment pieces together like a skilled paramedic can.

Like any other technology, once we become accustomed to it, we become dependent on it...try going a without your email or word editor and hand-write a few letters...get the point. In the case of EKG's I'm afraid we'll eventually decide we don't need to teach reading them any longer...what will we do when technology fails?

Anyway - here is a cool article on the use of Blackberrys and EKGs
http://www.theglobeandmail.com/news/technology/heart-attack-help-the-blackberry-solution/article665450/

Monday

Is there a Nuke in your neighborhood?

Is there a Nuke in your neighborhood? Check out Nukeometer at http://nukeometer.com/

Just enter your city and country to find out how many nukes are within range of your city! The breakdown is given by potentially offending country and by delivery...ICBM, submarines, short range missile...these guys thought of everything!

Here in Rochester, NY, we're in range of 6404 nuclear warheads...2347 from the USA and 3684 from Russia, 192 from UK, 121 from China. 2490 of those can be delivered from ICBM and 2771 by submarine with only 1143 available by bombers.

By contrast, Denver Colorado is within range of 8127 warheads and Washington DC 6404 warheads. Tune in and find out where your location stands...pleasant dreams.