I feel so frustrated about people refusing vaccination…

[Faith-manor]

4 minutes ago, TravelingChris said:

My eyes were really opened when I listened to the hearings for the Pfizer third shot for immunocompromised hearings in August.   Most of the doctors calling in wanted things like a second other shot for J and J,  wider allowances for immunocompromised, etc.  The way the govt officials were talking was like they want perfection.  It seemed that because they never see patients, they had a very unrealistic view if the world.

Agreed. I feel like they are so far removed from actual medical practice that they have entirely lost sight of what is happening on the ground. It is like some dumb general in DC making epic troop movement decisions having never visited the front or talking to the leaders living the fight. Not smart.

Edited October 15, 2021 by Faith-manor

[BronzeTurtle]

3 hours ago, LMD said:

I don't agree that the smoking analogy is a good one,

I think  the smoker metaphor is a really good one to define the differences people have in this discussion. If someone thinks we are all guaranteed a germ-free space same as non-smoking space and every healthy person potentially just by nature of existing is a 2-pack a day smoker, then there's nothing you can't do to curtail the behavior in public. pretty simple and black and white actually. there is some issue with people who can prove they are taking their chantix being allowed to smoke one or two indoors because it's less than someone who isn't on a smoking cessation program, but other than that somewhat simple. 

 

[Bootsie]

5 minutes ago, SeaConquest said:

What part of this was avoiding the claim:

"So, yes, if you have no way to know whether you are infectious or not, because you can be asymptomatic, and rapid home tests are still not readily available in this country, then when you are a nurse, you have a duty to your patients, who are relying on you for their safety, to err on the side of caution and assume that you are walking around with a loaded weapon. Therefore, IMO you *must* take the necessary precautions (masking + vaccinating) because, to do otherwise, and err on the side of assuming that you are healthy until proven otherwise, is to put your patients at risk because we know how Covid spreads silently and asymptomatically. And this choice, as I have said repeatedly, is a breach of your ethical duties as a nurse and grounds for termination by your employer."

I answered your question directly and I stated the evidentiary basis for my claim. That you fail to grasp that is not my issue.

And, I didn't ask you to assume that every person that you "come in contact with is a loaded gun," did I? You are making huge assumptions from very my specific claims, which is why I continue to point out your false equivalences. I said, "..."when you are a nurse, you have a duty to your patients, who are relying on you for their safety, to err on the side of caution..." Are you a nurse? If you aren't then I am not speaking to you because I have already stated numerous times that no duty = no breach. 

I speak to vaccine hesitant patients all of the time. My role is to educate people about the benefits and risks of vaccines. That's it. I do not guilt people. I do not pressure patients. I believe in informed consent and bodily autonomy. I also believe in personal responsibility for one's choices, and that if you choose to live in a collective society (versus self-sufficiently), we have certain duties and responsibilities, depending on the roles that we choose to take on in that society.

For example, I chose to serve in our all-volunteer force as a member of the military. Therefore, I lost the right to be a conscientious objector. If I didn't like the prospect of potentially killing people, I didn't have to volunteer to serve in the Army. Likewise, if you choose to become a nurse, then you know going in that you lose the right to opt out of vaccinating against deadly diseases because we know from nursing school that vaccination supports public health. This isn't some surprising concept that is being sprung on people out of nowhere. Like I said, it's literally nursing school 101.

So please cut it with the false equivalences. You're not fooling anyone here with these games.  

 

Your statement says "then when you as a nurse..." A claim about what a nurse should do is not addressing a statement about how every person who is walking and breathing being portrayed as a loaded gun ready to go in and intentionally shoot up a place.  If I am missing something, please let me know.  

[Bootsie]

8 minutes ago, TravelingChris said:

Yes that is right but it is because of buruecratic paperwork rules that they didn't file earlier. And since they filed last week and this can save lives, why not discuss it next week, and not wait till end of November ?

I would think that the committee has to have time to review what was filed, in addition to clear their schedules of other commitments they have. Also, part of the process is letting the general public comment, which means they must have the ability to review the material.  I heard a lot of comments after the meeting for Pfizer's booster that the committee members should not dismiss research because it hasn't been peer-reviewed, that they should just review it themselves--but that takes time.   

I have no idea how much buruecratic paperwork there is to file--I am sure, like most government processes, it is awful.  But, is it unusual to have this type of advisory committee for a drug (rather than a vaccine)?  I am not familiar with the usual process, but what I have read, it seems as if an additional layer may be in place here.  

[TravelingChris]

10 minutes ago, Bootsie said:

Your statement says "then when you as a nurse..." A claim about what a nurse should do is not addressing a statement about how every person who is walking and breathing being portrayed as a loaded gun ready to go in and intentionally shoot up a place.  If I am missing something, please let me know.  

I decided fairly early on in this pandemic that although I am disabled, have lots of chronic illnesses, I just can't live with this level of suspicion.  Which is why I go to restaurants, went to a concert last month, etc.  And so far, so good.  I am not willing to live in my house anymore than I already do.  I was living in my house for a number of years before the pandemic due to my disabilities and it is not good for my health.  So while I agree with wearing masks in most health care places- I didn't when I was in the hospital in my own room- because that is the place where the most vulnerable people still go, I do not see a need to stop living my life.  

[SeaConquest]

4 minutes ago, Bootsie said:

Your statement says "then when you as a nurse..." A claim about what a nurse should do is not addressing a statement about how every person who is walking and breathing being portrayed as a loaded gun ready to go in and intentionally shoot up a place.  If I am missing something, please let me know.  

Because I never made "a statement about how every person who is walking and breathing being portrayed as a loaded gun ready to go in and intentionally shoot up a place." Those are your words, not mine. You have repeatedly tried to reframe this issue as some sort of "scary" and "frightening" statement about my feeling towards patients, lecturing me about my "unconscious bias" and how I should stick to making a crap ton of money as lawyer. And people have called you out on your shenanigans. I've never said anything of the sort and I am not going to be baited into it because I don't believe it. This conversation has always been about my feelings re the mandates related to nurses and whether they should lose their jobs over them. 

Let's review what I said:

"I hope every nurse that refuses to be vaccinated and boosted regularly (unless he or she has a legit medical exemption) gets kicked to the curb because those nurses clearly don't understand science and have no business being representatives of a profession that is grounded in evidence-based practice. Good riddance."  

"People do stupid stuff all of the time. I do stupid stuff all of the time. I don't intentionally do stupid stuff that puts other people in harm's way at my job. And if I did, I would expect to be fired. Why is this even controversial?

We are not talking about people pigging out on too much pizza or drinking too much in their free time. We are talking about someone going into a hospital with a loaded weapon and intentionally shooting up the place. I don't care if you worked honorably for 20 years before that; you don't get to intentionally cause damage to people. When you know better, you do better. There was no vaccine at the beginning of the pandemic. Vaccines came out under emergency authorization. Some of us lined up to get them. Others hesitated. The vaccines were studied. Billions of doses were administered globally. They were deemed to be both safe and effective by physicians and scientists the world over. Now, those healthcare workers who hesitated are being told that the time for equivocation is over. It is time to be vaccinated to protect public health DURING A PANDEMIC. We are asked to be vaccinated for a myriad of other diseases and we do it. That's part of our job. You go into this profession knowing that that's part of our job. You don't get to opt out of vaccines and go to clinicals. It's part of the deal and everyone knows it. But, suddenly now, in the midst of a 100-year pandemic, after these vaccines have been vetted the world over, we have to put up with these refuseniks compromising patient care? GTFO here with that nonsense."

And let me be clear again, since you seem to have difficulty understanding this: I stand by my belief that a nurse who is working in direct patient care is indeed walking around with a loaded weapon, that could go off at any moment, if he or she is not taking appropriate precautions (masking + vaccinating), which IMO is a breach of a nurse's ethical duties and grounds for termination. None of which has anything to do with patients or anyone else, so stop extrapolating and making baseless claims.

[TravelingChris]

5 minutes ago, Bootsie said:

I would think that the committee has to have time to review what was filed, in addition to clear their schedules of other commitments they have. Also, part of the process is letting the general public comment, which means they must have the ability to review the material.  I heard a lot of comments after the meeting for Pfizer's booster that the committee members should not dismiss research because it hasn't been peer-reviewed, that they should just review it themselves--but that takes time.   

I have no idea how much buruecratic paperwork there is to file--I am sure, like most government processes, it is awful.  But, is it unusual to have this type of advisory committee for a drug (rather than a vaccine)?  I am not familiar with the usual process, but what I have read, it seems as if an additional layer may be in place here.  

They are trying to get Emergency Authorization.  I have heard from two seperate doctors that this really should be available- one is the man from Johns Hopkins who is a public health doctor and the other is local infectious disease doctor.  Now the infectious disease doctor said that for the immunocompromised, we should still do monoclonal antibodies as a first choice.  But for most people, this medication stops the disease to the extent that hospitalizations don't occur.  Considering that the main issue to all of us vaccinated people is the issue of hospitals and hospital and EMT staffs being overworked, this needs to be approved pronto.  It is a similar drug to the kinds that are used for the flu--- dd2 got the flu a few years ago and she stopped being sick after one and a half days with the flu medicine.  That is the kind of response we need. If that becomes standard, we won't have a COVID issue anymore.  Because even if people aren't vaccinated, they could still get over COVID in two days and for most people,, that is soon enough.

But I am totally not believing just about anything coming out of the government nowadays.  I see that my state keeps lowering how many people got COvid vaccines even though we had record vaccinations starting in August.  I see garbage about how the IRS needs to monitor everyone's bank account that has $600 dollars in it or has that amount ever in a year in order to catch the 1% of the population in income or wealth who cheat which makes zero sense at all. I see the WH chief of staff retweeting a tweet of a so-called economist from Harvard that inflation is a "high class problem" when anybody who knows anything about economics knows that lower income spend more of their income on food and utilities and gas for cars.  As a higher income person, we have much less proportion of our income spent on food, utilities and gas.  And about that gas, guess which income level people are more likely to work from home-  it isn't the lower incomes.

[SeaConquest]

10 minutes ago, TravelingChris said:

I decided fairly early on in this pandemic that although I am disabled, have lots of chronic illnesses, I just can't live with this level of suspicion.  Which is why I go to restaurants, went to a concert last month, etc.  And so far, so good.  I am not willing to live in my house anymore than I already do.  I was living in my house for a number of years before the pandemic due to my disabilities and it is not good for my health.  So while I agree with wearing masks in most health care places- I didn't when I was in the hospital in my own room- because that is the place where the most vulnerable people still go, I do not see a need to stop living my life.  

Chris, I didn't make that claim. I don't think that you should stop living your life. I have a disability as well, although it is not one that is apparent from looking at me and likely not one that would make me more susceptible to Covid (though, we don't really know that for sure yet, I suppose). My point in saying that is just for you to know that I understand what it is like to live with a chronic disability, and despite the claims made against me in this thread, I know that my lived experience with disability has made me a more empathic and compassionate caregiver to my patients.

I am incredibly grateful for the vaccines precisely because they have made it easier for my family and I to go back to living our lives. My kids go their charter school in-person classes again, my kids went to summer camp again, my son started taking his glider training classes again, we have traveled to my parents in Seattle again, my husband's family in Quebec can finally cross the border and come to see their grandkids again this year (after two years!), we can hopefully celebrate my son's bar mitzvah in Israel next year, I was able to finish my nursing school clinicals and graduate, etc. All of that happened thanks to these vaccines. And all of that has happened while all of us have stayed Covid-free (knock wood). We all wear masks when we are indoors, but outdoors, we went horse back riding for my son's birthday and had pool parties and went to pumpkin patches and spent time on our boat -- I am pretty lenient about outdoor stuff. I just haven't seen the data to convince me that outdoor spread is a serious concern unless you are really up close to each other. 

So, please please please. I don't know the extent of your disability, but to the extent that you are able and have support from friends and loved ones, please enjoy your life. Staying isolated is not good for anyone's mental health. Sending you so much love!

[Bootsie]

7 minutes ago, SeaConquest said:

Because I never made "a statement about how every person who is walking and breathing being portrayed as a loaded gun ready to go in and intentionally shoot up a place." Those are your words, not mine. You have repeatedly tried to reframe this issue as some sort of "scary" and "frightening" statement about my feeling towards patients, lecturing me about my "unconscious bias" and how I should stick to making a crap ton of money as lawyer. And people have called you out on your shenanigans. I've never said anything of the sort and I am not going to be baited into it because I don't believe it. This conversation has always been about my feelings re the mandates related to nurses and whether they should lose their jobs over them. 

Let's review what I said:

"I hope every nurse that refuses to be vaccinated and boosted regularly (unless he or she has a legit medical exemption) gets kicked to the curb because those nurses clearly don't understand science and have no business being representatives of a profession that is grounded in evidence-based practice. Good riddance."  

"People do stupid stuff all of the time. I do stupid stuff all of the time. I don't intentionally do stupid stuff that puts other people in harm's way at my job. And if I did, I would expect to be fired. Why is this even controversial?

We are not talking about people pigging out on too much pizza or drinking too much in their free time. We are talking about someone going into a hospital with a loaded weapon and intentionally shooting up the place. I don't care if you worked honorably for 20 years before that; you don't get to intentionally cause damage to people. When you know better, you do better. There was no vaccine at the beginning of the pandemic. Vaccines came out under emergency authorization. Some of us lined up to get them. Others hesitated. The vaccines were studied. Billions of doses were administered globally. They were deemed to be both safe and effective by physicians and scientists the world over. Now, those healthcare workers who hesitated are being told that the time for equivocation is over. It is time to be vaccinated to protect public health DURING A PANDEMIC. We are asked to be vaccinated for a myriad of other diseases and we do it. That's part of our job. You go into this profession knowing that that's part of our job. You don't get to opt out of vaccines and go to clinicals. It's part of the deal and everyone knows it. But, suddenly now, in the midst of a 100-year pandemic, after these vaccines have been vetted the world over, we have to put up with these refuseniks compromising patient care? GTFO here with that nonsense."

And let me be clear again, since you seem to have difficulty understanding this: I stand by my belief that a nurse who is working in direct patient care is indeed walking around with a loaded weapon, that could go off at any moment, if he or she is not taking appropriate precautions (masking + vaccinating), which IMO is a breach of a nurse's ethical duties and grounds for termination. None of which has anything to do with patients or anyone else, so stop extrapolating and making baseless claims.

Yes I was paraphrasing your words:

"And as long as you and I are walking around and breathing in close proximity to others, we are literally walking around with a loaded weapon that could potentially go off. " and "We are talking about someone going into a hospital with a loaded weapon and intentionally shooting up the place."

If I misinterpreted those statements and misrepresented what you said, I apologize.  They appeared to me to be referring to everyone (not simply to nurses or you professionally).  

I am unwaware of ever making a statement about your feelings toward your patients, lecturing you on unconcious bias, or saying anything about how much money you should make, or how you should be a lawyer.  I will be happy to review any such statements like that I made.  

[TravelingChris]

26 minutes ago, Bootsie said:

Yes I was paraphrasing your words:

"And as long as you and I are walking around and breathing in close proximity to others, we are literally walking around with a loaded weapon that could potentially go off. " and "We are talking about someone going into a hospital with a loaded weapon and intentionally shooting up the place."

If I misinterpreted those statements and misrepresented what you said, I apologize.  They appeared to me to be referring to everyone (not simply to nurses or you professionally).  

I am unwaware of ever making a statement about your feelings toward your patients, lecturing you on unconcious bias, or saying anything about how much money you should make, or how you should be a lawyer.  I will be happy to review any such statements like that I made.  

You both seem to be agreeing.  Yes, healthcare workers should protect their patients and yes, we should continue to live our lives.  And yes, vaccines are wonderful.  And I agree with all of the above.  

[SeaConquest]

33 minutes ago, Bootsie said:

Yes I was paraphrasing your words:

"And as long as you and I are walking around and breathing in close proximity to others, we are literally walking around with a loaded weapon that could potentially go off. " and "We are talking about someone going into a hospital with a loaded weapon and intentionally shooting up the place."

If I misinterpreted those statements and misrepresented what you said, I apologize.  They appeared to me to be referring to everyone (not simply to nurses or you professionally).  

I am unwaware of ever making a statement about your feelings toward your patients, lecturing you on unconcious bias, or saying anything about how much money you should make, or how you should be a lawyer.  I will be happy to review any such statements like that I made.  

I apologize as well. I was likely thinking of another poster in the thread who made those statements.

[wathe]

7 hours ago, SlowRiver said:

There are a few thousand people that die every year in the US from diphtheria.

It's a bit odd to be disagreeing about how possible it is to eliminate viruses, when we still have only eliminated two in human history, after more than 60 years of widespread vaccination for many of them. And none of them are even in the same family of viruses - the closest comparator to covid now is flu and no one thinks that is going anywhere.

How is it suddenly a real possibility now when it's been so difficult before? 

Smallpox was able to be actually eradicated because of it's particular characteristics. Easy to see, quick to become visible after infection, doesn't mutate readily, no animal equivalent, immunity is permanent and lifelong,  There are a few other diseases that scientists think it might be possible to really eradicate which share similar characteristics - a few being less than 10 . Covid is not similar to those.

No!  No! No! This is absolutely untrue.

There has been 14 cases and ONE death from diptheria in theUSA since 1996 (CDC pink book report quoted below), and he didn't catch it here.:

Diphtheria Secular Trends in the United States

• 100,000-200,000 cases and 13,000-15,000 deaths reported annually in 1920s before vaccine
• Cases gradually declined after vaccines introduced in 1940s; cases rapidly declined after universal vaccination program introduction in late 1940s
• From 1996 to 2018, 14 cases and 1 death reported in the United States

From 1996 through 2018, 14 cases of diphtheria were reported in the United States, an average of less than 1 per year. One fatal case occurred in a 63-year-old male returning to the United States from a country with endemic diphtheria disease.

WHO table of case by country.

Diphtheria is an example of a  spectacular vaccination success story.  We still have diphtheria in the world (CDC yellowbook) because some countries, because of poverty, war, and other structural problems, aren't universally vaccinating.  VACCINES WORK.

Measles, mumps, rubella, polio, H. influenza, pertussis, even chickenpox.  All vaccine success stories.  Most practitioners under the age fo 40 have never seen case of any of them (excepting chickenpox, but many have never seen a case of that either, c-px vax is universal here).  

The Museum of Healthcare in Kingston (Ontario) website has a fantastic virtual exhibit on vaccines and immunization, for those who are interested in some of the history (bonus for Canadians, there is some really good Canadian content)

ETA nitpicky point that diphtheria is a bacterial disease, not viral.  Ditto pertussis.

ETA again to clarify:  the reason diphtheria and polio haven't been eradicated is social - dysfunctional human social systems.  Not science.

Edited October 15, 2021 by wathe

[wathe]

4 hours ago, Dmmetler said:

On the pumpkin patch, unless it is actually your local government mandating masks, I don't see why it is any different than any other business requiring them. I required masks for my piano studio all last summer when we had no mask mandate because my students were under 16 and therefore could not be vaccinated at all, or were in the process of being so until about late June. There was no county mandate, but individual businesses could still choose to do so provided we posted signage to that effect. 

 

The pumpkin patches we've been to often have playhouses, bounce houses, and other amusements where children are close together. I don't see it at all unreasonable to choose to keep a mask mandate in place for that reason, because while the adults can be vaccinated and almost certainly will keep distanced from others outside their party, the kids cannot be yet, and probably won't. 

 

Similarly, we're going to the local zoo's Halloween event tonight. It will be mostly outdoors, and is spacious enough that you can stay away from other people if you so choose. Masks are still required. And it makes sense-the most vulnerable who cannot yet be vaccinated are also the most likely to want to crowd close to see the magician, or to be on the dance floor together, and rather than cancel the event, as has happened to so much in the last year, mandating masks provides extra protection for those kids. 

 

 

This is part of the issue - much of what people think of as outdoor isn't truly outdoor.  there are often indoor or crowded spaces where people cluster together at so-called outdoor events.

[wathe]

5 hours ago, Faith-manor said:

Not in the USA with mandatory DTaP for children to attend school. You are being dishonest again. The average is less than two per year. Two. In the USA. Where the vaccines are mandated and distribution is efficient, diphtheria is NOT a problem in communities.

It's even bette than you suggest; less than 2 cases per year, not deaths.  Many fewer deaths than even that.  One death in since 1996.  (Diphtheria is treatable.  The modern difficulty with treatment in developed nations would be the practitioner failing to recognize it - very, very few practitioners have ever seen a case. ) 

[Faith-manor]

21 minutes ago, wathe said:

It's even bette than you suggest; less than 2 cases per year, not deaths.  Many fewer deaths than even that.  One death in since 1996.  (Diphtheria is treatable.  The modern difficulty with treatment in developed nations would be the practitioner failing to recognize it - very, very few practitioners have ever seen a case. ) 

Agreed. I think it would absolutely be missed here because no practitioner would.even think, "Oy, Diphtheria is going around!" Just doesn't compute. And of course that is because of the vaccine. But, that will only continue to be this way so long as people continue to vaccinate their kids. If that falls off a bunch, all it will take is a traveler from elsewhere to bring it here, and an outbreak will occur. 

It is amazing to me the ridiculous arguments people will make in order to be against covid mandates.

I was just pointing out the glaring error, but didn't take the time to read the full article to see exactly what the breakdown was for cases vs. deaths.

[wathe]

Just now, Faith-manor said:

Agreed. I think it would absolutely be missed here because no practitioner would.even think, "Oy, Diphtheria is going around!" Just doesn't compute. And of course that is because of the vaccine. But, that will only continue to be this way so long as people continue to vaccinate their kids. If that falls off a bunch, all it will take is a traveler from elsewhere to bring it here, and an outbreak will occur. 

It is amazing to me the ridiculous arguments people will make in order to be against covid mandates.

I was just pointing out the glaring error, but didn't take the time to read the full article to see exactly what the breakdown was for cases vs. deaths.

I think and advanced case would be obvious.  But I don't think that anyone is going to catch it early, 'cause it's just not on our radar, and even if it is, it's just really improbable.

[Faith-manor]

Just now, wathe said:

I think and advanced case would be obvious.  But I don't think that anyone is going to catch it early, 'cause it's just not on our radar, and even if it is, it's just really improbable.

Right. It just isn't something on the scope for respiratory diseases these days. So unfortunately it would have to get pretty bad or have progressed to the point that "everything else plus the kitchen sink", so to speak, had been tested for before a doc would test for diphtheria.

[whitestavern]

I wish they would do more research on aspirin as a preventative and treatment. This looks about as promising as the Merck pill. 

https://www.jpost.com/health-and-wellness/aspirin-lowers-risk-of-covid-new-findings-support-preliminary-israeli-trial-681127

[SeaConquest]

3 minutes ago, Faith-manor said:

Agreed. I think it would absolutely be missed here because no practitioner would.even think, "Oy, Diphtheria is going around!" Just doesn't compute. And of course that is because of the vaccine. But, that will only continue to be this way so long as people continue to vaccinate their kids. If that falls off a bunch, all it will take is a traveler from elsewhere to bring it here, and an outbreak will occur. 

It is amazing to me the ridiculous arguments people will make in order to be against covid mandates.

Just think about the R0 for varicella and the effectiveness of vaccines for it.  

https://www.cdc.gov/chickenpox/vaccine-infographic.html

https://www.cdc.gov/mmwr/volumes/65/wr/mm6534a4.htm

[Dmmetler]

My Endo recommended that I start taking baby aspirin again over a year ago because I have a higher risk of clotting issues during pregnancy-and her feeling was that since COVID seemed to affect clotting in some people, it was a "can't hurt, might help" thing, like raising D to optimal levels. 

[Corraleno]

4 hours ago, TravelingChris said:

Apparently that Merck drug that is a very effective pill to stop Covid from being as serious as it can be was actually ready for use last December but FDA just yesterday said they won't decide anything about it to late November so it won't be out till Dec at least. 

That is not true. Phase 1 of that study only started in late October last year, and the estimated completion date for Phase 3 was November 2021. The FDA actually recommended that Merck stop the study early, before the full number of patients had even been enrolled, because the interim data were so positive. Merck stopped enrolling new trial subjects on August 5th, followed everyone up for the required minimum of 29 days, compiled all the data and submitted the EUA request to the FDA on Monday. The Antimicrobial Drugs Advisory Committee will meet on November 30th to discuss it. Seven weeks may seem like a long time, but there are thousands of pages of data and they need a date when all 15 members of the committee, many of whom are med school professors and/or hospital directors, are available to attend. The US government has already ordered 1.7 million doses of molnupiravir, which Merck has already manufactured and should be available as soon as the EUA is granted.

[Dmmetler]

2 minutes ago, SeaConquest said:

Just think about the R0 for varicella and the effectiveness of vaccines for it.  

https://www.cdc.gov/chickenpox/vaccine-infographic.html

https://www.cdc.gov/mmwr/volumes/65/wr/mm6534a4.htm

As someone who was teaching in public schools before Varicella was available and as the rollout happened, we went from having almost the entire kindergarten and a good chunk of 1st and second out, at least one or two older kids or adults also getting it and having a really, really rough time, and usually at least one member of a school community of about 750 being hospitalized every year to almost NO cases-and that was before the 2 dose series was standard. The change was undeniable. 

[Corraleno]

2 hours ago, TravelingChris said:

I see the WH chief of staff retweeting a tweet of a so-called economist from Harvard that inflation is a "high class problem" when anybody who knows anything about economics knows that lower income spend more of their income on food and utilities and gas for cars.  As a higher income person, we have much less proportion of our income spent on food, utilities and gas.  And about that gas, guess which income level people are more likely to work from home-  it isn't the lower incomes.

That is not at all what Furman meant, although Fox, NY Post, Washington Examiner, etc, have purposely  twisted it that way to create outrage. He was not saying that inflation only affects wealthy people, he was saying that the sort of inflation we are currently seeing is one of the "better" kinds of problems to have, because it's being driven by high demand for goods by consumers who have the money to pay for them as unemployment continues to fall. The second sentence in his tweet was that if we were still in the position of having 10% unemployment, we wouldn't have the current rate of inflation — because millions more people would not be able to afford it — and that would be a much worse problem. 

[SKL]

Regarding the healthcare worker discussion:

1) I would rather they get the vax if it is not contraindicated for them.

2) I would rather ALL patient care workers get tested VERY frequently for COVID, whether they are vaccinated or not.

3) Employers in the healthcare industry should weigh the real-life pros and cons in deciding their specific workplace policies re vaccination. 

4) Employers should build work assignments in ways that provide flexibility during the pandemic.  For example, there are probably no-patient-contact jobs that can be done by nurses in quarantine (if they are not sick), while non-nurses could be brought in to help with some of the traditional nurses' burden when Covid hospitalizations are high.

5) What do people think of putting nurses who oppose the vax on the Covid wards?

    a) can't spread Covid to patients who already have it,

    b) it might address the above-mentioned issue of possible compassion fatigue,

    c) it could be educational for said nurses.

6) Regardless of the above, someone should work to better understand the hesitancy to this vax.  I do understand that some of it is probably just bullheadedness, but for those who genuinely believe the vax is more dangerous than Covid for them:

    a) Are there educational deficits that should not be acceptable in the nursing profession?

   b) What are the short-term and long-term solutions that lead to a better-educated AND sufficiently staffed workforce?

 

 

[SKL]

On 10/15/2021 at 3:28 PM, Dmmetler said:

My Endo recommended that I start taking baby aspirin again over a year ago because I have a higher risk of clotting issues during pregnancy-and her feeling was that since COVID seemed to affect clotting in some people, it was a "can't hurt, might help" thing, like raising D to optimal levels. 

Correction!  I had this backwards, sorry:

Not to be a downer, but just this week I saw an article to the effect that people [incorrect: under a certain age (60?)] correction - OVER 60 should NOT take daily aspirin as a preventative unless they have already had a previous heart attack or stroke.  Apparently it does more damage to the GI tract than it's worth on average.

Edited October 17, 2021 by SKL

[SKL]

And not to offend any healthcare workers in this thread, but I've posted before about my general distrust of the way conventional healthcare is managed, and that includes the fact that many HCWs are simply not very knowledgeable about most things my family has needed help with.  I'm not to the point of completely boycotting them, but it really does not surprise me at all to hear that a number of trained, educated HCWs are choosing contrary to science, even science I accept (and I tend to be skeptical until I read a lot, due to the many biases that play into "science" reporting).

In the present case, there has been plenty of time to educate HCWs that the currently approved vaxes are at least as safe as other vaxes they have agreed to take for their jobs.  I understand that there have been times and places when hospitals experienced overwhelm, but that doesn't explain the overall issue at hand.

Perhaps this is an opportunity to spark a more general discussion about initial and continuing education of healthcare workers.

[wathe]

A quite thoughtful NYT piece, published today, on vaccine hesitancy.

This bit about mandates struck me:

It may well be that some of the unvaccinated are a bit like cats stuck in a tree. They’ve made bad decisions earlier and now may be frozen, part in fear, and unable to admit their initial hesitancy wasn’t a good idea, so they may come back with a version of how they are just doing “more research.”

We know from research into human behavior but also just common sense that in such situations, face-saving can be crucial.

In fact, that’s exactly why the mandates may be working so well. If all the unvaccinated truly believed that vaccines were that dangerous, more of them would have quit. These mandates may be making it possible for those people previously frozen in fear to cross the line, but in a face-saving manner.

[whitestavern]

4 minutes ago, wathe said:

A quite thoughtful NYT piece, published today, on vaccine hesitancy.

This bit about mandates struck me:

It may well be that some of the unvaccinated are a bit like cats stuck in a tree. They’ve made bad decisions earlier and now may be frozen, part in fear, and unable to admit their initial hesitancy wasn’t a good idea, so they may come back with a version of how they are just doing “more research.”

We know from research into human behavior but also just common sense that in such situations, face-saving can be crucial.

In fact, that’s exactly why the mandates may be working so well. If all the unvaccinated truly believed that vaccines were that dangerous, more of them would have quit. These mandates may be making it possible for those people previously frozen in fear to cross the line, but in a face-saving manner.

If it makes Zeynep and others feel better to believe that, fine. The majority who are getting vaxxed due to the mandates are more likely to be doing it because they need to put food on their table. 

Also, for everyone in favor of mandates, do you think additional doses and/or boosters should be mandated? In Israel fully vaxxed now means three doses. Should that be the case in the US?

[TravelingChris]

57 minutes ago, Corraleno said:

That is not at all what Furman meant, although Fox, NY Post, Washington Examiner, etc, have purposely  twisted it that way to create outrage. He was not saying that inflation only affects wealthy people, he was saying that the sort of inflation we are currently seeing is one of the "better" kinds of problems to have, because it's being driven by high demand for goods by consumers who have the money to pay for them as unemployment continues to fall. The second sentence in his tweet was that if we were still in the position of having 10% unemployment, we wouldn't have the current rate of inflation — because millions more people would not be able to afford it — and that would be a much worse problem. 

It isn't a good kind of inflation. There is no good kind of inflation.  And this bozo doesn't seem to understand that even though people are getting raises, etc it still isn't keeping up.  And what is driving the inflation is bad energy policy (we are getting a 14% rise in gas prices and we have TVA and that is one of the smallest gas increases happening).  The huge increases in food costs, gas and natural gas costs, and all sorts of other costs are not because of people being flush with cash.  And the people who suffer most are the poorer workers who do not get any type of government aid.

[wathe]

19 minutes ago, whitestavern said:

If it makes Zeynep and others feel better to believe that, fine. The majority who are getting vaxxed due to the mandates are more likely to be doing it because they need to put food on their table. 

 

I don't think so.  I administer covid vaccines.  Lately we are getting lots of people who just needed a nudge.  They aren't strongly opposed, but just hadn't gotten around to it, or didn't think they needed it.  Now that they "need it for work" (or for youth around here, "need it for hockey") they are getting it done without complaint.  

I do see a small number who are very vocal about how they are feeling coerced into the vaccine, but that's a small, small minority.

Edited October 15, 2021 by wathe

[SeaConquest]

1 hour ago, SKL said:

Regarding the healthcare worker discussion:

1) I would rather they get the vax if it is not contraindicated for them.

2) I would rather ALL patient care workers get tested VERY frequently for COVID, whether they are vaccinated or not.

3) Employers in the healthcare industry should weigh the real-life pros and cons in deciding their specific workplace policies re vaccination. 

4) Employers should build work assignments in ways that provide flexibility during the pandemic.  For example, there are probably no-patient-contact jobs that can be done by nurses in quarantine (if they are not sick), while non-nurses could be brought in to help with some of the traditional nurses' burden when Covid hospitalizations are high.

5) What do people think of putting nurses who oppose the vax on the Covid wards?

    a) can't spread Covid to patients who already have it,

    b) it might address the above-mentioned issue of possible compassion fatigue,

    c) it could be educational for said nurses.

6) Regardless of the above, someone should work to better understand the hesitancy to this vax.  I do understand that some of it is probably just bullheadedness, but for those who genuinely believe the vax is more dangerous than Covid for them:

    a) Are there educational deficits that should not be acceptable in the nursing profession?

   b) What are the short-term and long-term solutions that lead to a better-educated AND sufficiently staffed workforce?

 

 

There is a push for all nurses to have their BSN, but the additional courses (from RN to BSN) are not science-focused, so I don't think that really addresses the science deficit. Our science-focused pre-reqs in CA are one semester each of Intro to Bio, Intro to Gen, Organic, and Biochem, Anatomy, Physiology, Developmental Psych, and Sociology. Then you have your actual nursing school didactics and clinicals, which are focused primarily on assessment, pathophysiology, and pharmacology. But, there is no question that there could be more extensive science pre-reqs.

Physicians take gen bio, gen chem, o chem, a year of physics, often genetics and bio chem, and math at least through calculus before they enter medical school. And that's really a very bare bones list of pre-reqs. Most medical students today will apply with a much more rigorous course load, as well as scientific research, etc.

I am not saying that nurses need to be educated like physicians, but from the data that I have seen, education level (vs party affiliation, gender, race, etc.) seems to be the primary driver re vaccine hesitancy. So, I agree with you that something needs to change fundamentally re nursing education.   

Edited October 15, 2021 by SeaConquest

[Corraleno]

1 hour ago, TravelingChris said:

It isn't a good kind of inflation. There is no good kind of inflation.  And this bozo doesn't seem to understand that even though people are getting raises, etc it still isn't keeping up.  And what is driving the inflation is bad energy policy (we are getting a 14% rise in gas prices and we have TVA and that is one of the smallest gas increases happening).  The huge increases in food costs, gas and natural gas costs, and all sorts of other costs are not because of people being flush with cash.  And the people who suffer most are the poorer workers who do not get any type of government aid.

I'm sure this "bozo" understands very well that inflation affects the poor disproportionately — so does being unemployed. Monetary policy requires balancing competing interests, and the Federal Reserve has been quite explicit that they are currently prioritizing employment and will tolerate somewhat higher inflation rates in the short term. They expect that as the employment rate gets back to where they want it, and supply chain issues resolve, inflation will go back down. Furman's tweet was in support of the policy of prioritizing higher employment over lower inflation.  You can agree or disagree with the Federal Reserve's monetary policy, but it doesn't change the fact that Jason Furman never said or even implied that inflation doesn't affect poor people, as was falsely reported by certain media outlets. 

 

 

Edited October 15, 2021 by Corraleno

[SeaConquest]

21 hours ago, whitestavern said:

Also, for everyone in favor of mandates, do you think additional doses and/or boosters should be mandated? In Israel fully vaxxed now means three doses. Should that be the case in the US?

I don't see it as any different than our annual flu shots. We get boosted every year for flu as part of our job. I also have to get an annual interferon quant test to prove that I don't have TB. It's just part of the job. This shouldn't be shocking for a healthcare worker.

My stance is the same for things like school entry. Kids have booster requirements for some vaccines in order to attend school.

And, *as long as we are in our current state, with Covid running rampant throughout the world*, I don't have a problem with our mandates in other contexts extending to boosters. However, I have no reason to believe that the pandemic will continue in its present state if our global vaccination campaign (mandates inclusive) is successful. Covid will die down, and booster mandates will likely become unnecessary, save for certain professions where mandating annual vaccination as a condition of employment is the standard (like mine).

So, no. I don't think people are going to have show their Covid vaccine passport, with annual boosters, to go to a restaurant ad infinitum. I think that is typical anti-vax hyperbole, without any basis in the science of vaccines or the history of pandemics.

ETA: I listen to the folks that study viral evolution. One example: 

 

Edited October 16, 2021 by SeaConquest

[prairiewindmomma]

I think if you work in certain professions (the list I mentioned upthread of those in healthcare, military, communal living, teachers, etc.) you should be required to have updated boosters, just as you are currently required to have current other vaccines as part of your employment.

 I am supportive of employers requiring full vaccination of their employees as a condition of employment. I don't know that I'm supportive of weekly testing as an alternative to vaccination for those who don't qualify for a waiver. (I'm totally supportive of those who aren't capable of being vaccinated getting weekly testing as an alternative.)

[KSera]

3 hours ago, SKL said:

5) What do people think of putting nurses who oppose the vax on the Covid wards?

    a) can't spread Covid to patients who already have it,

    b) it might address the above-mentioned issue of possible compassion fatigue,

    c) it could be educational for said nurses.

I've considered this idea when I've tried to think of a solution for the problem of vaccine hesitant nurses, but while there are some pros to it like you list above, I keep coming back to it being a bad idea from a public health standpoint, and for that reason, I think it would probably be the wrong thing. To put the people most likely to get very ill and spread the disease in the community and take up hospital beds themselves in the highest risk positions seems like a bad idea, despite the problems it solves. If we could trust them to use excellent PPE protocols, maybe? But honestly, those that aren't getting vaccinated are the ones I would trust least to do that.

2 hours ago, SKL said:

And not to offend any healthcare workers in this thread, but I've posted before about my general distrust of the way conventional healthcare is managed, and that includes the fact that many HCWs are simply not very knowledgeable about most things my family has needed help with.  I'm not to the point of completely boycotting them, but it really does not surprise me at all to hear that a number of trained, educated HCWs are choosing contrary to science, even science I accept (and I tend to be skeptical until I read a lot, due to the many biases that play into "science" reporting).

I posted this already a week or so ago, but chiropractors have turned out to be one of the big purveyors of virus and vaccine misinformation and have the lowest vaccination rate among heath professionals (much lower than nurses). FWIW. Anti-vaccine chiropractors rising force of misinformation

1 hour ago, SeaConquest said:

Physicians take gen bio, gen chem, o chem, a year of physics, often genetics and bio chem, and math at least through calculus before they enter medical school. And that's really a very bare bones list of pre-reqs. Most medical students today will apply with a much more rigorous course load, as well as scientific research, etc.

Do nurses need to take stats and/or need to participate in or study research design and methods?

1 hour ago, SeaConquest said:

ETA: I listen to the folks that study viral evolution. One example: https://twitter.com/trvrb/status/1448297954306150401

That's a good thread. I follow Trevor Bedford as well, but missed this one; thanks for sharing.

[kbutton]

20 hours ago, SeaConquest said:

There is a push for all nurses to have their BSN, but the additional courses (from RN to BSN) are not science-focused, so I don't think that really addresses the science deficit. Our science-focused pre-reqs in CA are one semester each of Intro to Bio, Intro to Gen, Organic, and Biochem, Anatomy, Physiology, Developmental Psych, and Sociology. Then you have your actual nursing school didactics and clinicals, which are focused primarily on assessment, pathophysiology, and pharmacology. But, there is no question that there could be more extensive science pre-reqs.

Between the pre-reqs and the bolded, please tell me they are getting some infectious disease information, possibly stats, etc. Having known people in college who went into biology (some on to medical training, such as PA school) or were in nursing (BSN program), I can say that the pre-reqs don't seem to really get into infectious diseases unless something has changed. That was tackled more in core clinical programs or pediatric information. 

[SeaConquest]

1 hour ago, kbutton said:

Between the pre-reqs and the bolded, please tell me they are getting some infectious disease information, possibly stats, etc. Having known people in college who went into biology (some on to medical training, such as PA school) or were in nursing (BSN program), I can say that the pre-reqs don't seem to really get into infectious diseases unless something has changed. That was tackled more in core clinical programs or pediatric information. 

We covered a section on epidemiology in our community health class, which is a BSN-level class, but epidemiology was not a separate course in my BSN program. Typically, epidemiology is covered more in an MSN or DNP program. All those RNs who are associate-degreed nurses are not required to take community health and have not taken epidemiology, to my knowledge. The highest math class that most RNs have had is college algebra. They have to be able to pass their medical calculations course (basically, the ability to do dimensional analysis is required), but they are not required to take stats. Stats is a pretty typical requirement of BSN programs and is definitely a requirement for MSN programs. So, this is the kind of stuff that is leading to the separation between nurses on this issue. As much as we want to say that all nurses are equal, when you get down to it, you start to see some of the differences in the educational background between LVNs, associate-degree RNs, and BSN-RNs, and how that is playing out in this issue.

ETA: I found some info on the % of BSN prepared nurses by state. I think this means % of RNs. I don't think this includes % of BSNs when including RNs + LVNs, so keep that in mind. There were 4,096,607 registered nurses (RNs) and 920,655 licensed practical nurses/licensed vocational nurses (LPN/LVNs) in the United States, as of October 2019 (NCSBN, 2020). So, if you add the additional 920k to the denominator, the % obviously drops. This is important when John Q. Public hears about "nurses" protesting or saying XYZ about vaccines; they make no distinction in their mind between an LVN and a BSN. A nurse is a nurse to most people.

https://campaignforaction.org/wp-content/uploads/2019/02/Education-map-2018.pdf

*By way of background, I've also taken two semesters of advanced pathophysiology and one semester of advanced pharmacology -- MSN level courses -- but haven't taken any other upper division science or nursing courses, and still consider my educational background in this area pretty weak. I do a lot of reading on my own to try to make up for my lack of formal education.

Edited October 16, 2021 by SeaConquest

[SeaConquest]

18 hours ago, KSera said:

I posted this already a week or so ago, but chiropractors have turned out to be one of the big purveyors of virus and vaccine misinformation and have the lowest vaccination rate among heath professionals (much lower than nurses). FWIW. Anti-vaccine chiropractors rising force of misinformation

Do nurses need to take stats and/or need to participate in or study research design and methods?

That's a good thread. I follow Trevor Bedford as well, but missed this one; thanks for sharing.

Chiropractors are notorious spreaders of anti-science woo.

Stats and research design/methods are all BSN courses. A typical RN program covers Nursing Fundamentals, Med Surg I, Med Surg II, Pharmacology, Psych, Peds, OB, Critical Care, maybe Nursing Leadership, and a Final Preceptorship in whatever unit you want to train in when you graduate. Plus, the pre-reqs.

Did you watch Trevor Bedford's 40 minute YouTube video, on viral evolution, that was in the Twitter thread? I found it very informative.

Edited October 16, 2021 by SeaConquest

[kbutton]

15 minutes ago, SeaConquest said:

We covered a section on epidemiology in our community health class, which is a BSN-level class, but epidemiology was not a separate course in my BSN program. Typically, epidemiology is covered more in an MSN or DNP program. All those RNs who are associate-degreed nurses, which is the majority of nurses in the US, are not required to take community health and have not taken epidemiology, to my knowledge. The highest math class that most RNs have had is college algebra. They have to be able to pass their medical calculations course (basically, the ability to do dimensional analysis is required), but they are not required to take stats. Stats is a pretty typical requirement of BSN programs and is definitely a requirement for MSN programs. So, this is the kind of stuff that is leading to the separation between nurses on this issue. As much as we want to say that all nurses are equal, when you get down to it, you start to see some of the differences in the educational background between LVNs, associate-degree RNs, and BSN-RNs, and how that is playing out in this issue.

*By way of background, I've also taken two semesters of advanced pathophysiology and one semester of advanced pharmacology -- MSN level courses -- but haven't taken any other upper division science or nursing courses, and still consider my educational background in this area pretty weak. I do a lot of reading on my own to try to make up for lack of formal education.

Even without epidemiology, infectious disease information would be useful somewhere. I am pretty sure my DH got all his information in clinical classes vs. pre-reqs, but I don't think he had classes in epidemiology. His training left him with a really, really strong background WRT vaccine knowledge. Experience in peds and living in a MRSA hotspot cemented the infectious disease/vaccination information, but he had some direct instruction in it. (He's a mid-level, not via the nursing route, but still.) 

I guess I figure understanding vaccinations should be basic, and he was so stunned the other day when a nurse/RN could NOT understand the flu vaccine details he was trying to explain. I posted previously about this--she really couldn't understand why he would prefer getting a quadrivalent shot over a trivalent shot no matter how many ways he explained it, and he's really good at explaining such things. 

[Jean in Newcastle]

13 minutes ago, kbutton said:

Even without epidemiology, infectious disease information would be useful somewhere. I am pretty sure my DH got all his information in clinical classes vs. pre-reqs, but I don't think he had classes in epidemiology. His training left him with a really, really strong background WRT vaccine knowledge. Experience in peds and living in a MRSA hotspot cemented the infectious disease/vaccination information, but he had some direct instruction in it. (He's a mid-level, not via the nursing route, but still.) 

I guess I figure understanding vaccinations should be basic, and he was so stunned the other day when a nurse/RN could NOT understand the flu vaccine details he was trying to explain. I posted previously about this--she really couldn't understand why he would prefer getting a quadrivalent shot over a trivalent shot no matter how many ways he explained it, and he's really good at explaining such things. 

But what I don't understand is this.  I don't have a BSN and am not an RN (though I am married to one) and I understand the basics, including why a quadrivalent shot would be preferrable.  No, I don't understand the nitty-gritty details but I understand the big picture details of vaccination and how infectious diseases work.  This level of basic understanding is not rocket science even though if you dig deep into the subject it is complicated of course. 

[SeaConquest]

1 hour ago, kbutton said:

Even without epidemiology, infectious disease information would be useful somewhere. I am pretty sure my DH got all his information in clinical classes vs. pre-reqs, but I don't think he had classes in epidemiology. His training left him with a really, really strong background WRT vaccine knowledge. Experience in peds and living in a MRSA hotspot cemented the infectious disease/vaccination information, but he had some direct instruction in it. (He's a mid-level, not via the nursing route, but still.) 

I guess I figure understanding vaccinations should be basic, and he was so stunned the other day when a nurse/RN could NOT understand the flu vaccine details he was trying to explain. I posted previously about this--she really couldn't understand why he would prefer getting a quadrivalent shot over a trivalent shot no matter how many ways he explained it, and he's really good at explaining such things. 

I mean, yes we do cover basic ID as part of peds, if they are a part of the normal childhood vaccination schedule (varicella, measles, DTAP, etc.). But, it's more like, "This is what varicella looks like (symptomology), this is what you should do to prevent it (vaccinate according to the standard schedule), this is the treatment if you do happen to see it (nursing care to memorize),... next ID. Obviously, this varies by program and professor, but at most schools they're not going to explain how epidemiologists track the flu season in the southern hemi, understand statistical data to track how influenza is mutating, which strains are showing the greatest viral fitness and why, are most likely to be the biggest threat in the northern hemi this flu season, are being incorporated into our vaccines, and which vaccine therefore would be the most effective.

I am sorry to say, but that is just far beyond the critical thinking skills of your average RN, who lacks the education we have been discussing and has watched some very convincing social media post, by a Russian bot that her chiropractor and a couple of her friends have been sharing, about how the flu shot can make you sick. So, now she has doubt in her mind about the vaccine and her patients are skeptical about getting the flu shot as well because they saw the same social media post too. What is her ability to really address the situation? How have we empowered her to combat this onslaught of misinformation? We are failing patients by not educating our workforce to the full scope of their practice.   

Edited October 16, 2021 by SeaConquest

[SeaConquest]

9 minutes ago, Jean in Newcastle said:

But what I don't understand is this.  I don't have a BSN and am not an RN (though I am married to one) and I understand the basics, including why a quadrivalent shot would be preferrable.  No, I don't understand the nitty-gritty details but I understand the big picture details of vaccination and how infectious diseases work.  This level of basic understanding is not rocket science even though if you dig deep into the subject it is complicated of course. 

I don't know what to say, Jean. My 12 year old watched a 40 minute video on viral evolution by one of the nation's preeminent virologists and understood the whole thing. I guess the main driver is that you are motivated to want to understand the information, and so was he. Most people just can't be bothered. 

[KSera]

48 minutes ago, SeaConquest said:

Did you watch Trevor Bedford's 40 minute YouTube video, on viral evolution, that was in the Twitter thread? I found it very informative.

I did not. For some reason I have a short attention span for learning things via video. I much prefer to read about something.

12 minutes ago, SeaConquest said:

I don't know what to say, Jean. My 12 year old watched a 40 minute video on viral evolution by one of the nation's preeminent virologists and understood the whole thing. I guess the main driver is that you are motivated to want to understand the information, and so was he. Most people just can't be bothered. 

But, now that you say this, I will put this video on my to do list and watch it with my 12 year old as part of school this week 😊.

[kbutton]

3 minutes ago, SeaConquest said:

I mean, yes we do cover basic ID as part of peds, if they are a part of the normal childhood vaccination schedule (varicella, measles, DTAP, etc.). But, it's more like, "This is what varicella looks like (symptomology), this is what you should do to prevent it (vaccinate according to the standard schedule), this is the treatment if you do happen to see it (nursing care to memorize),... next ID. Obviously, this varies by program and professor, but at most schools they're not going to explain how epidemiologists track the flu season in the southern hemi, understand statistical data to track how influenza is mutating, which strains are showing the greatest viral fitness and why, are most likely to be the biggest threat in the northern hemi this flu season, are being incorporated into our vaccines, and which vaccine therefore would be the most effective.

I am sorry to say, but that is just far beyond the critical thinking skills of your average RN who lacks the education we have been talking about and has watched some very convincing social media post, by a Russian bot that her chiropractor and a couple of her friends have been sharing, that the flu shot can make you sick. So, now she has doubt in her mind about the vaccine and her patients she skeptical about getting the flu shot too because they saw the same social media post too. What is her ability to really address the situation? How have we empowered her to combat this onslaught of misinformation? We are failing patients by not educating our workforce to full scope of their duties.   

So, a great deal of nursing is "job training" vs. education up to a point? That's somewhat a surprise to me, as in, I knew nursing majors in college (BSN, select college) that definitely got more than job training--they did tons of critical thinking. At the same time, nurses I meet who are trained more locally are less likely to be critical thinkers.

So, do we fix this via education or gate-keeping or both? I guess I keep hearing that nurses should know better, but if training doesn't cover it, then they won't know better, and that's terrifying. I so agree with the bolded.

I feel like my DH got this information with hardly an epidemiology. I wonder if we separate things into siloes that are less than productive sometimes--"Hey, that's covered in epidemiology, so I don't have to cover that; good--more time for xyz." 

I would've thought that the critical thinking required to pass the nursing exams would ensure decent critical thinkers. 

 

[KSera]

On a different note, I've been wondering throughout this how many of the people who are vax hesitant are actually needle phobic, and just for the first time saw a discussion of this. It does sound like this is a segment out there that is not being well reached. I think it's a tough one, because the nature of a phobia is that someone will do whatever they need to to avoid their trigger, and the anti vax stuff gives phobic people perfect cover to not need to confront the actual phobia that is holding them back.

This thread addresses needle phobia and more about the sociology of the unvaccinated. Mandates as a way of letting people save face is an interesting thing as well:

 

[SeaConquest]

And here's my biggest rationale for why nurses need to be better educated (and better paid):

We spend more time with the patients than anyone else.

Physicians have to have a crap ton of education because they have to diagnose, treat, and prescribe. They have to do that for a huge number of patients, across a wide variety of disease states. Doesn't matter what field you are in, it's an awesome amount of information and no one can know it all, so you have to specialize. It was the same in the law.

But nurses are the eyes and ears of physicians. We are constantly assessing our patients. We have to know if what we are seeing is normal or not. We have to know if it deviates from baseline just a little, so we can just monitor it, or if it is serious enough to merit an immediate nursing intervention that we can perform autonomously, or if it's serious enough that it merits a call to the physician for new orders.

These are the people spending 12+ hours at the bedside of your patient. People who have to understand patients who are living longer, have a greater number of co-morbidities, are being prescribed a greater number of medications (which can interact with one another, so we need to ensure the docs don't make errors when they Rx, which they do), and are being kept alive with increasingly more complex devices and machines. You really want well-educated people doing all of this.  

Gone are the days when nurses just took orders. Nurses are licensed professionals, who have a ton of autonomy within their scope of practice. It is not uncommon in smaller, regional and rural hospitals for there to be no physician on a floor. The nurses are literally running everything and we will phone a doc in the middle of the night if we need new orders. In one hospital I worked in *Orange County, California* (hardly a rural area), they had one doc on night shift in the ED and that was it. We called him when we needed him to pronounce a patient with a DNR, but I literally watched this patient die of a STEMI (heart attack) and did all the post-mortem care with no doc around. It's not uncommon. Watch the Covid ICU videos I posted. The docs will be the first to tell you who runs the units.

So again, we need nurses with a very high degree of education relevant to their scope of practice, which has become quite complex and requires critical thinking and a thorough understanding of foundational scientific subjects. We don't need to be trained as physicians, but for the love of G-d, people need to know how vaccines work. This is madness. So, yeah, I am not sad to see the vax refusers go. 

Edited October 16, 2021 by SeaConquest

[kbutton]

1 hour ago, Jean in Newcastle said:

But what I don't understand is this.  I don't have a BSN and am not an RN (though I am married to one) and I understand the basics, including why a quadrivalent shot would be preferrable.  No, I don't understand the nitty-gritty details but I understand the big picture details of vaccination and how infectious diseases work.  This level of basic understanding is not rocket science even though if you dig deep into the subject it is complicated of course. 

You'd think that tri- and quad- would be enough of a clue to get you started, lol!!! 

[TravelingChris]

22 hours ago, Corraleno said:

I'm sure this "bozo" understands very well that inflation affects the poor disproportionately — so does being unemployed. Monetary policy requires balancing competing interests, and the Federal Reserve has been quite explicit that they are currently prioritizing employment and will tolerate somewhat higher inflation rates in the short term. They expect that as the employment rate gets back to where they want it, and supply chain issues resolve, inflation will go back down. Furman's tweet was in support of the policy of prioritizing higher employment over lower inflation.  You can agree or disagree with the Federal Reserve's monetary policy, but it doesn't change the fact that Jason Furman never said or even implied that inflation doesn't affect poor people, as was falsely reported by certain media outlets. 

 

 

 

2 hours ago, kbutton said:

Even without epidemiology, infectious disease information would be useful somewhere. I am pretty sure my DH got all his information in clinical classes vs. pre-reqs, but I don't think he had classes in epidemiology. His training 

I guess I figure understanding vaccinations should be basic, and he was so stunned the other day when a nurse/RN could NOT understand the flu vaccine details he was trying to explain. I posted previously about this--she really couldn't understand why he would prefer getting a quadrivalent shot over a trivalent shot no matter how many ways he explained it, and he's really good at explaining such things. 

My son used to work as a senior pharmacy tech.  And before that, as a regular pharmacy tech.  You would not believe how many times he had to argue and try to explain to nurses why some dose the doctor ( or often it is nurses writing scripts and doctor just signing) would kill the patient or oppositely, not work at all. In my state, pharmacy techs have to pass math exams.  It is so necessary because the math skills of so many doctors and nurses is poor.

 

[Guest]

On 10/15/2021 at 4:38 PM, wathe said:

A quite thoughtful NYT piece, published today, on vaccine hesitancy.

This bit about mandates struck me:

It may well be that some of the unvaccinated are a bit like cats stuck in a tree. They’ve made bad decisions earlier and now may be frozen, part in fear, and unable to admit their initial hesitancy wasn’t a good idea, so they may come back with a version of how they are just doing “more research.”

We know from research into human behavior but also just common sense that in such situations, face-saving can be crucial.

In fact, that’s exactly why the mandates may be working so well. If all the unvaccinated truly believed that vaccines were that dangerous, more of them would have quit. These mandates may be making it possible for those people previously frozen in fear to cross the line, but in a face-saving manner.

I could not agree with this more. It is exactly what I saw in my own family Re: masks (pre-vaccine). It’s why I was grateful to be in a mandatory mask state. Because, yeah, I definitely knew people who don’t think masks work or do any good, but having it mandatory let those people “grudgingly comply,” because it was required. The number of people willing to actually refuse at the time (here, at least) was very small. 
 

One man I know, who was “against the vaccine” earlier told me he was “giving in” and getting it, because his wife had to for her job, so he was “grudgingly going along” to show solidarity for her. Literally, that is the reason he gave me. For all I know, he may be secretly relieved he has a reason to get the vax. 

[TravelingChris]

On 10/15/2021 at 3:23 PM, SKL said:

Not to be a downer, but just this week I saw an article to the effect that people under a certain age (60?) should NOT take daily aspirin as a preventative unless they have already had a previous heart attack or stroke.  Apparently it does more damage to the GI tract than it's

No, the danger is for older people, not under 65.  Considering how many people take things like ibuprofen, taking a tiny dose of aspirin is much less likely to cause a problem than drinking a lot, and eatinh certain things.

You can lessen any pitzntial problem by taking enteric aspirin or taking it with food.