Re: Nursing school forcing me to get the flu vaccine.

September 10, 2009

so sorry that has happened to you. Please keep us updated w/everything.

Holly

In a message dated 9/10/2009 11:07:55 P.M. Eastern Daylight Time,

heathercozart@... writes:

Just wanted to share my story

September 10, 2009

I doubt they will accept a letter from a chiropractor. I think you need a better

plan because your rights ARE being violated.

Do you have a copy of what the program required at the time you signed on? Or

even one from the beginning of this year that does not include wording requiring

the flu shot. I think they should be held at their word. A lawyer might be able

to make them, or at least make them back down.

How do the rest of the students feel? Are they strongly against getting the

vaccine, too? Band together and storm the dean's office. Demand they accept your

refusal. I think the fact that they accepted it earlier is important. That

amounts to a contract. It's an agreement that they would not require it. I would

fight them on this and for that you really need a lawyer. Set a precedent to

protect future students, too.

There was a case a couple of years ago in Seattle, I believe, for nurses (not

students). If I recall the hospital backed down. Let me see what I can find.

Winnie

Good luck. Hang tough and don't get the vaccine unless you feel it's safe and

effective and something you would have gotten anyway.

Nursing school forcing me to get the flu vaccine.

Vaccinations

> I've been a memeber of this group since my kids were babies

> (they are now 6 & 8) & I recieved a lot of great information and

> support from other moms that chose not too vaccinate like me.

> Since then, I've gone back to school and I am currently in

> my last year of Nursing School. In school I've been able to

> continue in my reasearch into the dangers of vaccines. I've

> written research papers, and given speeches promoting awareness.

> In our lecture courses we've even discussed the dangers of

> vaccines being linked to a disease called Myasthenia Gravis.

> When I entered school I had all my titers checked from

> previous vaccinations that I had done earlier in life because I

> did not want to be injected again. The results came back that I

> did not need to update any vaccines to start nursing school.

> The only vaccine I needed to sign an affidavit for was to

> decline receiving the flu vaccine. My school accepted my letter,

> and I have had no problems up till now.

>

> Tonight I have just received a letter stating that every student

> will be forced to receive the flu vaccine regardless of any

> reason they previously submitted, and the school will only

> accept medical letters from doctors stating a contraindication.

> I just feel that my rights are being violated. In

> California we have the philosophical choice to reject

> vaccinations that I have used for my own children in the public

> schools. Tonight I'm being told from my private University that

> I will not be allowed to use the philosophical affidavit. I

> have one last resort that I will do tommorow and that is to

> contact our Chiropractor/Kinesiologist Alternative Medicine

> Provider to write me a letter. He is against vaccinations, I

> just hope my University accepts the letter.

>

> Just wanted to share my story. I'm feeling frustrated, as I do

> not want to receive this vaccination.

>

September 10, 2009

Here it is:

(http://journals.lww.com/ajnonline/pages/articleviewer.aspx?year=2006 & issue=1000\

0 & article=00046 & type=fulltext)

Should RNs Be Forced To Get the Flu Vaccine?: Some facilities are mandating it,

in an effort to protect patients

Olsen, P. PhD, RN

Free Access

Article Outline

Author Information

P. Olsen is an associate professor in the psychiatric mental health

nursing specialty at the Yale University School of Nursing, New Haven, CT, where

he is also associate director of the Center for Health Policy and Ethics. He

also coordinates Ethical Issues (douglas.olsen@...), with Pamela Grace,

PhD, APRN (gracepa@...).

In September 2004, the Virginia Mason Medical Center in Seattle made influenza

vaccination for nurses mandatory, calling it a fitness for duty requirement. The

nurses objected and asked the Washington State Nurses Association (WSNA), their

bargaining unit, to oppose the policy. An article in the Seattle Times explained

the organization's position on the policy: it takes individuals' away right to

decide about their own health care and violates labor law because it was

dictated without bargaining with the nurses association.1 In August 2005, an

arbitrator ruled the hospital could not compel nurses to receive the influenza

vaccine as a condition of employment. Six months later, this decision was backed

by the U.S. District Court in Seattle.

This conflict raises certain ethical questions: What is the nurse's obligation

to the patient-what level of risk should she be expected to assume? To what

degree can the nurse be compelled to meet that obligation? Finally, to what

degree should autonomy be respected regarding a person's interpretation of data?

If a health care decision is based on erroneous information, must it be

respected?

Back to Top | Article Outline

NURSES AND RISK

The ANA Code of Ethics states, The nurse's primary commitment is to the patient;

this entails an obligation to take some risk on the patient's behalf.2 While

modern antibiotics and other interventions reduce risk of infection, such risk

is still inherent to the nurses' role. For example, between 1995 and 2004 there

were 1,350 documented occupational exposures to HIV-infected blood.3 Indeed, the

history of HIV-AIDS treatment presents a case study in acceptable risk. When

AIDS first appeared in the United States, some clinicians were reluctant to

provide care. Ethicists and health care professionals reconsidered the issue of

risk to clinicians and found that nurses were unequivocally obligated to care

for AIDS patients despite some risk.4, 5

Table 1

Image Tools

While nurses are obligated to incur some risk, the ANA code also supports

self-care. Interpretive statement 5.1 asserts: the same duties that we owe to

others we owe to ourselves.2 Thus, nurses are responsible for promoting their

own health as well as that of their patients' (the ANA stipulates, however, that

judgments must be based on current knowledge) and there is a limit to the risk

that can be considered ethically mandatory.4 The ANA provides a method for

assessing this limit declaring that, The benefit the client will gain outweighs

any harm the nurse might incur and does not present more than an acceptable risk

to the nurse.4 However, this formula may prove difficult to apply to specific

cases due to individual variability in the interpretation of acceptable risk.

It is interesting to note, however, that the praise accorded to nurses perceived

to have put themselves in great risk (such as those going to work in war zones)

provides some evidence of popular feeling that great risk is supererogatory.

Back to Top | Article Outline

THE WSNA VERSUS VIRGINIA MASON

Ethical disputes arise when parties disagree over what constitutes prudent

behavior; they become further complicated when a party with power decides that

its case is strong enough to override disagreement and compel compliance, as did

the Virginia Mason Medical Center. The WSNA took the position that the hospital

was correct to encourage vaccination, but incorrect to mandate vaccination by

threat of termination. The WSNA argued that the policy does not respect the

nurses' right to control decisions regarding their own health care and that the

vaccine could cause adverse medical consequences.6 The hospital argued that the

policy was justified by scientifically demonstrated benefit for their patients.

The disagreement between the WSNA and Virginia Mason Medical Center was

difficult to resolve because the two parties agreed on most points. Both sides

agreed on the benefits of the influenza vaccine and believed nurses should

receive vaccinations. The WSNA was quite careful to point out that it recommends

prophylactic flu vaccination for nurses.6 Both entities support the use of

inducements, such as policy statements and education, to encourage nurses to

choose vaccination. Controversy originated from the hospital's attempt to

mandate vaccination without negotiation. In our society, extraordinarily

convincing justification is required to compel a person to act against her own

best judgment. Support of such a measure usually entails clear incompetence,

overwhelming benefit, or imminent harm to others.

The hospital presented weak justification for coercing compliance. Furthermore,

the degree of intrusion involved in forcing an injection provides a strong

argument against the policy, as giving an unwanted injection can be grounds for

a charge of assault and battery. Ultimately, however, the argument was fought

and decided outside the real ethical issue-the coercive nature of the demand

that took choice away from the nurses. The arbiter (and later the U.S. District

Court) decided the case in favor of the nurses on procedural grounds, finding

that the hospital inappropriately added conditions to employment.

Back to Top | Article Outline

ETHICAL CONSIDERATIONS

In considering the ethics of vaccination, society generally considers that

significant public good greatly outweighs minimal risk to the individual; this

justifies some level of coercion. The nursing profession generally addresses

this issue by recommending vaccination and relying on nurses' judgment and

desire to act ethically.7 However, if only a few people refuse to be vaccinated,

little damage is done to the public good-leaving room to respect autonomy (so

long as the number remains low). This minority is protected by herd immunity,

the immunity of those who can no longer transmit the illness because a high

percentage of the population has been vaccinated.8 However, it's important to

note that generally, less than 40% of health care providers receive influenza

vaccinations, far too few to ensure herd immunity.9

Benefits and risks of the influenza vaccine. There is considerable evidence

supporting vaccination as a patient safety measure. The Centers for Disease

Control and Prevention (CDC) reported that while influenza is highly infectious,

the vaccine is effective in preventing up to 90% of cases in healthy people

under age 65 when the vaccine strain is similar to the circulating strain.10

Further, Salgado and colleagues reported that an increased rate of vaccination

in health care workers was significantly correlated to a decreased rate of

nosocomial flu infections in hospitalized patients.11 In comparison, the CDC

reported that of those who receive the vaccine, about 20% have a mild local

reaction and less than 1% have fever and malaise; rare instances of more serious

reactions were reported.10

Patients treated by nurses who refuse vaccination are at risk of being infected

if the nurse contracts the flu. Certain patients, such as older adults or those

who are immunocompromised, face severe consequences if this occurs. This threat

supports the argument for greater latitude in encouraging vaccination.

Evidence and autonomy: Can the two diverge? Difficulty occurs when people refuse

vaccination because of fears that are not supported by expert opinions. A

patient having relevant information and being able to understand it are critical

to the nurse's application of the widely accepted principle that the patient's

decisions are autonomous and should be respected. Situations like this have

become more common as concern about vaccination safety and necessity has

increased. Soldiers refused the anthrax vaccine, health care workers resisted a

presidential request for smallpox vaccination, and a sizable minority of parents

are currently hesitating to vaccinate their children with the

measles-mumps-rubella vaccine.12-14

While patients' values and health care goals require the provider's absolute

respect, choices based on misinterpreted or illegitimate data are more open to

question. For example, a cancer patient's decision that clear thinking has

priority over pain relief must be respected. However, if the patient decides to

achieve mental clarity by taking a drug that actually clouds thinking, then a

nurse would be justified in exerting her influence to prevent the taking of that

drug. However, if the patient requested an herbal remedy based on deceptive

advertising-a remedy known to cloud the sensorium-then not only would the nurse

not be compelled by the principle of respect for autonomy to assist the patient

in obtaining this remedy, but beneficence would justify that she take steps to

keep it out of the patient's hands.

Respect for autonomy is intended to provide patients with the freedom to

determine their goals of treatment and the values they wish to be enacted as

part of treatment. It is not intended to compel society or nurses to support

decisions based on false premises. The difficulty is in establishing a boundary

between what is clearly junk science and what is legitimate minority opinion.

The first option would always be to provide an accurate explanation, helping the

patient to make a more beneficial choice. However, this will not work in all

cases and the degree of variation society will support should be defined. I

would argue that the following approach should be considered: You can believe

what you want, but society won't support it and may compel action if others are

at risk.

September 10, 2009

Maybe go to your GP and lie through your teeth. Tell him you have an

allergy to egg. My husband recently started having bloody stools

everytime he eats eggs. That wasn't always the case, but it is now.

Use that!

On Thu, Sep 10, 2009 at 9:01 PM, heathercozart <heathercozart@...> wrote:

>

> Tonight I have just received a letter stating that every student will be

forced to receive the flu vaccine regardless of any reason they previously

submitted, and the school will only accept medical letters from doctors stating

a contraindication.

September 10, 2009

I totally agree with Winnie. Fight it. What they are doing is totally illegal

and unconstitutional.

>

> I doubt they will accept a letter from a chiropractor. I think you need a

better plan because your rights ARE being violated.

>

> Do you have a copy of what the program required at the time you signed on? Or

even one from the beginning of this year that does not include wording requiring

the flu shot. I think they should be held at their word. A lawyer might be able

to make them, or at least make them back down.

>

> How do the rest of the students feel? Are they strongly against getting the

vaccine, too? Band together and storm the dean's office. Demand they accept your

refusal. I think the fact that they accepted it earlier is important. That

amounts to a contract. It's an agreement that they would not require it. I would

fight them on this and for that you really need a lawyer. Set a precedent to

protect future students, too.

>

> There was a case a couple of years ago in Seattle, I believe, for nurses (not

students). If I recall the hospital backed down. Let me see what I can find.

>

> Winnie

>

> Good luck. Hang tough and don't get the vaccine unless you feel it's safe and

effective and something you would have gotten anyway.

>

> Nursing school forcing me to get the flu vaccine.

> Vaccinations

>

> > I've been a memeber of this group since my kids were babies

> > (they are now 6 & 8) & I recieved a lot of great information and

> > support from other moms that chose not too vaccinate like me.

> > Since then, I've gone back to school and I am currently in

> > my last year of Nursing School. In school I've been able to

> > continue in my reasearch into the dangers of vaccines. I've

> > written research papers, and given speeches promoting awareness.

> > In our lecture courses we've even discussed the dangers of

> > vaccines being linked to a disease called Myasthenia Gravis.

> > When I entered school I had all my titers checked from

> > previous vaccinations that I had done earlier in life because I

> > did not want to be injected again. The results came back that I

> > did not need to update any vaccines to start nursing school.

> > The only vaccine I needed to sign an affidavit for was to

> > decline receiving the flu vaccine. My school accepted my letter,

> > and I have had no problems up till now.

> >

> > Tonight I have just received a letter stating that every student

> > will be forced to receive the flu vaccine regardless of any

> > reason they previously submitted, and the school will only

> > accept medical letters from doctors stating a contraindication.

> > I just feel that my rights are being violated. In

> > California we have the philosophical choice to reject

> > vaccinations that I have used for my own children in the public

> > schools. Tonight I'm being told from my private University that

> > I will not be allowed to use the philosophical affidavit. I

> > have one last resort that I will do tommorow and that is to

> > contact our Chiropractor/Kinesiologist Alternative Medicine

> > Provider to write me a letter. He is against vaccinations, I

> > just hope my University accepts the letter.

> >

> > Just wanted to share my story. I'm feeling frustrated, as I do

> > not want to receive this vaccination.

> >

>

September 11, 2009

What an outrageous violation of your rights! I too wonder how many other

students feel like they can stand up to this, or if they are already so

brainwashed to think they have to submit to such violations?

: have you contacted NVIC yet? Maybe they can advise you on how to

proceed.

Best of luck!

Sylvia