Sep 18, 2009

Seasonal Flu Myths

In the spirit of the upcoming flu season I decided to share with my followers this list of common misunderstandings and misperceptions of the seasonal flu vaccine. An alarming 50% of healthcare workers do not get the flu vaccine annually and some of these myths are the reasons I've heard of before...

Flu Myth #1: The seasonal flu vaccine protects against swine flu. Unfortunately, it doesn’t. The swine flu virus that first appeared in Mexico during April 2009 is a different strain of influenza virus. There is no vaccine for it. So even if you got a flu vaccine earlier this season, it won’t offer any protection against swine influenza.

Flu Myth #2: The seasonal flu is annoying but harmless. There has been a lot of focus on swine flu, but it’s important to remember that the run-of-the-mill seasonal flu can be a serious condition itself. “A lot of people just think of the flu as a very bad cold,” says Curtis Allen, a spokesman for the CDC in Atlanta. But it’s much worse than that. For one, you usually feel terrible. In addition to the congest ion and cough, you’re apt to have nasty body aches and fever, which are less likely with a garden-variety cold. “When you get the flu, you know it,” says Christine Hay, MD, assistant professor at the University of Rochester Medical Center. “You feel like you’ve been hit by a Mack truck.” Aside from the short-term misery and lost workdays, flu can have more serious implications. Sure, most people who get the seasonal flu recover just fine. But the seasonal flu also hospitalizes 200,000 people in the U.S. each year. It kills about 36,000. That’s close to the number of women killed by breast cancer each year, and more than twice the number of people killed by AIDS.

Flu Myth #3: Swine flu is transmitted by pork products. Lots of people have reacted to the swine flu outbreaks by swearing off bacon – just as some countries reacted by banning pork or slaughtering pigs. But experts say that despite the name, there’s no reason to worry about pork products spreading swine flu. Though the virus did originate in pigs, it’s now jumped to people. Since then, the spread has been from person to person, not from pork to person.

Flu Myth #4: The flu vaccine can give you the flu.
This is the flu myth most likely to drive experts bonkers. “There is simply no way that the flu vaccine can give you the flu,” says Hay. “It’s impossible.” Why? For one, injected flu vaccines only contain de
ad virus, and a dead virus is, well, dead: it can’t infect you. There is one type of live virus flu vaccine, the nasal vaccine, FluMist. But in this case, the virus is specially engineered to remove the parts of the virus that make people sick.

Flu Myth #5: There is no treatment for the flu. I
f you can get to the doctor quickly -- within 48 hours of having flu symptoms-- there are antiviral medications that can help. These drugs, such as Tamiflu and Relenza, won’t cure the flu. But they can reduce the amount of time you’re sick by one or two days and make you less contagious to others. These drugs work with both the typical strains of seasonal flu as well as swine flu.

Flu Myth #6: Antibiotics can fight the flu.
Antibiotics only fight bacterial infections. Flu – whether it’s seasonal flu or swine flu -- is not caused by bacteria, but by a virus. So antibiotics have absolutely no effect on any kind of flu. But this message just won’t sink in for some people.
“We still have oodles of patients coming into the doctors, or bringing their children to the doctors, who want antibiotics for influenza,” says Schaffner.

Flu Myth #7: The flu is only dangerous for the elderly.
It’s true that the people most likely to become seriously ill or die from the seasonal flu are over age 65. But flu can become risky for anyone, even healthy young adults. Some of the most susceptible people to seasonal influenza are young children. Experts don’t have enough evidence yet to say whether young children are at increased risk from swine flu. However, based on pa
st experience with the seasonal flu and previous flu pandemics, it’s possible. “Children under 2 years have some of the highest rates of hospitalization from [seasonal] flu,” says Hay. Children under 6 months are at the most risk from the seasonal flu because they’re too young to get the vaccine.

Flu Myth #8: “Stomach flu” is a form of influenza. The word “flu” is so overused that it’s lost much of its actual meaning. Gastrointestinal viruses are called the “stomach flu,” but they have no connection to the actual influenza virus. If you suffer vomiting and diarrhea, but no fever or body ache, you probably do not have the flu.

Flu Myth #9: If you get the flu, you can’t get it again during that flu seaso
n. Many people assume that if they’ve had the flu recently, they can’t get it again -- and thus don’t need to get the vaccine, Perl says. That’s not the case because the flu isn’t a single virus. “In any flu season, there’s usually both Type A and Type B influenza in circulation,” Perl tells WebMD. Both can cause the flu. It’s quite possible that you could get infected with one type and then the other.

Flu Myth #10: If you’re young and healthy, you don’t need to worry about getting the vaccine. First of all, we should all get the seasonal flu vaccine. Sure, if you’re in good health, you’ll probably recover from the seasonal flu just fine. But why suffer through the flu if you can avoid it? Second, protecting yourself isn’t the only reason to get vaccinated. “Healthy adults forget that while they themselves might be at low risk for getting serious flu complications, other people in their family might not,” says Hay. If you have a small child at home, or an older parent, your failure to get yourself vaccinated could endanger them. And that’s true on a larger, societal level. People with the weakest defenses, like children under 6 months, can’t get the flu vaccine. Their safety depends on the rest of us getting immunized.

Flu Myth #11: You can skip years between flu vaccinations.
Experts say that some of us don’t understand that we need a new seasonal flu vaccine every year. “It’s confusing, since the flu vaccine is different from most vaccines, which offer longer-lasting protection,” says Schaffner. “With the measles vaccine, you get two injections and then you don’t have to worry about it for the rest of your life.” The flu vaccine isn’t like that.

Flu Myth #12: Vaccines are dangerous.
In recent years, there’s be
en growing mistrust of vaccines, including the flu vaccine. Some believe that there could be a link between vaccines -- specifically the ingredient thimerosal -- and developmental disorders in children, like autism. However, there is no evidence that vaccines cause autism, and experts say that we’re losing sight of how important vaccines are. “Vaccines are, arguably, the greatest medical advance in history,” says Perl. They’ve prevented more illness and death than any treatment.

Flu Myth #13: Cold weather causes the flu.
No matter what your grandmother may have said, going outside in the winter hatless does not increase your risk of flu. While there might seem to be a connection -- since flu season coincides with colder months in the U.S. -- there isn’t. After all, flu season is the same throughout the whole country: even if it’s frigid in Minnesota, it’s still warm in Florida. The rise and fall of flu season each year has more to do with the natural cycle of the virus, although experts aren’t exactly sure
how it works.

Flu Myth #14: If you haven’t gotten the seasonal flu vaccine by November, there’s no point getting vaccinated.
While supplies of vaccine used to run out by November, that’s not the case anymore, says Allen. Nowadays, there should be enough vaccine for anyone who wants it, and you should be able to get it as late as December or January. Besides, the flu often doesn’t hit its peak until February or sometimes as late as March.

(Original source article:

Sep 15, 2009

"A 98.8% passing rate...?"

While promoting and publishing my own CEN review course and CEN Review Manual, I have been keeping abreast of what others are doing out there.

One "competitior" company is Med-Ed. On their website they boldy proclaim a "98.8%" passing rate.
While they do not specific which exam that refers to, they do print it on their flyer for their CEN classes.

I found this passing rate pretty high and had some questions as to how they calculated it so on 9/12 I called them. I called their office in Charlotte and spoke with the lady who answered the phone. She was nice and pleasant. I introduced myself and stated that I was wondering about their quoted passing rate. I asked her how they knew who did and did not pass the exam. (I do not have her permission to use her name publicly, so I will honor that).

She politely told me that they know the pass rate based on the number of people who have requested a refund based on not passing their exam.

Okay, I can buy that, I guess. But, what if someone doesn't even take the exam? I asked her this, and she said, "well, why wouldn't they take it?".

So I clarified by saying to her that she was telling me that they calculate their pass rate based on how many attendees request a refund for not passing; she said "Yes"....

Seems to me this isn't very scientific at all.
Just because someone doesn't pass the exam, does NOT mean they will contact Med-Ed for a refund.

I can think of several scenarios where someone would NOT be contacting them for a refund....

1) If the attendee is taking the class merely for CEU (continuing education) purposes and they are already certified as a CEN - they have NO NEED to take the exam! (I've had a few of these people in my own classes)

2) If the attendee does not take their exam within the 60 day window, then they do not qualify for a refund; there is the potential for many delays in this 60 day time frame. It takes at LEAST 3-4 weeks to get the "permission to test" letter from the BCEN, then you still have to make an appointment to take the exam. Some exam centers have very limited openings.

3) Another person who would not qualify for a refund is an attendee who has had their registration paid for by the hosting institution in a "flat fee" pricing structure.

There are other permutations of similar scenarios here but I believe the point is clear, there is ABSOLUTELY no sure way to know who has not passed their CEN exam.

The opposite is true however, you can find out who HAS passed their exam by checking the BCEN website and looking at the names of those who have passed their CEN. However, that still would not account for those who have NOT taken it yet.

I'll be doing my own research and study from an upcoming Med-Ed CEN review class and seeing just who is and who isn't passing their exam and running my own numbers.

In the meantime, feel free to check out MY CEN revivew book which is 10% off through the end of September!

10% OFF Thru September 30, 2009

Use code "LULUBOOK" at checkout.

(Click on the Book to Preview or Purchase!)

Sep 14, 2009

ER Wait Times....

While reviewing some of the Emergency/EMS blogs I read, I came across Paul Bond's "Emergency Nursing Today Show" latest post... Public Tracking of ED wait times. This made me think of a site I had seen a while back that was doing sometihng similar....

North Florida ER Wait Times

Middelsex Hospital Wait Times

These are just two examples and apparently there are several more out there.

I find this interesting because my mind looks at this in several different ways.

1) If you are having a "real-emergency" why would wait times mater? If it's life or death, you go straight back and your wait time is essentially non existent. So obviously this marketing of "wait times" is for the non-urgent population and for customers to consider where they could go to be seen quicker.

2) If we are marketing ED wait times to the public, does that mean that inappropriate use of the ED is being encouraged?

3) Shouldn't we be spending more money on injury/accident prevention and community education to help de-emphasize the need to for non-urgent patients to come to the ED?

4) Finally, does it really matter? Is there some patient satisfaction quality trend that is associated with this? As of THIS MOMENT the times on the Middelsex website are: 22min, 0 min, and 9 min for each of their facilities. So I guess the potential customer would want to go to the one that is ZERO minutes so they could be seen immediately (??); but I ask is 22 minutes really that much?

These ongoing trends in Emergency Services towards "customer service" and increased satisfaction are of themselves, okay. It does help the system to strive for excellence, but sometimes I feel that the emphasis is being placed on the wrong areas and right now, much more spending on these websites to "track ER wait times" seems to be not the most appropriate focus for today.

Sep 11, 2009

Remembrance 9-11-01

No words necessary for today's post
However you choose to honor and give respect today - make sure you do and NEVER FORGET!