NEW YORK NURSE: October 2009
by Nancy Webber
In early September, healthcare facilities across the state began complying with an emergency state regulation that requires thousands of healthcare personnel to get flu vaccinations before Nov. 30.
Many registered nurses heard for the first time that they might have to choose between getting flu shots and keeping their jobs. And many of them were outraged at the implications of such a decision. NYSNA set up a telephone hotline due to the high volume of calls on this issue.
“Callers are asking, does the government have a right to do this, and what can I do if I don’t want to get the shot?” said Renee Gecsedi, director of the NYSNA Education, Practice & Research (EPR) Program. “Some are saying they will either leave the nursing profession or practice in another state.”
The rule applies to workers in hospitals, diagnostic and treatment centers, certified home health agencies, long-term health care programs, AIDS home care programs, licensed home care services, and hospices.
It does not cover workers in private medical offices or nursing homes. The state is pursuing legislation that will create a similar mandate for nursing home personnel.
The regulation also covers unpaid volunteers who come into contact with patients and nursing students who enter hospitals for clinical education.
Despite the controversy over this unprecedented mandate, the New York State Department of Health (NYSDOH) refused to withdraw the regulation. In fact, instead of allowing the emergency rule to expire after 90 days, a NYSDOH committee renewed it in September.
NYSNA delivered testimony to the committee, urging the group to allow the regulation to expire so a task force of stakeholders could be formed to develop a plan that would more effectively deal with issues of patient safety, workers’ rights, infection control, and the impact on the healthcare workforce.
NYSNA also helped form a coalition of infection control professionals and union representatives to oppose mandatory vaccinations. The group has met with State Health Commissioner Richard Daines, health department staff, legislators, and other interested parties.
As the union representative for thousands of direct-care nurses, NYSNA has sent letters to employers requesting them to participate in impact bargaining over the mandatory flu vaccinations.
While the state regulation supersedes contract agreements, how employers implement the requirement may be negotiated. For example, will the employer pay for time off if a nurse has a reaction to the injection? Will the employer cover all medical expenses resulting from a reaction? Will nurses be treated in a nonpunitive way if they choose not to be vaccinated?
In many facilities, nurses are being given a consent form to sign when they go for their mandatory flu shots. NYSNA representatives are recommending that nurses refuse to sign or change the wording if they are being given the vaccine against their will.
New York State remains the only government entity to impose mandatory vaccinations on a portion of the public when no public health emergency has been declared.
Nearly all government agencies and professional organizations across the nation say that voluntary immunization programs are more effective in both promoting patient safety and maintaining staff morale.
“We don’t believe that registered nurses have fewer rights because they provide patient care,” said NYSNA Chief Executive Officer Tina Gerardi. “We will continue to explore every possible means to protect our members and to support science-based public health policies and practices.”
State officials have criticized nurses for opposing mandatory flu shots, stating that the requirement will protect patients from infection. During a press conference on Sept. 29, State Health Commissioner Richard Daines said that people who go into healthcare facilities should be able to “count on not getting influenza.”
There is ample evidence that patients are less likely to become infected with the flu (as are healthcare workers themselves) when a large percentage of the staff are vaccinated. But flu shots alone do not guarantee that patients won’t be exposed to the virus. In fact, relying on vaccinations to protect patients may provide a false sense of security.
Patients are safest when facilities aggressively promote voluntary immunizations, which have increased acceptance rates to 75% or higher, coupled with a comprehensive infection control program.
“The flu virus mutates constantly,” said Thomas Lowe, NYSNA occupational safety and health representative. “Because of this, the vaccine varies in effectiveness from year to year. Facilities must put just as much emphasis, if not more, on proven infection control measures.”