Nurses Love Flu Vacs (Nursing in general)

Member Name: milmol

Product:	Nursing in general
Date:	17/06/02 (879 review reads)
Rating:

Advantages: Protects at risk patients, See lots of patients we may not see very often

Disadvantages: Huge drain on nursing time, requires lots of work in a limited period.

Pull up a chair because this is a long one. Flu vac season is one of my favorite things (I know, pretty sick), so lets examine what they are and why I enjoy this part of my job.

Who needs one? ~ Government guidelines state – Anyone 65 years of age or older.

Anyone (whatever their age) with a chronic heart or chest complaint, this includes asthma.

Chronic kidney disease

Diabetes

Lowered immunity i.e. due to long-term steroids or cancer treatment.

People with HIV/Aids.

Some other chronic diseases i.e. Coeliac Disease

Anyone living in a residential or nursing home.

All of the above are entitled to a vaccine on the NHS.

Who does not need one? ~ Fit healthy people. This is because although flu is a nuisance to them and generally unpleasant, it is not usually serious or life threatening and occasional bouts of flu give better protection than the vaccination. The vaccine gives 70–80% protection. For this first time this year I noticed that healthy individuals could purchase flu vacs from supermarkets and chemists like Boots. My only concern about this is every year in general practice we struggle to buy enough vaccines to offer to everyone at risk. Surgeries are always phoning each other and asking ‘Do you have any spare?’. If a portion of the vaccines made are being sold to healthy people, will there be enough? It’s not that we don’t order enough for the patients as we know how many we will need due to the computer searches, but amount of vaccines made is not infinite and has to be shared.

On average adults suffer from 1-3 respiratory tract infections each year; young children suffer more as they have not yet made antibodies to the viruses. It is very unusual however to have flu more than once a year.

How is the vaccine made? ~ Every year the World Health Organisation has the difficult job of predicting which 3 influen
za viruses need to be included in this years vaccine. As the vaccines have to be ready for October, they have to predict this in advance, this must be difficult. The viruses are then grown in hens eggs, then killed and purified and made into a vaccine. The vaccines are different every year.

How long does it take to work? ~ The body takes 7-10 days after receiving the vaccine to make antibodies that will protect you for one year. This is why people who come across the virus before the body has made antibodies may still develop the flu although the attack may be less severe than without the vaccine.

Who should not have the vaccine? ~ Pregnant women, there is no evidence that the vaccine causes foetal abnormalities but like most medications it is best avoided. Anyone with a serious allergy to hen’s eggs or who previously had a serious reaction to a flu vac should not be given the vaccine.

How is it given? ~ By subcutaneous injection (beneath the skin, ideal for people with hemophilia) or more usually by deep intramuscular injection, usually into the outer aspect of the deltoid (the upper arm muscle). Children can have the injection in the thigh if preferred. This is not as horrific as it sounds as the needles are actually quite small. Dose – Adults and children over 13 are given a single injection of 0.5mls (usually comes in a pre filled syringe). Children aged 4–12 also receive 0.5mls but if this is the first time the child has had the immunization, it should be repeated 4 weeks later. 6 months to 3 years are given 0.25 – 0.5mls depending on the manufacturer, again repeated after 4 weeks if necessary. Under 6 months – not recommended.

Side Effects ~ Most commonly some soreness at the injection site. Sometimes fever and malaise 6-12 hours later and lasting for 48 hours. Very rarely but possible a severe allergic reaction (Touch wood I haven't seen one yet).

Common Myth ~ The flu vaccina
tion gave me the flu. Not possible, it is an inactivated virus and cannot cause the infection. As it takes 7–10 days for antibodies to be made, if you come across the virus in this period you may still suffer from it although the attack is likely to be less severe. In reality most people do not have the flu and instead have a common cold, but that’s another op to write.

The reality of administering flu vaccines from a nurse’s point of view. I love flu jab season, or so I believe before the clinics start. Funny how amnesia kicks in making me forget the horrible bits. I spend a lot of time undertaking work that requires lots of thinking and concentration, immunising on mass seems a doddle in comparison, until we start. The theory is that a nurse shall immunise 3 patients every 5 minutes, an achievable task only if all goes to plan. We administer approximately 4000 flu vacs every year; the computer is wonderful for finding the patients in the ‘at risk group’ and invitations are sent. The same computer is programmed so that at a flick of a button, the immunisation is recorded, along with the batch no and a prescription and claim made (You didn’t know Gps got paid for this did you?). The room is ready, with several chairs outside. Now last year, the Department of Health lowered the age limit for at risk patients, a wonderful initiative that unfortunately meant the number of vaccines was limited and even likely to be inadequate, therefore rendering the nurse very protective of who may receive one. On entering the treatment room, patients should be ready for immunisation.

Large notices outside, requesting them to remove outer clothing seem to be going unnoticed as elderly people wearing more skins than an onion are taking ten minutes to disrobe. This is all very inconvenient, especially as it takes them ten minutes to dress again, which they insist on doing in the room despite the large queues outside.There are also a
large group of patients who have not yet perfected the art of removing coats and talking at the same time, so questions such as ‘Are you allergic to anything’ require them to stop undressing whilst they answer. One question to be avoided at all costs is ‘Are you well at the moment’. As well as being an utterly stupid question to ask, it encourages the patient to tell you about every ache and ailment they have had for the last 50 years.

Once successfully immunised, patients are requested to remain in the waiting room for a certain period of time, this often results in standing room only as the volume of patients resembles a West Life concert, probably the same age range as well.

Then there are the problems, patients who, were not invited but need a flu jab. On enquiring which high-risk group he belonged to, one gentleman told me he was a furniture polisher. Now I realise the Department of Health have negligently omitted to include this patient’s occupation in the high-risk group, but I wonder how tables and polishing put him at risk of flu. ‘Because’ he tells me in a voice that says you stupid woman, ‘I go into lots of peoples houses that have the flu, I may catch it and I cannot afford to be off work’. An explanation that vaccinations are only administered on the grounds of clinical need is met with surprise, incredulity and downright disgust. Oh the joys of the job.

Another favourite patient is the one who says ‘No my appointments tomorrow but my neighbour/friend/long lost cousin came today so I came with him’. Now being ever affable, I am perfectly happy to bend the rules occasionally for these patients, but these are always the ones who spoil it with the famous words ‘While I’m here’, every practice nurses nightmare. This is often followed by ‘Could you check my blood pressure, check what holiday vaccinations myself/husband/daughter/grandchildr
en need for Turkey, weigh me, do my dressing and see if my smear is due’. These people often exit even more hastily than they arrived, and hopefully don’t mention ‘While I’m here’ again………..

Hope this didn’t offend anyone who has ever done this, but I only see this side of the fence. Seriously, it is fun and we get to see lots of patients, plenty of whom make the job worthwhile, so that’s my op

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