Saturday, August 08, 2009

Pandemic Vital Signs

 

 

# 3601

 

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As a paramedic it was drummed into me that you should always treat the patient, not the EKG.   It is entirely possible to show a cardiac rhythm on the monitor, yet not have a pulse (Electromechanical dissociation (EMD). 

 

That’s why we always check for a pulse when a patient is unconscious, even if they are hooked up to a monitor.

 

Likewise, Doctors are taught to treat the patient, not the lab best. It’s the same concept.  Lab reports and EKGs can be misleading.

 

Your best diagnostics are often the basic ones.  Pulse, blood pressure, respirations,  skin color and temperature.

 

For hospital administrators, emergency planners, along with state, local, and Federal agencies . . . there are a number of basic vital signs they should be monitoring on the Internet that will give them some insight into how the public, and health care workers, view the coming pandemic.

 

We are a nation of netizens, and increasingly, if you want to take the pulse of our nation you have to do it online.  

 

I’m not talking about the lunatic fringe here, or the fast-buck artists out to make a killing off the fears of the public.   Planners need to be aware of them, of course, because they may influence enough people to be problematic during a crisis. 

 

But they don’t represent the mainstream.  At least, I hope they don’t.

 

And since most Americans are oblivious to the pandemic threat (or in denial), regular online polling sites won’t tell you much either.    You need to find where the pulse is strongest in order to accurately take it.

 

If the pandemic of 2009 turns out to be serious (and the jury is still out on that), the general public will eventually start paying attention.   But for now, the only good indication of how they will feel and react comes from the subset of people who are already paying attention.

 

And I can think of no better place to look than the online flu forums, such as Flutrackers and Flu Wiki, and the largest online community of nurses and healthcare workers (HCWs), Allnurses.com.

 

The flu forums are a genuine cross section of the public, with members representing everything from housewives, soccer moms, and retirees to doctors, HCWs, and scientists.  You will find a wide range of opinion and concern on these forums, and yes . . . a certain amount of skepticism over public policy.

 

These are folks who have been thinking about, and sometimes preparing for, a pandemic for some time.   They are far more aware of the issues, have followed local, national and international pandemic policies, and have developed strong opinions. 

 

Policy wonks and emergency planners may not always share or appreciate these opinions, but they should be aware of them.  

 

These posters are likely the harbinger of the rest of the public, once they catch up with the issues this fall.

 

More importantly, at least for emergency planners and hospital administrators, probably are the opinions shared on the pandemic-flu-forum at allnurses.com.  

 

Here you will find more than 300 threads, and thousands of responses, about pandemic issues important to health care professionals.    

 

While there are hundreds of participants on these threads, a great deal of credit goes to Indigo Girl who has made it her mission to keep the online nursing community informed about pandemic news and information.  

 

 

These are educated, dedicated, and concerned professionals who work on the front lines every day, and who will be asked to give more than any other group during a pandemic.  

 

They have a lot at stake here.

 

If you aren’t listening to them, you are missing one of the most important vital signs on the net.

 

It is far too easy as a hospital administrator, or an emergency planner, or an agency head to become isolated from the troops who will be doing the heavy lifting during a crisis.   You surround yourself with others in your milieu, and soon all you hear are the opinions of others in management. 

 

Here, amongst these threads, you will find the thoughts, concerns, and fears of the very human resources we are all going to be depending upon during this crisis.   Without them, any emergency plans being made are certain to fail.

 


We ignore their concerns at our own considerable peril.

 

 

How likely is it that HCWs will willingly take a pandemic vaccine this fall?   What are HCW’s concerns over the vaccine?

 

Follow the thread Would You Accept Swine Flu Vaccine? and you will find out (this is a new thread, so the number of responses is low).

 

 

If the pandemic turns severe, how many HCWs plan to work?  What are their primary concerns?   How can facilities encourage people to work through the crisis?

The poll accompanying the thread Will you work during a Pandemic? has nearly 8,700 responses.  And there are nearly 600 comments on this thread.   

 

This thread should be required reading for every hospital administrator, nursing supervisor, and emergency planner in the country.

 

 newpoll

 

How do HCWs feel about the proposed change in infection control standards for novel H1N1 patients, moving from N95 masks to surgical masks?

 

One good way to find out is to follow  Are you using the right mask?

 

 

These are just a few of the hundreds of topics being discussed by HCWs on this forum.   Other subjects include HCW fatalities, what hospitals are telling their employees, school closures, absenteeism, and antiviral availability (among many others). 

 

You’ll find that in many cases HCWs feel that they are being left in the dark by management, that no one is listening, and some fear they are considered `expendable’ in a pandemic.   

 

These are problems and concerns that need to be addressed (and corrected) now, before this pandemic crisis escalates.   These are your warhorses, the ones you will depend on to work the long hours, and risk exposure, to keep things going.  

 

Without them, all pandemic plans in the world are just worthless documents.

 

These are clear and important vital signs about how the public in general, and healthcare workers in particular, are likely to feel (and deal) with a pandemic this fall and winter. 

 

They are easy to find.


You just need to know where to look.