Nursing in Virginia Magazine - Richmond Times-Dispatch

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Staying Healthy Comes Down to a Few Simple Rules
By Doug Childers

It has been a tough year to stay healthy. A new strain of the H1N1 flu virus, which appeared in Mexico City in March, sparked a global pandemic and fueled worries throughout the summer that it might mutate into a more lethal form. In the fall, as the number of H1N1 cases climbed, doctors' offices and hospitals felt the strain.

Concern about H1N1's impact on young and otherwise healthy patients sent many people scrambling for flu shots. By November, federal offi cials announced a severe shortage of vaccines for both the seasonal flu and the H1N1 strain, although the Virginia Department of Health said it expected the H1N1 flu shots to be more widely available in December.

To contain the virus spread, some hospitals isolated flu patients. The Virginia Commonwealth University Medical Center in Richmond, for example, set up separate waiting and examining areas for patients presenting flu-like symptoms in its Emergency Department. Those patients accounted for 25 to 35 percent of theEmergency Department's ambulatory visits this fall, says Deb Zimmermann, RN, MSN, chief nursing offi cer and vice president of Patient Care Services for the VCU Medical Center.

Nurses can't isolate themselves from sick patients, though. So how's a nurse supposed to stay healthy in a decidedly unhealthy season? It comes down to following a few simple rules. "The best way to prevent the flu is through immunization," Zimmermann says. "We've given more than 2,500 H1N1 doses to employees.

And we've immunized about 6,000 employees and medical staff against the seasonal flu."

It also provided flu shots to its employees on the weekends and during night shifts, in case they couldn't make it to the hospital during regular business hours. The VCU Medical Center,

which employs 2,500 nurses, provides vaccinations to its employees free.

Of course, the H1N1 vaccine has been in short supply, and the VCU Medical Center has had to prioritize its distribution. It first offered H1N1 flu shots to staff in its Emergency Department, pediatric areas and Neonatal Intensive Care Unit. On Nov. 5 it expanded vaccinations to include all direct-care providers.

"Our hope is that we will continue to receive vaccine from the Department of Health and expand to our inpatients and ambulatory sites," Zimmermann says. So far, the VCU Medical Center has seen a 2 to 3 percent increase in the number of employees reporting flu-like symptoms, which is lower than Zimmermann expected.

Lewis-Gale Medical Center in Salem has vaccinated approximately 90 percent of its employees against seasonal flu, and it offered H1N1 flu shots to employees when it became available.

The medical center offers free flu shots to its employees every year. The medical center employs about 600 nurses.

"Staff that decline the seasonal influenza vaccine wear a surgical mask while in patient-care areas of the facility," says Amy Ferguson, RN, BSN, a QA specialist in infection control and risk management at Lewis-Gale. "This is to protect both patients and staff from influenza." In addition to getting flu shots, nurses also can stay healthy by continuing to use good aseptic technique, particularly hand-washing.

"It's just like our mothers said," Zimmermann says. "Washing our hands is the best way to keep germs from spreading."

The VCU Medical Centers has placed handsanitizing dispensers for public use in front of every elevator in its medical facilities as well as throughout every nursing unit.

Patient First, a Glen Allen-based company that provides medical care at 26 centers in Virginia, Maryland and Washington, D.C., installed permanent stations in its waiting rooms to provide patients with hand sanitizer and tissues, as well as face masks for patients presenting flulike symptoms.

"Patients appreciate the new stations," says Tracie Myers, RN, director of medical support at the Patient First medical center in Mechanicsville.

"It also protects us nurses."

The company also offered free seasonal and H1N1 flu shots to its nurses, including the 68 nurses who work at its eight medical centers in Richmond.

The company's vigilance may be paying off. While Myers says the company's medical centers have seen as many patients with flu-like symptoms in two and a half months as they normally would in an entire seasonal flu season, the number of nurses presenting flu-like symptoms is low.

The nurses interviewed for this article also recommend taking the following steps to stay healthy:

• Eat a well-balanced diet;
• Exercise regularly;
• And get an adequate night's sleep.

And to help curb the flu's spread, they encourage good respiratory etiquette. Covering your mouth when you cough is a simple act, but it can greatly affect others' health, Lewis- Gale's Ferguson says.

"We can have a signifi cant impact on our patients' lives," VCU's Zimmermann says. "But it starts with us being healthy."