Can there be a budget during a pandemic?

It is well established that we are about to face a flu season that will take a heavy toll on health care workers as well as the general public. Meetings are held to provide information and plans on how to cope, but there are also phrases like “we still have stay within budget” from administration. This sets a dangerous environment where the cost of caring for the ill and dying takes precedent over the actual care needed. Can there be a budget during a pandemic? Bureaucrats and politicians think so. Front line health care providers do not. Managers are pressured to keep their budgets under control under all circumstances.

As a nurse, I have to question just how safe patient care will be during this crisis. Increased staff shortages will be a certainty with health care workers ill themselves or caring for family members. Paying overtime for replacement staff is already discouraged so how do units replace badly needed staff to care for the ill in the hospitals? There will be a lack of equipment as unit budgets are stretched to pay for supplies. There are already reports of defective protective equipment from poor quality sources and from being stored under the wrong conditions.

The fallout from the H1N1 pandemic will resound for years. No doubt it will also find its way into lawyers’ offices and court rooms. Perhaps there the question of how much a pandemic will cost will be answered.

Can H1N1 be contained in hospitals?

The last few months have seen the outbreak of the H1N1 virus. It has been appearing all over the world and varies from mild to severe, sometimes resulting in death.

People present to the hospital for various reasons. Some are staff. Some are visitors. Some are injured. Some are booked surgeries and diagnostic tests. Some are very ill. When word of an outbreak occurs, everyone assumes that doctors, nurses and other hospital staff will take every precaution to protect themselves and others so that the infection cannot be spread within the hospital itself.

But is this true?

Sadly, it is not. The worst culprits are often doctors. Doctors who make dangerous assumptions. They discount the need for isolation precaution procedures already in place. They ignore nurses who tell them of the risk and precautions necessary before, during and after patient contact. They don't wash or sanitize their hands before and after seeing a patient. They contaminate the charts and the desk area where others work.

Often it is only after they receive as positive lab result (sometimes days later) that they acknowledge what they have done... and only to themselves.

Patients who develop complications after a hospital visit-- no matter what they were doing there-- need to have a thorough examination of the timeline. There is a very good chance it is a case of "white coat" contamination. Questions that need answers include: were isolation procedures implemented, reinforced and carried out at all times? Was any caregiver diagnosed with the same illness or treated with anti-flu drugs due to an unprotected exposure? Detective work by someone who knows how a hospital works behind the scenes can provide the answers.