The Flu Pandemic and You: A Canadian Guide
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The anticipated arrival of a global influenza pandemic has spurred discussion of ethical issues related to it. Once a flu pandemic occurs, it will force hospital leaders to make difficult decisions — concerning, for example, which patients should and should not be admitted to critical care services that are already overrun. Such decisions are inherently values-based decisions, and are therefore ethical in nature.
If hospital leaders are to make good decisions when the time comes, they should begin preparing for them now. Among other preparations, they should begin thinking about pandemic recovery — that is, about what happens six months or more after the crisis is over. The fact is that hospital staff members will find themselves making very personal, sometimes anguish-filled decisions at the height of a pandemic.
They must, for example, decide whether their first loyalty is due to their work or to their families. Intensive care unit ICU nurses who have young children at home may question their duty to care for seriously ill patients, knowing that, by doing so, they risk exposing both themselves and their families to the illness. On the other hand, ICU nurses have freely chosen and assumed the risks of their profession and are counted on by the public to lend their specialized knowledge to the treatment of sick patients.
Should failure to work under such circumstances be deemed insubordination and, therefore, grounds for dismissal? How does the organization reconcile different responses to crises by different staff members? Shouldn't an organization that puts such a great emphasis on extending care and compassion to patients extend that same care and compassion to its employees?
Questions like these deserve the same diligent attention as those concerning other aspects of pandemic preparedness. Once the worst of a pandemic is over, health care organizations must pay attention to the long-haul goal of rebuilding trust , both in the community and among their own staff members. The extended recovery efforts may raise the most challenging ethical issues for the organization to sort through. Trust Issues An organization's ability to rebuild trust is contingent upon the quality of the relationships existing among its staff members before a crisis strikes.
No amount of strategic planning, motivational speechmaking, or convening of town hall meetings can recapture what never existed in the first place. Trust must be earned.
What is Influenza?
Pandemic preparedness is one way to strengthen trust among employees and the public alike. This is done best by providing transparent, detailed operational planning that equips organizations with the resources — and thus the confidence — to respond to the pending crisis. In Canada, Alberta is known as one of the provinces most prepared to deal with a pandemic. Most provinces have these health authorities, which are ultimately responsible for the provision of health services to the community.
Preparing for a pandemic can itself foster the formation of trusting relationships, especially given the urgency with which contingency plans must be ramped up. There are good reasons to be prepared. History teaches us that pandemic influenzas strike as frequently as three to four times a century; and health care experts tell us that North America is overdue for such an event.
The experts say that the question is not if but when the expected pandemic will occur. The Face of Pandemic Flu What does pandemic flu look like? Of course, most people experience influenza at some time during their lives. Symptoms include sudden onset of fever, extreme fatigue, general malaise, upper respiratory congestion, and cough. New strains of flu appear regularly and circulate in the community, most notably between November and April. During the annual flu season, hospitals see increased admissions, particularly among the frail elderly, and increased deaths.
Because most flu strains vary from each other only in slight ways, people who have acquired a degree of immunity through previous exposure to a similar strain become less ill than others. The variability of strains is also the reason why a new vaccine is required each year. Sometimes, though, a strain appears that is significantly different than earlier strains. The population, having had no previous exposure to it, is unprotected by immunity. The virus spreads very efficiently and rapidly, and large numbers of people become infected.
When this occurs in multiple countries, we have a pandemic. Influenza is transmitted by droplets of fluid or physical contact, not by an airborne mechanism. It is spread through, for example, shaking hands, improper disposal of a used tissue, and coughing or sneezing. The spread of any strain can be controlled to some extent by good hand washing, covering the nose and mouth when coughing and sneezing, and proper disposal of discarded tissues.
Annual vaccination against the flu is advisable because it is thought to offer some protection during a pandemic outbreak of a variant strain. When the expected flu pandemic occurs, it will come in waves, each lasting six to eight weeks, the second wave coming as soon as three months after the first.
Vaccines will take three to four months to develop.
Thematic Guides - Spanish Flu Epidemic
Estimates are that 30 to 50 percent of the population may become clinically ill. There will be shortages of vaccines, antivirals, hospital beds, equipment, and skilled staff. Essential services in the community will be disrupted, and public gatherings may be banned.
Businesses may be unable to operate, and, as a result, some goods and services will not be readily available. In Alberta, it is estimated that , to 1. Of those, some , to , will require outpatient care. From 5, to 13, people will require hospital admission, and between 1, and 2, will die. Given the resource challenges that already confront the province, these numbers — conservative figures at best — are overwhelming.
Planning to meet the expected crisis in Alberta is under way at multiple levels of government, various agencies, nongovernmental organizations, and health authorities. All involved in the planning are following similar formats and have similar approaches. The planning concerns three phases: pre-pandemic, pandemic, and post-pandemic.
Although the province's health authorities have devoted much attention to the first two phases, they have paid much less attention to the post-pandemic recovery period. As noted, Alberta is relatively well prepared for a flu pandemic. If, however, it has done less to get ready for pandemic recovery, the same is probably true for other Canadian provinces and for the United States.
Beginning the Conversation Given the fact that the anticipated flu pandemic will touch the lives of millions of people, planning for it should extend beyond emergency preparedness committees and senior health officials. As we said earlier, many of the decisions to be made concerning a pandemic are ethical in nature. To prepare for them, hospital leaders and clinicians should educate themselves about the ethical principles upon which their policy decisions are based, identify the operative values inherent in those decisions, and prepare to publicly defend the decisions from a moral standpoint.
This is especially true for Catholic hospitals. Leaders and clinicians of such organizations must not wait until the first wave of flu occurs before they become knowledgeable about the ethical principles involved.
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Subjects Influenza -- Popular works. Epidemics -- Popular works. Influenza -- Prevention. View all subjects More like this Similar Items. Allow this favorite library to be seen by others Keep this favorite library private. Find a copy in the library Finding libraries that hold this item Reviews User-contributed reviews Add a review and share your thoughts with other readers.
Influenza pandemic - Wikipedia
Be the first. Add a review and share your thoughts with other readers. Alberta uses the same four pandemic planning impact scenarios used nationally to reflect varying transmissibility and virulence characteristics. Planning scenarios are not predictions and will be replaced with evidence when a pandemic occurs.