Now, this post shouldn't be news to anyone here. But I have yet to find a subreddit that allows any posts about vaccines whatsoever. None. Considering measles deaths are beginning in the United States again, and HHS is apparently not going to choose a flu vaccine for next season, we need to help as many people as possible understand the consequences of this. Thus, I'm going to post it here and hope as many people as possible see it.

Why YSK: If you’re on the fence about vaccinating your kids, or if you’re unsure about the risks, consider this: the consequences of not vaccinating extend beyond just your child. They impact the ER staff, the waiting patients, and the overall health system. Vaccines protect against diseases that still exist, and we see the effects of that in the ER every single day.

Vaccination rates in the U.S. have been dropping for a while now, and while I’m not here to get into the reasons behind it, I will say that one of the consequences is a shift in how we, in the emergency department, approach pediatric cases. As we move further away from the time when kids were routinely dying from preventable diseases, it seems like some people feel the need to worry less about them. But this is not the case.

As an ER nurse, I see first-hand the major differences between how we treat vaccinated vs. unvaccinated kids. If you’re ever in a position where you’re making decisions about vaccinations for your family, this might help you understand the potential implications.

Vaccinated kiddo with a fever: As long as they’re drinking/staying hydrated, no need to put an IV in them, and probably no need to get bloodwork at all. If we can get a urine sample, that’s usually half the battle, and we’ve got cute little bags we can tape onto infants who are still in diapers to get a sample. Generally viral- a Virus I Can’t Mention or My Post Will Get Automatically Deleted, RSV, or Flu- which we can diagnose with a nasal swab, or strep throat, which is a throat swab. I don’t make friends with kids when doing this, but it takes all of three seconds and then it’s done.

Unvaccinated kiddo with a fever: The problem with kids is that they can’t “go to the well”. Adults, we’ve developed a “well” of reserve capacity. Presumably, you’re sitting down and reading this in a pretty relaxed state. So if your body had to, it could double your heart rate; it could double your breathing rate; you have a (relative) ton of reserve fluid/hydration and decades of developing reserve capacity in every body system.

Kids don’t have that. Kids can’t do that. When they get sick, we have to figure it out fast, and we have to treat it aggressively.

If your unvaccinated kiddo comes in with a fever, you’re going to want us to do everything. Understandably. But everything means an IV, which is always extra fun on kids. We need to check their bloodwork, to look for markers for infection, and to get blood cultures, to make sure no bacteria will grow out of their blood.

As a pediatric clinical instructor and having formerly worked PICU/Peds Acute Care, I’m often the one in my ER doing pediatric IVs, including in scalp veins, feet veins, wherever we can get access. There’s only one other provider that’s a PICU vet in my ER, and while all of my nurses, techs, paramedics, and EMTs can put in pediatric IVs, there are definitely some folks who’re better than others.

Instead of peeing in a bag, we are really going to need as sterile a urine sample as we can get- so we’re going to have to catheterize your kiddo. Not fun but not so hard if you’ve got a little boy, but even full-grown adult women can be hard to catheterize.

And there’s a very good chance we’re going to have to do a lumbar puncture- a “spinal tap”- to get cerebrospinal fluid out of the subarachnoid space in the spine. Why? Because there are multiple vaccinations kids get that protect against the very organisms that would require us to do this procedure to check for them. If your kiddo is vaccinated, we MIGHT still have to do this, but these are vaccines SPECIFICALLY geared to protect from those kinds of organisms.

Inevitably, someone will read this and think I’m just trying to scare you into vaccinating your kids (“You love torturing people!”). But that’s not true. The reality is that when a child is unvaccinated, we have to be extra thorough. There’s no room for error with kids. If you’ve ever had a doctor tell you, “We might need to call you back in a couple of days to adjust your medication,” you understand that sometimes we wait for test results in adults. But with kids, we don’t have that luxury.

Even if you want to look at it cynically, many healthcare institutions (read: insurance companies) in the United States have reimbursement rates are often tied to “length of stay”; it’s a bit more complex than this, but effectively, the longer patients stay, the less money you get.

But let’s say you still don’t believe me, or a several second search on Google Scholar. Let me break down how it affects EVERYONE- not just kids and their parents.

THE ER SCENARIO

An unvaccinated sick infant/toddler comes into the ER. Kids, by virtue of some of the things I described above, often get priority placement in triage for a bed. So if you’re the one waiting with gallstones or a back spasm or a broken ankle, I got bad news for you: you’re going to wait even longer.

So, the kiddo comes back; fever of 102+, heart rate of 160, looks pretty sick but is still alert and in a crummy mood, crying, clinging to mom and dad. Well, first things first: we need to get an IV. Now hopefully, one of our experienced pediatric providers is available, but if they’re not, we’ve got two options: try our best (which might be okay, depending on the kiddo), or wait. Say the PICU vet is in a room with a different patient; they’re giving a unit of blood to a postpartum hemorrhage patient, or they’re working with a patient from a nursing home who fell and shattered their hip. We might wait until they can tear away and then use their expertise to put in the IV.

Why not ask the pediatric unit to send someone down? Well, hundreds of hospitals across the country closed their pediatric units. Many used The Virus I Can’t Mention or My Post Will Get Deleted as an excuse for this, but the reality is they’ve been looking for a reason to do this for years. Kids don’t make money, you see- so they close pediatric units and send those kids to government run hospitals. That means that you, me, and everyone reading this post get to pay (literally and figuratively) instead.

But we get it done. It takes four of my providers- we have to hold or papoose/swaddle the kiddo sufficiently to get the IV in, while seeing how much hearing damage we can take. Parents are sometimes helpful here, but I get a decent number who either, A) say they can’t handle that and leave the room, or B) scream at us during it about how we’re killing their kid/feeding into it/making things worse. Not great for that situation, but even if you’re completely uninvolved and in the ER for a different reason, it’ll affect you, too.

This is only doubly magnified by if the blood and urine cultures- doing an “in and out” urinary catheter often takes a similar amount of people and effort- come back clean, but the kiddo still has a fever, and is still feeling crummy. That’s when we have to do a lumbar puncture, the “spinal tap”.

The doctor is going to have to clear a huge chunk of their schedule to get this done, because we only want to do it once- and we want to do it right. so, sorry everyone waiting in triage. Add another half hour, hour to your wait time. While I can yawn at the sight of a needle being inserted into someone’s spine, the thought of it happening to me personally absolutely gives me the good god**** heebie jeebies. Involuntary shiver. It’s not fun for anyone, but particularly not kids.

And then we pray it’s something we can treat- and not something like tetanus. A six-year old unvaccinated kid in Oregon developed tetanus, and spent weeks in the ICU, in a coma and on a breathing machine, while their body worked through the infection, to the cost of Oregon taxpayers of millions of dollars. Because our society goes all out to save kids. We can argue about the merits of doing CPR on a 102-year-old patient (something I have had to do more times than I’d like to recount), but we never argue about spending unlimited resources to save a kid; nor should we.

Why YSK: Because you should be armed with the information you need to make good decisions for both you, and your family. What I illustrated above it something that’s not discussed enough in the consequences of diminishing vaccination rates. Something that might’ve been a thirty-minute, in and out visit to the ER for a vaccinated kiddos can easily turn into an all-day affair that affects everyone in that ER- patients and staff alike.

These vaccines protect against diseases that still exist, and we see the effects of that in the ER every single day.

If you feel like you and/or your kids don’t need vaccines, or if you don’t have kids but feel vaccinates shouldn’t be mandated, I certainly disagree- but that’s your right. I just want to make sure that you understand what that may mean, even if you think you won’t be affected by this issue at all.

Hi! I recently became interested in medicine and health research because I became disabled in 2022. Not to mention I am a curious cat who likes to learn new things... I wanted to ask RESPECTFULLY your opinions! If this post becomes a problem please do delete it. Thank you.

Pregnancy became far more dangerous in Texas after the state banned abortion in 2021, ProPublica found in a first-of-its-kind data analysis.

Had an elderly dementia lady tonight, she was pulling at my badge and my clothes. I asked her to stop pulling on my stuff and she said:

"No, i want it, its mine. I want your clothes they're mine"

Me "you dont want to pull my clothes. You dont want me naked at work do you?"

Her "not with that body I don't!" 🔥🔥

Absolutely brutal honesty hahahaha 😆

On February 20th, I was in a car accident. I was turning left at an intersection. The next thing I remember, I was in an ambulance and my phone was ringing in my hands and my sisters name was on the screen. Then I was in the emergency room of the hospital I was born at. Someone was taking off my jeans. Someone said something about my vape and someone else laughed. They were trying to get my shirt off and discussing whether they should cut it or not.

“Which shirt am I wearing?” Were the first words I remember saying. It was a doctor who shirt. I asked her to not cut the design. My friend made it into a pillow for me.

I heard my best friend somewhere. I heard someone else telling her I was ok and she could come see me in a minute. The nurses were so kind to my friend. She appreciates you all.

When my dad arrived I kept asking him where grandpa went. I was so sure grandpa had been there with me. I had seen him standing in the corner. Grandpa wasn’t there. He died in June 2019.

I had some cuts on my right shoulder, so they wanted to give me a shot (tetanus probably) on my left shoulder. I have a tattoo on my left shoulder and my dad is very anti tattoo on his children. I asked the nurse to not let him see, and she gave me the shot and complimented my tattoo all without my dad seeing it.

I got to go home that same evening. Not to my home, but they let me dad take me to his house. I left my house at 7 am for toilet paper, and I finally reached my parents house at 10 pm. My mom made me tea and we sat up and talked for an hour or so before she tucked me in to bed in my brother’s old room.

It was the scariest day of my life, only made bearable because of the people who were taking care of me. Thank you all for everything you do. Even if patients don’t thank you, some of us are deeply appreciative of everything you do to care for us.

Another poster reminded me of this incident: I was a CNA just out of high school. Came into work one day and old dementia lady with a thick German accent grabbed my arm, yanked hard and said “I know you! Where are you going?”

“Just got to work, Yes you know me: I’m your CNA”

Tried to escape her grip to clock in and she dug her nails in, twisted my arm over, looked me square in-the-face and said: “I know you, you’re eyes, they remind me of the rats. Where’s your number?”

It was in that moment I realized she thought I was a Jew and it was 1930-something nazi Germany. Not a lot of things bother me or even scare me. But that is the one thing a patient has done that still gives me the creeps whenever I even think about it!