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Nursing students face the dilemma of whether or not to get flu shot. While not required to get the shot for their program, the placements that they go on require it since they will be working with vulnerable patients.

Nursing students at Western University and Fanshawe College are conflicted by their right of choice versus what their nursing placement requires.

In order to graduate from the nursing program at either school, students must complete a placement. Thelma Riddell, lecturer at Arthur Labatt Family School of Nursing said, "Nursing is a practice profession. There would be no point in studying nursing science if you did not plan to interact with patients."

While it is not a program requirement for the students to receive a flu shot, placement agencies require nursing students to receive the influenza vaccination before they begin their co-ops. According to Marlene Price, manager for the Vaccine Preventable Diseases Program at the Middlesex-London Health Unit, "When students are doing their placements, they may be in hospitals, long-term care facilities, places where they are caring for someone who is ill. So if the nursing student has their flu shot, they can't be infecting anyone else. It's for the protection of the patients in the hospitals."

One Western nursing student, Sara Gasior, felt uneasy with this policy, as she would not have gotten the vaccination had she not been in the program or had it not been a requirement.

She said it's contrary to everything she is being taught in the nursing program. "I think being able to take the flu shot should be a right of choice of personal autonomy and that's what they focus on in nursing; however, they kind of take that away with the flu shot."

Neither school has any control over this policy, which is why "the question about fairness is a tough one as the requirement is set by an outside clinical agency," according to Shelley Masse, coordinator of Practical Nursing at Fanshawe. "Most agencies recommend that their staff get the vaccine but it is not required for staff in some places as it is for students. From that perspective, the practice is not fair as not all 'nurses' or 'nursing students' are held to the same standard."

Riddell said the bigger issue has to do with the fairness of exposing vulnerable patients to unvaccinated care providers. "People can die from acquiring influenza, especially when their bodies are coping with other challenges such as chronic disease or infections, lower immunity due to old age or very young age. It is an expectation that, as health professionals, we get vaccinated annually to protect our patients."

Nonetheless, Gasior still said she feels that "it should be a choice. If you want to get the flu shot, you can, but if you don't want to, you should be able to state that you don't want to and you should still be able to pass."

While some students, like Gasior, struggle with the injustice of the situation, "students are aware of the placement requirements when they come into the nursing program," said Riddell.

But Gasior said she feels her right of choice is being denied by the policy because she understands that medical practices and beliefs vary among individuals. She acknowledged that some people prefer to use homeopathic remedies.

"Homeopathic products are out there," said Price. "But it's the flu vaccine produced and distributed by Health Canada is the one that has been researched and shown to be effective."

People can carry the flu even when they don't have the flu, and so therefore, "the best way to protect yourself from getting sick and those around you is to get the flu shot," according to Price.

While it is an agency requirement for students to be vaccinated, there are some agencies that "will allow them in the facility as long as there isn't an outbreak; however, if one develops, they will not allow the student to be in the facility. This absence from clinical may put the student at risk for not meeting the course outcomes."

For nursing students that have a documented reason as to why they are not receiving the flu shot, the same policy applies. They could encounter an outbreak and they cannot return "until the outbreak is over or until they have been prescribed medication to treat/prevent the flu," said Masse.

Even though all the information is readily available for students planning to enroll in the nursing program, it is evident that some still struggle with the idea of getting the flu shot. Ultimately it comes down to what is more important for Gasior: becoming a nurse or saving herself from a few pricks. In Gasior's case, she would readily take the flu shot knowing the outcome is of the greater interest for her.