So you say you want to work in Infection Control, but do you know what that really means? Lately, for me, it means gritting your teeth and saying things you might not whole-heartedly believe. It means you’ll spend many valuable hours reporting data that offers little value to the patients or the public. It means you pledge to uphold published guidelines, even if the evidence is weak. It means you don’t mind egg on your face when new evidence refutes whatever policy you’ve put into place based on those guidelines, then touted and spouted about for 2 years.
You can be a journal reader and a free-thinker and a researcher. But if your conclusions don’t match the decade-old conclusions of a guideline-writing workgroup, you may find no support amongst your peers and little sympathy from auditors.
I can’t stand one more industry-co-written “research” article about how some instrument or device significantly reduced infections, when the study results are either not significant, important factors were not disclosed or ignored, or the intervention was a bundle when one part of the bundle is already proven to reduce contamination or infection. But everyone is buying one. Because of the ‘evidence’. And I look bad because I don’t buy the magic infection machine. “Oh, you don’t have one? When will you be getting one?” Step up to the line.
I hate going to meetings to present infections that clearly aren’t, and saying “Well, this is the surveillance definition.” Nobody wants to hear that. Nobody understands why we are reporting and discussing “infections” that aren’t, those with no opportunity for improvement. And neither do I. This AJM editorial came out recently and I briefly had fantasies of flinging a thousand copies of it into the air at the next infection control meeting and saying, ““Infection Control” isn’t even a thing. Peace, out.” Is my job the Truman Show?
I don’t like to be told by an inspector that the 50 hours I spent at conferences, my graduate degree in public health, my IC certification, the infection control assessment I do and the plan I write, the committee I run, and the initiatives I implement do not show evidence of my competence, and that I’ll have to come up with something else to prove I know how to do my job.
I’m on the fence about forcing people to get flu shots, and I’m about to fall off. I believe 100% that healthcare workers should be vaccinated against communicable disease. And for those that gripe about “their rights”, I don’t see any of them suing their parents for giving them a measles vaccine 30 years ago. I’m frustrated by the lack of available data on EXACTLY HOW LONG FLU IMMUNITY LASTS. Does it really cut out at the end of April? Not one second longer? Drops off to literally zero? Like a little hourglass running out? And how ‘bout those efficacy numbers?
But I put on my hat and tell staff they have to get a new one each year, even when it was exactly the same strains as last year’s vaccine. Have to. Or they risk their jobs. Current recommendations from the party line. I am, however, in favor of not hiring uncommitted clinical staff who don’t wash their hands, can’t bother to collect a proper culture, and show up sick, because they aren’t truly here for the good of the patient. I’m in favor of hiring better staff. But I’m not sold on the flu shot mandate.
I found a glimmer of hope, though, in APIC’s new public policy agenda. It’s a lovely document identifying the challenges and priorities of the field, and what can be done to make improvements that do positively affect patient care and public health. It advocates addressing gaps in knowledge and prioritizing HAI prevention activities and evaluating financial incentives. It addresses accurate data collection (!) and standardization. It tells me people are working on the things that frustrate me most.
The transparent agenda shows you the party line, and you can decide if it’s a party you want to join. And while the party continues to advocate for influenza vaccination mandates for healthcare workers, the agenda also contains guidance for how to lobby for change. You are your profession, and you can participate and mold it. So for all my frustrations, I will continue to participate and work towards change and promote the value of infection control, because I do believe in it.
But I will never wear a hand costume.
