Yale threatens to kick a student out

[Canarr]

If this is the same Yale I'm thinking of, it's in the United States. Student Health Services would have committed a CRIME by releasing the student's medical information to the administration. Someone is begging to be trampled by an angry HIPPApotamus.

Read the article carefully: It was Student Health Services that was bugging her, not the administration.

[HYHYBT]

That doesn't solve things. Health Services may have been bugging her, but unless things are set up very strangely at Yale, they're not in charge of who is allowed to register for classes. If her continued enrollment was genuinely at risk, another department would, surely, have to be involved.

[linguist]

That doesn't solve things. Health Services may have been bugging her, but unless things are set up very strangely at Yale, they're not in charge of who is allowed to register for classes. If her continued enrollment was genuinely at risk, another department would, surely, have to be involved.

They may not be directly have control over who can register for classes, but they can stop students from registering without violating HIPAA by placing a nonspecific "Health Services" hold on their account. At my university a Health Services hold can be for anything from an unpaid bill to Student Health to not having a required vaccination. If the hold shows up you aren't allowed to register until you contact Health Services and clear the matter up directly with them.

[HYHYBT]

Thank you; that was very informative.

[gremcint]

I'm wondering if the threatened expulsion was not from the eating disorder itself but some sort of policy regarding her refusing to go to the doctor's appointments they made for her.

[Panacea]

The problem with this shit is that you are considered anorectic if you are 25% of the minimum weight for height or more [less?] and anorexia I think is still considered a mental illness. We can't have nutters in university now, can we

You're considered anorexic because you ARE.

The problem is, too many people, including some health professions, confuse anorexia (which is a symptom) with anorexia nervosa (which is an eating disorder).

This is what happens when you get GP's diagnosing mental problems who have no fucking idea how to use the DSM V. I really think no one should be diagnosed with a mental or developmental disorder without seeing a mental health professional first.

as has been said, forget the fact that she doesn't (apparently) have an eating disorder in the first place, why kick someone out for having an eating disorder?

The University actually does have a responsibility for the health and welfare of their students.

If this is the same Yale I'm thinking of, it's in the United States. Student Health Services would have committed a CRIME by releasing the student's medical information to the administration. Someone is begging to be trampled by an angry HIPPApotamus.

They didn't. Health Services made the threat, not the administration.

They may not be directly have control over who can register for classes, but they can stop students from registering without violating HIPAA by placing a nonspecific "Health Services" hold on their account. At my university a Health Services hold can be for anything from an unpaid bill to Student Health to not having a required vaccination. If the hold shows up you aren't allowed to register until you contact Health Services and clear the matter up directly with them.

Bingo! We drop students from our nursing program all the time for not having required vaccinations. We don't go through administration and don't have to.

[Rageaholic]

The University actually does have a responsibility for the health and welfare of their students.

But surely that doesn't include harassing and threatening her with expulsion until she takes their advice?

[fireheart17]

Bingo! We drop students from our nursing program all the time for not having required vaccinations. We don't go through administration and don't have to.

I'm guessing that of that cohort, the majority are just not up to speed and the rest are trying to undermine the current health system under the belief that "if I come in sick with an illness that can be immunised against, won't they be alright because they've been immunised?" (Aka idiot troll logic)

[AccountingDrone]

Originally Posted by AccountingDrone View Post
The problem with this shit is that you are considered anorectic if you are 25% of the minimum weight for height or more [less?] and anorexia I think is still considered a mental illness. We can't have nutters in university now, can we

You're considered anorexic because you ARE.

The problem is, too many people, including some health professions, confuse anorexia (which is a symptom) with anorexia nervosa (which is an eating disorder).

This is what happens when you get GP's diagnosing mental problems who have no fucking idea how to use the DSM V. I really think no one should be diagnosed with a mental or developmental disorder without seeing a mental health professional first.
.

Being anorectic vs anorexis nervosa - as you said, someone is playing with a DSM V. They see her being so thin and figure she is doing the mental ill version instead of the metabolic version [my way was the third type, intense illness combined with a 5 month pregnancy going down the tubes abruptly and temp dialysis ... not recommended for fast weight loss.]

What they should have done is have her see a doctor to confirm that she was underweight, determine that it was not AN related and a metabolic issue, something that should have been easily confirmed by shooting a note to her PCP at home and that should have been the end of it.

[I have a note in my medical records going back some 25 odd years stating that I am normally setpointed at 94-95 degrees f instead of the more normal 97-98 degrees f. It also says that if I show up for a medical appointment with anything over 98 degrees to treat me as if I were 102 degrees or better. I also can get whizz quizzed for infection whenever I want as I am asymptomatic for bladder infections. My symptom is when it rolls into my kidneys and they start to shut down. Real fun.]

[Panacea]

But surely that doesn't include harassing and threatening her with expulsion until she takes their advice?

I don't know that that's what happened, and neither do you. We only have one side of the story: the student's. Yale can't talk about it because of HIPAA.

How many people here have complained about their doctors always telling them to lose weight or quit smoking? What the physician (or nurse) sees as part of their ethical responsibility towards the patient is interpreted by the patient as harassment. Patients often react that way when told something they don't want to hear.

That doesn't mean I think the health care staff at Yale didn't make a mistake in how they approached this. I do question whether their thinking went in the right direction. And it makes me wonder if some policies regarding student health don't need to be revised. Forcing a student to leave school over a health care issue, physical or mental, is not in the best interest of the student if the student is doing well in their course of study.

I've had many students who have had either physical or mental issues while they were in my nursing program. Pregnancy is a common issue. One student was in acute renal failure and waiting for a kidney transplant. They were able to meet the requirements of the program and most will graduate (the renal failure student was one of the best students in her class). However, we collaborated closely with the students to make sure they were taking care of their health issues. We required letters from their physicians stating they were medical cleared to be in the hospital. We also made resources (counseling, referrals, emergency loans) available to them. I also one a student who was suicidal in my class one semester. She agreed to sign a contract for safety, and we got her in to see a health care professional at once. She was deemed stable to remain in school. I followed up with her frequently to make sure she was taking her medication and seeing her therapist. She graduated at the top of the class.

Rarely, I've had to tell a student she had to take a leave of absence. A student with a fractured foot, in an open toed cast and no weight bearing was not able to function in the hospital environment. She was devastated when I told her she would have to take a semester off to let her foot heal. She fought the decision, but eventually came to understand it was the right decision. She came back the following semester and graduated with high marks.

I don't know how Yale handles these things. Maybe they need to change their approach. Community colleges focus on student success. Maybe Ivy League schools let other issues get in the way of that; I do not know.

I'm guessing that of that cohort, the majority are just not up to speed and the rest are trying to undermine the current health system under the belief that "if I come in sick with an illness that can be immunised against, won't they be alright because they've been immunised?" (Aka idiot troll logic)

Usually the student loses their early immunization records. It happened to me as well; Mom could not find them. They need a titer to confirm immunity or have to get the childhood immunizations all over again. Sometimes the students can't afford to get the titer done (most don't have health insurance). I keep a copy of my titers, and have to submit it to a new employer every time I change jobs.

I've only seen one student who had no immunizations at all because her parents were anti-vaxxers. She had been accepted into the program, but was refusing to provide proof of immunization on religious grounds.

We dropped her from the program before it even started because of this. You cannot go into the hospital without proof of immunization for clinic. If you can't do clinic, you can't meet the course objectives. It's that simple.

You can claim religious exemption for public schools. You can't get away with that in the hospital setting. Hell, the hospitals fire people every year for refusing to get a simple flu shot (the only way out of it is a documented allergy to eggs).

The only immunization you can refuse if you're a health care worker is Hep B. I've had the series twice and have never seroconverted (displayed immunity), and refuse to get it again because if it hasn't worked twice, it's not likely to work a third time. But last year, the local hospitals wanted proof of immunization for pertussis (whooping cough) because we've had an outbreak in our area. If I didn't get a booster shot, I would not be able to take students to clinic, and that would have meant my job.

The only problem for me was that I can't get it as a stand alone vaccine. It's part of the TdaP, and I'm allergic to tetanus vaccine. So my doctor gave it to me along with a course of prednisone and anti-histamines. I did fine.

[wolfie]

I've only seen one student who had no immunizations at all because her parents were anti-vaxxers. She had been accepted into the program, but was refusing to provide proof of immunization on religious grounds.

We dropped her from the program before it even started because of this. You cannot go into the hospital without proof of immunization for clinic. If you can't do clinic, you can't meet the course objectives. It's that simple.

You can claim religious exemption for public schools. You can't get away with that in the hospital setting.

My understanding of this is that public school is compulsory (at least to age 16), so that someone with religious objections to vaccination doesn't have the option of not attending. Failure to attend would land their parents in legal trouble (and them in the "unemployable" category once they grow up), forcing them to get the vaccination would be a violation of freedom of religion.

Attending a nursing program is not compulsory. If they don't want to be vaccinated, there are other career options (for example, if they go in for Tool&Die, I've NEVER heard of a case where a milling machine caught a disease from its operator). Therefore it's OK to bar people who won't get immunized for religious reasons.

Hell, the hospitals fire people every year for refusing to get a simple flu shot (the only way out of it is a documented allergy to eggs).

But last year, the local hospitals wanted proof of immunization for pertussis (whooping cough) because we've had an outbreak in our area. If I didn't get a booster shot, I would not be able to take students to clinic, and that would have meant my job.

The only problem for me was that I can't get it as a stand alone vaccine. It's part of the TdaP, and I'm allergic to tetanus vaccine. So my doctor gave it to me along with a course of prednisone and anti-histamines. I did fine.

How is it that allergy to one of the constituents for flu vaccine (the culture medium) is a valid ticket to going unvaccinated, but an allergy to one of the constituents of the pertussis vaccine (one of the other vaccines it's administered with) doesn't exempt you? It's my understanding that allergic reactions become stronger with repeated exposure. What happens if your allergy to the tetanus vaccine reaches the point of "get exposed to this and you die", and the hospital requires another pertussis booster? Do you wind up out of a job over it?

[Sleepwalker]

Possibly because hospitals(and the human world at large) are hotbeds of flu anyway so they're not going to get all het up over one of their staff having or not having the yearly, not super effective vax for it.

[s_stabeler]

probably because flu is ultimately relatively minor for most people- usually resolving itself after a couple of weeks, with complications like pneumonia being rare- wehile whopping cough is far more dangerous, commonly causing complications like pneumonia, or Encephalopathy ( aka, it screws with your brain) or even seizures.

[Panacea]

My understanding of this is that public school is compulsory (at least to age 16), so that someone with religious objections to vaccination doesn't have the option of not attending.

That varies by state. Some states allow religious exemptions.

How is it that allergy to one of the constituents for flu vaccine (the culture medium) is a valid ticket to going unvaccinated, but an allergy to one of the constituents of the pertussis vaccine (one of the other vaccines it's administered with) doesn't exempt you?

In a word (or two): Herd immunity. Basically, if the majority of the population is immunized, herd immunity will protect the handful of people who either don't develop immunity from the vaccine (rare, but it happens as with me and Hep B), or who for whatever reason don't get vaccinated.

Egg allergies are very serious and not to be trifled with. Since most flu vaccines are cultured in eggs (the nasal vaccine being an exception), hospitals don't want the legal liability of forcing vaccination to egg sensitive folks, and the nasal vaccine is more expensive and not as prevalent.

My reaction to tetanus was pretty mild. If it had been more serious, I would have pushed finding the stand alone pertussis vaccine rather than risk the TDaP.

It's my understanding that allergic reactions become stronger with repeated exposure. What happens if your allergy to the tetanus vaccine reaches the point of "get exposed to this and you die", and the hospital requires another pertussis booster? Do you wind up out of a job over it?

I'll look into finding the stand alone version of pertussis. If I can't find it, it will become a documented disability and I can probably keep my job based on the ADA. That doesn't mean the hospital has to let me through the door, it just means the college will have to allow me to work without doing clinic, and assign me other duties. They can always substitute Simulation clinic for real clinic, and there are other folks in the department whose jobs have no clinic at all, so it's not without precedent.

Possibly because hospitals(and the human world at large) are hotbeds of flu anyway so they're not going to get all het up over one of their staff having or not having the yearly, not super effective vax for it.

Uh, no. Hospitals are NOT hotbeds of flu. We isolate patients with documented flu, and we discourage visitation during cold and flu season, and encourage handwashing by visitors.

The flu vaccine is very effective if the right strains are in the vaccine that year. That is almost always the case. I've never gotten the flu when I've gotten the vaccine.

probably because flu is ultimately relatively minor for most people- usually resolving itself after a couple of weeks, with complications like pneumonia being rare- wehile whopping cough is far more dangerous, commonly causing complications like pneumonia, or Encephalopathy ( aka, it screws with your brain) or even seizures.

Flu still kills 250,000 to 500,000 people a year world wide, according to the World Health Organization (WHO). The CDC estimates about 36,000 deaths a year in the US. Why the discrepancy? Access to better health care and vaccinations.

Whooping cough (pertussis) kills about 195,000 people per year world wide; and the pertussis vaccine is actually less effective than the flu vaccine. Many people have mild cases and don't even know they have it, much like the flu. However, cases are on the rise because so many people in the US are not getting vaccinated at all, or not getting their booster shots. Infants are the most vulnerable group, and thats where the uptick in cases is happening.