Last autumn, the hospital where I work initiated a new policy: Nurses in the medical/surgical units are expected to assess newly admitted patients to identify those needing flu shots. The policy provides a checklist to follow to determine if a patient is a candidate and a preprinted order sheet we fill out to obtain the vaccine from the pharmacy. We then administer injections to patients who meet the criteria.

In the past, physicians had this responsibility. The hospital shifted the responsibility to nurses because physicians were ignoring the forms.

So far, no errors have occurred because of this policy, but I'm still uneasy. We're already overworked at the bedside, and I'm worried that I could make a mistake that would jeopardize a patient and my license. Don't you think this is a responsibility best left to community or outpatient nurses?-H.H., IND.

Because flu can be so dangerous to many people, our consultant thinks your hospital is offering a wonderful service to its patients. For everyone's safety, however, the policy must be both practical and in compliance with current standards, such as recommendations issued by the Centers for Disease Control and Prevention.

If the policy is sound and you follow it, your license shouldn't be in danger if a problem arises. But if you have reason to think the policy jeopardizes patients, document your concerns, including specific examples, and take them through channels to your nurse-manager, infection control practitioner, and risk manager.