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Fully Vaccinated or Anti-Vaccine? How Nurses Can Approach Patient Care During Charged Times

There may not be a more current divisive topic than COVID-19 vaccines, with nurses in the thick of the debate daily. Nurses dedicate their lives to saving patients and must contend vaccine misconceptions. Yet, on the other hand, nurses are responsible for caring for every patient, even when those patients make decisions that are counter to their well-being, and even life.  

Nurses must understand the vaccine confusion and the many ethical issues arising from a fight between potential personal risk and professional responsibility. A Registered Nurse (RN) to Master of Science in Nursing (MSN) – Family Nurse Practitioner online degree can help nurses develop strategies to mentally deal with patients who make decisions that run counter to vaccine protection.  

Behind the Vaccine Confusion

Social media noise, political controversy and the lack of national unity contribute to vaccine confusion. For almost two centuries, the U.S. government has mandated certain vaccines to attend school. To date, fourteen diseases (including: polio, measles and rubella) remain well controlled because of widespread vaccine mandates, yet COVID-19 is not one of them. Because of its partisan ties, the Supreme Court sends mixed messages with mandating and blocking vaccine efforts. In addition, the lack of government agreement with the American Nurses Association (ANA) position statements and the vaccine science creates ethical conflicts for nurses.

Personal Choice Impacting Others

Nurses deal with poor patient choices all the time. Many medical problems stem from poor lifestyle choices, or preventable accidents. For example, patients do not quit smoking, even after being diagnosed with chronic obstructive pulmonary disease (COPD) or lung cancer. Patients with hypertension might not lessen their salt intake, or patients with diabetes continue to eat a high carbohydrates diet.

However, most poor personal choices only impact that person, not someone else's health or care team. Banning smoking in public places is an example of protective action from the dangers of secondhand smoke. Many feel that if someone chooses not to receive the COVID vaccine, they are essentially ignoring the threat to others. According to a January 2022 article from TIME Magazine, the current state of the COVID-19 pandemic is that of the unvaccinated. As of early 2022, in Mississippi, 14% of those hospitalized with COVID-19 were vaccinated and 86% were unvaccinated. In Montana, those figures were 19% and 81% respectively.

Because many individuals who are now hospitalized from COVID-19 are unvaccinated, exhausted nurses are suffering from compassion fatigue and thinking, "if they chose to get sick, then I chose not to care for them." Of course, this thinking is counterintuitive to their professional responsibility.

Numerous Ethical Dilemmas

The COVID-19 pandemic has highlighted numerous ethical challenges for nurses regarding safety, patient refusal of vaccines and mass casualty consequences, including the severe nursing shortage

  • Patient care versus personal/family safety. Early in the pandemic, safety protocols were in flux and supplies was scarce, which required nurses to either put patients first or their personal or family safety. Today, nurses still struggle with their professional obligation to either care for patients or sacrifice their safety because people refuse vaccines.
  • Vaccine choice. When the pandemic first started, many nurses mentally prepared themselves to continue patient care until vaccines were publicly available despite the conditions. Vaccines provided hope, and many healthcare workers shed tears as they received their first dose. Unfortunately, disbelief and shock soon replaced hope as a percentage of the U.S. public declined or refused vaccines, and nurses continue to treat unvaccinated people suffering from COVID-19 in large numbers.
  • Mass casualties. As hospitals become overrun with mostly unvaccinated patients, organizations may need to prioritize care and make hard choices. Nurses prepare for this in ethics class using the metaphor of a boat where not everyone can fit.

ANA President Ernest Grant, Ph.D., RN, FAAN pleads for more work to address nurse staffing issues exacerbated by the pandemic: "The nation's health care delivery systems are overwhelmed, and nurses are tired and frustrated as this persistent pandemic rages on with no end in sight. Nurses alone cannot solve this longstanding issue and it is not our burden to carry."

What Can You Do Today?

While key national stakeholders work on solutions, there are three ways to help nurse work with unvaccinated patients.

  1. Accept reality. You can provide patients and caregivers with the facts, but you cannot force change, just like with a person who smokes. Instead, discuss the potential consequences of their choices.
  2. Protect yourself. Put as much protection as possible between yourself and unvaccinated patients. Keep up screening guidelines and be vigilant about safety precautions. Finally, mentally note that you are doing everything possible for the safety of you and your family.
  3. Build resilience. Numerous strategies like journaling, mindfulness and exercise can help you cope with the stress of the healthcare industry. Anything you can do to tip the balance to reduce the sources of stress or increase supportive, responsive relationships can help. At the same time, strengthen your core skills.

Vaccines protect both the individual and the public from preventable and possibly life-threatening diseases. Nurses know that vaccines protect the most vulnerable — young, elderly, those with disabilities and fragile immune systems. Unfortunately, this fight is between personal choice and community protection, and nurses are caught in the middle.

However, an advanced nursing degree can not only provide nurses with the skills to do their jobs well but also do so with job security, high compensation and purpose.

Learn more about The University of Texas at Arlington's online RN to MSN – Family Nurse Practitioner program.


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