Nurses Refusing to Administer COVID-19 Vaccinations!? | Nurses Week Contest

[SafetyNurse1968]

Month-Long Nurses Week Celebration Starts Today! Nurses Week Contest #4

Healthcare professionals have expressed vaccine hesitancy due to fear, mistrust, and misinformation. Although nurses are entitled to their opinion, should this influence them when it comes to administering vaccines? Should nurses be allowed to refuse to administer COVID vaccines? What do YOU think? The best Pro or Anti Vaccine read will win $100 Amazon Gift Card courtesy of allnurses Ebooks. Contest rules are found below.

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Vaccine Controversy

There’s a lot of controversy about the COVID-19 vaccines. I’ve seen articles about how it causes infertility, autoimmunity and even death. Almost 50% of my students have expressed vaccine hesitancy due to fear and misinformation. Some of them have told me they are immunocompromised, and one said that their religion forbids vaccination.  Most of them said, “I just want to wait and see if it’s safe.”

Are vaccinations safe?

There’s been a huge debate for years over whether vaccines cause health problems. When I was about to give birth back in 2009, I did my own research to be absolutely sure that vaccinating my newborn was the way to go. I found no evidence then that vaccination causes autism, and there’s even more evidence now that there is no link between autism and vaccines or any of their ingredients (like thimerosal, which was removed from all vaccines except multi-dose flu vaccines by 2001)¹

The flu shot gave me the flu…

You’ve probably heard someone say, “I got the flu vaccine once, and it gave me the flu – I’m never getting it again.” What they don’t realize is that 1) the flu vaccine cannot give you the flu and, 2) in these cases, the person had already been exposed to the flu when they got vaccinated. The development of the flu would have occurred regardless of the vaccination. Modern vaccines are constructed in such a way that they cannot cause the disease for which you are being vaccinated against.

What about the COVID-19 vaccines?

As I stated in the summary, there’s a lot of misinformation about the COVID-19 vaccines including that they cause infertility or autoimmunity.^2,3 In addition I have read that they contain a tracking chip and that the RNA from the Moderna and Pfizer vaccines can modify your genes. There is no evidence that any of these assertions are true.⁴ Though there may be small, isolated cases of side effects occurring with vaccines, they do not outweigh the very real danger of becoming significantly ill from COVID-19. Right now, all the vaccines being used in the US (Moderna, Pfizer and Johnson & Johnson) have 100% efficacy in preventing hospitalization and/or death from COVID-19. Millions of people have been safely vaccinated against COVID-19, and while the evidence is still out as to whether those of us who have been vaccinated can give it to others, we do know that it is working to prevent hospitalization and death from COVID-19.

mRNA technology such as that used in the Moderna and Pfizer vaccines has been around for over a decade. You may recall from A&P or biology that mRNA is made in your body from DNA. The way it works in your body is: Segments of your DNA (called genes) code for mRNA (transcription) and then mRNA codes for proteins (translation). An mRNA vaccine enters your body and is translated into proteins that elicit an immune response. There’s no machinery or ability for your body to incorporate the mRNA into your genetic code. Once it’s translated, the mRNA just gets destroyed by catalytic enzymes.⁵

It’s also important to note that despite the vaccines being offered under emergency use authorization (EUA), “For this EUA, the FDA required significantly more data on safety and efficacy than usual,” said Janis Orlowski, MD, chief health care officer at the AAMC.⁵

No serious health problems were reported by the tens of thousands of people who received their vaccines during clinical trials. The most common side effects — fatigue, headaches, chills, and muscle pain — lasted about one day and most often occurred after the second dose. Since the vaccine rollout began in the U.K. and U.S., there have been sporadic reports of severe reactions in people with histories of significant allergic reactions to some foods and drugs.⁶

Our duty as nurses

The American Nurses Association supports that all nurses get vaccinated for COVID-19.⁷ The Code of Ethics for Nurses Provision 3 states, “The nurse promotes, advocates for and protects the rights, health and safety of patients.” Not getting a flu vaccine can result in increased risk of contracting flu for patients, co-workers and yourself. Despite this, nurses do refuse to take the flu vaccine – usually due to religious, medical or philosophical objections. Only 21 states have a law that requires healthcare workers to get flu vaccinations and even those laws require exemptions be allowed. Many employers mandate a flu shot, but also allow exemptions. About 1/3 of states require hospitals to offer employees flu shots and track their vaccination status. In many of these states, employees can decline a flu shot without an exemption.⁸

But what about the COVID-19 vaccines? Can those be required? The federal government says that COVID-19 vaccination can be required, but so far no healthcare organizations have taken this confrontational stance.^5,6

I believe we have a duty as nurses to get vaccinated against COVID-19 to protect our patients and coworkers and also to prevent mutations/variations in the vaccine. We all need to work together to eradicate COVID from the planet.

My Question: Can a nurse refuse to GIVE the vaccine?

In nursing school, I recall an ethical debate on whether or not a nurse could refuse to care for a patient having an abortion. We decided that nurses should have the right to refuse to take part in an abortion based on moral objection, though once the pregnancy is terminated, the nurse should no longer be able to refuse to give care. Does that translate to giving vaccinations? If a nurse is morally opposed to vaccinations, can they refuse to give them?

I googled “Can a nurse refuse to administer vaccines” and all I came up with was a list of articles about how many nurses are refusing to get the vaccine. It’s hard to find information on this topic. 

What do you think? Should a nurse be allowed to refuse to give vaccinations? Should the reason for that opposition play a role (religious, ethical, moral, philosophical)?

Contest Rules

1. Open to registered allnurses.com members only. (Free and quick to Register)
2. Participate in the Poll.
3. Answer 'Should a nurse be allowed to refuse to give vaccinations? Why?'
4. One winner will be announced.

This contest is sponsored by allnurses Ebooks.

Quality Nursing Ebooks. Anytime. Anywhere. Our ebooks are created by nurses, educators, students, and healthcare professionals. We have one goal - To help you succeed in your nursing career.

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References

¹ Autism and vaccines
² Why the vaccinations do NOT cause infertility
³ Vaccine myths
⁴ The vaccine does not cause autoimmune disorders
⁵ Association of American Medical Colleges: What health care workers need to know
⁶ COVID-19 vaccine safety
⁷ ANA position statement on vaccines
⁸ Becker’s flu shot requirements

[Surfin USA]

Ps I am sorry for being extra angry with people on here. Today was a better day than we have had in 2 weeks, and its just been really hard on me. Hes been a grumpy little sock monkey (OK hes really not little but anyways) and I just feel like I cant do anything right for him, no matter how hard I try and I am very depressed about that. 

But today was better. 

So I feel optimistic for once. 

So Im sorry but the shiznit rolls downhill so whomever is being disrespectful is gonna get some lip from me, lmao 

Seriously though. Im going to try to do better. I promise. I don't want to he an A**Hole. 

[Sonya jordan]

I believe that as a nurse you have the right to refuse to take an assignment as it is unsafe.  I do not believe that administering a vaccine that a patient has the right to refuse or the right to obtain would be considered an unsafe assignment.  If you are that adament about not administering vaccines then you are probably in the wrong job.  It is about what the patient wants not what we want.  The patients have the right to get the medical care that they feel safe and necessary for them.  It is not our jobs to choose that for them.  We as nurses are there to support them educate them and deliver the care that has been prescribed.  

[CindyGRosario]

If a nurse doesn't feel comfortable giving the vaccine then just asked to be given another role. I don't think refusing is the right term as there are many different things we can help with. As a nurse, don't do anything that makes you nervous, leave that to those who want to do it.

[MaxAttack, BSN, RN]

On 4/29/2021 at 10:44 AM, JKL33 said:

As it stands right now, there is no reason to think that a patient's successful receipt of a covid-19 vaccine is dependent upon a single/specific RN.

I have several times explained why I believe that RNs who wish to refuse to give the vaccines are outliers and don't have a big effect on vaccine administration.

LOL at this point you're either trolling or intentionally misconstruing the argument.

This is about the limits to the nurses ability to refuse orders (refer to poll title: "Can nurses refuse to give ordered care?"), not about the impact an individual nurse has on global vaccine distribution and administration. Beautiful straw man argument but that's not a thing. That was never a thing. 

Quote

How do you think that would play out? That's just it for him?  He dies right there and you are accused of single-handedly "refusing [him] life-saving surgery"?  Your manager calls you in and terminates you for "shouldn't even be allowed to call yourself a nurse" while the guy dies?

Know that if you are able to handle yourself (and your concern about the old guy) professionally, our code of ethics does allow for that, and it is for everyone's good. And that's really the crux of my entire argument.

Again with the overboard off-the-wall misinterpretations LOL. Yes, that's exactly what I mean. The guy will die and everyone will just sit around and play cards.

We are expected as educated professionals to address our concerns *to a point*. There is a proper way to do this, but it does not give the nurse ultimate decision making abilities.

So let's try to get to the core of the argument in the most unambiguous terms: What legal right does a nurse have to override both the physician, patient, and informed consent and refuse to administer a medication at the correct route, dose, and frequency to a correct patient population that has already been cleared by our government for this specific indication and is within their scope and job description?

 

This is from a quick Google search. Worth a read.

http://www.nursinglaw.com/scope-of-nursing-practice.pdf

"The scope of practice of a registered nurse does not include the authority unilaterally to decline to follow a physician’s order."

[JKL33]

1 hour ago, MaxAttack said:

LOL at this point you're either trolling or intentionally misconstruing the argument.

Wrong. Glad you're entertained though.

I am not sure why you're arguing that there's no material difference  between a scenario where the patient does receive the care in question vs. one where the patient ultimately does not receive the care in question.  That's what you're arguing. If that's your view, no problem. I just disagree.

[Surfin USA]

13 hours ago, MaxAttack said:

 

http://www.nursinglaw.com/scope-of-nursing-practice.pdf

"The scope of practice of a registered nurse does not include the authority unilaterally to decline to follow a physician’s order."

So if a seemingly healthy 25 year old is rolled in with some minor injuries and has a DNR bracelet, in the state of California, and this person stops breathing, you HAVE to adhere to that physicians order and NOT resuscitate them. 

Not to change the scope or hijack the thread. Just sayin. 

And some states do recognize a health care professional's right to pass on that order, due to having a moral or religious belief against the care the patients wants, and their doctor orders, and in those cases they must pass that patient's care on to someone who can follow the order. 

At the end of the day, the patient is entitled to have their doctor's order followed. 

These vaccines are NOT prescribed by doctors, however. They are merely recommended. 

Its a whole other thing. The doctor can recommend a lot of things, that arent actually ordered and don't necessarily have to be followed. 

All they can do is make recommendations and encourage people to use them.

So my answer to this, after some deliberation, is that it is highly unlikely that a nurse that does not wish to engage in giving covid vaccines will even be included in administering them. I certainly don't think they will lose their jobs over it, though, at least not right now. 

Some nurses, however, are facing losing their jobs for not GETTING vaccinated. But thats another story for another thread. 

[MaxAttack, BSN, RN]

14 hours ago, JKL33 said:

Wrong. Glad you're entertained though.

I am not sure why you're arguing that there's no material difference  between a scenario where the patient does receive the care in question vs. one where the patient ultimately does not receive the care in question.  That's what you're arguing. If that's your view, no problem. I just disagree.

Bruh. Where am I arguing this? Where do you pull this stuff from? 

Let me try one more time

What legal right does a nurse have to override both patient and informed consent and refuse to administer a medication at the correct route, dose, and frequency to a correct patient population that has already been cleared by our government for this specific indication and is within their scope and job description?

[NurseBlaq]

If a patient wants the vaccine, give it to them! I haven't been vaccinated because they're contraindicated for me but I would gladly admin the vax to a patient who requested it. If a patient wanted to be vaccinated and it was contraindicated, I would provide heavy teaching. However, if they persisted, I'd give it to them if they have a signed consent and would document all the teaching and noting the patient chose to move ahead anyway. I'm more disturbed by people not wearing masks than wanting to be vaccinated.

[MaxAttack, BSN, RN]

2 hours ago, Surfin USA said:

So if a seemingly healthy 25 year old is rolled in with some minor injuries and has a DNR bracelet, in the state of California, and this person stops breathing, you HAVE to adhere to that physicians order and NOT resuscitate them. 

If a 25 y/o stopped breathing from minor injuries then they might not have been as healthy as you thought. ? I don't know California law. There's a standardized form in my state that is legally binding. Just like you don't HAVE to drive sober, you don't HAVE to follow this paperwork. I wouldn't recommend either.

Quote

And some states do recognize a health care professional's right to pass on that order, due to having a moral or religious belief against the care the patients wants, and their doctor orders, and in those cases they must pass that patient's care on to someone who can follow the order. 

Yes there are exemptions for religious and moral beliefs for certain procedures. IMO - especially since the leaders of many major religions have addressed this specifically - using this excuse at this point is more a mental health issue than a moral one.

[MunoRN, RN]

21 hours ago, MaxAttack said:

LOL at this point you're either trolling or intentionally misconstruing the argument.

This is about the limits to the nurses ability to refuse orders (refer to poll title: "Can nurses refuse to give ordered care?"), not about the impact an individual nurse has on global vaccine distribution and administration. Beautiful straw man argument but that's not a thing. That was never a thing. 

Again with the overboard off-the-wall misinterpretations LOL. Yes, that's exactly what I mean. The guy will die and everyone will just sit around and play cards.

We are expected as educated professionals to address our concerns *to a point*. There is a proper way to do this, but it does not give the nurse ultimate decision making abilities.

So let's try to get to the core of the argument in the most unambiguous terms: What legal right does a nurse have to override both the physician, patient, and informed consent and refuse to administer a medication at the correct route, dose, and frequency to a correct patient population that has already been cleared by our government for this specific indication and is within their scope and job description?

 

This is from a quick Google search. Worth a read.

http://www.nursinglaw.com/scope-of-nursing-practice.pdf

"The scope of practice of a registered nurse does not include the authority unilaterally to decline to follow a physician’s order."

I'm not really clear which stance you're arguing for, but being familiar with that case it should be clarified that the court mistated the Washington State Nursing Commission's position on nurses refusing to carry out a Physician's order, which was that a nurse needs to notify the prescribing physician of their refusal, but can then still refuse.  The nurse does not need the Physician's approval to not carry out an order, which by definition means they have the authority to unilaterally decline to follow a physician's order.

The State Nursing Commission's explanation was that in order for a nurse to be practicing within their scope, a nurse must have a common understanding with the prescriber of the purpose of the order and how it is to be interpreted, this goes for following an or order or declining to follow an order, so to ensure that this common understanding exists when declining to follow an order, the nurse must notify the Physician and ensure that the nurse understands the purpose of the order.

This case was notable at the time since it initially seemed to contradict the premise that nurse's are not only allowed, but required to refuse to follow prescribed orders that are inappropriate, unsafe, reckless, etc.   

But even though the nurse has the right and responsibility to refuse to follow an inappropriate order, the basis of their decision is still up for scrutiny by the board.  

[MaxAttack, BSN, RN]

38 minutes ago, MunoRN said:

I'm not really clear which stance you're arguing for, but being familiar with that case it should be clarified that the court mistated the Washington State Nursing Commission's position on nurses refusing to carry out a Physician's order ...

Thank you for the clarification.

My argument is that if it there is a legitimate order within the scope of practice and the patient has given informed consent, a nurse has no legal argument to refuse to carry it out - specifically because they've decided on their own that a specific medication is too new, untested, unknown (or whatever else they've read on facebook) to be administered.

[MunoRN, RN]

5 hours ago, MaxAttack said:

Thank you for the clarification.

My argument is that if it there is a legitimate order within the scope of practice and the patient has given informed consent, a nurse has no legal argument to refuse to carry it out - specifically because they've decided on their own that a specific medication is too new, untested, unknown (or whatever else they've read on facebook) to be administered.

That I agree with, nurses can't refuse to provide a treatment, medication, or other intervention simply because it's not something they wouldn't chose for themselves.