Patient Refusing Unvaccinated RN

Nurses COVID

Updated:   Published

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Just as the tittle implies, we recently had a patient's family refusing a nurse who is not vaccinated. As of now, vaccination at my facility is still voluntary; becoming mandatory after September 1st (we still have several staff on the fence about it). My understanding is that the patient happened to come in as a stroke, with a prior  hx of prostate CA. Not sure what was the context of the conversation, but the patient's wife asked the nurse at the time if she was vaccinated (she was not and answered honestly...she could had refused); prompting the wife to request a different nurse due her fear of exposing her possible immunocompromised husband...the assignment was changed. The feeling of some of my co-workers is that we shouldn't had accommodated the request in support of the staff; however, many feel the wife had the right to advocate for her husband and had a valid concern. This has become a hot topic of conversation in the unit during downtime. 

Have anyone come across to anything similar?? If so, how was it handled?

Specializes in NICU, PICU, Transport, L&D, Hospice.
2 minutes ago, vintagegal said:

Don’t share anything with your patients. There is an art to being compassionate and caring without crossing boundaries.

I have had patients ask me if I’m married, where my kids go to school, my phone number in case the on call missed something. I dodge all of these as they open Pandora’s box. For example when I was in nursing school I had a patient ask me if I was married, without thinking I blurted out “I was, I’m divorced, it didn’t work out”. The patient blankly looked at me and said “well the good lord frowns on that, there is no reason anyone who’s going to heaven would get divorced”. Since that day I promised myself to be caring and understanding but not share anything personal. 
I’m vaccinated, but I have only disclosed that to my place of employment where it is a condition of my work. 

Excellent choice to maintain healthy and safe boundaries.  

I tell my friends and contacts that I am vaccinated so that they know what their risk might include when they they are in my company. 

Specializes in Public Health, TB.

I don't mind telling anyone who asks that I am vaccinated. If they ask, I will describe the minimal side effects I had and the feeling of elation I felt when I got vaccinated. I work with immunocompromised and TB patients in whom COVID could be deadly. I am happy to assure them I am at low risk to transmit virus to them. 

My marital status has nothing to do with promoting health so I don't see how that serves as an analogy for vaccine status. 

On 7/24/2021 at 7:58 AM, Horseshoe said:

Why are you "sure" how a total stranger feels?

The same reasoning that some believe that just because a RN is vaccinated that they will follow proper PPE all the time.

Just found out that a patient was positive, this after God knows how many RNs and CNAs have taken care of this patient. Now do think that woman wouldn't be uncomfortable if the staff taking care of her husband also took care of that newly discovered COVID patient just because the they were vaccinated?

It is true that you can still get and transmit COVID even after being vaccinated. 

On 7/24/2021 at 7:58 AM, Horseshoe said:

Why are you "sure" how a total stranger feels? We don't have enough information to know if the wife understands that she can only reduce risk rather than eliminate it. We don't know if she is realistic or engaging in magical thinking or if she is simply feeling out of control and attempting to grab some sense of it wherever she can. This is common with families whether we are talking about COVID or any other perceived threat.

I had a patient who had a stage 4 brain tumor. He was barely conscious and his death was clearly imminent. His wife was completely obsessed with his blood sugars. If they were ordered to be checked at 8 am, she was livid if they hadn't been checked by 08:01. I could have explained to her that those times have a cushion built into them, or could have stressed the more obvious fact that he was dying of a brain tumor and his blood sugar levels at 8:01 rather than 8:00 were not going to impact him whatsoever in any meaningful way. After dealing with this for several days and observing the family dynamic, I realized that maybe she was feeling completely powerless to effect the outcome of her husband's situation, and this was the ONE thing she could have any influence on. I made sure that his blood sugars were checked exactly on time. 

Maybe this is what is driving the wife's behavior, maybe not. We don't know based on what we have been told.

What?!?! You literally just over explained what I said. I appreciate you.

Specializes in BSN, RN, CVRN-BC.

The wife was not wrong.  

Vaccination dramatically reduces the odds of infection.  Info coming out of England is that when a vaccinated person catches COVID the case is less severe.  Their viral loads are lower and the amount of virus they shed is lower. 

If the unvaccinated person has taken recommended precautions and uses PPE effectively the odds of infection are already low.  All things being equal, having the vaccinated nurse just puts the odds of avoiding infection a little more in her husband's favor.

If it were my wife I might do the same.

Perhaps hospitals need to review their policies regarding their staff sharing their vaccination status with patients.  Some might say that the patients have a right to know, but do we divulge the staff's HIV status?  How about Hepatitis B,C, and D?

I would encourage everyone who can to get the vaccine.  I just called a 44M to schedule his stress test.  I got a hold of his wife who was barely keeping it together because he is at another area hospital in the ICU on ECMO.  Other than being over-weight he had no comorbidities.  There was the case in the news of an otherwise healthy 27 year old who ended up with a lung transplant due to COVID.  Being young and healthy doesn't mean that COVID won't make one seriously ill and have lasting health consequences.  If I could persuade people not to roll the dice, I would.

 

2 hours ago, Robmoo said:

Perhaps hospitals need to review their policies regarding their staff sharing their vaccination status with patients.  Some might say that the patients have a right to know, but do we divulge the staff's HIV status?  How about Hepatitis B,C, and D?

 

You cannot get HIV or Hepatitis simply by sharing the same space with an infected caregiver. That's a false equivalency.

Specializes in NICU, PICU, Transport, L&D, Hospice.
2 hours ago, Robmoo said:

Perhaps hospitals need to review their policies regarding their staff sharing their vaccination status with patients.  Some might say that the patients have a right to know, but do we divulge the staff's HIV status?  How about Hepatitis B,C, and D?

If the hospital is aware that the patient has been exposed to a contagion by an infected staff member, they have an obligation to inform the patient. It happens that this virus is much more contagious than any of the other illnesses you mentioned. 

A further differentiation is that none of those diseases are currently in pandemic status and none of them (besides Hep B) are vaccine preventable with wide access to a free vaccine. 

Specializes in CRNA, Finally retired.
On 7/21/2021 at 9:41 AM, DesiDani said:

My mistake 5 not 5% and I already answered that question. I point is that if she is so concerned BECAUSE her husband is immune compromised why would it matter to her if the RN was vaccinated or not? A vaccinated person, yes is better off if they get the virus, but they still can get and transmit the virus.  Just because I am FULLY VACCINATED I still know that there are some out there who choice not to and CANNOT get the vaccine. I am not going to throw caution to the wind just because I am fully vaccinated?

Yes she is naïve many people come in and out of a hospital room and who knows maybe they all might be vaccinated, but there is no guarantee her immune compromised husband is not at risk of getting it just because she doesn't want one nurse to take care of him.

If every single person in that hospital, including the patients, were vaccinated there would be next to 0 Covid infections.  If one doesn't get Covid, one can't spread it.  The husband in question from the OP most likely cannot mount antibodies despite having 2 doses of vaccine and should not be put in the position of being cared for by someone with no vaccination.  That would be a careless policy for any hospital to assume.  I can hear the lawyer now:)

Specializes in CRNA, Finally retired.
On 7/24/2021 at 8:19 AM, DesiDani said:

She can better his chances, but it is not going to eliminate his risk since according to her he highly susceptible?

Are you even a nurse?  I've always had the sense that you are not since you don't seem to be familiar with medical science.  Also the above was just a stupid comment since NO ONE is insinuating that the risk to the patient will be eliminated but you just ignore that and keep blathering on as if we are talking about someone who isn't sick.  OF COURSE he is highly susceptible.  He has CANCER.  If he's in the hospital I assume it is being treated which makes him HIGHLY SUSEPTIBLE.  And you say "according to her he is highly susceptible."  According to the laws of physics he IS highly susceptible and you insinuating that he really isn't just shows that you have no iota of medical training.  

Specializes in NICU, PICU, Transport, L&D, Hospice.
9 minutes ago, subee said:

Are you even a nurse?  I've always had the sense that you are not since you don't seem to be familiar with medical science.  Also the above was just a stupid comment since NO ONE is insinuating that the risk to the patient will be eliminated but you just ignore that and keep blathering on as if we are talking about someone who isn't sick.  OF COURSE he is highly susceptible.  He has CANCER.  If he's in the hospital I assume it is being treated which makes him HIGHLY SUSEPTIBLE.  And you say "according to her he is highly susceptible."  According to the laws of physics he IS highly susceptible and you insinuating that he really isn't just shows that you have no iota of medical training.  

You are likely going to be accused of bullying now.

Specializes in CRNA, Finally retired.
1 minute ago, toomuchbaloney said:

You are likely going to be accused of bullying now.

Maybe.  The power of capitalization is probably larger than a micro-aggression:)

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