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.

Major health care professional organizations call for COVID-19 vaccine mandates for all health workers

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“Health care workers have an ethical duty to put patients’ health and well-being first, and getting vaccinated for COVID-19 is integral to that duty,” said Dr. Ezekiel Emanuel, vice provost for global initiatives at the University of Pennsylvania, who organized the statement. “Employer vaccine mandates are effective and lifesaving, and they are especially appropriate in health care and long-term care settings. No patient should have to worry that they could become infected by one of their care providers, and no provider should put their patient at risk.”

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“The COVID-19 vaccines are one of the best tools we have to end the pandemic. For the health and safety of patients, surgeons, and health care workers everywhere, we call for surgeons and health care workers to receive their vaccines and do their part in helping their patients get vaccinated,” said ACS Executive Director, David B. Hoyt, MD, FACS.

It's a good time to get vaccinated. 

Specializes in BSN, RN, CVRN-BC.
16 hours ago, Horseshoe said:

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

Vaccination status is not a disease.  

16 hours ago, toomuchbaloney said:

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. 

Vaccination status is not a disease.

10 minutes ago, Robmoo said:

Vaccination status is not a disease.  

Vaccination status is not a disease.

no, but it can be an increased risk for a patient. one that could be easily avoided.

Specializes in CRNA, Finally retired.

Vaccination is not a disease....  I don't know what this mantra means.  Can you lay this out in more detail for me?  How does this fit into the argument?

I'm not accusing.  I'm just asking because so much gets lost in translation online:)

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

Vaccination status is not a disease.  

Vaccination status is not a disease.

Are you indicating that you are unaware of the relationship between vaccination status and vaccine preventable disease? Do you need an explanation or do you want to look it up?

Specializes in Urgent Care, Oncology.

Back in early January I wound up in the ER for a bad flare of AS while 3 months pregnant, after being put on bedrest for 3 weeks due to a sub chorionic hematoma. For context, I'm a cancer survivor, have two autoimmune issues (AS & Sjogren's), have chronic HTN, and am overweight.  My pregnancy was also deemed high risk early on because of the SCH. I went to the ER because I literally could not walk or move, my back was so stiff from sitting on my butt for 3 weeks. 

I had quit my nursing job because of being on bedrest and COVID so I had not been vaccinated yet but wanted to be. The ER nurse came in and kept removing her mask to speak to me and complete tasks around me, like start my IV and administer meds. I made some comment about how it must have be nice to be vaccinated and she goes, "OH NO, I AM NOT VACCINATED and I WILL NOT BE GETTING VACCINATED. I would never put that in my body. My body can fight this naturally. COVID is not that bad." She goes on to talk about essential oils and yada yada yada. 

I'm sitting there flabbergasted, and her mask is still down. I wish I had said something to her about it at the time (hindsight is 20/20), but I just kept my mouth shut, wanting to get out of there. I fell into the high risk category and yet this RN felt she didn't need to wear a mask around me because to her COVID was nothing. 

So why am I telling you guys this? Because, as a nurse, it makes me question a nurses' competency to practice when he/she does not follow evidenced-based practice, which at this time says vaccination is best and mask-wearing is necessary in high transmission areas. I wonder then what else do they not believe it, and how else is it influencing their practice. I live in Florida where many people are not vaccinated. This was quite true at my last place of employment, in an Oncology practice. Nobody would get vaccinated except the docs and APPs. With highly immunocompromised elderly patients who are most susceptible to this disease. My co-workers were going out all the time without a mask. Or they'd take the mask off around people at work. The charge didn't believe in COVID since she got it but was asymptomatic so she didn't enforce the rules. Several of them got sick, and several patients got sick. 

So, when I give birth next week, I do plan on having a nurse that is vaccinated. I've already spoken to the nurse manager as I'm scheduled for an induction and it's been indicated it is not a problem. I don't want a nurse taking care of me that doesn't believe in basic science and cowtown to pseudoscience. Luckily, I'm giving birth at a large hospital within an academic setting, and while the vaccine is not currently required, 95% of the staff is already vaccinated.

 

Specializes in Anesthesia, ER, EMS.

Good. Feeedom of choice for all. You can refuse caregivers, we should be able to refuse patients and on it can go. 

On 7/27/2021 at 11:51 AM, toomuchbaloney said:

Are you indicating that you are unaware of the relationship between vaccination status and vaccine preventable disease? Do you need an explanation or do you want to look it up?

 

The sheep are the people who follow the advice of people who have no expertise in virology, epidemiology, or infectious disease. Yep, little lemmings happy to follow their ignorant and malevolent prophets off the cliff all the while buying their snake oils, supplements, and donating money to fund their extravagant lifestyles. Real critical thinkers, those people are. ?

Specializes in CVICU, Travel RN, Cath Lab, Clinic RN.

Back to the original question of how to respond to the patient's wife:  As healthcare professionals we have a responsibility to keep our patients safe. In a pandemic with vaccines available that can help protect not just the vaccinated person but also those in close contact, I would argue that a patient does have the right to know vaccination status of all staff who enter the room. The wife is advocating for her husband's safety. An unvaccinated individual is statistically a bigger threat to his health. 

Specializes in MedSurg, phone triage.

Personal opinion:

I think a patient should always be able to request a new caregiver no matter what their reasons are, or whether we agree with their reasons. If they are uncomfortable with a situation and it is within our ability to adjust to accommodate them- why not?

Specializes in Psych.

You are very right. As a nurse I was first in line to get the vaccine and felt it was part of my duty to protect patients.

On 7/27/2021 at 7:54 AM, Robmoo said:

Vaccination status is not a disease.  

Vaccination status may not be a disease, but antibody titers to certain diseases are no laughing matter for nursing (at least in my state, others may differ). 

I do not think it is illogical for families to want vaccinated caregivers for their loved ones -- or for those vaccinated caregivers to still practice masking and for the hospital to supply enough PPE for those caregivers to change them between patients. Some things are beyond our control (supplies, if an admitted pt flips to positive COVID status). Others are not (wearing the supplies we're given and changing them as often as we can -- and yes, vaccinations).

I do not see it as a "false sense of security" to want to reduce a risk that could be reduced -- even if that risk cannot be eliminated.  Patients and their families both already feel loss of control when sick, especially when sick enough to be in the hospital.

It might make up for the additional loss of control that limited visitation during this pandemic has caused to at least respond with an equivocation like "Well, I likely won't be your mom/dad/husband/wife's nurse for their entire stay, plus if I'm busy someone else might have to cover for me.  How about I go ahead make sure the charge nurse understands their situation and that you request *all* their caregivers be vaccinated?"

Then pass on the request like I would any other.

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