Per policy, I am not allowed to give an opinion on whether to COVID vaccinate

[FolksBtrippin]

This is a new job. I’m a nurse manager for children’s group homes and we are told we can’t give an opinion on whether or not parents should consent to vaccinate their children. We can educate but not give an opinion. 

When I educate you, you’re probably going to infer my opinion.

Am I making a big deal out of nothing?

I think nurses should encourage vaccination.  I’m annoyed.

Please share your experience. 

[FolksBtrippin, BSN, RN]

31 minutes ago, jive turkey said:

I have an easy way for you to deal with situations like these.  I encounter them often even for things not related to COVID.

It's the doctors job to give advice. 

It's my job to educate and perform according to orders when legal, ethical, safe with consent within my scope of practice.

 I'll educate them about vaccines but tell them to speak to a provider to learn if it is appropriate for them. 

Vaccines are really a nursing responsibility though. Vaccines do not require an order. I actually don’t think it’s appropriate to defer to the doctor on this. 

[toomuchbaloney]

13 minutes ago, FolksBtrippin said:

Vaccines are really a nursing responsibility though. Vaccines do not require an order. I actually don’t think it’s appropriate to defer to the doctor on this. 

He's not the first member to post as if they don't understand the scope of nursing practice.  It's interesting that they are all sympathetic to covid vaccine refusal because of feelings about one thing or another. 

[jive turkey]

42 minutes ago, FolksBtrippin said:

Vaccines are really a nursing responsibility though. Vaccines do not require an order. I actually don’t think it’s appropriate to defer to the doctor on this. 

I want to make sure I understand you.  What do you mean when you say vaccines don't require an order? I don't give any drugs without an order.  Maybe it's different in your state?

For me, it's my responsibility to offer it if policy and/or orders say so, then administer it when it's ordered.  

[FolksBtrippin, BSN, RN]

9 minutes ago, jive turkey said:

I want to make sure I understand you.  What do you mean when you say vaccines don't require an order? I don't give any drugs without an order.  Maybe it's different in your state?

For me, it's my responsibility to offer it if policy and/or orders say so, then administer it when it's ordered.  

Vaccines do not require an order in any state. That’s why we can open vaccine clinics and give vaccines to hundreds of people a day with no doctor anywhere. 

[jive turkey]

8 minutes ago, FolksBtrippin said:

Vaccines do not require an order in any state. That’s why we can open vaccine clinics and give vaccines to hundreds of people a day with no doctor anywhere. 

Please cite a reference or source confirming that I can practice medicine when it comes to vaccines.  I'm receptive to learning what law allows me to administer a drug without an order/standing orders in this country, and start a vaccination clinic without the supervision of a provider.  

I do appreciate that.  

Despite the information, I personally will never give a drug, not even normal saline without a doctor's order.  If anything happens to them I risk being liable. 

[Horseshoe, BSN, RN]

1 hour ago, jive turkey said:

Please cite a reference or source confirming that I can practice medicine when it comes to vaccines.  I'm receptive to learning what law allows me to administer a drug without an order/standing orders in this country, and start a vaccination clinic without the supervision of a provider.  

I do appreciate that.  

Despite the information, I personally will never give a drug, not even normal saline without a doctor's order.  If anything happens to them I risk being liable. 

I'm interested to hear the answer to this-I would think there would be standing orders somewhere so nurses wouldn't need an order to administer a vaccine each time they do so. I could be wrong, though. But I can't say I've ever called a doctor to give saline. "Hi Doctor Jones, it's nurse Horseshoe. It's protocol to flush a patient's IV every shift, but I'm concerned about the integrity of Mr. Jones' IV, and I've already flushed it once this shift. Can I get an order to inject a few cc's of saline into my patient's IV now to check patency? Sorry to bother you at 3 am, but I can't give drugs without an order."

[jive turkey]

2 hours ago, Horseshoe said:

I'm interested to hear the answer to this-I would think there would be standing orders somewhere so nurses wouldn't need an order to administer a vaccine each time they do so. I could be wrong, though. But I can't say I've ever called a doctor to give saline. "Hi Doctor Jones, it's nurse Horseshoe. It's protocol to flush a patient's IV every shift, but I'm concerned about the integrity of Mr. Jones' IV, and I've already flushed it once this shift. Can I get an order to inject a few cc's of saline into my patient's IV now to check patency? Sorry to bother you at 3 am, but I can't give drugs without an order."

Exactly. A standing order means there are physician orders to administer a vaccine. 

If the patient is on the unit at 3am, they've already been admitted. That means the attending physician already ordered IV access which also includes orders to maintain it (flush), saline lock it when applicable, and its hospital protocol.  

Therefore, I would be giving saline at the direction of physician orders and hospital protocol.  I didn't say I would need an order for that.

 

I'd be interested to know, if you had a patient (not coding) you suspected needed IV fluids, but they weren't ordered, would you just go ahead and hang a bag of NS or would you get an order?  Your answer to this might clarify what I was saying.  

[Horseshoe, BSN, RN]

2 minutes ago, jive turkey said:

Exactly. A standing order means there are physician orders to administer a vaccine. 

If the patient is on the unit at 3am, they've already been admitted. That means the attending physician already ordered IV access which also includes orders to maintain it (flush), saline lock it when applicable, and its hospital protocol.  

Therefore, I would be giving saline at the direction of physician orders and hospital protocol.  I didn't say I would need an order for that.

 

I'd be interested to know, if you had a patient (not coding) you suspected needed IV fluids, but they weren't ordered, would you just go ahead and hang a bag of NS or would you get an order?  Your answer to this might clarify what I was saying.  

I would get an order. How do I know whether the doc would want NS or RL or what have you. 

In terms of vaccines, I truly don't know what the protocols are so I'm waiting to hear from someone who knows and is not speculating.

[jive turkey]

7 minutes ago, Horseshoe said:

I would get an order. How do I know whether the doc would want NS or RL or what have you. 

In terms of vaccines, I truly don't know what the protocols are so I'm waiting to hear from someone who knows and is not speculating.

EXACTLY.  You'd get orders because you don't know what solution the Dr. wants, or if they even want them on IV fluids.  So when I said I wouldn't even give saline without an order, I was talking more along those lines vs giving a flush (which coincidentally comes with orders anyway)

My point to the other poster was giving vaccines requires an order.  In my experience it's been in the form of a standing or transcribed order.  

[toomuchbaloney]

Quote

Eight states authorize RNs to administer under their own authority (8/48), whereas 43 require delegated authority (43/48).

State Law and Standing Orders for Immunization Services

Quote

Conclusions

Because immunizations are recognized as an effective method to prevent infectious disease, policymakers continue to identify opportunities to encourage uptake. Recent efforts focus on recognizing and reducing disparities among adults and underserved populations. SOPs may have the potential to:

save patient and physician time;

increase the capacity of NPHPs to deliver vaccinations;

promote vaccination in readily accessible community settings; and

support patients who have limited access to health care.26,12

A legal foundation that permits increased use of SOPs for immunization services, performed by a wide range of providers, administered to broad patient populations, in several settings, could contribute to optimal administration of recommended adult vaccines.

I've worked in environments where the RNs assessed health status, including vaccination recommendations, that the providers either ordered or didn't. The well child visits were largely nursing visits in terms of plan of care and assessment.  

[vintagegal, BSN, DNP, RN, NP]

“The evidence shows…” “According to latest guidance from the CDC…” “Many parents have concerns and questions regarding the vaccine, I want to stress this is a personal choice, however I want to share with you what the health care community and what the research has shown regarding the effective use of vaccines to prevent serious illness and death related to the novel coronavirus” 

[Alex Kowalcyk]

On 8/8/2021 at 3:52 PM, FolksBtrippin said:

This is a new job. I’m a nurse manager for children’s group homes and we are told we can’t give an opinion on whether or not parents should consent to vaccinate their children. We can educate but not give an opinion. 

When I educate you, you’re probably going to infer my opinion.

Am I making a big deal out of nothing?

I think nurses should encourage vaccination.  I’m annoyed.

Please share your experience. 

If fully informed consent for these "vaccines" were given, I don't believe anybody would choose to receive one.