Working in a rural community access hospital during the pandemic has been a struggle. Here as in many areas of the U.S., many in the surrounding community have not accepted the the existence of a virus like Covid-19. Against the backdrop of this widespread disbelief in the reality of the virus, the “government-mandated” vaccine was a final straw for many.
Many of these patients wholeheartedly believe that the vaccine is the “mark of the beast” mentioned in the Book of Revelation and that this is the beginning of the end of the world, with getting the vaccine understood as an expression of loyalty to Satan.
This belief is shared by various religious groups in other areas of our country. Many patients in our community also believe the vaccine is made with stem cells and fetal tissue and includes microchips. There are widely circulated rumors of tracking devices in the vaccine itself.
How do we as nurses and advanced practice registered nurses (APRNs) educate patients on the science of vaccinations in the face of the anger and passion we experience daily from a suspicious community?
The many other strains on nurses.
It hasn’t helped that nurses and APRNs alike have had to deal with more than they bargained for on many levels in relation to this pandemic.
As one of three full-time APRNs covering a small medical-surgical unit, my background is in ICU care. My nursing peers are not so lucky. Many of the staff are new to nursing, just graduating or only a few years on the medical-surgical floor prior to the pandemic. Many patients are not transferable to a higher level of care due to lack of beds, so they are left in our care. The acuity of the patients we see skyrocketed over the last two years.
When the pandemic began in March 2020, no visitors were allowed and many Covid patients died alone. Nurses were swamped under PPE gowns and masks, not to mention their own fear of contracting the virus while working long hours, extra shifts, and to the brink of exhaustion. The mass exodus of hospital staff across the U.S. tells how much suffering hospital staff have endured since the beginning of the pandemic.
Nurses educate patients on treatments and diseases, but how does anyone offer definitive information about an initially unknown (‘novel’) coronavirus to disbelievers? The continuous addition of new information as scientists and clinicians gathered data and experience and learned more about the Covid virus and its variants complicated our efforts to communicate clearly and consistently. As nurses, we are taught to use evidence-based practice, but what was our evidence in practice with a new virus that the world had never seen?
So, how do we cope in a community of disbelief and fear?
The best approach is to work hard to educate every person we can, whether patient or a family member, one at a time. We learned early on that a loving demeanor is the best way to communicate with unvaccinated/disbelieving individuals. If the patient or family asks our thoughts, we are happy to tenderly tell our stories of the virus and our experiences, without judgment.
We are lucky as nurses to have been voted by the public as one of the most trusted professions in the world year after year. Patients and families who ask questions hope we will give them an honest answer. The main priority is to not to let our anger or hurt get the best of us and say anything that could completely close off conversation regarding the virus and vaccination. Even using “in my experience, this is what I am seeing” statements can help keep the conversation calm and unbiased.
If we become exhausted or angry, we let someone know. We take a minute to go to a closed office, sit, cry, and give ourselves some grace to regroup. It is easy to despair when patients decide to not be ventilated or try other resources. We also do not let anyone die alone. Being there as their support and showing empathy brought many opportunities to show the community that we will provide the best care, regardless of their beliefs, from admission to discharge. We slowly continue to gain the trust of our community.
In the words the Florence Nightingale pledge, “With loyalty will I endeavor to aid the physician…, and devote myself to the welfare of those committed to my care.” Our nursing oath is a gentle reminder not only of the honor in service a nurse provides, but that we are dedicated to providing unbiased care for all in need at any time, pandemic or not.
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