Nadine got the vaccine in April. She usually wears a mask whenever she is in public. Every Friday, she goes out to dinner to one of her favorite restaurants. Nadine even attended several concerts this summer, removing her mask for lots of eating and drinking. She loved her August trip to California because of the relaxed mask mandate there. She can’t understand Erika.
Erika is about to be fired for not getting the vaccine. She doesn’t believe in it. But she does believe in keeping her own immune system in good shape so she takes supplements, eats well, exercises, wears a mask, and doesn’t attend public events. She stopped talking to Nadine because there were so many bad vibes.
If nurses are the most trusted profession, then which of these nurses does the public trust?
Just because Nadine got the vaccine doesn’t mean she isn’t carrying the variant to her family and patients. Unfortunately, while the vaccine is preventing deaths by decreasing the severity, it does not mean that you are immune from being a carrier. Each public exposure, from the airplane to the dinners and concerts, puts her at a higher risk for bringing the vaccine back to her patients and community. Furthermore, a recent study showed that the Delta variant combined with reduced mask wearing is decreasing the potency of the vaccine (NEJM).
Erika’s exposure is much less. She has a lower chance of carrying the Delta variant, but a higher chance of dying if she contracts COVID. A primary reason for the CDC insisting on Americans getting vaccinated now is the potential surge in hospitalizations (we missed the herd immunity boat). Nurses are exhausted, in short supply, and there is little relief in sight as physicians begin rationing care. Now the floor will be even more understaffed when Erika is fired for refusing the vaccine.
Both nurses feel that they are doing the right thing – and their battle is echoed in the rhetoric of millions of Americans. So who do Americans trust?
A closer look shows us that both nurses can produce peer-reviewed papers that support their decisions. If Erika wants to take a chance with her life, that is her choice. But her decision to not take the vaccine affects many others because there are simply not enough beds and staff to care for the unvaccinated whose chance of getting the virus is 11 times higher. If Nadine keeps socializing frequently and not always using a mask, then she is also impacting the greater society because her behavior is decreasing the efficacy of the vaccine for her entire community (NEJM).
The most trusted profession is divided, and this pattern is echoed in the public narrative where the tale of two nurses results in a polarized nation. Bad vibes have turned into angry protests as emotions rise. The tension between individual freedom and collective responsibility has never been so taut.
We wouldn’t be in this mess if a nurse had led the call to action. But that didn’t happen, so here’s what we can do:
Both nurses can exercise their own personal freedom while acknowledging their civic responsibility and change their behavior:
- Nadine would always wear a mask outdoors and decrease her social engagements, knowing people who get the vaccine have the same carrier risk
- Erika would assume the risk that the hospital cannot care for her by making backup plans now prior to getting emergency care if/when she becomes seriously ill
Do what you believe is right for you, then by your actions, support all of us.
Kathleen Bartholomew, RN, MN, is an internationally recognized patient safety and health culture expert. Kathleen has spoken on leadership, communication, patient safety, and peer relationships to hospital executives and nurse leaders for twenty years.
All of her books come from her passion to understand the stories of nurses. Her books, “Ending Nurse to Nurse Hostility” and “Speak Your Truth” illuminate our relationships with our peers and physician partners. She is also co-author of “The Dauntless Nurse” which was written as a communication confidence builder.
Kathleen is also a guest Op Ed writer to the Seattle Times and has been interviewed twice on NPR’s “People’s Pharmacy”. Her Tedx Talk calls for changing our belief system from a hierarchy to equality in order to keep our patients safe – and also explains how disaster thrust her into ‘the best profession ever’.