COVID-19, nursing ethics, and the core tenets of public health nursing – New Hampshire Bulletin

During this legislative session lawmakers introduced numerous vaccine bills, with only a few granting more authority to mitigate COVID-19’s transmission. The remaining bills, under the guise of bodily autonomy and personal freedom, oppose mandates and are also anti-science. The American Nurses Association Code of Ethics for Nurses emphasizes primary prevention to achieve “the greatest good for the greatest number of people or the entire population.” In the context of COVID-19, this pandemic is not about “me” but about “all of us.”   

Unfortunately, during this COVID-19 pandemic nurses have been faced with challenges to their ethical obligations resulting in considerable moral distress. Moral distress occurs when one knows the ethically correct action to take but feels powerless to take that action. The COVID-19 pandemic has nurtured hostility toward health care professionals and their desire and obligation to provide science-based care, leaving many of these essential workers questioning their commitment to the profession. One New Hampshire Intensive Care Unit nurse was recently quoted as saying: “Historically, one of the most trusted professions. To feel like we’ve lost the trust of the public is very disheartening for our staff.” 

For the 20th year in a row a Gallup poll ranks nursing as the most trusted and ethical profession. Despite this, many nurses are experiencing burnout; the product of long hours, short staffing, and a public that has been reluctant to heed their calls for measures to curb or slow the spread of the coronavirus. The root of moral distress impacting nurses is related to the dissemination of misinformation generated by those opposing mandates and those generating testimony in favor of broadening vaccine exemptions, neither of which is supported by best evidence. The questioning of the knowledge and the expertise of direct care nurses, gained by being on the front lines during this extended pandemic, poses a threat to our professional practice.   

The dissemination of misinformation “jeopardizes the health and well-being of the public.” The New Hampshire Nurses Association would like the public to know that nurses, members of this most trusted profession, empowered by our code of ethics will continue to:

  • Be prepared to practice from an evidence base; 
  • Promote safe, quality patient care; 
  • Use clinical/critical reasoning to address simple to complex situations; and
  • Assume accountability for one’s own and delegated nursing care.

During these difficult times, ethical nurses must and will take action. Despite threats to our professional practice and the challenges faced by misinformation, nurses continue to have the public’s trust.  We encourage the citizens of New Hampshire to discriminate between misinformation and rhetoric by continuing to educate themselves and to trust those experts who have firsthand knowledge and expertise by virtue of their vast experience.

The New Hampshire Nurses Association continues to advocate for the most powerful mitigation tools available to protect the public’s health, including masks, vaccines, social distancing, and universal infection protection measures. We support legislation that would standardize and strengthen those protections that are science-based and will provide for the enduring health of the population.

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By Betty C. Giordano

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