Unless pressure on healthcare facilities and workers eases, 'our health system is in peril,' AACN president warns.
The American Association of Critical-Care Nurses (AACN) has launched Hear Us Out, a nationwide effort to show the COVID-19 pandemic from frontline nurses' perspective and urge those who have yet to be vaccinated to reconsider.
Nurses and healthcare systems are being pushed to the breaking point as the Delta variant fills hospitals with younger and sicker patients.
"We don't want to scare the public, yet we are obligated to paint an accurate picture of life and death with COVID-19 in an ICU," says Beth Wathen, president of AACN, which supports mandatory vaccines for healthcare workers.
"COVID kills, and the death is a difficult, tragic, and lonely one," she says. "By engaging in an honest dialogue, we hope to help Americans understand the consequences of what is now a preventable disease."
The sustained and extreme demands of caring for hospitalized, largely unvaccinated, patients are taking their toll. A recent AACN survey of more than 6,000 acute and critical care nurses revealed:
- 92% of nurses surveyed said they believe the pandemic has depleted nurses at their hospitals and, as a result, their careers will be shorter than they intended
- 66% feel their experiences during the pandemic have caused them to consider leaving nursing
- 76% say that people who have yet to be vaccinated threaten nurses' physical and mental well-being
But unvaccinated adults have concerns about the COVID-19 vaccines and share many of the same reasons for rejecting the shot, according to a Kaiser Family Foundation survey.
Newness of COVID-19 vaccines (53%) and worries about side effects (53%) are the main reasons, says the KFF survey. Other major reasons include simply not wanting to get the vaccine (43%), thinking they do not need the vaccine (38%), not trusting the government (38%), not believing COVID-19 vaccines are safe (37%), and not trusting vaccines in general (26%).
HealthLeaders spoke with Wathen about the AACN's efforts to change the minds of nearly 23% of Americans who have not received at least one dose of the COVID-19 vaccine.
This transcript has been edited for clarity and brevity.
HealthLeaders: What does the AACN hope to accomplish with this new campaign?
Beth Wathen: We're worried about our nursing workforce. We're worried about the stability of our healthcare system if nurses and others continue to leave. And we're worried that many more lives will be lost if we don't do everything we can.
As the leading professional voice of acute and critical care nurses, AACN has been advocating for the wellbeing of frontline nurses since the start of the pandemic, partnering with policymakers and other professional organizations, but honestly, as we saw Delta surging and ICU volumes skyrocketing, we realized the situation called for a different approach—a public-facing effort above and beyond how we might normally respond.
HL: How cognizant do you really think the public is about the toll the pandemic is taking on nurses and healthcare workers?
Wathen: I don't think they understand the depth of the toll and burden on frontline healthcare workers, and that's part of our message. Our health system is in peril. Nurses are leaving in record numbers and if the health system falters because we don't have enough nurses to care for patients, lives will continue to be lost long after this pandemic and that's a message we really want the public to understand.
This is more than just COVID. We already are hearing stories about health systems that are already at their brink, that can no longer provide care to patients with heart attacks or cancer or any other reason that you might need care.
HL: What are some of the tools in the Hear Us Out toolkit?
Wathen: The toolkit will contain materials that will help to empower and educate vaccinated members of our community on how to have constructive, nonjudgmental conversations with those in their circle—their family and friends who are not yet vaccinated.
It's about building trust, and [asking,] how do we have those conversations? We have to listen; we have to be nonjudgmental; we have to make it safe, build trust, and stay the course. Recent research showed that those who have yet to be vaccinated sometimes fear social death more than physical death itself, so that means we need a different approach to how to have these conversations and … try to understand where their concerns and hesitancies lie.
The toolkit will also include information on the rigorous testing and evaluation of the vaccine because we know that's been a source of questions for people. Finally, it will include nurse stories. It's important that our broader community truly understands what it's like to have COVID, to be in the ICU, to see people dying—young, previously healthy people—from COVID. Our intent is to paint of picture of what that reality is like and partner with our community to help us to change minds and save lives.
HL: Regarding the vaccine, lines have been drawn in the sand between employers and employees, between friends, and among family members. What are some techniques that Hear Us Out offers that can begin to erase some of those lines?
Wathen: First and foremost, the campaign is completely apolitical and aims to talk about what it's like to live and die from COVID from everyday people on the front lines. There may be people out there that will never change their mind but there's a lot of people out there that still have some questions and we can turn that tide through open honest dialogues, through answering questions, through not judging, and not making assumptions about people.
This is beyond just COVID; this is our ability to provide care. We already know what's happening in certain parts of the country, where people are having to be flown out of state hundreds of miles away just to get care for other illnesses. It's absolutely [imperative] for the general public to understand what's at stake here.
HL: An American Nurses Association survey indicates about 90% of nurses have been vaccinated, leaving 10% who have not. They have witnessed the deaths and the trauma of COVID-19. How can Hear Us Out change their minds?
Wathen: Like the general public, healthcare providers can also benefit from this campaign by seeing different points of view and seeing firsthand how hospitalizations of unvaccinated Americans are impacting their peers. Nurses or other healthcare providers can absolutely have questions or concerns around the vaccine [and] if I have a colleague who has not had a vaccine, I'm going to sit down and try to understand where the concerns lie and how I can help clarify, answer questions, listen, [and] have that dialog to see what's holding them back.
[I would ask them to] think about your circle. Think about who you'd like to protect by helping to bring an end to this pandemic. I want to get to the day when I can hold my brand-new grandbaby inside without a mask or visit my mom who is 94 years old without worrying I'm putting her at risk.
Think about how we can protect those people in our individual circles, because this is not just about individuals anymore. This is about understanding that our individual actions impact others and so this is our call to action. This is our request to partner with the public, to partner with our healthcare colleagues to do our part to help bring an end to this pandemic.
“If the health system falters because we don't have enough nurses to care for patients, lives will continue to be lost long after this pandemic and that's a message we really want the public to understand.”
Beth Wathen, president, American Association of Critical-Care Nurses
Carol Davis is the Nursing Editor at HealthLeaders, an HCPro brand.
The sustained and extreme demands of caring for hospitalized, largely unvaccinated, patients are taking a toll on healthcare systems and providers.
AANC's new campaign is designed to encourage the unvaccinated to get vaccinated.
Hear Us Out is apolitical and focuses on what it's like to die from COVID.