Medical equality, equity, and disparity were the focus of this year’s Reuters Events Total Health USA, a well-known national medical conference I had the honor to attend.

Health care leaders came together to share insight and solutions to some of America’s broken health care systems. As an oncology nurse for more than 2 decades, I especially appreciated the concern about increased mortality rates among African Americans with multiple myeloma (MM).

Marc Harrison, MD, president & CEO of Intermountain Health Care, and Kathy Giusti, Founder & Chief Mission Officer of the Multiple Myeloma Research Foundation (MMRF), delivered an authentic presentation uncovering the negligence of this gap in care. Since both these powerhouse CEOs are MM survivors, the conversation became quite passionate. At one point, Giusti grinned at the moderator and said, “This is the joy when you have two patients doing a fireside chat who live with a death sentence.” Here, I will share the hope for improved health equity as seen through the eyes of these top executives.

Although both words sound similar, they are relatively different. Health care equality simply means that the opportunity for proper treatment exists, whereas health care equity involves tailormade plans designed specifically for an individual’s unique needs. Unfortunately, many believe that if there is equal opportunity for those diagnosed with cancer, there is also equity. Sadly, this is not the case. Dr. Harrison noted that it was difficult as an affluent, White male and CEO of a major health care system to get the care he needed when fighting MM. He acknowledged that accessing care is even harder for both people of color and financially disadvantaged individuals. Therefore, although a healthcare organization may offer lifesaving MM treatments, the capability (financial, social, economic) to implement those treatments is anything but “equal.”

Uncovering Why More African Americans Die From Myeloma Than Caucasians

Giusti described a pivotal moment in MM research with the launching of the CoMMpass Study (NCT01454297) over a decade ago.

 The significance of the study came from the large number of African American involvement. According to Giusti, the goal for any clinical trial is to have at least 20% Black participation to represent this population accurately. The CoMMpass trial had an unprecedented 17% African American participation rate.

However, this led to startling data revealing that Black patients with MM had a lower genomic risk profile than White patients—yet were dying at twice the rate. After much investigation, Giusti described, “Their access to triple and quadruple therapy or even a stem cell transplant was much lower, and as a result, it was the access to the most cutting-edge therapies that was the problem.” In fact, if Black patients received equal and equitable MM treatment, their outcomes would be as good or better as other ethnicities.

How to Improve Health Disparities in the African American Population

Firstly, Giusti believes that “the best equity officers are often CEOs who are truly passionate about the topic—and set a clear message to the company that health equity is a priority.” Secondly, she speaks about how crucial retrieving health data is. How can we understand MM and other diseases if the patients with these conditions are not in easily accessible databases?

She points out that if Black people with MM are not in registries, they will not have the opportunity to be located and guided to progressive clinical trials that improve survival. Harrison recognizes that Black patients with lower incomes are not seen in big, fancy academic centers. Instead, he suggests these companies are “taking care of as few poor people as possible,” leaving community-level health systems to care for the underprivileged. Both speakers fervently agreed that health care systems need to reveal where these patients are. It’s imperative that clinical research organizations (CROs), pharmaceutical companies, and NCORP share where these folks reside and are being treated.

Thirdly, once high-risk patient populations are identified, an infrastructure needs to be created to help alleviate the burden of getting patients into registries and clinical trials. Asking staff that is already overworked to review records and get these folks onboarded is burdensome. Giusti suggested creating a foundation at the community level armed with “coordinators, community liaisons, and navigators is crucial to successfully obtaining and distributing data.” Lastly, she believes patient education is critical. When equipped with the correct knowledge, patients are empowered to make well-informed health decisions.

During the fireside chat, Giusti’s laid-back presentation was nicely complimented by Harrison’s bulldog approach. Her professional activism, along with his demands for improvement, inspired many viewers to be change agents. In fact, after reminding the audience that one-third of Americans are rationing medications because they can’t afford them, Harrison directly addressed the pharmaceutical companies.

He challenged them to evaluate their overly priced products, stating, “It’s unfair for Americans to bear the disproportionate burden for the cost of these products when the rest of the world benefits. We have poor Americans achieving poor health outcomes because of how much healthcare costs, and that’s a tragedy in the richest country in the world, and it has to change.” In addition, Giusti believes that creating private/public partnerships between profit and nonprofit organizations could be essential to decreasing health disparities.

Oncology nurses are often the main point of contact for newly diagnosed cancer patients. We have the opportunity to ensure that each person starts their journey with equality and equity on their side. Since the first step in resolving medical disparities is acknowledging them, we must stay informed about how our patients are affected by these inadequacies. From there, we remain committed to reform by creating custom-made resources and providing innovative education to staff and patients. As Harrison proclaimed, “Poor patient outcomes based on someone’s demographics is intolerable.”

Harrison M, Giusti K. Fireside chat: Spotlight on improving equity and inclusion. Presented at: Total Health Reuters Events; September 2022; Chicago, IL.

The MMRF CoMMpass Study. Multiple Myeloma Research Foundation. Accessed December 17, 2021. https://bit.ly/3sgk2ey

Articles

Oncology nurses are often the main point of contact for newly diagnosed patients with cancer. We have the opportunity to ensure that each person starts their journey with equality and equity on their side. 

Top Executives Vow to Improve Health Disparities among Patients with Multiple Myeloma

For most institutions, the final date for being fully vaccinated for COVID-19 has passed or is quickly approaching—leaving some nurses feeling more pressure than ever.

Many had hopes of calling the bluff of their health care organization, but now are scrambling for a new career move. Although resistance to vaccinations has been around for 2 centuries, it has never been more politicized or debated following the COVID-19 pandemic. From freedom rallies to No. 1 hit songs, COVID-19 represents more than just widespread illness­—it is a socioeconomic torrent.

As nurses around the country weigh their professional options, some wonder if the answer resides in telling a white lie. But every choice has a consequence. What are the ramifications of lying on a religious exemption form?

These nurses are single moms and dads, breadwinners, 401K earners, and insurance providers. They need to work. A large number have survived the virus after caring for those who did not.

Feeling used and abused by hospitals and politicians, the temptation to fabricate a religious exemption is tempting. What's the big deal if there are suddenly more Dutch Reformed Congregationalists who don't believe in taking vaccinations?

 For starters, nurses are 1 of the most trusted professions in our country. And although we do not officially take the Hippocratic Oath, we abide by nonmaleficence (do no harm) and beneficence (do good) . Being deceptive may damage both of those principles.

Nurses have an innate desire to advocate for the ethical treatment of their patients, yet the foundation of continued employment could be established on deception. Having to choose a job over one’s honor is a cruel circumstance without a clear answer.

Due to burnout and stress, nurses have been leaving in droves even before the vaccine mandate. The thought of abandoning an already understaffed unit has many in our profession feeling guilty.

The hospital is often our home away from home—making the decision to conform or rebel more difficult. Many friendships are formed during each shift's long hours, and leaving behind these unique relationships is disheartening. However, there have been several reports of health care organizations approving nearly all religious exemption requests, and thereby staying tolerably staffed. This may be an appealing option for not only nurses, but hospital executives as well.

What about natural immunity? Do those nurses get a pass? The lack of conclusive data regarding the efficacy of antibodies produced by organic inoculation vs immunization has many nurses questioning the need for further viral protection.

Evidence-based practice is the backbone of the nursing profession, just ask our research instructors! Being told to forgo this fundamental learning objective is a hard pill to swallow (literally). Since medical experts can't even agree on the science of this subject, the nursing community is left feeling confused and leery. A bill was recently introduced to the House of Representatives called the "

," asking that natural immunity be considered when creating federal regulations. But as local politicians butt heads with the current administration, the bill will likely result in a long dragged-out ordeal. In the meantime, religious accommodation requests are at an all-time high.

To make matters even more complicated, we must consider the imperfections of the vaccine. Breakthrough cases of COVID-19 after full vaccination are being reported by local health departments daily. Unfortunately, many organizations are only subjecting non-vaccinated nurses to testing—leaving the potential for the vaccinated to spread the virus unknowingly. Many nurses fear that not only is this dangerous for patients, but this method will make anti-vaxxers appear solely responsible for being the disease spreaders. Perhaps the safest way to keep the virus out of the hospital is by testing every employee—leaving little room for error.

Either way, if COVID-19 can be contracted and spread whether vaccinated or not, what merit is there in removing great nurses from the workforce?

The predicament of fudging a religious exemption form goes deeper than just being dishonest. For many, it is their livelihood and freedom. So rather than incentivizing nurses to lie on exemption forms, perhaps we can provide COVID-19 testing for every health care worker to keep our patients surviving and our nurses thriving.

Vanderbilt Faculty & Staff Health and Wellness. Immunizations and religion. Accessed November 12, 2021. Available from: 

https://www.vumc.org/health-wellness/news-resource-articles/immunizations-and-religion

As nurses around the country weigh their professional options, some wonder if the answer resides in telling a white lie. But every choice has a consequence. What are the ramifications of lying on a religious exemption form?










Ramifications of Lying on a Religious Exemption Form for COVID-19 Vaccinations

Increasing burnout rates, vaccination mandates, and overall health care stress have some oncology nurses looking for a change. Switching from hospital to hospital doesn’t usually improve symptoms of being overworked, and going back to school can be expensive and time-consuming. However, becoming a nurse entrepreneur can be a surprisingly easy and sometimes affordable option that most nurses never consider.

Nothing beats working autonomously while providing excellent patient care on your terms! As a business owner, I know firsthand that getting started can be fun if you have the right tools. So, here are 3 easy and inexpensive ways you can become a nurse entrepreneur, too.

Before diving into the details, you may be wondering what type of businesses registered nurses (RNs) or nurse practitioners (NPs) can own. Here are a few new and exciting ideas:

IV hydration clinics (RNs and NPs): This quickly expanding market offers IV replenishment for post-op recovery support, as well as for immunity boosters and performance formulas.

Concierge nursing (RNs and NPs): This business allows RNs to deliver elite care in the home-based care of the patient’s individual needs and requests.

Integrative health (RNs and NPs): Integrative health services practice holistic care through activities like mindfulness, acupuncture, and herbal remedies.

Chronic care management (RNs and NPs): The 2015 change in chronic care management for Medicare patients makes this an attractive practice for many nurses.

Health writing (RNs and NPs): As the need for credible online content increases, so do 

Health and wellness coaching (RNs and NPs): Working directly with patients endorsing health, providing general support, and helping develop empowerment.

Med spa (RNs and NPs): Providing non-surgical procedures to improve skin and body health.

Retail medical clinics (NPs). Found in grocery stores, pharmacies, and retail stores, NPs provide acute care keeping people out of emergency departments.

Keep in mind that the state you live in plays a significant role in your scope of practice. Sometimes, physician oversight is required–but don’t let that scare you away. Many physicians love helping nurse-led health care practices, especially if they can earn a few bucks as well. In addition, some agencies provide medical directors for nurse-owned businesses at an affordable price.

Here are ways you can get started on the rewarding path to entrepreneurialism.

You would be amazed by all the free resources found on the internet. I stumbled across health writing after viewing a Facebook ad. After much investigating (reading reviews and social media following), I found a trustworthy company and got to work. Reading newsletters, blogs, and watching Youtube videos are easy ways to acquire more knowledge on a potential business idea. Subscribing to free masterclasses and online courses provides a wealth of helpful information as well. Once you’re fully committed to pursuing your new career, affordable memberships offer step-by-step guidelines to being a successful business owner. Up to that point, however, you don’t have to spend a dime. You will also need to contact your local government to discuss the rules and regulations of business ownership in your county/state.

Reaching out to other nurse entrepreneurs for support is crucial for business startups. Finding a safe community to share successes and bounce ideas off of one another decreases anxiety and provides motivation. Networking with like-minded nurse entrepreneurs is accessible with platforms such as LinkedIn. I suggest creating a profile and searching for people within your workspace. Learning tricks of the trade from those further along the entrepreneurial journey provides valuable advice and learning opportunities. These connections may be free of charge but worth more than money can provide!

The road to becoming a nurse entrepreneur can be lonely and often tests your confidence. Success can be slow to come, leaving you wondering if you chose the right path. Mistakes and bumps in the road can lead to self-doubt and feelings of inadequacy. Despite it all, however, you must be persistent and persevere. It’s ok to take a break and re-group, but you must keep moving forward. Samuel Johnson said, “Great works are performed not by strength, but by perseverance.” Although I am a novice business owner, I am proof that grit pays off–check out the byline for this article!

We became nurses to heal, soothe, and support the sick. But, who says nursing can only be done in a hospital? The landscape of health care is changing quickly, leading to opportunities for nurses to run their own businesses. Nurses can provide the autonomy and knowledge required to deliver outstanding patient care in unique and creative ways. You could be 3 easy and inexpensive steps away from your dream job. Go for it!

Becoming a nurse entrepreneur can be a surprisingly easy and sometimes affordable option that most nurses never consider.

Three Easy and Inexpensive Steps to Becoming a Nurse Entrepreneur

It’s interesting how oncology nurses can have two patients with the same diagnosis, prognosis, and treatment, but with entirely different outcomes. Although each patient may be cured, why will one easily tolerate cancer treatment while the other struggles every step of the way?

Mindset is often an overlooked aspect of the experience, but it is perhaps the most essential quality. Integrative remedies such as massage, aromatherapy, and acupuncture have become commonplace treatments at most cancer centers nationwide. However, there are some other unique methods oncology nurses that can use to help patients ‘

’ their way to well-being during cancer treatment.

I recently realized that for the past 12 years, I may have been teaching visual imagery wrong. Having patients imagine their tumors shrinking while chemotherapy attacks cancer cells could be doing more harm than good, and here’s why. If we consider the belief that positive thoughts bring positive results while negative thoughts bring negative results, asking patients to visualize cancer in their bodies could be a disadvantage.

Overlooking one’s disease may sound counterintuitive, but having patients focus on the healthy aspects of their bodies could be a far better approach. So, rather than encouraging patients to acknowledge their sickness, it’s more valuable to have them recognize their wellness. Replacing words like ‘kill’, ‘attack,’ ‘fight,’ or ‘win’ with terms like ‘healthy,’ ‘strong,’ ‘healing,’ and ‘clarity’ fosters an environment of grace and empowerment. There are also visual meditation techniques that may lead to enhanced immune responses and an improved positive mindset. Honoring each cell’s innate ability to heal through optimistic imagination is an effective way for patients to 

themselves as the healthy beings they are.

Another approach to helping patients stay focused on well-being is to encourage the ‘practice of appreciation’ through daily journaling. Studies show that giving thanks

 leads to more happiness and pleasure. Why appreciation and not gratitude? Often, gratitude evokes feelings of scarcity or lack because being grateful can mean there was a struggle to overcome.In comparison, having appreciation comes from a neutral place of pure love and acceptance. Gratitude conjures feelings of effort and work while appreciation represents ease and contentment. It is important for the patient to focus on comfort rather than hardship.

Because it can be challenging to maintain appreciation during the cancer journey, starting small is helpful. For example, being thankful for a soft pillow, a comfortable couch, a great view from the bedroom, or the warmth of a pet are simple ways to express appreciation. Encourage patients to keep cancer out of this journal! Only give attention to things that feel good and bring joy. If a patient wakes up without nausea, have them write about how good a particular food may taste or smell. If they have the energy to walk around the block, encourage them to journal about how lovely the sun felt or how uplifting the fresh air was.

The physical act of writing keeps people in a place of thankfulness longer because more time is spent concentrating on words, grammar, and spelling. In addition, when feeling blue, reading previous entries can be uplifting. It takes practice, but these small visual shifts can improve resilience and attract more health and wellness.

It may sound absurd to promote a ‘giving’ attitude when patients are spending much of their time healing. However, acts of kindness

 are known to release hormones that improve mood and happiness. For example, dopamine, serotonin, and oxytocin are known as ‘feel good’ chemicals that lower blood pressure, reduce pain, and produce a sense of euphoria. Since these chemical reactions only last for several minutes, repeating acts of kindness throughout the day is a great way to maintain gratification.

I’m not suggesting that patients with cancer volunteer hours of their time or run marathons to raise money, but I am suggesting that they consider sending flowers to a friend or mailing love letters to those they adore. These little acts can help provide relief from negative thoughts or worry. Not only is there a “helpers-high” by offering acts of kindness, but there is also delight in watching someone receive an unexpected gift of love.

Oncology nurses are more than managers of disease. They are also promoters of health. Although we ensure that our patients are equipped with the tools they need to survive cancer, we also need to inspire them to thrive with cancer. In the words of Sadhuguru, “Health is not just being disease-free. Health is when every cell in your body is bouncing with joy.” By teaching our patients how to ‘see’ their way to well-being, we get to watch courage and hope turn into joy.

Harvard Health Publishing. Giving thanks can make you happier. August 14, 2021. Accessed October 21, 2021. 

https://www.health.harvard.edu/healthbeat/giving-thanks-can-make-you-happier

Cedars Sinai. The Science of Kindness. February 13, 2019. Accessed October 21, 2021. 

https://www.cedars-sinai.org/blog/science-of-kindness.html

Rather than encouraging patients to acknowledge their sickness, it’s more valuable to have them recognize their wellness.

Unique Methods Help Patients ‘See’ Their Way to Well-Being During Cancer Treatment

She walked into the room radiating with excitement and nervousness. I stood next to her wearing my lab coat with a fancy name badge pinned to the collar, also eager for the day. I watched as the night nurses, donned in blue scrubs, prepared to give report to the next shift. I also noticed that not a single greeting was offered our way; there was an evident aversion towards us. It was as if our existence would be confirmed should eye contact be made, our invisibility cloak removed with a simple hello.

As I observed the awkward avoidance, I could feel my blood pressure begin to rise. “How long will they pretend we aren’t here?” I wondered. Several minutes after report was given, the shunning was finally shattered with the following greeting - “We aren’t that busy, so I’m not sure what to do with you; go sit over there until we figure it out.” My cheeks flushed with anger and I felt like a mama bear ready to protect her young. I turned and looked at my student. She was dressed in perfectly ironed white scrubs, notebook in hand, and still smiling. Aware of my indignation, she whispered, “It’s ok, this happens to us all the time; I’ll be alright.” Then she obediently walked to her appointed seat where she would remain–out of sight –until invited to participate.

I recently retired from a local hospital after 25 years of employment and decided to take the next natural step and become a clinical nursing instructor. When I worked in the hospital, nurses were known to “eat their young,” meaning nursing students or new nurses were treated with hostility. Full-blown snubbing seems to have been added to that ageless practice. In a recent rotation, I was even pulled into an empty room by a nurse who wanted to gossip about ‘how terrible nursing students are these days.’ My students gave me an equally negative appraisal of that nurse.

Perhaps I’ve become naïve to the hospital culture, coming from a lovely outpatient oncology clinic, or maybe nurses are just that tired and burned out. Don’t get me wrong; I would be lying if I didn’t admit that one perk to working in the summers is having a break from students, but I could never deliberately ignore a human being’s existence. Sadly, in my short time as an instructor, I’ve been both embarrassed and discouraged by my peers and colleagues. What has happened to America’s sweethearts?

Unfortunately, the pandemic resulted in many nursing students being banned from clinical sites. Beyond a few outpatient clinics, many have had to rely on simulation and virtual simulation to meet their required clinical hours. These future healthcare heroes need comprehensive hands-on clinical instruction more than ever! Giving them grace while they navigate caring for real-life patients is essential to their professional growth. One study suggests that positive clinical engagement fosters the desire for “deep learning.”

 Although more research is needed to better understand how clinical engagement can be enhanced, we can certainly agree that giving nursing students the cold shoulder does not make for an informative or constructive educational experience.

I love a great underdog story, and nursing students are today’s come-back kids! In post-clinical a few weeks ago, my students shared stories of needing to chase nurses around who barely spoke to them or being plopped in front of computers down the hall from where their preceptors mingled. One student pointedly asked, “Shouldn’t they want us to graduate and come back here to work? They are so understaffed it seems like they need us.” I couldn’t have said it better myself.

According to a survey analysis published in 

 in 2018, approximately 31.5% of nurses who leave their jobs do so due to burnout.

 But help is on the way, and just because they are in white scrubs today doesn’t mean they won’t be carrying your life preserver tomorrow! Teaching nursing students everything you know now will preparethem to keep the ship from sinking once they graduate.

Jenny Han said, “Victory is a thousand times sweeter when you’re the underdog,” so to every nursing student – hang in there, victory will soon be yours!

Alas, the beast exists, but its yang is always nearby, found in most nurse preceptors' bright eyes and warm smiles. I saved the beauties for last because they are worth remembering.

To all the nurse preceptors who take the time to engage with the students: You are the best kind of memory. Your name comes up often in class because students hope you will be their mentor for the day. They say things like “s/he is the type of nurse I want to be.” You renew their passion for our profession.

They know you are tired, yet have the patience to teach, because you recognize they 

the future. They know you are busy, yet educate on-the-go, because you understand they will be your co-workers. They know you have personal stress, yet share your tricks of the trade, because you realize they will be caring for your family one day. They know, and they are thankful.

Nursing students are mere buds of the nurses they will become. Nurse preceptors can be the drought that stunts their growth, or they can be the warmth that encourages them to bloom. It takes a village to raise outstanding nurses, so next time you are given the opportunity to shun or shine, we hope you choose to bask with the beauties.

Ghasemi MR, Moonaghi HK, Heydari A. Strategies for sustaining and enhancing nursing students' engagement in academic and clinical settings: a narrative review. 

. 2020;32(2):103-117. doi:10.3946/kjme.2020.159

Shah MK, Gandrakota N, Cimiotti JP, Ghose N, Moore M, Ali MK. Prevalence of and Factors Associated With Nurse Burnout in the US. 

 2021;4(2):e2036469. doi:10.1001/jamanetworkopen.2020.36469

Nursing students sometimes face surprising hostility from nurse preceptors, explains contributor, Serenity Mirabito. However, the best nurse preceptors operate as agents for good by training and fostering the enthusiasm of young nursing students.

Beauty and the Beast: The Two Faces of Nurse Preceptors

Last week, a patient asked me to be removed from their care team for not disclosing my COVID-19 vaccination status and shocked does not begin to accurately describe my reaction. As an expert oncology nurse with more than 2 decades of service under my belt (or scrubs), I have never had a patient ask me about my medical history. I was so taken aback that I found myself stumbling over my words. After finally spitting out an awful, unrehearsed retort about policies and personal rights, she informed me that she was not comfortable under my care. I gasped in disbelief. “I am a great nurse, and my patients love me!”, I wanted to reply, but I simply apologized and honored her wishes. Then, I began to ponder the need for professional privacy.

Despite where someone stands on the COVID-19 vaccine debate, it is hard to deny that it is awkward when a patient asks, "are you vaccinated?". Of course, as vaccine mandates nip at the heels of every healthcare provider, answering "yes" to this seemingly intrusive question may be the only acceptable answer. In the meantime, however, it is crucial for nurses to keep their medical choices private and to politely tell patients to mind their own business.

Although I understand their reasoning, I cringe every time I hear a nurse use HIPAA to protest being asked about their vaccination record. It is not a HIPAA violation for patients to ask their healthcare provider if they have been vaccinated against COVID-19.

This federal law protects privacy by defining 

 health information is protected, but it does not restrict patients from asking their nurse (doctor, medical assistant, phlebotomist, etc.) about their medical history.

However, health care providers are not required to answer any questions about our health choices, nor should we. It's that simple.

Not so straightforward, admittedly, is whether organizations can legally adorn their employees with badges and stickers that exploit their vaccination choice. The answer should be a solid no, but it's more like "no-ish". According to the Equal Employment Opportunity Commission (EEOC), vaccination status is considered confidential.

 So, although being forced to bear the scarlet letters “vaccinated” or “unvaccinated” on your scrub top is unlawful, we may be required to have an indiscreet sticker placed on our badge or wear a wristband that affirms our compliance with hospital policy.Why do we need visible evidence of our conformity? Hospital administrators explain that it allows for quick and clear assurance that staff is following safety rules. For example, if an associate is not wearing a mask, a nonchalant glance at the required "accessory" confirms their immunization status, and the proper steps can ensue.

Although there is value in this approach, I wonder about the ramifications for staff who do not yield the sign of obedience. Will judgement occur once patients catch on to the purpose of a covertly placed sticker? Backlash by coworkers has already been reported by nurses who do not want the vaccine. Even more troublesome could be the voluntary bearing of pins that exclaim in all capitals “I’M VACCINATED!”. As if healthcare workers weren’t under enough pressure, we now must compete with one another in garnishments that seem to establish two separate sides, the uncompliant anti-vaxxers versus the selfless vaccinated conformers. Why can’t simply being employed provide enough proof that we are following our institution’s policies, therefore, providing safe medical care? 

Although it is uncomfortable to have our personal medical decisions scrutinized by patients, we must remind ourselves to understand their intentions. Patients are not asking these questions to be nosy or rude but rather to feel safe under our care. Yet, now, more than ever, political views are influencing people’s medical decision making - creating a slippery slope for nurses to navigate.

Therefore, after much rehearsal, here is my new spiel if asked about my vaccine status (you’re welcome to use it as well) - "Mr. Smith, although my medical history is between my care provider and me, I understand that you want to feel safe today (tonight), so I assure you that I follow my organization's policies for COVID-19 safety and that you are in trusted hands.", then I will quickly place my stethoscope in my ears!

Even if you are proud of being vaccinated, I urge you to set clear precedence for privacy with patients, and here's why.

We already share so much with those we serve: our time, energy, healing, and devotion. So, whether you are in line to get the vaccine or in a rally to protest it, nurses should stand together to protect our privacy by maintaining professional boundaries with patients. An unknown author wrote, "I set boundaries not to offend you but to respect myself." Today's inquiry may be about our vaccination status, but tomorrow’s question could involve our mental health history, finances, or social status. The list goes on.

Therefore, in addition to politely telling our patients to mind their own business, it is crucial to strip ourselves of the decorative adornments that give clues to our personal health choices. By drawing a clear line now, maybe we can prevent crossing it in the future.

Is it a HIPPA violation to ask for proof of vaccine status? HIPPA Journal. May 25, 2021. Accessed September 29, 2021. 

https://www.hipaajournal.com/is-it-a-hipaa-violation-to-ask-for-proof-of-vaccine-status/

What you should know about COVID-19 and ADA rehabilitation act and other EEO laws. U.S. Equal Employment Opportunity Commission. Updated May 28, 2021. Accessed September 29, 2021. 

https://www.eeoc.gov/wysk/what-you-should-know-about-covid-19-and-ada-rehabilitation-act-and-other-eeo-laws

An oncology nurse with over 20 years of experience ponders the necessity of professional privacy in the workplace -particularly in light of COVID-19 vaccinations. 

Opinion: Nurses Need to Stop Disclosing Their Vaccination Status to Patients 

Serenity Mirabito MSN, RN, OCN is an oncology health writer and blogger. As a certified oncology nurse with a master's degree, her years of experience allow her to write with a relatable and humorous flair. Serenity is a strong advocate for oncology nurses everywhere so don't be surprised if you hear your own story in hers. You're welcome to reach out to Serenity by emailing her at 