Nursing Practice and Conduct in a Pandemic

Updated: September 24, 2021

The COVID-19 Pandemic has put extraordinary stress on the health system and on health care providers. Nurses [i] have been at the forefront of the pandemic response since the beginning. All nurses, by virtue of being members of a regulated profession, hold positions of trust and leadership. Actions and statements made by nurses, whether on duty or off duty, have the power to influence the public.

The CLPNM reminds all registrants that they are expected to practice and conduct themselves in accordance with the Standards of Practice, the Code of Ethics, and Practice Directions of their profession.

The CLPNM also reminds registrants that they must follow Provincial Public Health Orders.

Vaccination for Healthcare Workers

Nurses have a duty to provide clients with safe, competent, and ethical care. This includes taking appropriate measures to protect clients from harm. Protecting clients from harm has always included taking steps to decrease the risk of infection. Public health measures such as handwashing, vaccinations, masking, and physical distancing are effective strategies to help prevent the spread of COVID-19.

Evidence supports that widespread vaccination shortens the duration of disease outbreaks, maintains public safety, reduces the burden on the health care system, and keeps health care providers safe to care for clients in need. [ii] [iii] [iv] [v]

The Chief Public Health Officer of Manitoba has issued a Public Health Order that will require designated health care workers to be fully vaccinated for COVID-19 by October 18, 2021. (The deadline previously announced was October 31, 2021. This deadline was revised when the Public Health Order was issued).  Those who cannot be vaccinated for valid medical reasons or who choose not to be vaccinated will be required to undergo frequent COVID-19 testing.

The CLPNM supports Manitoba’s COVID-19 Immunization Plan. It is based on scientific evidence and recommendations from the National Advisory Committee on Immunization (NACI), Manitoba’s vaccine implementation task force, and Manitoba’s public health leadership. Canada also has a comprehensive and stringent system to approve and monitor new vaccines.

Nurses have the professional responsibility to:

  • adhere to policies and procedures of their employment setting [vii]
  • take all reasonable steps to avoid doing harm [viii]
  • recognize their own personal values and beliefs, and take measures to avoid any negative impact on client care, nursing practice, and the practice environment [ix]

The CLPNM recommends that all nurses, who provide direct client care, be vaccinated against COVID-19 (unless legitimate and rare medical reasons preclude vaccination) and encourages registrants to use current science-based sources and ethical frameworks as the foundation for their decision.

Providing Advice on Public Health Orders and COVID-19 Vaccines

Nurses are trusted health professionals. Views and statements made by nurses on important health issues that share or support misinformation can negatively impact the health and safety of the public. When clients ask a nurse for advice or opinion on Public Health Orders and/or COVID-19 immunization, they see the nurse as a trusted resource because of their professional designation. In keeping with this position of trust, the CLPNM expects nurses to provide clients with advice that:

  • is within the practical nursing profession’s legislated scope of practice [x]
  • uses known and accepted best practice and current scientific evidence [xi]
  • provides accurate, unbiased, and timely information to facilitate informed decision-making [xii]

If providing guidance on immunization is not within an individual nurse’s professional role/scope of employment, the nurse must direct the client to a legitimate trusted source for more information or assessment. The preferred source is the Manitoba COVID-19 Vaccine website or the individual’s primary care provider. Nurses are reminded to review the CLPNM’s COVID-19 Vaccination Frequently Asked Questions and Manitoba Health’s COVID-19 Vaccine Clinical Practice Guidelines for Immunizers and Healthcare Providers.

Professionalism

The CLPNM reminds all registrants that although they are free to hold their own opinions, nurses must reflect on their professional obligations (and workplace policies) before engaging in public forums.

Nurses are reminded that the standards for the profession do not allow nurses to publicly (whether in-person or virtually) express health care related views that are not supported by scientific evidence, including anti-mask and anti-vaccination opinions. Nurses may wish to encourage respectful discussion about COVID-19 measures without contributing inaccurate, unreliable, or unproven information that is harmful to the public’s best interest.

Nurses are not entitled to use protected titles [xiii], in any form, to spread misinformation as members of a regulated profession. When a nurse communicates with the public and identifies as a nurse, implicitly or explicitly, they invoke their professional position as a nurse and are accountable to CLPNM and the public it protects.

Nurses are required to:

  • display the characteristics and attributes of a professional [xiv]
  • maintain at all times standards of personal conduct which reflect well on the profession and enhance public confidence [xv]
  • adhere to licensed practical nurse legislation, regulations, by-laws, regulatory documents [xvi], while noting that Public Health Orders are part of the regulatory framework referred to here.

Summary

The CLPNM registrants, as members of a regulated profession, are required to support the mandate of the CLPNM to serve and protect the public. [xvii] The CLPNM’s practice expectations are defined in the Standards of Practice, Code of Ethics, Entry-Level Competencies, Nursing Competencies for LPNs in Manitoba, and CLPNM Practice Directions. Nurses found to be in violation of CLPNM standards are subject to investigation and possible disciplinary procedures.

Nurses who have questions or concerns about their ability to maintain their standards are encouraged to contact the CLPNM and speak with a Practice Consultant. The Practice Department can be contacted via email at practice@clpnm.ca or by phone at 204-663-1212 or toll-free at 1-877-663-1212, ext. 307.

Additional Resources

 

Social media
Public Health Resources
Covid 19 Vaccine Resources

For More Information

Contact us at
practice@clpnm.ca
204-663-1212 ext. 307
1-877-663-1212 ext. 307 (toll free)

View printable PDF version of this guidance here


[i] In this document, the term nurse refers to all CLPNM registrants, including licensed practical nurses, graduate practical nurses, student practical nurses.

[ii] Bloom, D. E., Cadarette, D., & Ferranna, M. (2021). The Societal Value of Vaccination in the Age of COVID-19. American Journal of Public Health, 111(6), 1049-1054.

[iii] International Coalition of Medicines Regulatory Authorities and World Health Organization.  Statement for healthcare professionals: How COVID-19 vaccines are regulated for safety and effectiveness https://www.who.int/news/item/11-06-2021-statement-for-healthcare-professionals-how-covid-19-vaccines-are-regulated-for-safety-and-effectiveness

[iv] Thompson, et al. (2021). Effectiveness of COVID-19 vaccines in ambulatory and inpatient care settings. New England Journal of Medicine. https://www.nejm.org/doi/full/10.1056/NEJMoa2110362

[v] Canadian Nurses Association (2021). COVID-19 Vaccinations. https://www.cna-aiic.ca/en/coronavirus-disease/covid-19-vaccinations

[vi] Government of Manitoba and Shared Health. COVID-19 Vaccination Requirements for Health-Care Workers Memo. August 24, 2021; https://sharedhealthmb.ca/wp-content/uploads/covid-19-vaccination-of-health-care-workers.pdf

[vii] CLPNM Standards of Practice, page 7.

[viii] CLPNM Code of Ethics, page 7.

[ix] CLPNM Code of Ethics, page 11.

[x] CLPNM Entry Level Competencies, page 15.

[xi] CLPNM Entry Level Competencies, page 12.

[xii] CLPNM Code of Ethics, page 5.

[xiii] Protected titles include licensed practical nurse, graduate practical nurse, student practical nurse, or any variation, abbreviation, or equivalent in another language.

[xiv] CLPNM Standards of Practice, page 7.

[xv] CLPNM Code of Ethics, page 10.

[xvi] CLPNM Entry Level Competencies, page 15.

[xvii] CLPNM Entry Level Competencies, page 15.