To: Ethics Advisory Board   

From: Troubled RN

Subject: Misinformation about COVID-19  

I’m in a work situation I find troubling. My RN coworker is consistently and increasingly proclaiming false truths about COVID-19 that simply aren’t supported by the Centers for Disease Control and Prevention and other scientific agencies. Perhaps it would be easier to understand if this person had one isolated concern, such as vaccines. Instead, she seems to be fabricating more and more misinformation as the pandemic progresses and sharing it freely with patients and families. How do I handle this situation? It concerns me that she’s influencing patients and fellow staff members with erroneous information. What action, if any, should I take?

From: ANA Center for Ethics and Human Rights 

You’re correct to raise concerns about this situation. It’s troubling, both as an individual nurse in a healthcare setting and as a member of the nation’s most trusted profession. You clearly recognize how valuable it is for nurses to be credible sources of scientific healthcare knowledge. 

The ANA Code of Ethics for Nurses with Interpretive Statements (the Code) (nursingworld.org/coe-view-only) provides guidance. Because trust is the centerpiece of the nurse-patient relationship, intentional erosion of this trust negatively affects patients, families, fellow staff members, and the profession. Provision 1.3 addresses nurses’ obligation in “assuring the responsible and appropriate use of interventions in order to optimize the health and well-being of those in their care,” and includes “acting to minimize unwarranted or unnecessary medical treatment and patient suffering.” As we know, many nursing interventions focus on communication and patient and family teaching. Sharing erroneous “facts” with others can create frustration and distress in not knowing who or what to believe. 

Your situation also involves a focus beyond patients and families, in that this nurse’s behavior is affecting the healthcare environment. Provision 6.3 states that “nurses are responsible for contributing to a moral environment that demands respectful interactions among colleagues,” and that “unsafe or inappropriate activities or practices must not be condoned or allowed to persist.” This nurse’s behavior is negatively impacting the healthcare environment. The right response would be to raise this concern with your nurse manager and provide examples so that the manager can consider exploring the situation with the nurse who is sharing misinformation and counsel her about appropriate actions. 

Your scientific understanding of the pressures and mental health consequences of the pandemic also might lead you to raise a different type of concern. This nurse’s increasingly loud voice regarding COVID-19 “facts” could be a symptom of mental health issues related to the stress of the pandemic. The nurse manager also needs to consider this possibility and decide whether to counsel or refer this nurse for further evaluation. Additional mental health knowledge and skills might be helpful as she navigates the long, difficult journey of being on the frontline of a world-wide pandemic.  

Misinformation, deliberate or otherwise, can be detrimental to patients, families, staff members, and the nursing profession. Action should be taken to address situations in which misinformation negatively affects healthcare quality.

— Response by Nelda Godfrey, PhD, RN, ACNS-BC, FAAN,
a member of the ANA Center for Ethics and Human
Rights Advisory Board.