During the COVID-19 pandemic, many health associations and membership organizations took a stand on the spread of misinformation by licensed clinical professionals. The National Council of State Boards of Nursing and 15 other nursing associations formed a policy statement, issued as a summary, that addressed the risk of disciplinary action by state boards of nursing when a nurse spreads misinformation. The act of sharing information that is contrary to current evidence could potentially threaten the well-being of the public and may be seen as a breach of the Nursing Practice Act.
Dissemination of information about COVID-19 and government announcements used online platforms and social media to reach the public. It is not surprising that in a digital revolution with limitless interactions, coupled with a lack of trust in government, the pandemic has become a politically polarizing issue.
According to the journal Frontiers in Public Health, the COVID pandemic is “characterized by inconsistent, ambiguous, and contradictory messages and the absence of clear, actionable, credible, and inclusive information from authorities that people trust, leaving room for other actors fill the void irresponsibly.” .” Online discussions about masking, distancing, and blocking become discourse.
It became clear that a line was drawn in the sand when it came to questioning and discussing vaccines, vaccine mandates, or treatment methods that were alternatives to the Centers for Disease Control and Prevention’s “follow the science” mantra . The line of restraint existed whether you were a consumer of health care, a patient, or a member of the health care team.
Clinicians and research scientists are conditioned to question the hypothesis, test, retest, discuss and debate until the best evidence surfaces. And when the evidence supports a recommendation, the evidence spreads and the cycle continues to test the next hypothesis. Emphasizing the “the” in the mantra “follow science” suggests that there is only one path that goes against scientific methodology.
Using a reflective practice lens, how did leaders and members of the medical community with differing viewpoints deal with the cholera outbreak in London, England in 1854? In August 1854, in 3 days, 127 people died of cholera and a total of 550 died in a period of 2 weeks.
John Snow, a physician, had long been curious about how cholera spread, from his early years of practice in the 1830s. In 1849, he wrote a pamphlet, “On the Mode of Communication of Cholera,” outlining his theory.
Snow reviewed 61 local cases brought to him who had drunk the water from the Broad Street water pump. Through data analysis, he plotted the cases on a map, confirming the common link. Snow petitioned the city council and presented his evidence on September 7, 1854. Although local government officials, the Board of Guardians, did not believe Snow was right, they responded and removed the handle, disabling the water pump The outbreak ended.
Snow found the source of contamination in the cholera pandemic, and experts, including Florence Nightingale, still clung to the miasma (bad air) theory of the disease and doubted the possible culprit of the water source. They rejected Snow’s evidence of a waterborne disease and recommended sanitary measures. It was not until 1861 that the germ theory emerged as an accepted hypothesis, 3 years after Snow’s death. Snow is recognized today as the father of modern epidemiology. So in the 1850s, was this misinformation, misinformation, or lack of information?
Before the pandemic, the spirit of inquiry and questioning was seen as progressive and necessary to reveal the best evidence. For patients, the same questioning would be recommended to reach a shared decision that incorporates the patient’s own values and preferences into treatment decisions. But during the pandemic and probably even now, questioning voices continue to be suppressed through guilt and shame. In today’s climate, would Nightingale, the mother of modern nursing, risk losing her status as a nurse if she accepted John Snow’s latest discovery, which went against the cultural norm?
With the delay in the willingness to consider alternative theories and recommendations, as with the cholera outbreak of 1854, we may not fully know or understand the consequences and influences of the public health mandates of COVID-19 (masking, social distancing , quarantine guidelines, vaccine initiatives). , treatment measures, etc.) for 5-10 years.
Medical professionals, including nurses, are part of the trusted messaging ecosystem. We have a role in advancing public health policy, but privileged status should not restrict questioning the science, exploring treatment alternatives, or sharing new evidence with the scientific community for fear of losing licenses because it goes against the cultural norm.
Leaders may consider proactively reviewing a community’s biodemographics and psychographics to improve delivery of public health information. To influence the acceptance and adoption of public health policy and behavior change, leaders should encourage the process of scientific methods, not silence it.
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About Charla Johnson
Charla Johnson, DNP, RN-BC, ONC, is a national leader in the health equity space. The majority of her nursing career has been focused on the promotion of musculoskeletal care, advocacy, and the integration of evidence-based practice in clinical settings. She is an author and national speaker on topics related to leadership, shared decision making in osteoarthritis, optimization in arthroplasty, remote workforce, informatics, and health equity. Charla is board certified in orthopedic nursing and nursing informatics. His mantra: clinical-critical thinking!