MedCity Influencers, Hospitals

HHS Prep Act amendment could fail the nurses it aims to support

The HHS amendment is meant to vaccinate Americans as quickly as possible.  This could be an incredible turning point in offering additional support for our frontline workforce or, if not executed correctly, could add additional and unnecessary stress to a field already experiencing widespread burnout.

For the last 12 months, our nation’s frontline healthcare workers have risked their own health and wellbeing to care for others. A recent report from the Joint Commission showed that fear of getting sick and bringing the novel coronavirus home are top concerns for nurses today. The near-constant strain on these professionals is driving moral injury, burnout, and contributing to nurses leaving the profession.

On Jan. 28, the U.S. Department of Health and Human Services (HHS) issued an amendment to the Declaration under the Public Readiness and Emergency Preparedness Act (PREP Act) that allows nursing students and retired nurses, among other qualified cohorts, to support vaccine distribution efforts. This is a step in the right direction – our nurses need more support.

However, administering a vaccine is just a single moment in time, and these reactivated professionals must be able to do much more than that. For example, those administering the vaccine need to also screen for contraindications and potential risk, and be equipped to offer the latest, evidence-based education so patients are comfortable walking out the door. If retired nurses and students aren’t brought into the workforce thoughtfully or trained adequately, an undue burden could fall on an already exhausted nursing workforce.

The pressure of vaccine distribution
There are two parts to the vaccine roll-out in the U.S. The first is vaccinating healthcare workers within a healthcare institution. To get this done, hospitals and other healthcare centers tapped nurses on staff to deliver the vaccinations, including nurses who were furloughed, worked in elective procedure areas, or other non-critical specialties who were available to help.

Today, we are in the second wave of vaccinations, moving into the community and through different tiers of prioritized patients. This is being addressed differently depending on what state you live in, and even what county – but across the board, distribution is not going the way it should. While some of this is due to supply chain issues, there is also a shortage of healthcare workers who are trained to deliver these vaccines. Rather than talking about delivering tens of thousands of doses to healthcare workers, we’re now attempting to deliver 11 million vaccines every week and need to keep this pace up over the coming months to vaccinate as many Americans as possible.

There is no question we need to get people vaccinated, and that will require many more qualified vaccinators. The HHS amendment paves the way for essential support on the frontlines, but if it is not executed properly, we risk failing our nation’s resilient nurses.

Bringing in additional support
Nursing students and retired nurses both bring unique benefits to the vaccine delivery equation – but their biggest asset is taking the pressure off our frontline staff. Fortunately, nursing students can be trained through their academic centers to ensure they receive the education needed – including intramuscular vaccine delivery specifically. We need to ensure retired nurses receive similar training.

The Centers for Disease Control and Prevention (CDC) also has implemented a Covid-19 Vaccine Training that all providers must complete. Beyond the technical elements of vaccine delivery, nurses need to be able to assess for contraindications and educate the patient on side effects and the importance of coming back for the second vaccine if needed.

Avoiding overstressing our nurses
There is a saying in the military that healthcare workers use daily – “I’ve got your back.”  Our nurses need to know that the staff working alongside them have been properly trained for all aspects of the job and are competent and confident in the care they are delivering to patients.

According to a recent Dutch study, perceiving colleagues as not skilled enough to care for patients is an increasing source of stress for nurses today. If we are adding undertrained nurses to an already tumultuous situation, we are essentially sending our frontline providers to battle without the confidence that someone has their back.

Instead of allowing them to focus on their existing patients – as this amendment intends – practicing nurses will be forced to step away from the bedside to support undertrained providers. And in situations like the one I outlined above, if a nurse giving a vaccine does not know when to raise a red flag, we could see an incredibly negative outcome for the patient.

The HHS amendment is meant to vaccinate Americans as quickly as possible.  This could be an incredible turning point in offering additional support for our frontline workforce or, if not executed correctly, could add additional and unnecessary stress to a field already experiencing widespread burnout and moral distress.

Photo: gpointstudio, Getty Images


Anne Dabrow Woods, DNP, RN, CRNP, ANP-BC, AGACNP-BC, FAAN, is a practicing nurse practitioner in critical care for Penn Medicine, Chester County Hospital and adjunct faculty for Drexel University in Philadelphia, PA and Neumann University in Aston, PA. Anne has over 39 years of experience in nursing and 25 years of experience as a nurse practitioner. She currently serves as Chief Nurse of Health Learning, Research & Practice, Wolters Kluwer.

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