Vaccines, transgender care, abortion: these are just a handful of trending topics nurses voice strong opinions over. But when the science is clear on these topics, why do some many nurses continue to speak out against them?

Facebook made me do it.

Since the advent of social media, our social spheres have widened considerably. It used to be that a nurse may bump up against differing opinions on controversial topics only within their proximal reach—co-workers, family, friends, and community members that they interact with fairly regularly. 

News media presented wider viewpoints, of course, but there was really no way—outside of reading nursing publications, or perhaps while attending school—that nurses might encounter the deluge of strong and influential opinions that today’s nurses do via social media. 

Here’s what we know—human beings form opinions and beliefs under the influence. We overestimate how much factual information comes into play, and underestimate the amount of emotional, experiential, anecdotal, and biased reasoning that affects our thinking. 

We then tend to die on many hills, when it comes to defending these core beliefs. Add in religious faith, and belief systems become even more personalized and rigid. Once we think we know something, anyone with a conflicting opinion will be dismissed. 

In our nursing lives, one would hope that our critical thinking skills and curious minds would seek out evidenced-based information only. Of course, we know that this is not what happens, at least when we live in worlds defined by murky and overlapping boundaries. 

With the COVID-19 pandemic thrusting healthcare topics into the mainstream spotlight like never before, it seems like there are more and more nurses popping up on social media sounding off with extreme beliefs. The thousands of comments under their posts tell us that just as many more share their flawed views. 

This begs the question—with nursing being a science-based profession, why are so many nurses stuck in the rhetoric of false beliefs? 

“Do your research”

Oh, how I loathe this phrase. Often thrown out as an “I’m taking my toys and leaving” closing statement on social media comment threads, this dismissive phrase attempts to convey the message that there’s information the opposing party has not considered. (With the subtext being—and if you did, you would realize how wrong you are!) 

Of course, as members of the scientific community, we should recognize how flawed this argument is. What it really conveys is that the “researcher” has Googled their way to finding a source that confirms their already solidified beliefs. They might as well type back “support my confirmation bias!”

The good news is the scientific community has already laid the groundwork for how research ought to be conducted. Peer-reviewed, reputable-sourced, duplicatable…are these concepts sounding familiar from your stats class and beyond? Hopefully, so. A mind capable of critical thinking understands why your weary and patient professors would not accept Google sources on your works cited. 

When it comes to our professional roles, it’s impossible to keep bias completely off the table. We are human, and therefore experts at flawed behavior. Knowing this makes it all the more important to take an active role in monitoring our own conduct. When in doubt, the Nursing Code of Ethics helps to fill in the gray areas when it comes to counseling and educating our patients. 

Autonomy, beneficence, justice, and non-maleficence

The four principles of nursing practice—autonomy, beneficence, justice, and non-maleficence—serve to relieve us of the burden of deciding ‘what’s best’ when it comes to public health truths. When our patients come to us for advice, it is from these ethical principles that we must operate. In the context of today’s controversial topics—abortion, vaccines, and gun control, for example—let’s examine them from a Nursing Code of Ethics perspective. 

Autonomy 

The principle of autonomy dictates that we must support a patient’s right to choose. Of course, “right to choose” has strong associations with abortion right now. Your own personal beliefs notwithstanding, our job as a nurse is to provide our patients with all available, evidence-based information so that they may choose what is best for them. 

There is no argument that pregnancy carried to term is risky, as are the known consequences to abortion bans. Choosing to terminate a pregnancy also carries risk. Both sides should be presented, and it’s a patient’s ethical right to choose.

Beneficence 

Beneficence is defined as acting with compassion towards others. This invites a whole spectrum of gray area because what one deems a compassionate act, another may not. The domain of public health is a good area to view this ethical principle within. What is good for most is a fair way to navigate the ethical waters here. 

However, when it comes to health mandates—like vaccines, for example—one of the main arguments against them is that one’s personal freedom is infringed upon. When this also seems to contradict the principle of autonomy, as discussed above, what’s a nurse to do? 

Unfortunately, this is a debate with no correct answer. The truth is that vaccines do carry some risk, and the argument that bodily autonomy must reign supreme cannot be conveniently brushed aside when the subject matter is changed. That’s precisely why arguing that abortion should be a choice but becoming vaccinated should not is problematic.

As nurses, it is our job to provide information, in the context of our patient’s personal health histories. At the same time, we can provide the context of how these decisions affect communities as well. For example, pregnancy risk affects only the pregnant person, while a highly infected population affects us all. When we stick to this lane, we are working most in service—compassionately—for our patients’ good. 

Justice 

In the nursing context, justice refers to our duty to treat patients equally and fairly. In 2022, that extends to being advocates for our patients in a world where we know all patients are not coming to us from a level playing field. Systemic, institutionalized racism is just one area of healthcare inequity and while an important topic to examine, beyond the scope of this article. To the best of our abilities, we must do the work to free ourselves from our personal biases when it comes to providing care. That involves educating ourselves on the impact that abortion bans and other public health gaps have in our society. When we know better, we do better. 

Non-maleficence 

Do no harm—perhaps the most well-known ethical principle. In the context of patient care, that means we have a duty to our patients to balance the care we provide with its overall impact on their health at large. In the larger public health sphere at the intersection of society and nursing, it means staying abreast and vocal about practices that will ultimately harm our communities. (Texas and Florida, I’m looking at you) 

It also means fighting misinformation. We nurses can’t be both the sources of and the warriors against this trend. 

In conclusion, nursing is not what it once was. Our reach is much greater today than in any other time. If we want to lay claim as the most trusted profession out there, we need to take that role seriously. Our voices are ones that are listened to, and at 4 million strong, we are a powerful force. Let’s wield it responsibly.