Dear Gina,
By: Tia Weinand
Tags: Nursing, Star Wars, The Mandalorian, Covid 19, Covid Vaccine

Recently I was told that because I am an infection prevention nurse, that I have a “holier-than-thou” attitude about COVID, vaccines, and prevention. My goal is always to share truths and science. My goal is to use my voice, my training, and my experience to keep people healthy and safe. I believe in science. I love science. Science gives us rules to follow by using the same process over and over and getting the same results each time. It allows us to try new processes and it allows us to fail and to try again without shame. Without it, we wouldn’t have fire or buildings or clothing or medicine.

Nursing is not a science per se. It applies science by assessing an individual for their needs and applying interventions (sometimes prescribed by a doctor, sometimes modalities that a nurse can do themselves). A nurse reviews whether or not those interventions meet the need, then lather, rinse, repeat. Nurses may be caring for families, individuals or whole communities; often we are caring for all three at the same time. We have independent tasks that we can implement without a “superior officer” and others that can’t, such as giving medications. Nursing is a delicate balance of science, social service, negotiation, medicine, caretaking, teaching, counseling and rocket surgery.

As an infection preventionist, it’s my job to make sure the facility I work for is appropriately cleaning and disinfecting the environment(including equipment and work surfaces), handling potentially infectious materials appropriately, giving injections, administering IVs correctly, and inserting catheters without additional risk of infection, for example. There is also basic hand hygiene, cough etiquette, personal protective equipment use and appropriate antibiotic administration to monitor and audit. When there is an illness in my facility, I must track what it is, why it occurred, and how I can prevent it from spreading or reoccurring. This is a teaching job. I am teaching everyone from housekeepers to doctors on how to put on gloves, why a certain antibiotic shouldn’t be used with certain other medications, or why I can no longer use nebulizers in my facility.

Vaccines are a large piece of the puzzle when it comes to infection prevention. It is a bolt cutter for the ubiquitous “chain of infection” we all know from high school science. If an infectious agent is a virus a vaccine can be made to inform our bodies’ immune systems to make antibodies for an illness we have never had. Pretty nifty. Normally, we are exposed to a virus, we get ill, we get a fever and then we get better. The fever is our body’s way of making the environment inhospitable to the disease (in kindergarten terms). Meanwhile, our bodies are working overtime to develop antibodies for this new invader. It makes us exhausted and grumpy. Sometimes this confers immunity on us. Sometimes it doesn’t. Science has given us the workaround of vaccines to provide those antibodies without exposing us to an actual illness. Your body — your beautifully complex and intelligent body — can’t tell the difference between a vaccine and a disease and that is why vaccines work. This is an immune response. Your body sees a foreign invader and launches an attack. Because the vaccine contains only the information necessary for your body to create antibodies against a certain disease, it doesn’t take as long to form an immunity and doesn’t actually make you sick. Yes, you will get an immune response. Your body is *smart*. It will launch ground forces and deploy the Navy… and when the antibodies are made, the rest of the brigade can pull back. An immune response is necessary, healthy, and proof that the vaccine is doing what it should.

My first child was the first great-grandchild on his father’s side. His grandfather and his brother both spent a good deal of their childhood in straight jackets due to polio. My own mother-in-law was one of the first babies to be put in an incubator in the 1950s. I let my own preemie (my third) be part of a study on prematurity and weight gain, and I weaned her within 24 hours so I could participate in an investigational chemotherapy drug when I was diagnosed with breast cancer at age 39. I am a post-HELA woman of color. I am uniquely positioned to understand the impact that events like the Tuskegee Experiment and the theft of personal data like that of Henrietta Lacks have had on people of color. I appreciate that we are severely underrepresented in clinical trials throughout all aspects of medicine. To that end, I became a nurse to say: I have educated myself, I understand the science and I want to use those two things to care for others. Instead of lamenting that we are underrepresented, we have to stand up and represent. I cannot complain if I am unwilling to be a part of the solution.

As a part of my duties as a nurse, I am also involved in my region’s Emergency Preparedness Coalition. Since Hurricane Katrina and the events at Memorial Hospital immediately following, every health care facility must have an emergency disaster plan. At our Coalition’s annual meeting in February 2020, we shifted focus from weather emergencies and supply chain interruptions to a then-unnamed illness. Since then, I have been looking down the barrel of COVID-19. It was my job to gather information, find alternative sources for personal protective equipment, and subscribed to every webinar, conference call and Zoom meeting on COVID-19 to figure out how this would impact my facility. And when the residents started getting sick and the health department was calling staff while they were working to tell them to go home and quarantine, it was me who had to gather staff around the phone and talk them off a ledge. In the midst of losing six of my beloved residents and not being able to say goodbye, George Floyd was murdered by police. I took the 200-something masks I hand made for my facility and distributed them to protesters while watching the marches on the news. The tear gas and the sound of helicopters were not the only things bringing me to tears those days. Minneapolis is my home. Always has been. George Floyd was one degree of separation from my family; Minneapolis is a small town. I couldn’t risk getting sick, couldn’t risk getting hurt because I have a building full of people relying on me. The only point of pride I have from 2020 is to say, the protests sparked by the murder of George Floyd did not cause a spike in COVID-19 cases and I hope I had at least a tiny part in that.

I am not an ER nurse working 12 hours shifts. I don’t work in an ICU or with medically fragile people. I work with mentally ill adults. People who, but for grace, could be any one of us. They are largely forgotten by society, on the fringes, many formerly homeless. I love my job. I am a firm believer that everyone deserves health care, a home, an education and a chance. Basic human rights. Mental illness is hard to talk about, and a subject that we need to speak more frankly about. There are so many things that we could solve if we could have frank discussions and actually listen to each other, believing that we have each other’s best interests at heart.

I wrote this after learning a celebrity had asked to have a respectful discussion about the COVID-19 vaccine. I would love to have that discussion. Said celebrity is in a television show that I personally love and that is very near and dear to me, based on films that I grew up loving. It shaped who I am as a person, developed my love of writing and my love of film. While I truly believe that people should be able to express any opinion they want, we all must be held accountable for our words and actions. I am not a fan of cancel culture, however, celebrities must acknowledge the impact they may have on individuals who take their words to heart. I wrote this after telling a friend of a friend that if they disagreed with a scientific fact that the onus was on them to disprove those facts. Science is provable. That’s what makes it science. You can just as easily stop a train with feelings as you can refute science with the same. I was told I was taking a “holier than thou” attitude when I said I didn’t have time to explain why I believe the COVID-19 vaccine will be safe.

And I still don’t have time. I am an infection control nurse. I am not naïve enough to believe that the American government is not infallible and that medicine in this country could not be managed better. What I do know is the science of infection control. I know the history of vaccine medicine. I know the impact of vaccines on global society. I know that there are few options when it comes to finding the end of this tangled web. The Black Death found it’s end with mass graves and the Earth’s population a fraction of what it was pre-1346. That is the scenario we will face without a vaccine. That is option B. Option A has been on the table for over a decade. We started building a Corona Virus vaccine when SARS and MERS entered the picture; this vaccine is not new. What is new is the speed at which the medical and scientific community have shared data and information. The genome for SARS-COV-2 was sequenced in record time! Collaboration in the interest of ending a pandemic. I want to see cooperation; I want to see all the things that make humans humane. I have to hope that the infinitesimal sacrifices I made, that the injustices forced on the men of Tuskegee and Henrietta Lacks, and the deaths of millions across the globe mean something. I have to believe that my residents didn’t die for nothing. I want my role in this to have some meaning. Nurses don’t want free coffee (well, we always want coffee… lets not pretend here…). We don’t want applause or free oil changes. We want our covered faces, our aching feet and our broken hearts to end someone else’s suffering. If one person lives because I convinced them to get a vaccine or wear a mask or take a medication, then it was all worth it. When I say, “I am an infection control nurse”, I hope that people hear that I am more like you than an unapproachable man on TV who gets to stand on ceremony and call himself an expert. I still go home to a rented house in a small city in a minivan, but I know some things. And I’d like to share them with you. Most days though, it feels as though no one is listening.