With millions of Americans now receiving COVID vaccines, the country may soon start to control the pandemic that has so greatly challenged the healthcare system and nursing. Still, the threat remains, with the potential that new variants of the coronavirus will cause more suffering and death.
As these variants menace public health, nurse practitioners (NPs) work to control those new strains. NPs have been on the frontlines of the pandemic since it started. Some 61% of NPs are treating patients who have been diagnosed with COVID-19, according to a recent survey from the American Association of Nurse Practitioners (AANP). Almost as many (58%) are offering COVID-19 testing at their practices.
In this article, we’ll take a look at the variants, testing, vaccination, and how NPs are dealing with patients who are hesitant to get the inoculation. First, let’s look at some of the numbers.
Tracking the variants
To understand the spread of the COVID variants, healthcare providers can consult a map from the Centers for Disease Control and Prevention (CDC) that tracks three “variants of concern.”
- B.1.1.7 (United Kingdom): This variant was first detected in the U.S. at the end of December 2020.
- B.1.351 (South Africa): Cases from the variant were first reported in the U.S. at the end of January 2021.
- P.1. (Brazil): This variant was first detected in the U.S. at the end of January 2021.
These variants, says the CDC, seem to spread more easily and quickly than other variants. As of mid-March, the U.K. variant was found in 49 states. According to the CDC, the U.K. variant is on track to be the dominant strain in the U.S. by April, says Mary Koslap-Petraco, DNP, PPCNP-BC, CPNP, FAANP, Pediatric Nurse Practitioner House Calls, Inc., Amityville, NY.
Testing challenge
In general, most healthcare providers are unlikely to know if a COVID patient has the variant. A lab result will simply say if the patient does or doesn’t have COVID, notes Sophia L. Thomas, DNP, APRN, FNP-BC, PPCNP-BC, FNAP, FAANP, president of AANP in an interview with DailyNurse. She practices at a community health center in New Orleans that serves a diverse patient population.
“We don’t know who has the variant or not.”
Doreen Cassarino, DNP, APRN, FNP-BC, BC-ADM, FAANP
“We really haven’t drilled down to testing every patient to see if they have a variant or not,” Thomas says. “That’s to come in the future. Right now, we’re doing so much testing it would be virtually impossible to test every patient to see what variant they have. From a patient’s perspective, they just want to know if they have COVID.”
“We don’t know who has the variant or not,” agrees Doreen Cassarino, DNP, APRN, FNP-BC, BC-ADM, FAANP, who practices at an internal medicine practice in Naples, FL. “All that we will get when we do testing is positive or negative. We don’t actually know if one of our patients has the variant or not.”
The treatment for COVID doesn’t differ with a patient infected with a variant. The symptoms are no different, notes Koslap-Petraco.
NPs can ask to have their patients typed to identify if the patient has a variant, Koslap-Petraco says. This can assist with public health, she notes. She worked as an NP/public health nurse for the Suffolk County Department of Health Services for 30 years.
“The problem with the strains is they’re more communicable,” Koslap-Petraco says. “When you have something that’s more communicable, you’re going to have more people being affected, and ultimately you’re going to wind up with more deaths, more long COVID and all of the other issues that are related to these viruses. But in order to contribute to public health efforts, nurse practitioners can ask to have these strains typed so that they know exactly what is circulating in their community.”
Koslap-Petraco hopes for more surveillance. “If the variants take hold and the vaccines don’t work, we’re in a lot of trouble. So that’s why we have to track these variants,” she says.
Vaccination to prevent mutation
Getting vaccine shots into arms as fast as possible holds the key to combating variants. “The big issue here to prevent the variants from taking hold further is to get as many people vaccinated as quickly as possible so we keep the virus out of the community, and then the virus doesn’t have the opportunity to mutate,” Koslap-Petraco says.
The Pfizer, Moderna, and AstraZeneca vaccines offer effective protection against the U.K. variant, notes Koslap-Petraco. NPs want to make sure, she says, that their patients get vaccinated before any other strain of the virus starts to take over, as the U.K. variant has done.
“For the most part, what I’ve seen is when patients hear that their friends, family, loved ones, or even me as their healthcare provider has gotten the vaccine, they’re much more likely to take it.”
Sophia L. Thomas, DNP, APRN, FNP-BC, PPCNP-BC, FNAP, FAANP
Cassarino agrees. In her Florida practice, since the week of February 22 she has tracked an increase in the number of patients age 65 and over getting the vaccine. “More and more people are getting vaccinated, which is really the main thing to preventing these variants–to encourage vaccination as soon as possible.”
Addressing hesitancy
With getting jabs into arms the major method to limit the spread of variants, vaccine hesitancy presents an obstacle NPs have to help overcome. “Overall, we are seeing some vaccine hesitancy,” says Thomas.
“Quite honestly, we saw a lot more vaccine hesitancy at the beginning of the pandemic because people didn’t know what to expect with the vaccine,” says Koslap-Petraco. “I am definitely seeing much less vaccine hesitancy now, especially in the African American population, but it’s all about building trust.”
“For the most part, what I’ve seen is when patients hear that their friends, family, loved ones, or even me as their healthcare provider has gotten the vaccine, they’re much more likely to take it,” says Thomas.
“I am definitely seeing much less vaccine hesitancy now, especially in the African American population, but it’s all about building trust.”
Mary Koslap-Petraco, DNP, PPCNP-BC, CPNP, FAANP
It helps, says Cassarino, to be able to tell a patient that Cassarino herself has received the vaccine, as have members of Cassarino’s family who are eligible. “It helps to be able to be a good role model for your patients,” she says.
Therapeutic communication plays a part, says Thomas. That involves acknowledging a patient’s concerns, showing empathy, and sharing the evidence and science about the vaccine, as well as sharing that the NP herself has gotten the vaccine. “The most important thing is communication with our patients, and when we do it effectively, it really makes a difference,” Thomas says.
“Nurse practitioners provide a huge potential service as far as educating our patients and the general public as well on the importance of vaccination, preventing the spread of this terrible virus,” says Cassarino.
Serving the community
As inoculations continue, the theme of NPs serving the community comes into play. “We have to treat this like we’re at war, and every single person in the United States is important,” says Koslap-Petraco. “That’s so important about what nurse practitioners do. We’re out there to make sure that everyone stays healthy.”
“We have a lot of NPs that are volunteering their personal time to go work at vaccine clinics on their off time. Service to the community is so important,” says Thomas. “The health of the community impacts the health of our nation, and so I think our dedication to community health just rings true as we see these NPs volunteering their time to go help others.”
Now a freelance writer and editor, he served as a Director at Elsevier, where he was instrumental in the development of major online nursing reference and procedure products. Previously, he served as Editorial Director at Nurses.com, one of the first nursing websites, and was Executive Editor at Nursing magazine, a premier large-circulation journal.
Today, he continues to serve nurses and other clinicians by reporting on developments and trends in healthcare with meaning, context, and insight.
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