Guidance statement on providing care to patients not vaccinated against COVID-19

From Sunday 26 September 2022 the Government no longer requires nurses to follow the mandatory vaccination requirements. The Nursing Council is maintaining this page as a historical record only. Please note that an individual employer might still have vaccination requirements and is permitted to ask about your vaccination status. If you are not vaccinated we recommend that you discuss this with any potential employers. 

Some nurses have raised questions about providing care to patients who have not received COVID-19 vaccinations. It is the view of the Nursing Council that nurses have a duty to ensure that all patients are provided with nursing care, regardless of vaccination status. This is supported by the Ministry of Health's position statement, which states that:

Individuals cannot be refused access to health care.

Any restrictions to access to health care must be informed by a risk assessment, and the onus is upon the provider to justify that risks are sufficiently high to support those restrictions.

The Ministry's full position statement is available here:

Ministry of Health position statement on pre-consultation testing of unvaccinated individuals in health care settings .

Nurses have a broad obligation to ensure people have equitable access to high quality, professional health services. This applies even if the views of the patient on topics like vaccination are contrary to those of the nurse.

Although COVID-19 vaccines are highly effective, a vaccinated patient is still able to become infected with and transmit the SARS-CoV-2 virus asymptomatically. An unvaccinated patient may present a higher health risk in this respect, but mitigating measures aligned with the level of risk can be implemented to ensure that appropriate care is provided.

Because of this, unvaccinated patients should not face any barriers to healthcare that have been implemented without robust evidence and assessment of risk. Where the level of community risk is relevant, this will be made clear by the Ministry of Health.

Your employer does have a responsibility to ensure that you can practise in a safe manner, and if you have concerns about safety arrangements we recommend that you discuss these with your employer. However, this is not a reason to deny care or provide a person with a lower standard of care than they would receive if vaccinated.

The rights of all people to equitable nursing care are reflected in the standards of competence and ethical conduct for nurses that the Nursing Council sets under section 118(i) of the Health Practitioners Competence Assurance Act 2003. They are also reflected in the New Zealand Nurses Organisation Code of Ethics for its members.

Relevant Professional Principles

The Code of Conduct for Nurses is a set of standards set by the Council that describes the behaviour or conduct that nurses are expected to exhibit and uphold. The Code provides guidance on appropriate behaviour for all nurses and can be used by health consumers, nurses, employers, the Nursing Council and other bodies to evaluate the behaviour of nurses.

The Competencies for Registered and Enrolled Nurses set down the requirements associated with being able to practise safely in those scopes. These include recognition of patients’ right to respect, and to actively participate in decisions around their health status and care.

Other professional documents and standards frameworks for the nursing profession, such as the New Zealand Nurses Organisation’s Code of Ethics, also recognise that nurses have a duty to respect the dignity, needs and values of their patients and provide health-related care for all members of society who are in need of it.

Relevant Code of Conduct Principles

Principle 1: Respect the dignity and individuality of health consumers

Relevant Standards:

1.3  Listen to health consumers, ask for and respect their views about their health and responding to their concerns and preferences where practicable.
1.6  Practise in a way that respects difference and does not discriminate against those in your care on the basis of ethnicity, religion, gender, sexual orientation, political or other opinion, disability or age.
1.7  Do not prejudice the care you give because you believe a health consumer's behaviour contributed to their condition.

Principle 2: Respect the cultural needs and values of the health consumers

Relevant Standards:

2.1  Practise in a way that respects each health consumer’s identity and right to hold personal beliefs, values and goals.

Principle 3: Work in partnership with health consumers to promote and protect their well-being

3.1  Respect health consumers’ rights to participate in decisions about their care and involve them and their families/whanau where appropriate in planning care. The concerns, priorities and needs of the health consumer and family/whanau must be elicited and respected in care planning.
3.2  Support and respect the contribution health consumers make to their own care and well-being.

Example Relevant Registered Nurse Competencies

Competency 1.1:     Accepts responsibility for ensuring that their nursing practice and conduct meet the standards of the professional, ethical and  relevant legislated requirements.

Example Indicator: Practises nursing in accord with relevant legislation/codes/policies and upholds health consumers rights derived from that legislation.

Competency 1.5:     Practises nursing in a manner that the health consumer determines as being culturally safe.

Example Indicator: Practises in a way that respects each health consumer’s identity and right to hold personal beliefs, values and goals.

Example Relevant Enrolled Nurse Competencies

Competency 1.1:     Accepts responsibility for ensuring that his/her nursing practice and conduct meet the standards of the professional, ethical and relevant legislated requirements.

Example Indicator: Ensures practice is within the scope of practice and adheres to legislated requirements and relevant ethical codes, policies and procedural guidelines.

Competency 1.5:     Practises nursing in a manner that the health consumer determines as being culturally safe.

Example Indicator: Demonstrates ability to provide culturally safe care to meet health consumers’ individual needs, beliefs and values. 

Competency 3.1:     Establishes, maintains and concludes therapeutic interpersonal relationships.

Example Indicator: Establishes rapport and trust with the health consumer and or family/whanau. Demonstrates respect, empathy and interest in the health consumer.