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Javier E

Katie Duke struggles to navigate advocating for nurses and working as one - The Washing... - 0 views

  • Nurses don’t dispute that patients deserve compassion and respect, but many feel that their roles are misunderstood and their expertise undervalued; as Duke repeatedly told me, people don’t respect nurses like they do doctors. As a result, nurses are leaving hospitals in droves. And they’re establishing new careers, not just in health care but as creatives and entrepreneurs.
  • Duke argues that nurses are especially fed up and burned out. And yet, as caretakers, nobody expects them to put their physical and emotional well-being first. But that’s starting to change. Once a lone voice, Duke is now a representative one.
  • Nurses make up the nation’s largest body of health-care workers, with three times as many RNs as physicians
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  • They also died of covid at higher rates than other health-care workers, and they experience high rates of burnout, “an occupational syndrome characterized by a high degree of emotional exhaustion and depersonalization, and a low sense of personal accomplishment at work,” according to the World Health Organization
  • high stress and anxiety are the “antecedents” to burnout. But you know you’ve hit the nadir when you become emotionally detached from your work. “It’s almost like a loss of meaning,” she said.
  • In April 2020, Miller said the public was “exalting nurses as these superheroes and angels,” while nurses themselves were tweeting about “the horrible working conditions, enormous amount of death without any break … being mentally and completely worn down and exhausted.”
  • Miller said nurses are experiencing “collective trauma,” a conclusion she reached by studying their social media usage through the pandemic
  • Before the pandemic, between a third and half of nurses and physicians already reported symptoms of burnout. A covid impact study published in March 2022 by the American Nurses Foundation found this number had risen to 60 percent among acute-care nurses. “Reports of feeling betrayed, undervalued, and unsupported have risen,
  • Miller and Groves also found a fivefold increase in references to quitting between the 2020 study and the 2021 study. “Our profession will never be the same,” Miller told me. “If you talked to any nurse who worked bedside through the pandemic, that’s what they’ll tell you.” From this, she says, has grown a desire to be heard. “We feel emboldened. We’re not as willing to be silent anymore.”
  • then, in late February 2013, Duke was abruptly fired. She’d posted a photo on Instagram showing an ER where hospital staff had just saved the life of a man hit by a subway train. It looked like a hurricane had blown through. There were no people in the photo, but Duke titled the post, “Man vs. 6 train.” She told me she wanted to showcase “the amazing things doctors and nurses do to save lives … the f---ing real deal.”
  • Duke says her superiors called her an “amazing nurse and team member” before they told her that “it was time to move on.” Her director handed her a printout of the Instagram post. According to Duke, he acknowledged that she hadn’t violated HIPAA or any hospital policies but said she’d been insensitive and unprofessional. She was escorted out of the building by security. When the episode aired, it showed Duke crying on the sidewalk outside the hospital.
  • She’d reposted the photo, with permission, from a male doctor’s Instagram account. He faced no repercussions. She now admits her caption was rather “cold” — especially compared with the doctor’s, “After the trauma.” In hindsight, she said, she might have been more sensitive. Maybe not even posted the photo at all. And yet this frustrates her. Why shouldn’t the public see nursing culture for what it really is? Man vs. 6 Train. “That’s ER speak,” she told me. “We say ‘head injury in room five.’ We don’t say ‘Mr. Smith in room five. We talk and think by mechanism of injury.”
  • But this is at odds with the romanticized image of the nurturing nurse — which hospitals often want to project. In some cases, nurses are explicitly told not to be forthright with their patients. “I know nurses in oncology who are not allowed to say to a patient and their family, ‘This will be the fourth clinical trial, but we all know your family member is dying,”
  • “The most frequent question is, ‘Katie, I have to get out of the hospital, but I don’t know what else to do.’” Her advice: “You have to create your own definition of what being a nursing professional means to you.” She has a ready list of alternative jobs, including “med spa” owner, educational consultant and YouTuber.
tsainten

Opinion | This Is Why Nursing Homes Failed So Badly - The New York Times - 0 views

  • Eight months into the pandemic, Brendan House, a nursing home in Kalispell, Mont., had not had a single resident test positive for the coronavirus.
  • The numbers of those testing positive in the surrounding community went up by a factor of 100 compared with in the summer. At Brendan House, one positive case “turned into 10, then 50. Before you know it, we had 54 people in our long-term area who were Covid-positive and only three residents who were not positive,” a certified nursing assistant told me.
  • A few weeks in, though it was too late to contain the spread, the home decided to put all Covid-19 patients on the same floor.
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  • They were moved into an unfamiliar setting, their belongings whittled down to a few pieces of clothing and mementos thrown in a plastic bag; a new set of masked nurses came in and out of their rooms. Only a handful of residents had cellphones, so Danielle used her own to help residents use FaceTime with family members and friends.
  • “Nursing homes are really little hospitals, yet they’re not staffed like it. If you asked an I.C.U. nurse to take care of 15 people, she’d laugh at you, but that’s essentially what we have,” Chris Laxton, the executive director of AMDA, the Society for Post-Acute and Long-Term Care Medicine, told me.
  • At the same time, many of these caregivers “are making $12 or $13 an hour,”
  • workers probably helped spread the virus from facility to facility, home to home.
  • Under President Trump, C.M.S. had already cut monetary fines for facilities with health and safety violations. Now it called off regular inspections in favor of a narrow, superficial infection-control survey. It also allowed for “temporary nursing assistants” with little training to fill in for certified aides.
  • But if now is not the time, when, and under what conditions, should nursing homes and assisted-living facilities be held accountable for the welfare of their residents and workers?
  • Factor in the risk of getting sick and dying, and retention, let alone recruitment, becomes far more difficult. In 2020, direct caregiving may have been the most dangerous job in America.
  • Joe Biden is about the age of the average nursing home resident. Over the summer, he announced a $775 billion proposal to provide care for children, seniors and people with disabilities. The plan, though notional at this point, would eliminate the 800,000-person waiting list for long-term care under Medicaid and pay for 150,000 new community health workers for seniors. It could also help transform millions of low-wage, high-turnover, often transient gigs into stable careers.
  • C.M.S. must ensure that the $264 billion paid by Medicaid and Medicare to long-term-care providers actually goes to caregiving, instead of shiny new buildings or executive pay.
  • To improve residents’ quality of life, the government should mandate that long-term-care facilities have appropriate staffing.
  • In addition, Mr. Biden must reverse Mr. Trump’s laissez-faire approach to this sector. Both C.M.S. and the Occupational Safety and Health Administration should be given the resources they need to inspect, investigate and fine providers for health and workplace violations. The incoming administration must also strengthen workers’ rights to organize and protest unsafe conditions under the National Labor Relations Act, as it has already promised to do.
  • “There are jobs that offer $45 per hour to do Covid testing,” she said. As if to nudge her out the door, her nursing home was recently purchased by a large corporation, nullifying the union contract, and management reneged on the promise of holiday bonuses.
andrespardo

Coronavirus mask guidance is endangering US health workers, experts say | US news | The... - 0 views

  • Coronavirus mask guidance is endangering US health workers, experts say
  • With crucial protective gear in short supply, federal authorities are saying health workers can wear lower-grade surgical masks while treating Covid-19 patients – but growing evidence suggests the practice is putting workers in jeopardy.
  • But scholars, not-for-profit leaders and former regulators in the specialized field of occupational safety say relying on surgical masks – which are considerably less protective than N95 respirators – is almost certainly fueling illness among frontline health workers, who probably make up about 11% of all known Covid-19 cases.
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  • The allowance for surgical masks made more sense when scientists initially thought the virus was spread by large droplets. But a growing body of research shows that it is spread by minuscule viral particles that can linger in the air as long as 16 hours.
  • A properly fitted N95 respirator will block 95% of tiny air particles – down to 0.3 micron in diameter, which are the hardest to catch – from reaching the wearer’s face. But surgical masks, designed to protect patients from a surgeon’s respiratory droplets, aren’t effective at blocking particles smaller than 100 microns, according to the mask maker 3M. A Covid-19 particle is smaller than 0.1 micron, according to South Korean researchers, and can pass through a surgical mask.
  • said Katie Scott, an RN at the hospital and vice-president of the Michigan Nurses Association. Employees who otherwise treat Covid-19 patients receive surgical masks.
  • A 2013 Chinese study found that twice as many health workers, 17%, contracted a respiratory illness if they wore only a surgical mask while treating sick patients, compared to 7% who continuously used an N95, per a study in the American Journal of Respiratory and Critical Care Medicine.
  • Earlier this month, the national Teamsters Union reported that 64% of its healthcare worker membership – which includes people working in nursing homes, hospitals and other medical facilities – could not get N95 masks.
  • The CDC’s recent advice on surgical masks contrasts with another CDC web page that says surgical masks do “NOT provide the wearer with a reliable level of protection from inhaling smaller airborne particles and is not considered respiratory protection”.
  • That matches CDC protocol, but leaves nurses like Scott – who has read the research on surgical masks versus N95s – feeling exposed.
  • At Michigan Medicine, employees are not allowed to bring in their own protective equipment, according to a complaint the nurses’ union filed with the Michigan Occupational Safety and Hazard Administration. Scott said friends and family have mailed her personal protective equipment (PPE), including N95 masks. It sits at home while she cares for patients.
  • “To think I’m going to work and am leaving this mask at home on my kitchen table, because the employer won’t let me wear it,”
  • News reports from Kentucky to Florida to California have documented nurses facing retaliation or pressure to step down when they’ve brought their own N95 respirators.
  • In New York, the center of the US’s outbreak, nurses across the state report receiving surgical masks, not N95s, to wear when treating Covid-19 patients, according to a court affidavit submitted by Lisa Baum, the lead occupational health and safety representative for the New York State Nurses Association (NYSNA).
  • White House to invoke the Defense Production Act, a Korean war-era law that allows the federal government, in an emergency, to direct private business in the production and distribution of goods.
  • provide health care workers with protective equipment, including N95s masks, when they interact with patients suspected to have Covid-19.
  • “Nurses are not afraid to care for our patients if we have the right protections,” said Bonnie Castillo, the executive director of National Nurses United, “but we’re not martyrs sacrificing our lives because our government and our employers didn’t do their job.”
anonymous

Pandemic Strain Pushes Some Health Care Workers Toward Unions : Shots - Health News : NPR - 0 views

  • In September, after six months of exhausting work battling the pandemic, nurses at Mission Hospital in Asheville, N.C., voted to unionize. The vote passed with 70%, a high margin of victory in a historically anti-union state,
  • The nurses had originally filed paperwork to hold this vote in March but were forced to delay it when the pandemic began heating up. And the issues that had driven them toward unionizing were only heightened by the crisis. It raised new, urgent problems too, including struggles to get enough PPE, and inconsistent testing and notification of exposures to COVID-positive patients.
  • For months now, front-line health workers across the country have faced a perpetual lack of personal protective equipment, or PPE, and inconsistent safety measures. Studies show they're more likely to be infected by the coronavirus than the general population, and hundreds have died,
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  • many hospitals across the country have said worker safety is already their top priority, and unions are taking advantage of a difficult situation to divide staff and management, rather than working together.
  • Recognizing that, some workers — like the nurses at Mission Hospital — are forming new unions or thinking about organizing for the first time. Others, who already belong to a union, are taking more active leadership roles, voting to strike, launching public information campaigns and filing lawsuits against employers.
  • Labor experts say it's too soon to know if the outrage over working conditions will translate into an increase in union membership, but early indications suggest a small uptick. Of the approximately 1,500 petitions for union representation posted on the National Labor Relations Board website in 2020, 16% appear related to the health care field, up from 14% the previous year.
  • Stephanie Felix-Sowy said her team is fielding dozens of calls a month from nonunion workers interested in joining. Not only are nurses and respiratory therapists reaching out, but dietary workers and cleaning staff are as well, including several from rural parts of the state where union representation has traditionally been low.
  • Research shows that health facilities with unions have better patient outcomes and are more likely to have inspections that can find and correct workplace hazards. One study found New York nursing homes with unionized workers had lower COVID-19 mortality rates, as well as better access to PPE and stronger infection control measures, than nonunion facilities.
  • The nurses at Mission Hospital say administrators have minimized and disregarded their concerns, often leaving them out of important planning and decision-making in the hospital's COVID-19 response.
  • Early in the pandemic, staffers struggled to find masks and other protective equipment,
  • The hospital discouraged them from wearing masks one day and required masks 10 days later. The staff wasn't consistently tested for COVID-19 and often not even notified when exposed to COVID-positive patients.
  • the concerns persisted for months. And some nurses said the situation fueled doubts about whether hospital executives were prioritizing staff and patients, or the bottom line.
  • Although the nurses didn't vote to unionize until September, Waters said, they began acting collectively from the early days of the pandemic. They drafted a petition and sent a letter to administrators together. When the hospital agreed to provide advanced training on how to use PPE to protect against COVID transmission, it was a small but significant victory
  • Even as union membership in most industries has declined in recent years, health workers unions have remained relatively stable:
  • But with another surge of COVID cases approaching, the nurses decided not to wait any longer to take action
cartergramiak

N.Y. Severely Undercounted Virus Deaths in Nursing Homes, Report Says - The New York Times - 0 views

  • ALBANY, N.Y. — For most of the past year, Gov. Andrew M. Cuomo has tried to brush away a persistent criticism that undermined his national image as the man who led New York through the pandemic: that his policies had allowed thousands of nursing home residents to die of the virus.
  • He also asserted that the lack of data on hospital deaths of nursing home residents was due to concern and caution about the accuracy of data that nursing homes supplied — an issue also raised by the attorney general. “D.O.H. does not disagree that the number of people transferred from a nursing home to a hospital is an important data point,” he said.
  • The report also cast a critical eye on perhaps the governor’s most criticized decision since the beginning of the pandemic last year: a March 25 directive from the Health Department that ordered nursing homes to accept and readmit patients who had tested positive..css-1xzcza9{list-style-type:disc;padding-inline-start:1em;}.css-c7gg1r{font-family:nyt-franklin,helvetica,arial,sans-serif;font-weight:700;font-size:0.875rem;line-height:0.875rem;margin-bottom:15px;color:#121212 !important;}@media (min-width:740px){.css-c7gg1r{font-size:0.9375rem;line-height:0.9375rem;}}.css-1sjr751{-webkit-text-decoration:none;text-decoration:none;}.css-1sjr751 a:hover{border-bottom:1px solid #dcdcdc;}.css-rqynmc{font-family:nyt-franklin,helvetica,arial,sans-serif;font-size:0.9375rem;line-height:1.25rem;color:#333;margin-bottom:0.78125rem;}@media (min-width:740px){.css-rqynmc{font-size:1.0625rem;line-height:1.5rem;margin-bottom:0.9375rem;}}.css-rqynmc strong{font-weight:600;}.css-rqynmc em{font-style:italic;}.css-yoay6m{margin:0 auto 5px;font-family:nyt-franklin,helvetica,arial,sans-serif;font-weight:700;font-size:1.125rem;line-height:1.3125rem;color:#121212;}@media (min-width:740px){.css-yoay6m{font-size:1.25rem;line-height:1.4375rem;}}.css-1dg6kl4{margin-top:5px;margin-bottom:15px;}#masthead-bar-one{display:none;}#masthead-bar-one{display:none;}.css-1pd7fgo{background-color:white;border:1px solid #e2e2e2;width:calc(100% - 40px);max-width:600px;margin:1.5rem auto 1.9rem;padding:15px;box-sizing:border-box;}@media (min-width:740px){.css-1pd7fgo{padding:20px;width:100%;}}.css-1pd7fgo:focus{outline:1px solid #e2e2e2;}#NYT_BELOW_MAIN_CONTENT_REGION .css-1pd7fgo{border:none;padding:20px 0 0;border-top:1px solid #121212;}.css-1pd7fgo[data-truncated] .css-rdoyk0{-webkit-transform:rotate(0deg);-ms-transform:rotate(0deg);transform:rotate(0deg);}.css-1pd7fgo[data-truncated] .css-eb027h{max-height:300px;overflow:hidden;-webkit-transition:none;transition:none;}.css-1pd7fgo[data-truncated] .css-5gimkt:after{content:'See more';}.css-1pd7fgo[data-truncated] .css-6mllg9{opacity:1;}.css-k9atqk{margin:0 auto;overflow:hidden;}.css-k9atqk strong{font-weight:700;}.css-k9atqk em{font-style:italic;}.css-k9atqk a{color:#326891;-webkit-text-decoration:none;text-decoration:none;border-bottom:1px solid #ccd9e3;}.css-k9atqk a:visited{color:#333;-webkit-text-decoration:none;text-decoration:none;border-bottom:1px solid #ddd;}.css-k9atqk a:hover{border-bottom:none;}
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  • The Democratic chairman of the investigations and government operations committee in the State Senate, James Skoufis, who has accused the Health Department of stonewalling investigators, suggested on Thursday that he would use a subpoena to compel the release of data from Dr. Zucker’s office.
  • The attorney general asked 62 nursing homes — about a tenth of the state’s total — for information about on-site and in-hospital deaths related to the virus; investigators then cross-referenced that information with public reports of deaths issued by the Health Department. The deaths reported to the attorney general’s office at most of those facilities totaled 1,914, compared to the state’s much lower count of 1,229.
  • Under normal circumstances, the attorney general’s office “would issue a report with findings and recommendations after its investigations and enforcement activities are completed,” Ms. James said in her report. “However, circumstances are far from normal.”
clairemann

Cuomo's controversial nursing home order was issued a year ago today | Fox News - 0 views

  • It has been exactly one year since New York Gov. Andrew Cuomo issued a directive that has led to critics blaming him for thousands of nursing home deaths during the coronavirus pandemic.
  • Cuomo's order required nursing homes to take in residents who had been hospitalized with COVID-19 after being declared "medically stable" and forbade them from turning people away for being infected.
  • "No resident shall be denied re-admission or admission to the [nursing home] solely based on a confirmed or suspected diagnosis of COVID-19," the order said. "[Nursing homes] are prohibited from requiring a hospitalized resident who is determined medically stable to be tested for COVID-19 prior to admission or readmission."
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  • When initially reporting the number of nursing home deaths caused by COVID-19, the state had only reported those who died in the facilities themselves, leaving out those who died after being taken to hospitals.
  • State lawmakers -- including many fellow Democrats -- began calling for Cuomo's resignation or impeachment after Cuomo aide Melissa DeRosa reportedly said on a call that nursing home death data had been withheld from state officials out of fear of repercussions from the U.S. Justice Department.
  • Cuomo has faced additional pressure to step down in the wake of multiple claims of sexual harassment, ranging from alleged inappropriate comments to an accusation that he groped a current staffer under her blouse. The governor has denied touching anyone improperly and claimed any offending remarks were not meant to cause discomfort.
cartergramiak

Opinion | This Is Why Nursing Homes Failed So Badly - The New York Times - 0 views

  • Then came November. The numbers of those testing positive in the surrounding community went up by a factor of 100 compared with in the summer. At Brendan House, one positive case “turned into 10, then 50. Before you know it, we had 54 people in our long-term area who were Covid-positive and only three residents who were not positive,” a certified nursing assistant told me.
  • The facility was marked like a disaster zone: red rooms (for full isolation), yellow (recovered) and green (negative).
  • Long-term care continues to be understaffed, poorly regulated and vulnerable to predation by for-profit conglomerates and private-equity firms.
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  • Sharon Wallace, 62, whose multiple sclerosis landed her in a Rockland County, N.Y., nursing home several years ago, said that an unattended rash recently turned into an open wound, and she described feeling lonely and trapped in quarantine. “I feel like my health is going downhill,” she told me.
  • “Nursing homes are really little hospitals, yet they’re not staffed like it. If you asked an I.C.U. nurse to take care of 15 people, she’d laugh at you, but that’s essentially what we have,”
  • Joe Biden is about the age of the average nursing home resident. Over the summer, he announced a $775 billion proposal to provide care for children, seniors and people with disabilities. The plan, though notional at this point, would eliminate the 800,000-person waiting list for long-term care under Medicaid and pay for 150,000 new community health workers for seniors. It could also help transform millions of low-wage, high-turnover, often transient gigs into stable careers.
  • “The stress is ungodly,” she told me. “Every day you go there, your family pays for it when you get home.”
qkirkpatrick

Belgium Marks WWI Execution of Britain Nurse 100 Years Ago - The New York Times - 0 views

  • Belgium on Monday commemorated the heroism of British World War I nurse Edith Cavell a century after she was executed by the German forces that occupied the country.
  • Germany accused Cavell — the head of a nursing school in Brussels — of helping injured Britons escape, and shot her at dawn on October 12, 1915. Around much of the world she has largely been forgotten, but at the time the allied nations considered her a
  • Cavell was the head of a nursing school in Brussels when Germany invaded Belgium in 1914. She was sentenced in the very rooms of the Belgian senate where the commemoration took place and which the Germans had occupied during the war.
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  • "Her crime was that she had helped allied soldiers, British, French and Belgian escape to freedom across the Dutch border," said biographer Diane Souhami.
brookegoodman

Health care workers on frontlines feel like 'lambs to the slaughterhouse' - CNN - 0 views

  • (CNN)An anesthesiologist in Arizona turned to eBay for N95 masks. A nurse in Ohio said she and her colleagues are forbidden from wearing any masks for fear that it would spread anxiety. A nursing home employee in Arkansas who developed a fever said she couldn't get tested.
  • The scarcity of equipment is at a critical stage, where medical workers are being asked do something that weeks ago would have brought reprimand or even termination: reuse supplies.
  • Although many hospitals and clinics are scrambling to refill dwindling supplies, the stories from health workers reflect a shaken American health care system that was caught flat-footed by the fast-spreading global pandemic.
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  • "It's unacceptable that we're sending medical professionals like lambs to the slaughterhouse without giving anything to protect themselves," said Dr. Marianne Hamra, who works in New Jersey. "Bandanas and scarves? C'mon CDC -- that's completely ridiculous."
  • Meanwhile, New York has now topped Washington state as the new epicenter of coronavirus cases with at least 20,875 infected, according to CNN's tally of cases.
  • In New Jersey, 35 physicians and nurses are no longer working at Holy Name Medical Center because they are either have or are suspected of having Covid-19.
  • "I'm very concerned that if things don't slow down, if the supply chains do not open up, if we don't figure out a way to get the nurses in here from the federal government (and) from the military," he said. "I feel in a week or so from now I may not be able to feel the same way."
  • A nurse in western Ohio said that, save for one specific unit where Covid-19 patients are supposed to be sent, nurses at the medical center are forbidden from wearing masks -- not just N95 masks, but surgical masks or any masks.
  • "I don't want to bring anything home to my kids," she said. "I'm a single mom. I signed up to be a frontline worker, but I don't have the equipment to do it."
  • Milla Kviatkovsky, a hospitalist physician in San Diego, helped launch a petition on Change.org called "US Physicians/Healthcare Workers For Personal Protective Equipment in Covid-19 Pandemic."
  • Many physicians, she said, worry about the ethical implications of institutions saying it's ok to perform procedures without protective gear when it's never been ok before.
  • "Are we doing more harm than good by going in there with no equipment and potentially spreading this to so many other people?" she said in an interview with CNN. "Are we taking out the front lines to our defense when we're so early on in the equivalent of a health care war right now?"
Javier E

Opinion | 'I Do Fear for My Staff,' a Doctor Said. He Lost His Job. - The New York Times - 0 views

  • Doctors and nurses responding to the Covid-19 pandemic are the superheroes of our age, putting themselves at risk to save the lives of others.
  • At least 61 doctors and nurses have died from the coronavirus in Italy so far. Already, in New York City alone, two nurses have died and more than 200 health workers are reported sick at a single major hospital.
  • Tension arises not only because of shortages of P.P.E. but also because of uncertainty about how much protection is optimal. No one knows. The Centers for Disease Control and Prevention have given conflicting advice, and other countries have varying standards
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  • These superheroes are at risk partly because we sometimes send them into battle without adequate personal protective equipment, or P.P.E. This should be a national scandal, and now hospitals are compounding the outrage by punishing staff members who speak up or simply try to keep themselves safe.
  • It’s baffling that the richest country in the history of the world fails so abysmally at protecting its health workers, especially when it had two months’ lead time. And for hospitals now to retaliate against health workers who try to protect themselves — ousting them just when they are most needed — is both unconscionable and idiotic.
  • On websites like allnurses.com, nurses wonder aloud whether they can refuse to work because of inadequate P.P.E. or even whether they should quit the profession.
  • The doctors, nurses, technicians and cleaning staff members on the front of this pandemic deserve our eternal gratitude. Instead, we’re betraying them: They have our back, but we don’t have theirs.
brickol

Germany coronavirus: Why is the Covid-19 death rate so low? (opinion) - CNN - 0 views

  • As of this past weekend, nine countries had diagnosed more than 9,000 cases, and three -- South Korea, Switzerland, and Germany -- had deaths rates well below the others. For South Korea, this in part is due to the cases occurring in much younger people, while the information in Switzerland is only now emerging. But for Germany, Covid-19 is being diagnosed in the same middle-aged people as other countries. The deaths in Germany also fit the seemingly established pattern of also occurring among the very old.
  • Recent articles have raised this issue with several theories put forth by local experts. Some feel that it is a temporary situation, since Germany, like South Korea, has been aggressively testing its population from the outset. Aggressive testing likely will identify persons otherwise too well to come to medical attention, thereby diluting the tested pool with a large set of infected but otherwise well people who are likely to remain so.
  • Others have speculated that the first cases in Germany were older adults who had used an early spring vacation to go skiing in countries that turned out to have high rates of Covid-19. So yes, goes this thinking: the German cases are in older persons, but all were well enough to ski, that is, they were people without the various other medical conditions that increase risk of death.
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  • There might be other explanations. With any infection, there are four basic questions to ask when looking at broad differences in death rates. Is the virus different here versus there? NO. Right now, there is no evidence that the virus is mutating toward a more potent strain in the US.Is one country diagnosing the virus sooner than another? YES. As above, this may be skewing German and South Korean results by identifying asymptomatic and mildly symptomatic persons unlikely to require medical care. Hospitalization rates by country, currently not tracked, would help sort out the contribution of aggressive testing to survival rates. Is the infected patient different here versus there? YES. South Korea (young patients) and Italy (old patients) are unique in the outbreak, and the characteristics in Iran are not well known. All other countries with specific information, from China to even the US epicenter of New York City, have shown the same basic distribution with respect to age, sex (more men than women) and smoking. Is the health care system different here versus there? OH YES. Health care system differences at the country level are hard to examine: information is sparse and, given the 50,000-foot view, possibly misleading. However, health care experts typically can rely on "structural measures" to determine the quality of a hospital or a state or a country.
  • The World Bank tracks health care information by country on three relevant structural measures (though recentness of information varies country to country), each measured per 1,000 general population: doctors, nurses and hospital beds. They and other sources also track two other relevant variables: lifespan per country and health care spending per individual. Neither of these demonstrate differences in affected Western European countries that might explain a difference in Covid-19 survival.
  • Among the nine countries with the highest number of Covid-19 cases, the country that has the highest nurse rate also has the lowest death rate from the disease. Germany has 13.2 nurses per 1,000 (echoing a trend for high nurse numbers throughout Northern Europe) far above the other heavily Covid-19 affected countries. This may be just another armchair epidemiologist observation of course. But higher numbers of nurses may reflect one of two beneficial factors (or both): first, that nurses, the backbone of hospital (and especially ICU) care, are essential to patient management and, ultimately, survival.
  • Either way, it is a reminder that Covid-19 will continue to reveal the strengths and weaknesses of health care systems across the world. The current observed differences also mandate that, when we finally are out from underneath the weight of the current crisis, we must work to determine how we can deliver better health care to large populations across the world.
anonymous

Julia Lyons, a 'fake flu nurse' in Chicago during the 1918 Spanish flu pandemic, stole ... - 0 views

  • Julia Lyons portrayed herself as a busy visiting nurse in Chicago during the great flu pandemic of 1918. But “Slick Julia,” as she came to be known, was no Florence Nightingale.
  • The 23-year-old Julia, “a woman of diamonds and furs, silken ankles, gem-studded fingers and aliases by the dozens,” was posing as a “flu nurse,” ripping off home-bound patients for cash and jewelry as they suffered and even died, the Chicago Tribune reported in late 1918.
  • A century before the coronavirus crisis, the 1918 flu was a killing machine, taking the lives of more than 675,000 people in the United States and 50 million around the world.
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  • Julia Lyons saw an opportunity. Figuring nobody would have time to check her lack of credentials, she signed on at a home-nurse registry under various names. In late 1918, the Tribune chronicled the fake flu nurse’s escapades like a dime detective novel.
  • The police tapped the phone and learned Julia lived nearby. Detectives trailed Julia. One day she set off to marry Charlie the Greek, who ran the Victory Restaurant on West Madison Avenue. Before vows could be exchanged, Julia was in handcuffs.
  • Instead of transporting Julia to the courthouse in a patrol wagon, the deputy sheriff took her on a street car. In court, some 50 victims testified against her. She was held under $13,000 bond, the equivalent of more than $190,000 today.Deputy Hickey started back to the county jail with Julia in tow. An hour and a half later he called the police and “excitedly” told them she had jumped from a moving street car and hopped into a waiting automobile. Based on the reported location, one official speculated Hickey and his prisoner had been going to cabarets.
  • Soon Julia was back at her old tricks. In March 1919, the police traced her through the nurse registry to a home on Fullerton Boulevard. When Julia answered the door, the police nabbed her.
rerobinson03

'A Shot of Hope': What the Vaccine Is Like for Frontline Doctors and Nurses - The New Y... - 0 views

  • Monday’s vaccinations, the first in a staggeringly complicated national campaign, were a moment infused with hope and pain for hundreds of America’s health care workers.
  • Ms. Hansen described the 5,000 frontline nurses of the Memorial Healthcare System as resilient but physically and mentally exhausted by the pandemic
  • Across the country, hospital auditoriums and conference rooms became makeshift vaccination sites,
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  • “It is hope,” said Kenzie Frankl, a registered nurse and clinical care leader for Sanford Health in Fargo who volunteered nine months ago to work in the hospital’s coronavirus unit and walked out of the vaccination room with a Day-Glo bandage on her arm.
  • New coronavirus cases have receded recently in North Dakota — which had the country’s highest rate of infections earlier this fall. But the pandemic is worse than ever in Kansas, where Dr. Maggie Hagan took a break from her rounds in Wichita to get vaccinated.
  • Five units in her hospital have been turned into coronavirus wards. She sees 50 patients each day.“I almost could cry talking to you now,” she said. “I feel like I didn’t just get a vaccine, I got a shot of hope.
  • Then there is the personal toll of working 12-hour shift after 12-hour shift sheathed in protective gear, worried that while one patient is treated another may be deteriorating. Some worried about carrying the virus home while others were treated by friends or neighbors as if they had the plague. Some have experienced post-traumatic stress disorder. Many have spent hours after work agonizing over the challenges of treating coronavirus patients.
  • Even as doctors and nurses lined up for the first shots, cheered on their colleagues and joked about barely feeling the prick of the syringe, they also reflected on their grueling months in the trenches of the country’s coronavirus nightmare.
  • Ms. Hansen said the vaccine brought a breath of relief after so much sickness, suffering and death.
  • Receiving the vaccine alleviates some of his fears, but he said he would continue to wear a mask and practice social distancing, just to be safe.
  • The lack of concrete options left him and his colleagues feeling demoralized about their ability to help their patients, who were some of the sickest they had ever seen. After long, desperate shifts, they sometimes talk on the phone about the challenge of treating such an aggressive and unknown illness.
  • Like many of the doctors and nurses who lined up on Monday, Yvonne Bieg-Cordova, a radiology manager at Christus St. Vincent in Santa Fe, N.M., has watched lots of people die. But nothing prepared her for Covid-19.
  • Ms. Bieg-Cordova received her first dose of the vaccine on Monday, a bright moment after a bleak year.
  • Ms. Bieg-Cordova said that the past couple months have been trying, but that the vaccine did provide the hope that an end was coming.
anonymous

Cash, Breakfasts and Firings: An All-Out Push to Vaccinate Wary Medical Workers - The N... - 0 views

  • Anxious about taking a new vaccine and scarred by a history of being mistreated, many frontline workers at hospitals and nursing homes are balking at getting inoculated against Covid-19.
  • Those opposing forces have spawned an unusual situation: In addition to educating their workers about the benefits of the Covid-19 vaccines, a growing number of employers are dangling incentives like cash, extra time off and even Waffle House gift cards for those who get inoculated, while in at least a few cases saying they will fire those who refuse.
  • “For us, this was not a tough decision,” said Lynne Katzmann, Juniper’s chief executive. “Our goal is to do everything possible to protect our residents and our team members and their families.”
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  • “This is a population of people who have been historically ignored, abused and mistreated,” said Dr. Mike Wasserman, a geriatrician and former president of the California Association of Long Term Care Medicine. “It is laziness on the part of anyone to force these folks to take a vaccine. I believe that we need to be putting all of our energy into respecting, honoring and valuing the work they do and educating them on the benefits to them and the folks they take care of in getting vaccinated.”
  • At Jackson Health System in Miami, a survey of about 5,900 employees found that only half wanted to get a vaccine immediately, a hospital spokeswoman said.
  • Henry Ford Health System, which runs six hospitals in Michigan, said that as of Wednesday morning, about 22 percent of its 33,000 employees had declined to be vaccinated.
  • At Houston Methodist, a hospital system in Texas with 26,000 employees, workers who take the vaccine will be eligible for a $500 bonus. “Vaccination is not mandatory for our employees yet (but will be eventually),” Dr. Marc Boom, the hospital’s chief executive, wrote in an email to employees last month.
  • Both have been found to be safe and highly effective. So why are so many hospital and long-term care workers reluctant to get inoculated?
  • Underlying the hesitancy is a lack of trust in authorities — the federal government, politicians, even their employers — that have failed for the past year to get the virus under control.
  • “We are left behind in the dust — no one sticks up for us,”
  • Another concern about forcing workers to get vaccinated is that it could prompt hesitant employees to resign. That’s a particular worry in long-term care, where the pandemic has exacerbated a shortage of certified nursing assistants.
  • Gov. Mike DeWine of Ohio said last month that roughly 60 percent of nursing home staff members offered the vaccine in his state had declined it.
  • At Norton Healthcare, a health system in Louisville, Ky., workers who refuse the vaccine and then catch Covid-19 will generally no longer be able to take advantage of the paid medical leave that Norton has been offering to infected employees since early in the pandemic.
  • At Juniper — which has 20 senior living communities in New Jersey, Pennsylvania and Colorado — officials have tried to educate workers about the safety and benefits of Covid-19 vaccines, including hosting a webinar with a registered nurse who was enrolled in a clinical trial of the Moderna vaccine. Officials told staff last month that vaccines would be mandatory.
Javier E

Covid-19 Vaccine's Slow Rollout Could Portend More Problems - WSJ - 0 views

  • the federal government came nowhere close to vaccinating 20 million people by the end of 2020, as it had promised.
  • Three weeks into the most ambitious vaccination campaign in modern U.S. history, far fewer people than expected are being immunized against Covid-19, as the process moves slower than officials had projected and has been beset by confusion and disorganization in many states.
  • Of the more than 12 million doses of vaccines from Moderna Inc. and Pfizer Inc. with BioNTech SE that have been shipped, only 2.8 million have been administered, according to federal figures
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  • as the federal government has left it to states to determine what to do with the vaccines it ships to them, and with some states pushing decision-making to local health departments and hospitals, the process has gone far from smoothly.
  • “There may have been an expectation from Operation Warp Speed or others that we’d give everyone the vaccine overnight.…It was a logistics equation for them. If you’ve been in vaccines for a long time, you know that’s the easy part. Getting it into actual arms is the hard part.”
  • Sen. Mitt Romney (R., Utah) criticized the vaccine rollout, saying in a statement that the lack of a comprehensive federal plan to be shared with states “is as incomprehensible as it is inexcusable.”
  • Public health officials and states say uptake is lagging for several reasons, beginning with holiday seasons that have kept staff of hospitals and nursing homes away from work. They also note they are facing high percentages of people, including some health-care workers, who are skeptical of taking the shots.
  • Hospitals and other sites are staggering appointments to avoid pulling too many workers from caring for patients amid a nationwide surge in Covid-19 cases, officials say. Administration of the vaccines also takes more time than a typical flu shot, particularly since they are being done in a socially distant way and may be preceded by a Covid-19 test.
  • Different state policies have led to confusion and shipment delays for hospitals, said Michael Wascovich, vice president of field pharmacy services for Premier Inc., a group purchasing organization whose members include 4,100 hospitals, 80% of which received doses.
  • “Every state is doing what they want to do,” he said. “You could be in Philadelphia and it’s completely different across the river if you’re in Trenton or Camden.”
  • Many states are following CDC guidelines to start with front-line medical workers and people in long-term care facilities, but not all. Florida Gov. Ron DeSantis on Dec. 23 extended eligibility to people aged 65 and older. Because each county and hospital in the state implemented its own approach, many people didn’t know whether to call, log on or show up in person to secure a spot.
  • CVS has begun administering doses at nursing homes and facilities in 48 states and Washington, D.C., with most eligible residents agreeing to be vaccinated, said Chris Cox, a CVS executive who is overseeing the vaccination rollout for the pharmacy chain.
  • In some cases, residents haven’t been vaccinated because of active outbreaks at facilities, while other facilities have taken longer than others to schedule their vaccination clinics, a challenge exacerbated by the holiday season, Mr. Cox said.
rerobinson03

CDC Says Nurses Are at High Risk for Covid-19 - The New York Times - 0 views

  • Among health care workers, nurses in particular have been at significant risk of contracting Covid-19, according to a new analysis of hospitalized patients by the Centers for Disease Control and Prevention.
  • About 6 percent of adults hospitalized from March through May were health care workers, according to the researchers, with more than a third either nurses or nursing assistants.
  • The study looked at 6,760 hospitalizations across 13 states, including California, New York, Ohio and Tennessee.
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  • From the beginning of the pandemic in the United States, front-line medical personnel have complained of shortages of personal protective equipment. Some of the shortages abated for a while, but supplies have become strained in certain areas of the country as a surge of coronavirus outbreaks has reached daily records.
  • Calling the findings no surprise, Ms. Mahon criticized federal officials for not having more robust guidelines in place. Her organization, which issued a report on workers’ deaths last month, says about 2,000 health care workers have so far died from the virus.
  • She says that workers should be tested more frequently so they can be identified and isolated so the infection does not spread, and that supplies of protective gear remain uneven, with some facilities unprepared for an increase in cases.
  • Most of the hospitalized workers in the analysis were female. They also tended to be older, and more were Black employees than the overall group of health care workers who contracted the virus.
rerobinson03

Caregivers Have Witnessed the Coronavirus's Pain. How Will They Vote? - The New York Times - 0 views

  • At the Pennsylvania long-term care facility where Tisheia Frazier works, the coronavirus was a terror. During the most harrowing weeks of the pandemic in April and May, she said, four residents died in a matter of hours, and 70 people in an 180-bed unit died in less than a month.
  • At the height of the pandemic, he sat at his desk, a shield over his face, so frustrated by the government’s handling of the virus and his own organization's bureaucracy that he thought to himself: “I don’t want to do this.”
  • The deaths of almost 40 percent of all Americans killed by the coronavirus have been linked to nursing homes and similar facilities — indoor spaces crowded with vulnerable adults.
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  • In interviews ahead of the election with more than a dozen caregivers in Pennsylvania, one of the country’s most important battleground states, they described how their experiences are shaping their political outlooks. It has hardened some convictions and transformed some caretakers, otherwise apolitical, into activists. It has forced others to reassess their beliefs about American exceptionalism, the role of government in their lives and their industry, and their decision about whom to vote for in November.
  • Nine months ago, I would have told you that I was 100 percent behind Trump,” Mr. Lohoefer, a lifelong Republican, said of the president. “But as a result of Covid, I’m not 100 percent sure where I stand now.”
  • There were struggles to procure personal protective equipment, difficulties with rapid testing, staffing shortages, disagreements between local, state and federal government agencies and new rules piled onto an already heavily regulated industry.
  • stakeholders in every corner of caregiving agree that the pandemic exposed the country’s overburdened health care system, testing the mental, emotional and physical limits of all of the people who work in it.
  • If you don’t see it, you really don’t understand how difficult it is,”
  • In interviews, caregivers as well as patient advocates, medical professionals, facility managers and residents themselves said they had never experienced anything like the first six months of the pandemic.
  • The chaos was so pervasive that it was nearly impossible, everyone said, to separate what was happening from the politics at play. As caretakers endured day after exhausting day, state officials set forth new regulations to govern how nursing homes should work. And President Trump delivered a drumbeat of dangerous claims — mocking masks, praising unproven treatments, speculating about bleach and about the virus disappearing.
  • And top officials at care facilities voiced deep frustration about how the virus response rapidly devolved from a public health issue to a partisan fight.
  • Surveys of Pennsylvania voters show that Mr. Trump’s standing has been damaged in recent months by his administration’s handling of the coronavirus.
  • Four years later, with its 20 electoral votes, Pennsylvania looms as one of the most important swing states in the election. Many of Mr. Trump’s remaining paths to victory require him to win the Keystone State, and to do that, he needs voters like Mr. Lohoefer, the nursing director, in his camp.
  • Mr. Lohoefer voted for Mr. Trump in 2016. But he has been pushed to his limits. He recalled with derision how the government and his corporate office would send sudden, often conflicting mandates during the early days of the pandemic.
  • Over all, he thinks the reaction to the virus was “overkill,” but he also thinks Mr. Trump was wrong to suggest it was “nothing to worry about.”
  • As the virus spread across her facility, Ms. Frazier, the caretaker who witnessed dozens of deaths, said she would see Mr. Trump on television without a mask and grow frustrated. And although she has voted for Republicans and had been a fan of Mr. Trump’s when he was on reality television, she began to blame his cavalier response for her worsening situation at work.
  • Americans, she came to believe, would not act until the virus affected them personally.
  • “If we want to make America great again, then we need to change the political face of our country,”
aqconces

Nurse Edith Cavell and the British World War One propaganda campaign - BBC News - 0 views

  • Edith Cavell worked as a nurse at the Berkendael Institute in Brussels from 1907, where she helped pioneer modern nursing techniques in Belgium.
  • She was arrested for treason in August 1915 for helping more than 200 Allied soldiers escape occupied Belgium
  • In the immediate aftermath of her death, the nurse was used heavily in the British propaganda drive - a campaign that sometimes obscured the real Edith Cavell.
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  • "World War One was the first time propaganda was used as a weapon of war.
  • "It was used to galvanise public opinion against the Germans."
brookegoodman

Hotels being converted into coronavirus hospitals and shelters | CNN Travel - 0 views

  • (CNN) — The Ayre Gran Hotel Colón is a four-star, 365-room design hotel in downtown Madrid close to Retiro Park and one of the city's largest hospitals.
  • With global travel at a standstill -- and millions of people projected to contract Covid-19 in the coming months -- governments around the world are looking to otherwise closed hotels as a way to alleviate stresses on overburdened health systems.
  • The latter was a strategy utilized by officials in Wuhan, China, who erected specialized facilities -- or in some cases, commandeered hotels -- to isolate doctors and nurses. Health workers, of course, are at a higher risk of contracting the illness and subsequently passing it on to their families or fellow commuters.
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  • Europe's largest hospitality company, Accor, opened up 40 of its hotels in France for nursing staff, vulnerable populations and anyone fighting the spread of coronavirus.
  • The US Army Corps of Engineers announced Friday it was working to create more than 10,000 hospital beds in hard-hit New York City by converting hotel rooms and college dormitories into makeshift care facilities. It's considering similar initiatives in California and Washington.
  • Under the plan, contractors would use air-conditioning units to create negative pressure rooms that could suck air outside the room through a vent, minimizing airborne contaminants. Plastic seals would also be placed by the doors, while nursing stations would be set up in the halls.
  • Hotels around the world have seen occupancy rates plummet in recent weeks. Industry experts hope models such as Chicago's could be a way for them to both weather the storm and maintain a skeleton staff.
  • The American Hotel & Lodging Association (AHLA) estimates that, since mid-February, US hotels have lost $2.4 billion in room revenue. Worse still, they're on pace to lose more than $200 million in room revenue per day going forward.
  • The Four Seasons has offered up its iconic property in midtown Manhattan to provide five-star rooms with a $0 price tag for doctors and nurses toiling away at nearby hospitals.
nrashkind

'That's when all hell broke loose': Coronavirus patients overwhelm US hospitals - CNN - 0 views

shared by nrashkind on 29 Mar 20 - No Cached
  • "We ended up getting our first positive patients -- and that's when all hell broke loose," said one New York City doctor.
  • "We don't have the machines, we don't have the beds," the doctor said.
  • "To think that we're in New York City and this is happening," he added. "It's like a third-world country type of scenario. It's mind-blowing."
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  • At first, patients skewed toward the 70-plus age group, but in the past week or so there have been a number of patients younger than 50.
  • "Two weeks ago, life was completely different."
  • There are simultaneous effort to procure ventilators for the most severe patients. According to Cuomo, New York has procured 7,000 ventilators in addition to 4,000 already on hand, and the White House said Tuesday that the state would receive two shipments of 2,000 machines this week from the national stockpile. But the state needs 30,000, Cuomo said.
  • "There is a very different air this week than there was last week."
  • Public health experts, including US Surgeon General Dr. Jerome Adams, have warned the US could "become Italy," where doctors in hospitals filled with Covid-19 patients have been forced to ration care and choose who gets a ventilator.
  • Cuomo also described the extreme measures hospitals are planning to take to increase their capacity for patients who need intensive care.
  • It's not just New York that's feeling the pressure. Hospitals across the country are seeing a surge of patients, a shortage of personal protective equipment such as masks and gowns, and health care workers who feel that they, their families and their patients are being put at risk.
  • Several nurses around the country also spoke to CNN on condition of anonymity, also fearing they could lose their jobs.
  • Judy Sheridan-Gonzalez, an ER nurse at Montefiore Medical Center and president of the New York State Nurses Association, said that "everybody is terrified" about becoming infected because many lack the proper protective gear, and many are being told to reuse the same mask between multiple patients.
  • to become sick and we also don't want to become carriers," she said. "In my own hospital -- and I don't think it's unique -- we have a nurse who is on a ventilator right now who contracted the virus."
  • The goal: to prevent hospitals from seeing a massive spike of patients arriving around the same time.
  • "Obviously, no one is going to want to tone down things when you see things going on like in New York City," Fauci said Tuesday.
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