‘Right Under Our Noses’: Nightmarish Nursing Home Conditions During the Pandemic

As vaccinations increase and COVID-19 infection rates in nursing homes plummet, it’s easy to forget just how bad things got in many of them and how ill-equipped many were in the the early months of the pandemic to provide humane and effective care.

The following excerpt is from our March Reflections essay, “Right Under Our Noses: Nursing Homes and COVID-19,” which was written by a California nursing professor who volunteered to join a California Medical Assistance Team. The mission of her team was to bring aid to a skilled nursing facility where the coronavirus was rapidly infecting both patients and staff, a facility with little PPE available and many staff members refusing to come to work out of fear of infection.

The conditions I saw were shocking, even to an experienced nurse. I saw soggy diapers on the floor at the heads of many beds on most mornings. One day a bedbound patient needed the bedpan. I searched every closet and drawer but there were no supplies. I filled a basin with warm water and cut up a PPE gown to make washcloths to clean the patient. On the second day of my deployment I realized that […]

2021-03-18T12:10:25-04:00March 18th, 2021|COVID-19, Ethics, infectious diseases, Nursing, nursing perspective, safe staffing|1 Comment
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No Country for Old People

In my editorial in the March issue, I ask, “Where do we go from here?’” in thinking about what’s next for nursing. In particular, I wonder if we’re going to make any strides in improving the quality of how we care for older adults who need long-term care.

Disasters give rise to assessments of what went wrong.

After prior disasters like hurricanes, heat waves, and flooding, there has often been a flurry of initial concern, with many committees convened to look at the deaths that occurred.

More recently, the New York Times has reported on the fate of nursing home residents during the Covid-19 pandemic in relation to the deterioration of quality in nursing homes once they are owned by for-profit entities—as 70% of nursing homes now are. So here we are once again, this time decrying the conditions revealed by Covid-19. Will things change this time?

In answer to this question, I’m especially pleased with the article in our March issue by 22 nurse gerontology experts. They issue a call (a challenge?) for the Centers for Medicare and Medicaid Services (CMS) Coronavirus Commission for Safety and Quality in Nursing Homes to rewrite standards to finally address under-resourcing and ensure residents get […]

2021-03-15T15:33:48-04:00March 15th, 2021|COVID-19, nursing roles, patient safety, Patients|1 Comment
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Johnson and Johnson Vaccine a Valuable Addition to the COVID-19 Toolbox

With the emergency use authorization (EUA) of the Janssen Pharmaceuticals/Johnson & Johnson COVID-19 vaccine, three vaccines are now available in the U.S. to prevent SARS-CoV-2 hospitalizations and death. The newest vaccine, given as a single dose and stable at refrigeration temperatures for at least three months, presents far fewer logistical challenges in getting doses to consumers.

All of the three current U.S. vaccines use a single protein from SARS-CoV-2 to enable the body to react to the whole virus. The Pfizer/BioNTech and Moderna vaccines are messenger RNA vaccines that use a synthetic version of part of the SARS-CoV-2 genome to teach our cells to replicate the spike protein found on the surface of the virus. This copy of the protein then stimulates the immune system to produce antibodies and other cells that will recognize the actual virus if it is encountered in the future.

The new vaccine employs a different mechanism to produce the same result. A human adenovirus, modified to disable its ability to multiply and infect, acts as a “vector” to carry a gene from the spike protein into our own cells, where the protein is replicated and activates the immune system as above.

(The Oxford/AstraZeneca COVID-19 vaccine, currently in use in the UK, Canada, and Australia, is also a vector vaccine. Granted emergency use listing by the […]

2021-03-08T12:31:39-05:00March 8th, 2021|COVID-19, infection control, infectious diseases, Nursing, Public health|0 Comments
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What Do Nurses Need?

“Covid-19 Is ‘Probably Going to End My Career’” is the title of my recent column in the New York Times. The nurse who made that statement spoke to me on the condition of anonymity because her hospital doesn’t like having nurses speak out. So—nurses are afraid to publicly complain about their difficulties on the job, struggle with a lack of PPE and short-staffing, and are overwhelmed by the number of deaths they are seeing. All this has led to the nursing profession being in crisis.

The six ideas below could help nurses drowning in difficulties imposed by Covid find their way back to solid ground.

  1. Staffing legislation. This could mean ratios, or some other way to insure that nurses are not expected to work short. The legislation should also require robust nursing float pools and keep secretarial and nursing assistant support at their usual levels. Units have to be staffed in a way that maximally benefits patients, not just to help balance a hospital’s bottom line.
  2. Mental health support. Nurses as a group are not always open to counseling, but during Covid nurses have spoken out about the emotional toll of the work and their ongoing PTSD. They have recognized their need for mental health support. Hospitals must give nurses health insurance that covers individual counseling, and have mental health resources available on the job for nurses. “Covid broke me” is being said by too many nurses, too often.

    3. […]

2021-03-05T09:52:27-05:00March 5th, 2021|COVID-19, Nursing|1 Comment
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Joy, Relief, Reverence: Positive Side Effects of a First COVID-19 Vaccination

A family’s long year, brushed by COVID-19.

Photo by Jon Tyson on Unsplash

On February 23, 2020, three days before a flight to Israel to speak at a nursing conference, I received a message from the host that the ministry of health had issued a restriction to stop all conferences and meetings in the health care system because of the coronavirus. I had other business scheduled, so I boarded the flight. While in Israel, I followed the global health news, and returned home a week later fully aware that COVID-19 was an emerging pandemic. But when I landed and entered the international arrivals terminal at Newark Airport, business was as usual and only a handful of us in line wore masks going through customs.

It’s been a hard year since that time. My son, a healthy 27-year-old, had COVID in late March, during the worst surge of positive cases and deaths in New York City. Testing wasn’t available. He lived a subway ride away. For 10 days, I monitored his symptoms by texts, along with his primary care provider. He fully recovered. My 95-year-old mother died in April in a  New York State assisted living facility. We don’t believe her death was COVID related. Restrictions prevented my […]

2021-02-26T09:33:01-05:00February 26th, 2021|COVID-19, infection control, Nursing, patient experience, Public health|3 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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