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 World […]

2021-03-08T12:31:39-05:00March 8th, 2021|COVID-19, infection control, infectious diseases, Nursing, Public health|0 Comments
Read More

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
Read More

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 visiting her […]

2021-02-26T09:33:01-05:00February 26th, 2021|COVID-19, infection control, Nursing, patient experience, Public health|3 Comments
Read More

The ‘Clog Kick’: In Trying Times, Adapting to the Loss of a Palliative Care Team’s Essential Rituals

Palliative care, under optimal circumstances.

I work as a palliative care NP on an inpatient consult team at an academic medical center in Massachusetts. In the best of times, palliative care teams are exemplars of interdisciplinary functioning. According to nationally accepted consensus reports, since palliative care is holistic in nature, it must be administered by a team that can address the multidimensional elements of suffering for both patients and families in the setting of serious or life-limiting illness.

In my experiences on two interdisciplinary palliative care teams, we were damn strong together. We met each morning to divvy up the workload; around the crowded table were NPs, physicians, chaplains, social workers, sometimes a pharmacist or a librarian, and a bevy of rotating students of all disciplines. On the table was often food: from someone’s garden, our own kitchens, or the grocery store bakery.

A ‘thread of lightheartedness’ amidst the heaviness.

The work was seemingly endless (as many people as there were around the table, there were scores more patient consults), and the situations were heavy and complex. We took our work seriously because the situations we waded into day after day were often worst-case scenarios for our patients and their families.

But there was also a thread of lightheartedness that ran through the days and weeks. We prioritized team and clinician wellness, and often laughter was the centerpiece of the table. We strategized together, cried and fretted about our patients, roared or seared in frustration, and yes, we watched funny cat videos to keep the […]

2021-02-23T17:02:36-05:00February 18th, 2021|COVID-19, Nursing|0 Comments
Read More

Levels of Weariness Among Nurses

I imagine that nurses throughout the world are constantly being asked “How are things at work these days?”—with the implied question being “How are you holding up with your work situation?” While my colleagues and I in our pediatric hospital have not seen an overwhelming surge of COVID+ patients come through our doors, we have certainly seen some, with an uptick in our COVID+ census as the numbers throughout the country have increased.

When I pause at this point in the conversation, the usual response I get is, “Oh, that’s so good to hear. You’re lucky.” And I agree and reflect this back to whoever I’m speaking with. My heart hurts for my fellow nurses in other parts of the nation who have been utterly overwhelmed by COVID and its cruelty. I recognize that I am indescribably lucky.

At the same time, though it’s hard to articulate why, even nurses who haven’t been hit by the surges seen in other hospitals bear layers of deep weariness by this point in the pandemic. […]

2021-01-21T11:28:06-05:00December 16th, 2020|career, COVID-19, infectious diseases, Nursing|1 Comment
Read More

Comment ground rules

1. Please be respectful.
2. We moderate all comments.

Content disclaimer

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.
Go to Top