Assessing the Post-Pandemic Future of Virtual Care

The following is a condensed version of an upcoming news article by Joan Zolot scheduled for AJN’s May edition.

Studies of safety and quality will determine the optimum use of this option.

Photo by Anna Shvets from Pexels

The use of telemedicine surged during the COVID-19 pandemic. Phone and videoconferencing limited patients’ exposure to the virus while maintaining their access to care. One estimate found that virtual care peaked at 42% of all ambulatory visits covered by commercial insurers in April 2020. The February 2 JAMA published several articles* addressing the safety, effectiveness, and quality of virtual consults and their future in health care.

Some obvious and potential benefits.

Because of its efficiency, virtual care has been shown to be particularly suitable for mental health consults, prescription refills, and straightforward evaluations. It can reduce patient inconveniences such as travel to appointments and lost work time. It can also enable patients to receive needed care sooner, especially those with limited mobility, caregiving responsibilities, or who live in remote areas. It may also have the potential to improve care coordination by enabling primary care clinicians and specialists to confer jointly with patients.

Risks, concerns, ongoing questions.

Because virtual medicine does not allow for physical examination, it’s inadequate for common clinical […]

2021-04-07T14:15:14-04:00April 7th, 2021|digital health, patient engagement, Patients, Public health, Technology|0 Comments
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Remembering the Polio Vaccine Rollout, Addressing Concerns Today

‘A Most Welcome Spring.’

That’s the title of the editorial in the recently published April issue of AJN. And if you receive the print issue or go to our Web site, www.ajnonline.com, I think you’ll see that our cover reflects an image that harkens to the end of a hard pandemic winter of isolation and—for many families—desolation. Spring has arrived, along with a feeling of hope that the vaccines will allow the world to open again, IF we can do so with caution and are successful in vaccine campaigns.

Remembering the relief at having a polio vaccine.

I was in kindergarten when Jonas Salk’s polio vaccine was rolled out. I remember my mother telling me that everyone was going to be getting a new medicine and I vividly recall my entire class lining up to get the injection from the school nurse.

I remember my mother being very happy about it because a boy in the neighborhood—a friend of my brother—had had polio and now wore leg braces and used crutches. When she saw him, she would sometimes say, “too bad the vaccine came too late for John.”

Nurses’ role in addressing vaccine concerns.

2021-04-26T11:50:12-04:00April 5th, 2021|COVID-19, infectious diseases, Nursing, patient engagement, Public health|0 Comments
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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 the care […]

2021-03-15T15:33:48-04:00March 15th, 2021|COVID-19, nursing roles, patient safety, Patients|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 visiting her […]

2021-02-26T09:33:01-05:00February 26th, 2021|COVID-19, infection control, Nursing, patient experience, Public health|3 Comments
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For the Mentally Ill in Crisis, Someone Safe to Call for Help

A troubling encounter.

by julianna paradisi

Although it happened over two months ago, I’m still haunted by the memory, particularly during this cold, harsh winter following on the heels of a politically tumultuous summer and fall.

I’ve run the same loop along the Willamette River in Portland, Oregon, for years. This particular morning, a young man walked some 20 feet ahead of me on the sidewalk. He carried by its neck a 1/2 gallon jug of apple juice. Unexpectedly, he tossed an opened box of granola bars, with several individually wrapped bars inside, to the ground and kept walking.

He stopped abruptly at the same time I stopped to wait on the curb for traffic to subside so I could cross to the other side of the street, which is what I routinely do on my route.

We were now six to eight feet apart. From my peripheral vision I noticed him turn and face me. Because we’re in the middle of a pandemic, I was wearing a mask; this and my proximity seemed to disturb him. I stepped away a few paces, giving him more space.

Over my shoulder he said, “You’re a bitch.” I ignored him. He stepped closer, and repeated more loudly, “You’re a […]

2021-02-25T10:54:11-05:00February 25th, 2021|mental illness, mental illness|0 Comments
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