Food or Meds? The Lose-Lose Choice Facing Some Older Americans

Food insecurity was already common in older adults before the pandemic.

image by congerdesign from Pixabay

Years ago, when I worked as an ED nurse at Bellevue Hospital, one patient who became a favorite was a charming octogenarian named Sam. He would frequently present in congestive heart failure or pulmonary edema. He always responded quickly to treatment and often just needed a bit of furosemide to get rid of excess fluid.

After one of his almost monthly admissions, we found out that Sam relied on canned soup for much of his diet. The high salt content would cause him to retain too much fluid. He knew the salt wasn’t good for him, but soup was cheap and sometimes all he could afford.

What is food insecurity?

The United States is one of the world’s richest countries, yet we know that hunger is a common problem for many people. Older adults, especially those over 65 with multiple chronic conditions and who take multiple medications, are especially at risk for food insecurity—the inability to afford healthy and nutritious food.

Hard choices for elderly on a fixed income.

Many older adults live on fixed incomes and many don’t have supplemental insurance to cover medications. Some may have to choose between paying for medication or paying for other necessities like housing and food.

Many rely on programs like Meals on Wheels or food banks, but a number of these programs were suspended, at least for a time, during the early days of […]

Racism, Social Justice, and Nurses

By Karen Roush, PhD, RN, FNP-BC

The murder of George Floyd under the knee of a police officer, following so quickly on the murders of Ahmaud Arbery, shot down while jogging in February, and Breonna Tayler, an EMT with plans of becoming a nurse who was killed by police in her own home in March, coalesced years of anger, fear, and despair into an extraordinary outcry for racial justice that has not been seen since the civil rights movement.

Black Lives Matter.

Credit: National Nurses United

The chilling casualness with which Derek Chauvin ended George Floyd’s life over nearly nine agonizing minutes exposed more dramatically than anything else why we need to insist that black lives matter. The fact that it took four days for any charges to be brought against Chauvin, and over two months for the murderers of Mr. Arbery to be charged, only serves to reinforce what many have been saying for a long time, that all lives do not matter equally.

People have filled the streets of large cities and small to march in solidarity for racial justice and the end of police brutality. (Looters and rioters are not part of the protests and unwelcome by those marching for justice.) Not everyone may agree on how to […]

2020-06-12T13:22:12-04:00June 11th, 2020|Nursing, Public health|3 Comments

Cast Into the Shadows: COVID-19’s Power Over Non-COVID Cases

As a pediatric ICU nurse in a hospital that has not experienced an overwhelming surge of COVID-19 patients, it has taken me some time to register the ways this pandemic has affected my perspective and practice.

Non-COVID diagnoses left in the shadows.

Photo by Unjay Markiewicz/ Unsplash

I recently took care of two young patients, each with acute and unexpected conditions. One was under post-operative care after a brain tumor had been removed the day before. The other had been newly diagnosed with acute lymphoblastic leukemia. What stood out to me as I interacted with their families was that these were some of the only people I would interact with in this period who did not have COVID foregrounded in their mental and emotional space. This feeling was followed by the sobering realization that this was only because they found themselves dealing with something just as insidious, if not more so.

In both cases, the families observed confusing symptoms in their children and had to wrestle with whether or not to go to the ED in the midst of a pandemic. Only when the symptoms became so severe and concerning did these families decide they could no longer avoid the ED. Now facing an inpatient hospital stay […]

Time Matters, Priorities Change: A Nurse and Cancer Survivor on Living with the Pandemic

Everything is different, and the same.

Michael Himbeault/Wikimedia Commons

It’s going to be a while before things get to normal, if they ever do. It’s more like the future will become the normal.

The only thing in my experience I can liken it to is my cancer survivorship: you start living your life again, but everything is different. Priorities change. Your sense of safety never fully returns, yet because of this you become more purposeful in living: time matters. It’s as though you go on living, but learn a new way to do it.

There’s actually a sense of freedom accompanying the realization that nothing/no one lasts forever.

Finding a middle ground.

After I completed treatment, I watched the Jeff Bridges film Fearless (1993). His character is a survivor of a horrendous airliner crash, and he develops a sense of invincibility as a way of coping. I understood his character really well. You either hide in fear, or you go forward as if you are invincible. Eventually, you discover a middle ground. […]

COVID-19: It’s Not Only About Hospital-Based Nurses

‘We all just went charging towards this monster…’

We’ve all seen the photos of nurses in PPE providing care to patients who are obviously very ill with COVID-19. These nurses have justifiably received recognition and accolades for their commitment to duty under the most challenging circumstances and often at great personal risk.

I recently spoke with Megan Brunson, the president of the American Association of Critical-Care Nurses (AACN), who is also a supervisor in the cardiovascular ICU at Medical City Dallas Hospital.

Brunson described her own experiences, but also what she was hearing from her colleagues as they all “just went charging towards this monster called COVID.” She also talked about how the organization was rapidly developing resources, not only for clinical care but to help nurses deal with emotional stress. One initiative is partnering with DearWorld.org to create a collection of portraits and stories from nurses caring for patients with COVID-19.

Disrupting work in many settings.

But it behooves us to realize that this pandemic has not caused stress and critical challenges just for acute care nurses; nurses in many settings have been challenged and have had their work disrupted.

In the last two weeks, I spoke with nurses and nursing leaders of several organizations to learn about how the coronavirus pandemic has changed their work. […]

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