The U.S. Still Can’t Manage COVID-19 Testing: Why Is This Such a Big Deal?

By Betsy Todd, MPH, RN, nurse epidemiologist and AJN clinical editor. Published April 20.

How is it that we in the U.S. make up 4% of the world’s population but account for more than 31% of global COVID-19 cases? Because at the start of the pandemic we weren’t prepared to test quickly and widely—and incredibly, after three months’ time, we still aren’t.

Coincidentally, both the U.S. and South Korea saw their first cases of COVID-19 on January 20. Two weeks later, South Korean scientists had perfected a diagnostic test for the virus, and infected people began to be identified and isolated.

Meanwhile, in the U.S. a series of problems and poor decisions held back test development. In early March, as the number of cases of COVID-19 exploded in parts of the country, Health and Human Services Secretary Alex Azar promised that by March 14, labs would be running four million tests per week. As of April 20, the total number of SARS-CoV-2 tests performed in the U.S. since the pandemic began was only 3.8 million, according to covidtracker.com. Our testing capacity is frighteningly low. Estimates of an […]

2020-04-20T12:32:03-04:00April 20th, 2020|infectious diseases, Nursing, Public health|0 Comments
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Practicing the ABCDEs of Self-Care in Pandemic Times

While talk of the surge in COVID-19 cases continues, what has been less audible in the national discourse is the surge in mental health distress that will be with us long after the pandemic is gone. Many of us who have enjoyed relative psychological well-being are feeling inundated with near-pathological levels of anxiety, uncertainty, anticipatory grief, and real or secondary trauma.

Here are ABCDEs of self-care to keep yourself and loved ones emotionally—and physically—well.

ABCDEs of Self-Care

About

Stay informed as you need to regarding the pandemic, but then promptly pull yourself away and unplug. Initiate what we call a “sensory diet” to limit anxiety-provoking exposure to TV and radio news, social media, print materials, etc., beyond what you must know for yourself, your family, and/or your job. Fearful news can be addictive. Don’t overindulge!

Body

Many people, when asked how they can best care for themselves to stay well, say something on the order of “handwashing, masks, social distancing….” Sure, all that! But we also need to respect the healthy things our mother tried to teach us. How about exercise and fresh air (even if it’s just a three-minute brisk walk around the block), adequate sleep and decent nutrition? Honoring our bodies now will help us stay healthy and […]

2021-01-21T11:10:16-05:00April 13th, 2020|infectious diseases, mental illness, Nursing, wellness|0 Comments
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Far from Home, a Flight Nurse Cares for One of COVID-19’s ‘Peripheral Victims’

‘Deemed stable to fly home.’

Our fixed-wing air ambulance was recently dispatched to Spain to bring 87-year-old John and his wife of 62 years, Rose, home to the US. They’d traveled to Spain for their annual vacation before “COVID-19” or “coronavirus” were household terms, but John had fallen early on in the trip and broken a hip. He’d spent four weeks in a local hospital and had his injured hip surgically repaired, and then was deemed “stable to fly home” by a doctor. And so he’d been transported back to his hotel two days prior to our arrival. The crew deposited him in the bed, bid farewell to his wife, and left.

Spain’s deserted beaches seen from author’s hotel room, March 2020

And now John was dying. He lay on the twin bed in his hotel room. His eyes were closed. His breathing was rapid and shallow. My partner and I stood, stunned into momentary silence. We had come straight to his hotel from the airport, and his condition was far worse than we had anticipated.

We’d left our equipment in the aircraft, as John’s transport was planned for the following morning to allow time for our pilots to rest. John’s respiratory rate was 60 with frequent pauses, his pulse weak, heart rate about 95 and irregular. He wouldn’t open his eyes or respond to us verbally, but he fought us when we tried to move him. He was covered in feces.

No room at […]

2020-04-09T10:25:10-04:00April 9th, 2020|infectious diseases, Nursing, nursing stories|3 Comments
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Preserving Integrity and Staying Power as a Nurse in a Pandemic

We are in unprecedented times—uncertainty and fear are ever present and nurses are being called to serve others in ways that challenge our appraisal of benefit to our patients and risk to our families’ health and well-being. Many of us are experiencing varying degrees of moral distress and moral outrage arising from the gaps between what we ought to be doing and what we are actually doing under these adverse conditions. It can feel as if it is impossible to do ‘the right thing.’

What can we do to remain whole in the midst of the COVID-19 crisis? How can we accept what seems unacceptable?

Instead of using precious energy in unproductive ways, we can focus on the things that are within our control for meeting the demands of the situation with integrity.

Recognize your moral distress.

It’s easy to get swept away with fear. When fear takes over, we can become paralyzed—unable to think clearly or to act in accordance with our values. One way to confront our fear is to recognize and name the source of the angst.

What is causing your distress? Notice tension anywhere in your body. Accept whatever it is you find. What are the conflicting obligations you are confronting? Try to name the conflict.

You may realize that your core value in the current situation is to not cause harm to your patients. You may say to yourself, […]

2020-04-07T11:14:22-04:00April 7th, 2020|infectious diseases, Nursing, nursing perspective|3 Comments
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As Conflicting Recommendations Sow Public Confusion, Nurses Still Lack Adequate PPE and Equipment

By Betsy Todd, MPH, RN, nurse epidemiologist and AJN clinical editor. April 3.

One problem central to the experience of nurses during this pandemic is the disastrous lack of essential supplies and equipment. How different would your work days be right now if you had plenty of PPE and ventilators? In the parts of the country with the most COVID-19 cases, this problem is far from being resolved. In many other cities and states, unbelievably (after three months), you are likely to be faced with it soon.

Where is our PPE?

For weeks, nurses and physicians in states that were initially hardest hit by the pandemic (New York, California, Washington) have reported severe shortages of personal protective equipment. (See, for example, this ICU nurse’s anonymously published note to AJN.) Respiratory protection has been in particularly short supply. In many hospitals, staff are reusing one droplet mask or N95 respirator for an entire shift or longer. These dire circumstances were predictable. A  2015 article from researchers at the National Institutes of Health predicted that in a pandemic in which only 20 to 30 percent of the population is infected, up to 7.3 billion N95 respirators would be needed. COVID-19 is likely to infect a considerably higher percentage of the population. Where are our masks? […]

2021-01-21T11:08:39-05:00April 3rd, 2020|infectious diseases, Nursing, Public health|3 Comments
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