Off the Charts

‘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 many of the […]

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Jacob Molyneux, senior editor/blog editor2021-03-18T12:10:25-04:00March 18th, 2021|COVID-19, Ethics, infectious diseases, Nursing, nursing perspective, safe staffing|1 Comment

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 they […]

Shawn Kennedy, MA, RN, FAAN, editor-in-chief (emerita)2021-03-15T15:33:48-04:00March 15th, 2021|COVID-19, nursing roles, patient safety, Patients|1 Comment

Congress Adds a Nurse

U.S. Representative Cori Bush goes to Washington.

U.S. Rep. Cori Bush (D-MO). Photo courtesy of Cori Bush.

“It’s critical that nurses have a seat at the table when it comes to the policies coming out of Congress. Every single policy needs a nurse’s eye. We talk a lot about the social determinants of health, because it’s all connected . . . nurses see things in a different way.”

As described in this month’s Profiles column, U.S. Representative Cori Bush, RN, arrived in Washington, DC, in January, bringing with her a nurse’s eye and experience as an activist and pastor.

An election representing several firsts.

Her election marked several firsts: she is the first nurse and Black woman Missouri has sent to Congress, and she is also the first woman representative in her district in its almost 200-year history. Bush joins two other nurses in Congress, Representatives Eddie Bernice Johnson of Texas and Lauren Underwood of Illinois. […]

Corinne McSpedon, senior editor2021-03-12T11:21:43-05:00March 12th, 2021|Nursing, nursing perspective, nursing roles|0 Comments

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 Health Organization, that […]

Betsy Todd, MPH, RN2021-03-08T12:31:39-05:00March 8th, 2021|COVID-19, infection control, infectious diseases, Nursing, Public health|0 Comments

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.

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.
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.

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Guest Author2021-03-05T09:52:27-05:00March 5th, 2021|COVID-19, Nursing|1 Comment