Like other largely rural states bearing the brunt of the brutal SARS-CoV-2 holiday spike, Oklahoma hospitals are scrambling to care for patients amid overcrowding, understaffing, and bed shortages. The state estimates that at present there are at least 1,000 Covid-19 in Oklahoma hospitals, and the health care system is at risk of splitting along its seams.
“And that’s the way it is in Oklahoma…”
According to Tulsa World, “Some hospitals are putting patients in hallways, renovating conference rooms into ERs, converting entire wings into COVID units, limiting nonemergency procedures and surgeries, and admitting only the “sickest of the sick” COVID patients.” The new year is having a harsh beginning. Last Wednesday, at a weekly Project ECHO meeting at Oklahoma State University, Dr. Jennifer Clark, who leads COVID-19 data sessions, said, “January is already stacking up to be a pretty significant month. My guess is we’ll probably see doubling of most of our numbers” She noted, “It’s no big secret that our nursing shortage existing prior to the pandemic is now kind of crippling us to some extent. We don’t have the staff to take care of between 1,000 and 2,000 extra hospitalizations.”
On average, 26 Oklahomans are dying of Covid-related complications each day, making it the third leading cause of death in the state, after heart disease and cancer. Clark remarked, “So you can see that our hospitals are not only full based on regular hospital folks who get sick in the wintertime, but now we have COVID on top of it. It’s almost overtaking our ability to take care of folks.” Clinicians in a range of specialties are being called upon to pitch in. Pediatricians, for example, are helping in adult hospitals, outpatient primary care providers are working shifts at their area hospitals, and doctors at rural health facilities are cramming to learn unfamiliar treatment techniques so they can treat incoming Covid patients.
“Our Covid patients are some of the sickest I’ve seen”
At a virtual news conference, ICU nurse Amy Petitt (who works at SSM Health St. Anthony Hospital in Oklahoma City) said that exhausted nurses are working 50-60 hour weeks. She said of current conditions: “We’re seeing more patients — more critically sick patients. Our COVID patients are some of the sickest we’ve seen. When they come to us in the ICU, a lot of them require intubation, lines, they have to be turned on their bellies, they require being paralyzed pharmacologically, sedation, blood pressure medication, dialysis…” Petitt added, “Everybody has stepped up, taking higher acuity patients and higher patient loads. [But] it’s not sustainable in the long run, and we need the community’s help.”
During the Covid surge, Oklahoma health officials are urging people with other serious illnesses to stay in touch with their HCPs via telemedicine visits and to contact community services for home health care or palliative care services.
For more on Oklahoma’s battle with Covid, see the coverage in Tulsa World.
Delaware is still debating whether to reopen in-person classes at public schools this month, but if they’re ready, our Nurse of the Week, Mispillion Elementary’s school nurse Sue Smith will be ready too.
After 25 years of working for the Milford school district—and seven years of nursing at Mispillion Elementary—the Delaware School Nursing Association’s 2019 School Nurse of the Year is not easily rattled. As the pandemic started to spread last year, Smith’s extensive experience prompted local officials to add her to Delaware Governor John Carney and the Delaware Department of Education’s Health and Wellness Workgroup for School Reopening, where she helped to assess the state’s plan to send kids back to school.
Smith has been ready to return to care for her kids since last fall when Delaware schools opened and swiftly sputtered to a close when Covid-19 cases began breaking out within days. Back when People magazine spoke to the 62-year-old school nurse in September, Smith’s view was quite matter-of-fact: “In my nurse’s office, I’ll still feel very comfortable doing what I normally do. I’ll have my mask and goggles on because I’ll be very close to the children, but I’ll feel very confident doing an assessment. Of course, I think there’s always going to be a level of anxiety for the unknown because this virus is an unknown. We don’t have a crystal ball to tell us everything will be okay. It’s not about if someone’s going to get infected — it’s when. But I truly believe we’re prepared to handle it.”
Mispillion Elementary Principal Teresa Wallace told Delaware State News that she places the utmost confidence in her school nurse. “She’s helped the district prepare and helped our school prepare. She is in the field of nursing and has a lot of background, not just as a school nurse, but in other areas. I feel like her knowledge base is really important in dealing with something that has so many unknowns.”
Smith’s debut in the pages of America’s best-known celebrity periodical hasn’t phased her. Asked about her remarks in People, she said, “All school nurses are feeling the same anxieties and those kinds of things. It’s important to know that in Delaware we’re all trying to work together to help each other.” What does she plan to do with her brush with fame? “I probably will put it [the magazine] in a frame for my granddaughter. That way, she’ll have it for a long, long time.”
Since 78-year-old nursing home resident Mauricette received the first Covid vaccination in France on December 27, the French have given the new Pfizer-BioNTech vaccine a cool reception. President Emile Macron declared, “Let’s have trust in our researchers and doctors. We are the nation of the Enlightenment and of Pasteur. Reason and science should guide us.” So far though, few seem to be heeding Macron’s words. Vaccinations for SARS-CoV-2 are proceeding at a painfully slow pace in many nations, but progress in France—which has lost more citizens to Covid-19 than almost any other EU country—has been moving at a (pre-climate-change) glacial pace.
One key issue is surely the logistics of the Pfizer-BioNTech vaccine. In France, nursing home residents were designated to be the first to receive shots, but most care home facilities lack the special freezers needed to store the vaccine at -70 degrees Centigrade. Another factor, one that affects most countries, is that politicians have been setting overly optimistic, pie-in-the-sky targets. For the French, though, the steepest barrier is an anti-vaxx climate that permeates the country. Repeated polls in the fall indicated that over 50% of of the French did not intend to get a shot when vaccines became available (compared to about 36% in US polls). In practice, the numbers are even more dismaying. During the first week of the national rollout—which placed care home residents at the top tier—fewer than 600 people received Covid jabs. (Some 400 French are dying every day of Covid complications). As a Bloomberg columnist put it, “At this rate, it would take France about 400 years to vaccinate its people.” France is a bastion of vaccine hesitancy—to such an extent that even many healthcare providers regard vaccines as suspect.
The stalled Covid vaccination campaign is the latest episode in the history of French vaccine misadventures. Officials are retooling plans in the hope of fending off a repeat of the disastrous 2009 H1N1 effort—in which only 8% of the population received shots and millions of vaccine doses were wasted.
This dubious attitude toward scientifically tested life-saving medicines in the home of Louis Pasteur may seem strange, but it does not arise from a mistrust of science so much as a mistrust of institutions, especially government. As vaccination campaigns tend to be government-run, politics, as in the US, can be a deciding factor. Social media falsehoods about the new vaccines run rampant, and both the far-right and far-left mingle vaccine hesitancy with a deep suspicion of the Macron administration. “Part of the population may reject the jabs just because they don’t see them as an anti-Covid vaccine, but as a pro-Macron one,” science historian and vaccine hesitancy researcher Laurent-Henri Vignaud told Wired UK. Mistrust is further fueled by mishandling of mask guidelines to a degree that makes the US fumbles seem quite venial.
What now? The country is engaged in a mad dash to jump-start the campaign. One positive step is that nursing home staff over age 50 were moved up the line to be vaccinated along with care home residents, along with healthcare providers. Progress among HCPs should speed things, as many hospitals have freezers capable of storing the Pfizer-BioNTech formula, and the arrival of the Moderna vaccine (which can be stored in a regular freezer) will ease the logistics of vaccinating France’s large elderly population. Also, it should be kept in mind that most countries have had deeply disappointing vaccine rollouts. As more types of vaccines become available, and as nations start to correct the hyper-inflated targets set by elected officials, the process should pick up speed, but it is probably too early to indulge in speculation about when communities will see a return to “normalcy.”
The results are in, and the American Journal of Nursing (AJN) Book of the Year Awards for 2020 offer a fascinating snapshot of the nursing profession as we assimilate the impact of the pandemic.
DailyNurse is proud to note that Springer Publishing (our parent company) swept this year’s Book of the Year awards, with 19 titles singled out for honors by AJN’s expert judges! (Including all three awards in the Gerontologic Nursing category). Eight Springer Publishing books received First Place awards, five titles earned Second Place awards, and another five books placed Third among the titles chosen by the AJN judges. One book, the Handbook of Perinatal and Neonatal Palliative Care, was even chosen by two judges as the first-place selection in two different categories. So, why hide one’s light under a bushel? Here are the 18 winning Springer Publishing titles of 2020, with comments by the judges…
Edited by Ann L. Cupp Curley. 3rd edition. New York City, Springer Publishing Company.
“This engaging text… is very well written, and its narrative flows seamlessly…. It also promotes the utilization of research evidence—this is vital, as advanced practice can serve a pivotal role in the translation of research into practice and can positively impact individual and population health.”
By Sylvia I. Mignon. New York City, Springer Publishing Company.
“I recommend it for public health nurses to gain insight into mental health care—an often underserved area within public health practice and the health care system… An excellent presentation of current issues surrounding mental health…. Uses enlightening real-world case examples… Provides a complete overview of mental health issues, including history, current status, and recommendations to promote health.”
By Frank J. Whittington, Suzanne R. Kunkel, and Kate de Medeiros. 2nd edition. New York City, Springer Publishing Company.
“An excellent introduction to major issues in societal and global aging… This is an important text both for students interested in global health and those who want to understand the cultural aspects of aging in their own country.”
By Abimbola Farinde and Megan Hebdon. New York City, Springer Publishing Company.
“This excellent guide provides useful information for prescribers, including a comprehensive overview of age-related considerations in prescribing medications and evaluating their effectiveness… Well organized, comprehensive, and presented in an accessible and helpful way to support busy clinicians… An excellent resource for practicing prescribers and educators.”
Edited by Marie Boltz, Elizabeth A. Capezuti, DeAnne Zwicker, and Terry Fulmer. 6th edition. New York City, Springer Publishing Company.
“A must-have for all practicing clinicians who care for older adults. Written by an outstanding group of authors who are leaders in the field of gerontological nursing, it provides a comprehensive guide to high-quality, person-centered care.”
Edited by Whende M. Carroll. New York City, Springer Publishing Company.
“An excellent text for nurses who have expertise in informatics topics. The inclusion of important contemporary topics makes this book stand out…. Includes practical and clinically relevant topics for nurses at all levels… Very inspiring for the nurse who wishes to learn more about informatics in health care.”
Susan Alexander, DNP, ANP-BC, ADM-BC
Awarded First and SecondPlace: MATERNAL–CHILD HEALTH/PRENATAL NURSING/CHILDBIRTH
By Chantal Cara, Marcia Hills, and Jean Watson. New York City, Springer Publishing Company.
“It is fitting and timely that a well-established nursing theory emphasizing caring be applied to improving the climate and practices of nursing education…. The book exemplifies [the characteristics of Jean Watson’s theory of caring and her 10 Caritas Processes]… as the underpinning of the nurse educator’s work and reminds us that the individuality of the student is as important as the individuality of the patient.”
By Bernadette Mazurek Melnyk and Tim Raderstorf. New York City, Springer Publishing Company.
“What I loved about this book is that the authors made complex leadership and business topics accessible and interesting by sharing leaders’ personal stories…. Provides actionable and practical strategies students can use to further their own development… Readable and clear, it is sure to be a favorite among students.”
Rose O. Sherman, EdD, RN, NEA-BC, FAAN
Awarded First Place (sole category winner): NURSING RESEARCH
Edited by Kathleen M. White, Sharon Dudley-Brown, and Mary F. Terhaar. 3rd edition. New York City, Springer Publishing Company.
“The authors of this text capture why we need to translate evidence into practice, and they present an unbiased collection of translation roadmaps for any nurse to use. Just reading the table of contents alone demonstrates the breadth of knowledge that academicians need to teach tomorrow’s nurse leaders about translation… Would be useful as core reading for DNP and Ph.D. programs.”
Rodney W. Hicks, PhD, RN, FNP-BC, FAANP, FAAN
Awarded First and Second Place:PALLIATIVE CARE AND HOSPICE
Edited by Jeffrey S. Jones and Kathleen R. Tusaie. New York City, Springer Publishing Company.
“In a concise, easy-to-read, and resource- and example-rich text, Jones and Tusaie, both experienced nurse psychotherapists, present information for both novice and experienced psychiatric advanced practice nurses who wish to provide psychotherapy.”
Donna Sabella, PhD, MEd, MSN, PMHNP-BC
To see the full list of all 2020 AJN Book of the Year Awards, click here. To see the judges’ reviews of all of the 2020 Book of the Year titles, click here (PDF file).
Our first Nurse of the Week in 2021 is a nursing icon. On December 27—the day before her 100th birthday—AAN Living Legend Loretta C. Ford, EdD, RN, PNP, NP-C, CRNP, FAAN, FAANP was awarded the Surgeon General’s Medallion for exceptional achievement in the cause of public health and medicine.
Dr. Ford, who helped to create the first NP program at the University of Colorado in 1965, is regarded as a co-founder of the Nurse Practitioner (NP) profession. As a public health nurse in the 1940s and 1950s, she became concerned about Colorado’s underserved rural communities, and came to believe that with specialized training, nurses could help to fill the gap. Ultimately, Ford and pediatrician Henry Silver joined forces to found the University of Colorado pediatric NP program and the NP profession itself. Ford’s pathblazing role has led to numerous honors. She was the inaugural member of the Fellows of the AANP (FAANP), a special title reserved for providers that have made a lasting impact on the NP profession, and in 2003, she received a Lifetime Achievement Award from the journal Nurse Practitioner. In 2011, she was inducted into the National Women’s Hall of Fame, which acclaimed her for having “transformed the profession of nursing and made health care more accessible to the general public.”
Ford’s latest award, the Surgeon General’s Medallion, is the highest honor granted to a civilian by the Public Health Service and the U.S. Public Health Service Commissioned Corps. AANP President, Sophia L. Thomas, DNP, APRN, FNP-BC, PPCNP-BC, FNAP, FAANP commented, “Dr. Ford has received this recognition for her vision and commitment to the health of our nation. Thanks to her trailblazing efforts, millions of patients have access to high-quality health care from NPs, the provider of their choice, and the profession has grown to more than 290,000 strong.”
David Hebert, JD, Chief Executive Officer of AANP, added, “As we celebrate Dr. Ford’s 100th birthday, I can’t think of a more fitting tribute to this titan of American health care. From co-creating the NP profession to advocating for patient access to NP care, she has played a profound role in strengthening health care access and choice for America’s patients.”