A growing number of letters, editorials, and petitions are urging the incoming Biden administration to include nurses in their Covid-19 task force. When the new team assembles to battle the pandemic in 2021, the Emergency Nurses Association, the American Association of Nurse Anesthetists, and representatives from Rutgers and NYU’s Rory Meyers School of Nursing, among others have declared that nurses must have a place at the table.
In a widely published opinion piece for CNN, Caroline Dorsen, PhD, FNP-BC, associate professor and associate dean of advanced practice and clinical partnerships at Rutgers School of Nursing and Lauren Ghazal, a PhD candidate at NYU Rory Meyers College of Nursing stated that nurses are “public health experts who will add a unique and important perspective to this critical work.” They added, “Nurses are vital to meeting the task force’s goals, including making rapid testing widely available, building a workforce of contact tracers, prioritizing getting vaccines to at-risk populations (including people of color that have been disproportionately affected by Covid-19), developing clear and detailed prevention and treatment guidelines, providing necessary resources for schools and businesses to reopen safely, protecting workers and the public and, of course, caring for the sick and dying with skill, kindness and dignity.”
Emergency Nurses Association (ENA) president Mike Hastings, MSN, RN, CEN, wrote an open letter to Biden, pressing for the inclusion of nurses on the task force: “As the surge in cases and hospitalizations are expected to continue in the months ahead, the nursing perspective will be critical as your team prepares to address the crisis. Once a vaccine is approved, nurses will play a critical role in its administration to the public. Accordingly, we respectfully request that you consider placing nurses with experience and expertise in pandemics, the frontline treatment of patients and infectious diseases on the COVID-19 task force.”
Using the hashtag #NurseOnTaskForce, a Change.org petition calling for the inclusion of nurses on the task force stated that “input from nurses is crucial to insure that the recommendations regarding COVID apply to all health care workers.” The petition had acquired over 5,000 signatures by November 17.
While there is some debate over including nurses as task force members, the Biden team’s actual plan for handling the pandemic (click here to see a summary of the plan) has been met with enthusiastic approval by National Nurses United. NNU president Zenei Cortez said, “Not only does the plan address the current crisis, it would begin to rebuild the infrastructure needed to be able to respond to infectious disease outbreaks, that are likely to happen more often due to the climate crisis, globalization, and rapid urbanization in the future.”
In a statement released Wednesday, the North Dakota Nurses Association objected to allowing nurses with the virus to continue working, emphasizing that a choice to work while infected should be up to individual nurses, not their employers.
The group also said all other public health measures to reduce the demand on the healthcare system should be implemented first, including a statewide mask mandate, which North Dakota does not have.
Neither the North Dakota Medical Association nor the North Dakota Hospital Association reacted publicly to the new policy as of press time.
On Wednesday, the North Dakota Department of Health announced a record number of active COVID-19 cases. “At this point, every county in our state is at high risk level,” said Tessa Johnson, MSN, RN, president of the North Dakota Nurses Association. “The governor has put this policy out and still, no masks are required. It feels like a slap in the face to nurses right now.”
“We really feel like if we’re going to make a big change, it needs to start with that,” Johnson told MedPage Today. “The governor has very much left it open to individual cities and counties, and some have chosen to have a mask mandate, but there’s no teeth behind it.”
On paper, the new policy appears to have protections built in for patients and co-workers, but that’s not the case in the real world, Johnson said.
“It’s not as simple as just putting a COVID-positive patient and staff member together,” she said. “There are shared spaces in hospitals, nursing homes, and clinics to be concerned about — bathrooms, break rooms, hallways, elevators.”
And in rural areas of the state, small facilities are connected to one another, Johnson pointed out. “You may have a long-term care facility, an ER, and a hospital all attached to each other, and the same RN may care for all those patients. How’s that going to work? No one has answers and there’s a lot of fear surrounding that question.”
When the governor’s statement was issued on Monday, the association reached out to nurses throughout the state and received immediate feedback. “A point they emphasized was make sure that, even with this order, nurses and their employers must have a choice: you cannot mandate any nurses to do this,” Johnson said.
The message the policy sends to the community is troubling, too, she noted: “We are a very ethical, trusted profession and people look to us for guidance. In this whole time, we’ve been saying wear your mask, socially distance, and stay home if you are in close contact. So how can we continue to be credible sources and tell people to stay home if we’re not?”
What’s happening in North Dakota may be due in part to the changing shape of COVID-19 patterns throughout the country, observed Cheryl Peterson, MSN, RN, vice president of the American Nurses Association, the national professional nursing organization based in Silver Spring, Maryland.
Early in the pandemic, nurses could move from one COVID-19 hotspot to another to help, but that’s no longer the case, she noted. “Because of how widespread the disease is circulating, there’s no place for that now,” she said.
“There’s no give in the system now to get more resources to these hospitals, and I think that is going to play out,” Peterson told MedPage Today. “We see it now in North Dakota,” she said. It wouldn’t surprise her if similar policies spread to other states “as we move higher up the spike or further into the pandemic,” she added.
“The piece we want to really focus on is that hospitals recognize it is up to the nurse as to whether or not they are interested in working when they are COVID-positive,” Peterson said.
“The CDC guidance says they have to be willing to work. It’s up to them whether they’re going to work and if they say, yes, they’ve made a decision. If they say no, that, too, is a decision and it must be respected by the facility and there should be no retaliation.”
If you are dubious about the hurried pace of the COVID vaccine trials, you’re not alone. Uncertainty was rife among the nearly 13,000 respondents to the American Nurses Foundation (ANF) Pulse on the Nation’s Nurses COVID-19 Survey Series: COVID-19 Vaccine, October 2020. While about half of the nurses surveyed (47% and 48% respectively) said they are “somewhat confident” regarding the development and efficacy of the promised vaccine, 40% have no confidence in the accelerated development process, and 38% doubt that it will result in an effective vaccine.
Nurses can usually be relied on to cheer the appearance of new vaccines and encourage their use, so why do 36% say that they probably would not voluntarily use a fast-tracked Covid vaccine? Most of their concerns revolve around the extreme (and unprecedented) haste of development; in fact, 84% believe that the process is “too fast,” and 75% are not happy with the expedited clinical trials. Skepticism runs so high that 44% say that they would not feel comfortable talking about a Covid vaccine with their patients. The general US public seems slightly more hopeful, but the numbers are still discouraging. In a recent Harris Poll, 40% of the respondents stated that “Warp Speed” is an unsuitable velocity for Covid vaccine development, and Americans planning to get vaccinated as soon as possible dropped by over 20%, falling from 79% in mid-August to 58% in mid-October. Nurses may be ahead of the curve owing to their training in evidence-based practice and professional knowledge. They are also more likely to seek authoritative sources. Most of the nurses in the ANF Covid vaccine survey get their information from a combination of mainstream media outlets, professional associations, and government agencies such as the CDC. What is prompting their concerns?
The breakneck pace of the Covid vaccine trial process, as mentioned, is a major sticking point. Normally, vaccine trials take at least two years to reach conclusive results. In the rush to curb the pandemic, though, pharmaceutical companies are setting their sights lower and instead of spending years on trials, some companies (such as Pfizer) are attempting to produce a viable vaccine in less than 12 months. (For more background, see this article in the Atlantic). As a recent article in Stat put it, “data generated in a few hundred people aren’t enough to determine whether a vaccine will actually fend off illness,” and the Operation Warp Speed forecast that a Covid vaccine will be available for seniors by January “Has always been aspirational — probably excessively so.” Kaiser Health News remarked that some specialists fear that the trials “Will be too short in duration and too small in size to prove that the vaccines will prevent what people fear most — being hospitalized or dying — by the time the first vaccine makers file for emergency authorization.”
This Covid vaccine survey was the third ANF Pulse on the Nation’s Nurses COVID-19 survey. The previous survey, released in September, examined the financial hardships nurses are experiencing during the pandemic. The first survey, released in July, focused on mental wellness.
The American Nurses Association’s (ANA) Board of Director’s decision to rescind the 1985 Presidential Endorsement process and replace it with a Presidential Engagement Policy received mixed reviews from the nursing community. Some nurses were appalled that a leading nursing organization would fail to endorse a more suitable candidate during this presidential election. For some, this was particularly disturbing given President Trump’s handling of the pandemic and his ongoing bashing of key experts and agencies who have ably provided science-based guidance to protect the public’s health for decades. As nurses who are committed to advancing the public’s health, I can understand why some nurses were disappointed with ANA’s decision. After all, there is growing consensus that our nation deserves a better and more trustworthy leadership. Further, there is ample evidence that the nation’s health is at stake.
However, it is not surprising that some organizations would shy away from endorsing political candidates. While the ANA represents hundreds of nurses across the country, they do not speak for ALL nurses. In fact, because of its diverse membership, it is inevitable that political affiliations and political perspectives would be diverse as well. Thus, the ability to make an endorsement that reflects the perspectives of such a diverse membership would be problematic, to say the least. Given that voting is also a personal responsibility, the ball will always be in our courts to evaluate presidential hopefuls as individual voters with or without an organization’s endorsement.
In response to this disappointment, a group of nurse leaders moved quickly to organize a “Nurses for Biden-Harris” campaign urging the profession and public to vote for Vice President Joe Biden and Senator Kamala Harris. These organizers believe that a Biden Harris agenda would be more responsive to addressing one of the nation’s most pressing needs, equitable and accessible health care.
“We urge Americans to vote for Joe Biden and Kamala Harris.” “The health and wellbeing of our nation are at stake,” were some of the sentiments put forth by this group. As nurses, we have a personal and professional responsibility to vote on behalf of the health and well-being of those we love and serve. I believe that regardless of the ANA’s position, nurses must and will vote for what is best for health care, the profession, and society as a whole.
Praising the New Jersey League for expanding its grants and scholarships program, NLN CEO Beverly Malone, PhD, RN, FAAN, said, “The National League for Nursing is enormously grateful to the New Jersey League for Nursing for its leadership in proactively boosting access to nursing education at a time when higher education is increasingly out of reach for so many deserving students.” The NJLN now offers direct material support to 25 students at all levels of educational progression. Each of the 25 students is eligible to receive up to $1,000, with one advanced degree candidate who pledges to join the state’s nursing workforce eligible for a $10,000 scholarship award.
“While we face the challenges of a pandemic, along with demonstrable health care disparities reflecting the social determinants of health, innovative programming, and other initiatives to support students and faculty are truly needed,” said NLN President Patricia S. Yoder-Wise, RN, EdD, NEA-BC, ANEF, FAONL, FAAN. “The New Jersey League for Nursing has been a role model in this regard, helping to spread the National League for Nursing’s message of sustained, inclusive, culturally sensitive educational excellence in the preparation of the next generation of nurses to deliver outstanding patient care, advancing, in particular, the health all New Jersey residents.”
The first nursing organization to be formed in the US, the National League for Nursing was founded in 1893 as the American Society of Superintendents of Training Schools for Nurses. Today, the NLN provides professional development, advocacy, and testing resources for 40,000 individual and 1,200 institutional members in nursing education programs at colleges and universities, health care organizations, and agencies. To learn more about the NLN and membership benefits, visit http://www.nln.org/.
Eight schools were honored for their efforts to recruit and retain male students at the virtual gathering for this year’s 45th annual American Assembly of Men in Nursing (AAMN) conference.
The number of men entering the profession is definitely on the upswing. Lewis University College, one of the schools honored, noted, “the percentage of men working as registered nurses has continued to rise. In 1970, only 2.7 percent of registered nurses were men while in 2017, it is estimated that 11 percent of registered nurses were men (U.S. Census Bureau, 2017).”
During the October 14-16 meeting, the AAMN placed the following schools at the top of the list, based on increases in male applicants, admissions, retentions, and/or improved program evaluations from male graduates:
At Johns Hopkins, JHSON Dean Patricia Davidson, PhD, MEd, RN, FAAN responded, “We are proud of our efforts to build a diverse pipeline of nurses, particularly for our support of men who bring needed perspective and experience to our profession. Especially now, our world needs competent and credentialed nurses across all genders, backgrounds, and experiences in order to provide the best health outcomes for the populations we serve.”
Duke also celebrated their 2020 AAMN honor. “Our organization thrives on the presence, engagement, and contributions of individuals from diverse backgrounds. Men who are nurses enrich our profession, bringing a wealth of experiences to the collective excellence our school strives for,” said Marion E. Broome, PhD, RN, FAAN, dean and Ruby Wilson Professor of Nursing at Duke. In a recorded acceptance speech, student Nikolas Silva said: “On behalf of the Duke Chapter of the American Association for Men in Nursing, thank you. Thank you to the Association for handing us this award, and thank you to our amazing faculty supervisors for all the hard work and guidance they’ve given us over the past year. But most importantly, thank you to our members. It is because of them that our organization is able to promote diversity and inclusivity in both our immediate community at the Duke School of Nursing and the surrounding community as well.”