Georgia Hospital Improves Organ Donation Process

Georgia Hospital Improves Organ Donation Process

Improved organ donation practices and greater program visibility led to a sustained increase in referrals, donors, and transplanted organs at a Georgia hospital, thanks to a focus on enhanced staff education and family communication.

Collaborative Approach to Organ Donation in a Level II Trauma Center  details the steps taken at Northeast Georgia Medical Center’s hospital campus in Gainesville as part of a multidisciplinary initiative to increase its organ donation rate.

Co-author Jesse Gibson, MBA, BSN, RN, TCRN, is the trauma program director and chair of the Donation Advisory Committee at the trauma center, serving 18 counties in a predominantly rural area. Part of a five-hospital health system, the medical center serves more than 2,600 trauma patients annually, with 95% having blunt trauma. Since the initiative was conducted, the hospital has been nationally verified as a Level I trauma center by the American College of Surgeons Committee on Trauma.

“By investing in staff members and partnering with bedside providers, our facility improved the organ donation experience for nurses, physicians, donors, and families,” Gibson says. “The outcome of that investment has been a hospital culture that values and celebrates organ donation as a standard of care for patients and families and an important part of honoring end-of-life wishes.”

The performance improvement initiative began at the end of 2017 to address concerns about lower-than-expected metrics related to the medical center’s organ donation process. Initial reviews of patient care revealed deviations from best practice, including missed referrals, care team members initiating discussions about donation with families, and misconceptions about the donation process.

The Donation Advisory Committee helped clarify language and revise policies related to end-of-life care, partnering with the hospital liaison at its organ procurement organization to increase physician and staff education and provide visibility for the process. Beyond engaging staff to reinforce the expected practice, a transitional language guide was provided to physicians and advanced providers to assist them in any initial discussions that may arise with families. A series of organ donation presentations in 2018 and 2019 provided staff education. They encouraged a dialogue about the process and review of the most recent organ and tissue data, metrics, and expectations.

To improve the program’s visibility, the project team arranged for a “Donate Life” flag to be raised on the main campus each time a family authorized organ donation. The team also implemented an “honor walk” to recognize the donor and family as donors are transported from the inpatient area to the operating room for organ procurement, with staff members lining the hallway to show respect and support. In 2019, the hospital held its first donation remembrance celebration, attended by families of organ donors and the clinical staff members who cared for them.

Since the project began, the number of organ referrals, donors, and transplanted organs has increased yearly, except for a slight dip in 2020 during the early COVID-19 pandemic. The number of organ referrals doubled, from 169 in 2015 to 320 in 2021. The number of organ donors in 2021 was 31, with more than 22 donors in 2015, 2016, and 2017. Similarly, the total number of organs donated in 2021 was 102, up from 16 in 2015. The rate at which an appropriate requestor initiated the conversation about organ donation with the family increased from 52% in 2015 to 90% in 2021.

Nurse of the Week: Evelyn Davis Does Special Deliveries

Nurse of the Week: Evelyn Davis Does Special Deliveries

There are some deliveries that are far beyond the abilities of USPS orPostmates.

Everyone knows that the old saw “any port in a storm” is a truism when a pregnant woman is in labor and trying to reach a hospital – but luckily, nurses are accustomed to serving at stormy ports.

On February 9, though, our Nurse of the Week, Public Health nurse Evelyn Davis RN, was still a little nonplussed when the grandmother of an expecting – imminently expecting – mom realized her daughter couldn’t wait a moment longer and swung into the parking lot at the Adamsville Regional Health Center in Fulton County, Georgia.

As the grandma imploringly flagged her down, Davis thought, “So this is a health center. You usually don’t show up here to deliver your baby!” However, although the Adamsville Regional HC is not in any way prepared for midwifery or deliveries, and Davis now specializes in caring for HIV/AIDS patients, the RN is a veteran nurse who delivered hundreds of babies on Hopi and Navaho reservations in Arizona earlier in her career.

Davis’ experience bringing all of those brand-new Hopi and Navaho infants into the world was fortuitous. The mother-to-be and grandmother were well into the “oh my gosh – it’s happening!! Help!” stage of a pending delivery, and soothing words from an experienced nurse were exactly what the mom needed.

“Lord! What are we gonna do?”

The ambiance of a parking lot at a downtown public health clinic bears little resemblance to a hospital labor and delivery unit. As Davis says, the situation was “chaotic.” She recalled that “There were people screaming, ‘She’s going to have the baby! Help her! Oh, Lord! What are we gonna do? This is not a hospital. She should not be here!’ So, I just asked everyone to calm down and got the mother to calm down.”

As the poor mother was frantic, Davis continued, “I introduced myself… because she was hysterical, understandably, and I calmed her down and let her know that we were here to help her. She was screaming trying to prevent the baby from coming and I told her not to do that because you’re gonna get a very strong contraction and that baby’s gonna fly out.” (Delightful as it might sound to a harried mom in labor, in general flight is not an optimal mode of exit from the womb).

Nurse Evalyn Davis points to delivery entrance.

Davis points to the ARHC’s new “ad hoc Delivery Entrance.”

As the mother began to understand that grandma had made the right call in pulling over into this particular parking lot, Nurse Davis pulled on gloves, and staffers inside the Center ran for supplies because this baby couldn’t wait. “I checked her,” Davis says, “and the baby was right there, and I knew it was a matter of one or two or three pushes and everything would happen.”

“Come on, baby! Breathe, breathe, breathe.”

In fact, more happened than any of the players had bargained for. As the newborn entered the world in front of the Adamsville Regional Health Center, there was a slight hiccup (of course the mother probably would not choose that phrase). Davis said that the actual birth came after a few pushes, but the baby girl who emerged had gray skin, and “She still wasn’t breathing, so we had her wrapped up. I started rubbing on her chest and I was like, ‘Come on, baby, breathe, breathe, breathe. Come on, take a breath, take a breath, baby.’ And I just rubbed the baby’s chest, and then she let out a scream.”

The mother and baby girl were taken to a nearby hospital for an examination and might not have realized just how fortunate they were. “I’m just glad we were all here to help,” Davis said, but observed, “Ten minutes later, this place would have been closed and no one would’ve been here…”

You can see a video interview with Evelyn Davis, RN here.

No School Mask Mandate? Here’s What One Parent Chose to Do

No School Mask Mandate? Here’s What One Parent Chose to Do

My second grader’s almond-shaped brown eyes widened over the doubled-up N95 and cloth masks I’d instructed her and her older sister to wear that day. There, in the foyer of her school, stood her unmasked principal, greeting the hundreds of families who were flocking to a July 29 open house.

We passed by the front office staff, also mostly unmasked. In the crowds we observed, there were as many unmasked parents and children as masked ones.Families bumped into each other in hallways as they searched for classrooms. They lined up in the cafeteria to sign up for PTA and extracurricular activities. The cafeteria, we were told, would be back to full capacity the following Monday, the first day of school in Cobb County, Georgia. Unlike last school year, when my girls had attended virtually, there would be no more social distancing when it came time to eat.

We found my younger daughter’s classroom. The maskless homeroom teacher presented a slideshow of her family’s summer adventures. Her classroom partner, a Spanish-language teacher who was paired with her as part of the school’s dual-language immersion program, donned a mask that matched her outfit.“Will you be masked while teaching?” asked a masked parent from the back of the crowded classroom.

“I will not,” the homeroom teacher answered, emphasizing the “not.”

“I will,” her Spanish-language teaching partner answered.

A few miles away, at about the same time the doors to the open house swung open, Dr. Janet Memark, director of public health for Cobb and Douglas counties, sat down in a conference room to record a somber update.

“We are up to 235 cases per 100,000 since last night” for new infections over a two-week period, Memark said, delivering a message  for community channels, news outlets and YouTube.

“So that has blown us past high transmission,” she said.

“And I heard today our numbers are looking even worse.”

Back in early May, when my family had to decide whether to send our daughters to their suburban Atlanta school for face-to-face learning in the upcoming school year, I was comfortable with the decision to let them go back. The coronavirus caseload in Cobb County at the time was low. Plus, the school had a mask mandate.

By the time of the open house, neither was true. Cobb County reversed course on its mask mandate in June and refused to budge even after the Centers for Disease Control and Prevention, whose headquarters is two counties over, on July 27 recommended masking for all K-12 students and teachers,even vaccinated ones.

Three days before the open house, we had requested to change our decision and return to virtual learning. The superintendent’s office denied our request. Too late, it said.

Cobb County Schools, the second largest school district in Georgia and among the first major metro districts nationwide to reopen for the 2021-22 school year, is one of only two of the eight districts in metro Atlanta’s five-county region without a mask mandate. The other is the city school system in Cobb’s county seat, Marietta, which operates as its own district and which ProPublica wrote about last year for its then-rare decision, among Georgia districts, to require masks.

“It’s disappointing that the districts are not implementing the strategies recommended by the CDC to keep these kids safe when there is moderate to high transmission,” said Elizabeth Stuart, a biostatistician at the Johns Hopkins Bloomberg School of Public Health, in reference to the metro Atlanta school districts that are not requiring masks. “It puts families into these really challenging situations.”

The school districts weren’t even heeding the warning of their county’s own public health director: “My best advice is that you go with the CDC recommendations. They are that everybody in K through 12 need to wear their mask,” Memark implored those watching her July 29 recording.

Asked why Cobb County Schools deviated from the CDC and its own county’s public health director on a mask mandate, a district spokesperson would only respond that its public health protocols “are intended to balance the importance of in-person learning and the frequent changes associated with COVID-19. This pandemic continues to impact students, staff, and families differently throughout Cobb County, and we will continue to update our school protocols accordingly.”

When I walked into that open house, I reminded myself of my husband’s words from earlier that morning: “Have an open mind.” When I walked out, I knew there was nothing that would make me feel safe sending my girls to school on Monday.

The car ride home from the open house was filled with excited back-to-school banter between the girls and my husband. I was silent, waiting for him to pull into the driveway and drop me off so he could take the kids for Happy Meals. He and I had planned to talk that night, after the girls and our toddler son went to bed. But I wasn’t sure I could wait that long.

I ignored the knot in my stomach and focused on figuring out Plan B.

Our immediate alternatives were private school (though we could scarcely afford it, and admissions had closed for most of them), home schooling (but what about our jobs?) or moving to another district (if we could find a house in this manic real estate market).

Waiting for my husband to come back from lunch, I threw up a prayer and tried to secure one more last-ditch option. I entered our daughters into a lottery for a virtual-only charter school that had just opened a few hundred additional slots statewide. It was the only free, accredited and teacher-led virtual alternative at the time.

Within five minutes, I received a response: They both got in.

When my husband got back, I intercepted him in the garage and sent the kids upstairs. 

“Can we have a pre-meeting?” I begged, then launched right into it: “I don’t like what I saw at the school.”

He was less bothered by what he’d observed than by our girls forgoing another year of in-person learning, arguing that he hadn’t yet seen data to convince him they needed any more protection than their own masks. Besides, he said, if it got bad enough, wouldn’t the school have to go back to virtual learning, anyway?

I countered that the data we were reviewing was based on current behavior, noting that the transmission and hospitalization rates were rising before the kids even packed into the buildings.

That afternoon, between calls to my daughters’ pediatrician and their elementary school to get records that the virtual charter needed, I forwarded the virtual school information to other concerned parents. At least one of them tried to get in, two and a half hours after my attempt. It didn’t work: She was stuck on a waitlist.

The next morning, still locked in a stalemate with my husband, I stopped by the pediatrician’s office to pick up the immunization records I needed. “Am I the only one doing this?” I asked the receptionist.

“No, ma’am, you’re not alone,” she said, holding up a folder full of vaccine records awaiting other parents who’d changed course.

I then went to the elementary school to pick up my daughters’ report cards and un-enroll them. A staff member wrote their names alongside those of more than a dozen students who would not be showing up on the first day of school.

Later, I reached out to Cobb County Schools and other districts to determine how many parents had withdrawn their children in recent weeks. Most districts, including Cobb, said it was not a request they could immediately fulfill.

While I was out trying to handle the new school enrollment, my husband called to apologize. He thanked me for executing a new plan at a time when he was consumed with disappointment for the kids. He just wanted them to be happy, he said, and didn’t want them to feel defeated by the news of another year of virtual learning.

On Sunday, Aug. 1, the day before the first day of school, I wrote an email to Cobb County School District Superintendent Chris Ragsdale, Assistant Superintendent Ehsan Kattoula and the county school board, to let them know we were leaving the county school system for now. I noted that, as difficult as this process had been for us, I couldn’t imagine what other families in tougher spots with fewer resources must be facing.

School board member Charisse Davis, one of three members of the Democratic minority on the Cobb County School Board, wrote back: “With school starting tomorrow, we are hearing from so many parents who are flat out scared about what is going to happen. I have no answers as to why we are rejecting the public health guidelines.” She added, “It almost feels like the last 18 months didn’t happen. We are just back to normal because of what? Denial, fatigue, politics?”

Several parents I spoke with while reporting this story expressed skepticism that COVID-19 could harm them. “We go out to eat. We go to the grocery store. We’ve traveled all summer long,” said Ashley Gentile, a West Cobb mother of two elementary school students. She said that any member of her family could have gotten the virus anywhere, but none had. “For our family, it’s not alarming when we hear numbers have risen in certain schools and certain areas. It doesn’t make us want to keep our kids home.”

Sharon Abney, Gentile’s sister, who lives in East Cobb and is a physical therapist, said the data isn’t concerning to her.

“The kids, yeah, they’re gonna get it, but they’re probably going to be asymptomatic or have a really mild case,” she said. “There are people in our community who believe that because we’re choosing not to send our kids in a mask, we’re killing them. And that’s not what’s happening.”

The same day I sent my email to the district, screengrabs of a message to parents at Cobb County’s King Springs Elementary School, near my daughters’ now-former school, began circulating on social media and in my parent text groups. The message concerned the school’s open house three days earlier. Up top it said in bold red: “Covid-19 Low Risk Letter.”

“Good Evening Everyone,” it read. “We are super excited to get this school year started! Following our wonderful Sneak A Peek on Thursday, we’ve been notified that several families have positive cases of Covid and attended our event. Since this was a fluid event with people mingling throughout the building, we thought it best to send a low risk letter to all families.”

The alert prompted Cobb County school board member Dr. Jaha Howard to request, the day before school started, an emergency meeting for the board to consider the repercussions of the district’s COVID-19 protocols when it came to keeping students safe.

Howard, a pediatric dentist whose three children attend Cobb schools, said he had spoken with dozens of parents who expressed a broad spectrum of opinions on masking in the classroom.

“You have a good number of parents who fundamentally would like to see less people getting infected and less people getting into the hospital, and they’re willing to do what needs to be done so that people don’t get sick,” Howard told me. “You have another group in this county and in this country that fundamentally believe that this virus has to run its course. And they’re not saying it out loud, but what I’m hearing between the lines is: ‘People are going to get sick. Some people are going to have to go to the hospital. Some people might tragically pass, but the best way through it is to literally allow it to take its course.’”

Howard had made previous unsuccessful attempts to get the school board to meet about COVID-19 protocol, including a meeting he tried to call between the board and Cobb’s public health director in June.

Like those previous appeals, his Aug. 1 request also was denied. Board Chair Randy Scramihorn did not respond to a request for comment. 

The board’s most publicized agenda item in recent months, which came to a vote in June, had nothing to do with the pandemic. Rather, the board voted to ban critical race theory from its curriculum.

On Aug. 4, the third day of school, Cobb County Schools emailed parents to let them know the district had updated its COVID-19 protocols. One change was that masks, though still optional, were now “strongly encouraged.”

https://cdfac1b64c06c4257b660078a3ccf7fa.safeframe.googlesyndication.com/safeframe/1-0-38/html/container.htmlA more significant change had to do with quarantining. The district’s new protocol allowed asymptomatic students and staff who’d been in close contact with a person who’d tested positive to return to school the next day, as long as they agreed to wear a mask for 10 days. The previous protocol was to follow CDC and Georgia Department of Public Health quarantine guidelines, which call for asymptomatic unvaccinated people to isolate at home for between seven and 14 days following a close contact with a coronavirus-infected person.

Not only is Cobb County one of two districts to fail to adopt a mask mandate among the eight in metro Atlanta, but, as of Aug. 4, Cobb has a far more lenient quarantine protocol, too.

Asked what precipitated the change, a Cobb County Schools spokesperson pointed to an Aug. 2 order signed by DPH Commissioner Dr. Kathleen Toomey, which states: “Following guidance from the Centers for Disease Control and Prevention on quarantine remains the safest way to protect teachers and students from the spread of COVID-19. However, recognizing the importance of in-person learning, schools may elect to adhere to different quarantine requirements as developed by the local school district to facilitate in-person learning.”

Yet the order clarifies that schools should adopt “such different quarantine requirements as long as the point of exposure occurred in the school setting” and as long as those exposed remain asymptomatic.

Cobb County Schools did not directly address ProPublica’s questions about how the district would distinguish point of contact or if there was a threshold at which it would adopt a mask mandate.

Over a 12-day period between my children’s school open house and Aug. 9, the second Monday of school, Cobb County and much of the rest of Georgia and the South saw rapid growth in coronavirus infections. In Cobb, cases per 100,000 nearly doubled in that time and the positivity rate went up, as well, a sign that the virus was spreading rapidly.

On Aug. 10, Memark, the Cobb-Douglas public health director, told the Cobb County Board of Commissioners that child cases had grown by 60 percent in the past week — the first week of school — for kids between the ages of 5 and 17. On Aug. 8, Georgia’s seven-day average number of cases among 5- to 9-year-olds reached a peak higher than at any previous point in the pandemic. As of Wednesday, it was higher still.

That first week of school, instead of posting pictures of the kids’ first day and sitting each afternoon in the carpool pickup line, my husband and I tried to come up with a schedule to fill their days in advance of virtual school starting later in the month.

I also attempted to turn off the notifications from my elementary school chat group. But for some reason, I kept getting them.

On Aug. 6, an alert popped up. A mom wanted us to know that her kindergartner, whose sibling is in the classroom where my second-grader would have been, tested positive. She said she doubted the school would notify us.

The next morning, another mother confirmed that she herself had tested positive; her kids were negative so far.

The day after, another family’s three-year-old tested positive. Their school-aged child remained negative.

That night, a fourth mother’s friend was rounding out a 24-hour hospital stay with her kindergartner who’d tested positive. So had multiple classmates.

“If you have a little one in that class,” she wrote, “I suggest you get them tested.”

Progress Against HIV is Faltering in Southern States

Progress Against HIV is Faltering in Southern States

Facing a yearlong siege from the coronavirus, the defenses in another, older war are faltering.

Originally published in Kaiser Health News.

For the last two decades, HIV/AIDS has been held at bay by potent antiviral drugs, aggressive testing and inventive public education campaigns. But the COVID-19 pandemic has caused profound disruptions in almost every aspect of that battle, grounding outreach teams, sharply curtailing testing and diverting critical staff away from laboratories and medical centers.

The exact impact of one pandemic on the other is still coming into focus, but preliminary evidence is disturbing experts who have celebrated the enormous strides in HIV treatment. While the shift in priorities is nationwide, delays in testing and treatment carry particularly grievous risks in Southern states, now the epicenter of the nation’s HIV crisis.

“This is a major derailing,” said Dr. Carlos del Rio, a professor of medicine at Emory University in Atlanta and head of the Emory AIDS International Training and Research Program . “There will be damage. The question is, how much?”

One large commercial lab reported nearly 700,000 fewer HIV screening tests across the country — a 45% drop — and 5,000 fewer diagnoses between March and September 2020.

Clinics have limited in-person visits and halted routine HIV screening in doctors’ offices and emergency rooms, with physicians relying instead on video calls with patients, a futile alternative for those who are homeless or fear family members will discover their status. Rapid-testing vans that once parked outside nightclubs and bars and handed out condoms are mothballed. And, in state capitals and county seats, government expertise has been singly focused on the all-hands-on-deck COVID response.

Concrete signs of the impact on HIV surveillance abound: One large commercial lab reported nearly 700,000 fewer HIV screening tests across the country — a 45% drop — and 5,000 fewer diagnoses between March and September 2020, compared with the same period the year before. Prescriptions of PrEP, a preexposure prophylaxis that can prevent HIV infection, have also fallen sharply, according to new research presented at a conference last month. State public health departments have recorded similarly steep declines in testing.

That dearth in new data has led to a precarious, unknowable moment: For the first time in decades, the nation’s lauded HIV surveillance system is blind to the virus’s movement.

Nowhere will the lack of data be felt more profoundly than in the South: The region accounts for 51% of all new infections, eight of the 10 states with the highest rates of new diagnoses, and half of all HIV-related deaths, according to the most recent data available from the Centers for Disease Control and Prevention.

Even before the COVID pandemic, Georgia had the highest rate of new HIV diagnoses of any state, though lower than that of Washington, D.C. The Georgia Department of Public Health recorded a 70% drop in testing last spring compared with spring 2019.

The slowdown in HIV patient services “could be felt for years,” said Dr. Melanie Thompson, principal investigator of the AIDS Research Consortium of Atlanta.

She added, “Every new HIV infection perpetuates the epidemic and will likely be passed to one or more people in the months to come if people are not diagnosed and offered HIV treatment.”

Coronavirus testing has commandeered the machines previously used for HIV/AIDS testing, further straining surveillance efforts. The polymerase chain reaction — or PCR — machines used to detect and measure the genetic material in the human immunodeficiency virus are the same machines that run COVID tests around-the-clock.

Over the decades, as HIV migrated inland from coastal cities like San Francisco, Los Angeles and New York, it took root in the South, where poverty is endemic, lack of health coverage is commonplace, and HIV stigma is pervasive.

“There is the stigma that’s real. There is legacy racism,” said Dr. Thomas Giordano, medical director of Thomas Street Health Center in Houston, one of the largest HIV clinics in the U.S. The state’s political leaders, he said, view HIV as “a disease of the poor, of Blacks, Latinos and gay. It’s just not mainstream at the state level.”

Black people represent 13% of the U.S. population but about 40% of HIV cases — and deaths.

Black people represent 13% of the U.S. population but about 40% of HIV cases — and deaths. In many Southern states, the disparities are stark: In Alabama, Black residents account for 27% of the population and 70% of new diagnoses; in Georgia, Black people make up 33% of residents and 69% of people with HIV.

HIV clinics that serve low-income patients also face limitations using video and phone appointments. Clinic directors say poor patients often lack data plans and many homeless patients simply don’t have phones. They also must contend with fear. “If a friend gave you a room to sleep and your friend finds out you have HIV, you might lose that place to sleep,” said del Rio of Emory University.

Texting can be tricky, too. “We have to be cautious about text messages,” said Dr. John Carlo, chief executive officer of PRISM Health Care North Texas in Dallas. “If someone sees their phone, it can be devastating.”

In Mississippi, HIV contact tracing — which was used as a model for some local efforts to track the coronavirus — has been limited by COVID-related travel restrictions meant “to protect both staff and client,” said Melverta Bender, director of the STD/HIV office at the Mississippi State Department of Health.

Of all regions in the U.S., the South has the weakest health safety nets. And Southern states have far fewer resources than states like California and New York. “Our public health infrastructures have been chronically underfunded and undermined over the decades,” said Thompson, the Atlanta researcher. “So we stand to do worse by many metrics.”

Georgia’s high HIV infection rate and the state’s slow pace of COVID vaccinations “are not unrelated,” Thompson said.

The porous safety net extends to health insurance, a vital need for those living with HIV. Nearly half of Americans without health coverage live in the South, where many states have not expanded Medicaid under the Affordable Care Act. That leaves many people with HIV to rely on the federal Ryan White HIV/AIDS Program and state-run AIDS drug assistance programs, known as ADAPs, which offer limited coverage.

“As a matter of equity, insurance is critical for people to live and thrive with HIV,” said Tim Horn, director of health care access at NASTAD, the National Alliance of State and Territorial AIDS Directors. Ryan White and ADAPs “are not equipped to provide that full sweep of comprehensive care,” he said.

Of all regions in the U.S., the South has the weakest health safety nets. And Southern states have far fewer resources than states like California and New York.

Roshan McDaniel, South Carolina’s ADAP program manager, says 60% of South Carolinians enrolled in ADAP would qualify if her state expanded Medicaid. “The first few years, we thought about it,” said McDaniel. “We don’t even think about it nowadays.”

Enrollment in the Ryan White program jumped during the early months of the pandemic when state economies froze and Americans hunkered down amid a grinding pandemic. Data from state health departments reflect the increased need. In Texas, enrollment in the state’s AIDS drug program increased 34% from March to December 2020. In Georgia, enrollment jumped by 10%.

State health officials attribute the increased enrollment to pandemic-related job losses, especially in states that didn’t expand Medicaid. Antiretroviral treatment, the established regimen that suppresses the amount of virus in the body and prevents AIDS, costs up to $36,000 a year, and medication interruptions can lead to viral mutations and drug resistance. But qualifying for state assistance is difficult: Approval can take up to two months, and missing paperwork can lead to canceled coverage.

Federal health experts say Southern states have generally lagged behind getting patients into medical care and suppressing their viral loads, and people with HIV infections tend to go undiagnosed longer there than in other regions. In Georgia, for example, nearly 1 out of 4 people who learned they were infected developed AIDS within a year, indicating their infections had long gone undiagnosed.

As vaccinations become widely available and restrictions ease, HIV clinic directors are scouring their patient lists to determine who they need to see first. “We are looking at how many people haven’t seen us in over a year. We think it’s over several hundred. Did they move? Did they move providers?” said Carlo, the doctor and health care CEO in Dallas. “We don’t know what the long-term consequences are going to be.”

Survived Covid, Aced Her NCLEX: Nurse of the Week Chelsie Turrubiartez, RN is Hard to Stop.

Survived Covid, Aced Her NCLEX: Nurse of the Week Chelsie Turrubiartez, RN is Hard to Stop.

Brand-new RN, Nurse of the Week Chelsie Turrubiartez didn’t allow anything to stand between her and her dreams of becoming a nurse. Over the course of nine eventful months, the 23-year-old Adel, Georgia resident was hospitalized for Covid, graduated from the School of Nursing at Abraham Baldwin Agricultural College , passed her NCLEX, and found an RN position at the hospital where she’s worked since high school as a nurse extender. “It’s like a nurse’s aide,” she explained. “I have always wanted to be a nurse, and now it feels really good to be able to do that.”

In March 2020, as much of the world was locking down and healthcare workers found themselves on the “frontlines” of the pandemic, Turrubiartez was busy studying, attending classes at ABAC, and looking forward to graduating with her class. Then, on the very last day of March, she was hospitalized for Covid and began fighting for her life. “The ventilator was on max setting,” she told the Albany Herald. “They put me in the ambulance, and I had to be on my stomach the entire way. I don’t remember the ride at all. I was out of it.” Her condition started to improve in late April, and Turrubiartez was finally able to go home on May 4, 2020. She hadn’t seen her family since March 31, had missed her last month of school, her eagerly anticipated virtual graduation ceremony, and, well, you do not simply bounce back after spending weeks on a ventilator in the ICU.

Turrubiartez received her associates degree from ABAC, and plans to enroll there for her BSN as well.

As she recovered from her frightening ordeal, ABAC gave Turrubiartez the opportunity to repeat her spring semester coursework that fall and graduate on December 3, 2020. “I was really happy when I graduated!” she said. “I didn’t think I would get a chance to do that.” Adding to her happiness that day, during the pinning ceremony, Turrubiartez received the Lisa Purvis Allison Spirit of Nursing Award and a scholarship check for $500. She followed that up by passing her NCLEX, and then, Southwell Tifton Hospital hired their former nurse extender to work as an RN on their general medicine surgical floor.

Now—with some help from that scholarship check—Turrubiartez is planning to study for her BSN as well. For more details on her story, visit here.

LPN Says Immigrant Detention Center Endangers Detainees and Staff

LPN Says Immigrant Detention Center Endangers Detainees and Staff

Immigrant women receive dubious hysterectomies and staffers openly neglect even basic COVID precautions at Georgia’s Irwin County Detention Center, says LPN Dawn Wooten in a complaint filed by four non-governmental organizations.

According to Wooten, the private immigrant detention facility has refused to test symptomatic inmates, has not been isolating those suspected of having the virus, and is disregarding mandatory CDC social distancing practices. Wooten’s complaint also notes that she and other nurses have been alarmed by the inordinate number of hysterectomy operations performed at the Center. In reference to the frequent and questionable hysterectomies one detainee described the detention center as “an experimental concentration camp.”

COVID-19 safety and treatment are given short shrift at the center, and Wooten says that even before the pandemic the facility was often dilatory in providing medical care for detained immigrants. Since the pandemic, the complaint alleges, the center has made almost no use of its two rapid-response COVID testing machines, and has instead sent swabs to be tested at a local hospital. Wooten was told she should not be “wasting tests” on people she suspected of being infected, and when she inquired about testing one detainee, a co-worker responded, “He ain’t got no damn corona, Wooten.”

In addition to failing to provide PPE for staff working directly with confirmed cases of COVID-19, Wooten’s complaint states that the facility forced symptomatic staff to continue to work in the facility and threatened them with discipline if they refused to work in dangerous conditions. Because she spoke out against such practices, Wooten says that she was transferred from her full-time position to a part-time job in which her shifts consisted of a few hours a month.

On Tuesday, September 15, House Speaker Nancy Pelosi called for an investigation. Regarding the alleged misuse of hysterectomies on immigrant women detainees, Pelosi said “The DHS Inspector General must immediately investigate the allegations detailed in this complaint. Congress and the American people need to know why and under what conditions so many women, reportedly without their informed consent, were pushed to undergo this extremely invasive and life-altering procedure.” She also called attention to the neglect of COVID safety measures and proper treatment, and referred to “ICE’s egregious handling of the coronavirus pandemic, in light of reports of their refusal to test detainees including those who are symptomatic, the destruction of medical requests submitted by immigrants and the fabrication of medical records.”

Project South, one of the organizations filing the complaint, states that “ICDC (Irwin County Detention Center) has a long track record  of human rights violations.”

For more details on this story and quotes from Dawn Wooten, see the article in The Intecept.