As we say goodbye and good riddance to a Delta August filled with distressing news, the Senate passage of the Dr. Lorna Breen Health Care Provider Protection Act (S. 610) was a bright spot in a dark month. The news is especially significant, coming as it does at a time that has been almost unbearably stressful for nurses and other health care workers.
“For far too long, the stoic culture of self-sufficiency in the health care community has driven stigmatized health issues underground.”
—Jennifer Breen Feist
On August 6, the US Senate called a brief halt to their internecine battles and unanimously passed the act. Aimed to dramatically increase support and reduce the stigma of seeking mental health assistance among health care professionals, the bill is named in honor of Dr. Lorna Breen, a New York City emergency room physician who cared for Covid patients at the height of the horrific NYC outbreak in 2020. Breen contracted the virus herself and committed suicide after returning to treat the sick New Yorkers who continued pouring into city hospitals (and all too often ended up housed in refrigerated morgue trucks).
Landmark Legislation Protecting the Mental Health of HCWs
This landmark legislation is the first to allocate specific funds towards grants for training students, residents, and health care professionals in evidence-informed strategies to reduce and prevent suicide, burnout, mental health conditions, and substance use disorders. An ANA statement celebrated the Senate passage, calling the act “Timely and critical legislation [that] will help reduce and prevent mental and behavioral health conditions… among health care professionals, especially those who continue to be overwhelmed by the COVID-19 response and recovery efforts.”
“Simply put, without a healthy and whole nursing workforce, we will be unable to meet the ever-growing needs of our patients and deploy successful COVID-19 response efforts. The Dr. Lorna Breen Health Care Provider Protection Act is a good first step in what will be a years-long process of caring for those who have long cared for us.”
—Ernest J. Grant
ANA President Dr. Ernest J. Grant, Ph.D., RN, FAAN also praised the nation’s nurses for their role in promoting the act: “Nurse advocates sent over 6,300 emails to Congress in support of this bill. Nurses know that the damaging aftereffects of the pandemic will linger long after they have intubated their final COVID-19 patients and grieved the loss of colleagues and loved ones. Grant added, “Simply put, without a healthy and whole nursing workforce, we will be unable to meet the ever-growing needs of our patients and deploy successful COVID-19 response efforts. The Dr. Lorna Breen Health Care Provider Protection Act is a good first step in what will be a years-long process of caring for those who have long cared for us.”
Breen’s sister, Jennifer Breen Feist, one of the most dedicated advocates of the act, said, “For far too long, the stoic culture of self-sufficiency in the health care community has driven stigmatized health issues underground. We sincerely thank the tireless efforts of Senator Tim Kaine in shedding light on this alarming trend, and Senators Cassidy, Young, and Reed for their leadership of this cause.” Breen Feist co-founded the Dr. Lorna Breen Heroes’ Foundation to advocate for the law and “to reduce burnout of health care professionals and safeguard their well-being and job satisfaction. We envision a world where seeking mental health services is universally viewed as a sign of strength for health care professionals.”
“Even before the pandemic, far too many health care workers suffered from work-related burnout and depression,” said Senator Tim Kaine (D-Va.), lead sponsor on the bill. “Unfortunately, these mental health challenges have only been exacerbated during COVID-19, putting the well-being of our healers at risk. I’m proud to see my bipartisan Dr. Lorna Breen Health Care Provider Protection Act, legislation to equip our medical professionals with resources to cope with the challenges they face, pass the Senate today and get one step closer to becoming law.”
The legislation has been passed back to the House, which will review the amended version after resuming in mid-September.
Summary of Dr. Lorna Breen Health Care Provider Protection Act
This bill establishes grants and requires other activities to improve mental and behavioral health among health care providers.
Specifically, the Department of Health and Human Services (HHS) must award grants to hospitals, medical professional associations, and other health care entities for programs to promote mental health and resiliency among health care providers. In addition, HHS may award grants for relevant mental and behavioral health training for health care students, residents, or professionals.
Additionally, HHS must conduct a campaign to encourage health care providers to seek support and treatment for mental and behavioral health concerns and disseminate best practices to prevent suicide and improve mental health and resiliency among health care providers.
HHS must also study and develop policy recommendations on
improving mental and behavioral health among health care providers,
removing barriers to accessing care and treatment, and
Jasmine De Moya, 17, has dreamed for years of working in the medical field, and she yearned to spend time with older people, missing her grandparents, who live in the Dominican Republic. A program sponsored by the New Jewish Home health system in New York City that combines volunteering and free training for entry-level health jobs, career coaching and assistance on her college prep is helping make her hopes come alive.
Over the past three years, Jasmine has learned a lot about caring for older people, from the importance of speaking slowly and being gentle with frail residents who may have hearing or comprehension problems to how to brush their teeth or bathe them.
“We practiced first with mannequins, so when we actually [worked on residents] I was in shock,” she said. “Cleaning a body and their private areas, I never expected I would do that. But then I got used to it.”
Last summer, Jasmine completed a certified nursing assistant training course. She has also researched and applied for colleges and student loans with help from an organization that the geriatrics career development program provides to volunteers like her. After graduating from high school last month, Jasmine will start nursing school at Lehman College in the Bronx in the fall. She’ll be the first in her family to attend college.
Since it launched in 2006, the geriatrics career development program has helped more than 700 high school students from 10 underserved schools in New York City get hands-on experience with geriatric care at the New Jewish Home in Manhattan and the Harry and Jeanette Weinberg Gardens senior living facility in the Bronx. Ninety-nine percent of program participants graduate from high school, and more than 150 have gone on to college.
The advantages of the program are also evident for the New Jewish Home, which operates two nursing homes, senior housing and assisted living facilities and a home care business in the New York City area. By familiarizing young people with geriatric care careers, the system aims to address its growing need for workers as the tide of baby boomers enter their later years.
Six of the top 10 fastest-growing jobs in the decade leading up to 2029 are projected to be in health care, according to the federal Bureau of Labor Statistics, including home health and personal care aides.
“One of our biggest challenges is that there aren’t enough people who want to work in this industry,” said Dr. Jeffrey Farber, president and CEO of the New Jewish Home system. “People don’t want to work with older adults.”
The New Jewish Home began its career development program for teens 15 years ago with the idea of training and hiring them as nursing assistants, Farber said.
But it has become more than that. Working a few afternoons a week for three years with older adults, students gain insights into aging and develop relationships with residents, some of whom are assigned as mentors. It also gives students assistance with figuring out career goals and putting the pieces in place to get there.
“I think the students would be successful without us, but we provide the structure and resources to help them succeed,” said John Cruz, senior director of workforce initiatives at the New Jewish Home, who oversees the program.
Students generally must devote two afternoons after school every week and several weeks during the summer, said Cruz. The program curriculum, developed with Columbia University Teachers College, initially teaches students basics about patient privacy, Medicare/Medicaid and overcoming stereotypes about older people. By the time they’re seniors in high school, students can train as certified nursing assistants and work as paid interns supporting the residents on the days they spend at the facility.
As part of the program, students may also become certified in other jobs, including patient care technician, phlebotomist, EKG technician, and medical coding and billing staff.
The pandemic, however, changed things. The New Jewish Home in Manhattan was hit hard, with dozens of covid deaths at the 514-bed facility.
Since volunteers weren’t permitted inside the facility, the home instead hired many of them as part-time employees so they could continue to help seniors. This also gave students a chance to complete the clinical training portion of their certified nursing assistant coursework.
In addition to the program for high school students, the health system created a program in 2014 for people ages 18 to 24 who are unemployed and out of school, training them to become certified home health aides and nursing assistants. Nearly 200 have completed the program and the New Jewish Home has hired three-quarters of them, at a starting wage of $15 to $19 an hour.
Both programs are supported primarily by grants from foundations.
In February, the state announced that nursing homes could accept visitors again, following federal guidelines. But many nursing home residents still rely on virtual visits, and during the spring Jasmine spent her time helping them connect with their families and other loved ones by iPad or phone.
The isolation was hard on the residents, and students provided sorely missed company. Asked how the students helped her, resident Dominga Marquez, 78, said, “Just talk.”
“We are lonely,” said Marquez. “I have a lot of friends that used to come every week to visit but, with the pandemic, nobody came.”
Kennedy Johnson, 17, said helping seniors experience virtual visits with their families during the pandemic made him realize how much he takes for granted.
“With the pandemic and doing the virtual calls, seeing how these families don’t get to interact with their loved ones every day, that really opened my eyes,” he said.
Working at the New Jewish Home was the first time Kennedy had ever been in a nursing home or seen the kinds of work that staff members do.
In the fall, he will start at Morehouse College in Atlanta and plans to major in political science. His goal: “I want to be a health care attorney so I can represent people … like this.”
Published courtesy of KHN (Kaiser Health News) a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.
We honored Sandra Lindsay, DHSc, MS, MBA, RN, CCRN-K, NE-BC as Nurse of the Week just last week. Did we run out of outstanding nurses? No, our in-box is still overflowing with NotW suggestions (and please keep them coming!). However, after careful consideration, we bowed in the face of overwhelming evidence indicating that Dr. Lindsay is owed a two-week reign as Nurse of the Week. The nursing student who described her as “the [American] face of the Covid-19 vaccine” was merely being accurate, and the events of this week can certainly attest to Lindsay’s iconic status. What has Dr. Sandra Lindsay been doing since last Wednesday? Well, we can only account for perhaps a few hours last Friday and today — but it is clear that she will have to add Vaccination Icon Duties to her schedule from now on.
Last Friday, US President Joe Biden brought her closer to Elvis status (Presley was a dedicated crusader for the polio vaccine in the 1950s) by presenting the Jamaican-born Lindsay with the Outstanding American by Choice Award. “She represents the very best of us all,” said Biden during a special ceremony at the White House, and “pursued her dream of becoming a nurse to allow her to do what she wanted to do most: give back to her new country.” He also shared a bit more of Lindsay’s own pandemic story. “During the height of the pandemic, she poured her heart and soul into her work… With a grandson at home — prematurely — she did what she had to do. She kept her distance and kept him safe. He is safe, but she lost an aunt and an uncle to the virus.”
Linsday responded, “I came to this country for the opportunities – not only for myself but to be able to help others. As a nurse, I do everything to care for the sickest patients and lead by example. More than 24 years after becoming a naturalized citizen, I could never have imagined where I am today, at the White House receiving high honors from the President. It’s truly a privilege to be a part of this great nation and I will continue to lead and help those in need.”
After the White House ceremony, Lindsay was also asked to surrender her vaccination card, hospital badge, and a pair of scrubs into the custody of the Smithsonian Institution. The items will be on display at the Smithsonian’s Covid-19 historical exhibit (She naturally complied with the request, being as eager as all of us to see Covid-19 become History).
Lindsay had more Icon Duty on Wednesday, July 7, as she joined the ranks of Nurse Grand Marshals. For three hours, she presided over New York City’s Hometown Heroes ticker-tape parade. Lindsay was an obvious choice to lead festivities celebrating the courage and dedication of essential/healthcare workers caring for a city that is still trying to comprehend the loss of over 33,400 lives to the virus. “It is truly an honor and privilege to serve as the grand marshal in the Hometown Heroes ticker-tape parade and represent all health care and essential workers whose heroic efforts saved lives during the COVID-19 pandemic,” Lindsay said. Photos of the Grand Marshal smiling and waving from the back of a plush red convertible look suitably… iconic.
Dr. Lindsay, it is a pleasure to see a nurse knock The King back into his lane and take over as the US Vaccination Icon. Thank you!
People with dementia receiving home health care visits are less likely to be readmitted to the hospital when there is consistency in nursing staff, according to a new study by researchers at NYU Rory Meyers College of Nursing. The findings are published in the journal Medical Care, a journal of the American Public Health Association.
Home health care—in which health providers, primarily nurses, visit patients’ homes to deliver care—has become a leading source of home- and community-based services caring for people living with dementia. These individuals often have multiple chronic conditions, take several medications, and need assistance with activities of daily living. In 2018, more than 5 million Medicare beneficiaries received home health care, including 1.2 million with Alzheimer’s disease and related dementias.
“Nurses play a pivotal role in providing home health care,” said Chenjuan Ma, PhD, MSN, assistant professor at NYU Meyers and the study’s lead author. “As the population ages and older adults choose to ‘age in place’ as long as possible, the demand for home health care for people with dementia is expected to grow rapidly.”
For most patients, their home health care often begins after being discharged from the hospital. Given that hospital readmissions are a significant quality, safety, and financial issue in healthcare, Ma and her colleagues wanted to understand if having continuity of care, or the same nurse coming to each home visit, could help prevent patients from being readmitted.
Using multiple years of data from a large, not-for-profit home health agency, the researchers studied 23,886 older adults with dementia who received home health care following a hospitalization. They measured continuity of care based on the number of nurses and visits during home health care, with a higher score indicating better continuity of care.
Approximately one in four (24 percent) of the older adults with dementia in the study were rehospitalized from home health care. Infections, respiratory problems, and heart disease were the three most common reasons for being readmitted to the hospital.
The researchers found wide variations in continuity of nursing care in home health visits for people with dementia. Eight percent had no continuity of care, with a different nurse visiting each time, while 26 percent received all visits from one nurse. They also found that the higher the visit intensity, or more hours of care provided each week, the lower the continuity of care.
“This may suggest that it is hard to achieve continuity of care when a patient requires more care, though we cannot exclude the possibility that high continuity of care results in more efficient care delivery and thus fewer hours of care,” explained Ma.
Notably, increased continuity of home health care led to a lower risk for rehospitalization, even after the researchers controlled for other clinical risk factors and the intensity of home health care (the average hours of care per week). Compared to those with a high continuity of nursing care, people with dementia receiving low or moderate continuity of nursing care were 30 to 33 percent more likely to be rehospitalized.
“Continuity of nursing care is valuable for home health care because of its decentralized and intermittent care model,” said Ma. “While continuity of nursing care may benefit every home health care patient, it may be particularly critical for people with dementia. Having the same person delivering care can increase familiarity, instill trust, and reduce confusion for patients and their families.”
To improve continuity of nursing care, the researchers recommend addressing the shortage of home health care nurses, improving care coordination, and embracing telehealth in home health care.
“Multiple structural factors present challenges for continuity of care for home health nurses and other staff. These can include long commute times, few full- or part-time staff, agencies relying mostly on per diem staff, and organizational cultures that do not foster retention of home health care staff,” said Allison Squires, PhD, RN, FAAN, associate professor at NYU Meyers and the study’s senior author. “Proposed legislation in Congress that seeks to increase nursing and home health care frontline staff salaries will pay for itself because agencies can improve continuity of care, and therefore reduce penalties associated with hospital readmissions.”
A hybrid care model of in-person visits and telehealth visits could also help achieve more continuity of care, the researchers note. They encourage policymakers to consider expanding coverage for telehealth visits in home health care.
In addition to Ma and Squires, study authors include Margaret McDonald and Penny Feldman of the Visiting Nurse Service of New York, Sarah Miner of St. John Fisher College Wegmans School of Nursing, and Simon Jones of NYU Grossman School of Medicine. The research was supported by the Agency for Healthcare Research and Quality (R01HS023593) and the NYU Center for the Study of Asian American Health under a National Institute on Minority Health and Health Disparities grant (3U54MD000538-18S1).
Dr. Sandra Lindsay made headlines around the world (and in DailyNurse) for being the first person—and first nurse—in the US to hold out her arm for a vaccine that was regarded by many with uncertainty. How could they produce a vaccine at such a ferocious pace? (How? To paraphrase Samuel Johnson’s famous remark, when scientists fear that they or their loved ones will be killed by a virus, it concentrates their minds wonderfully). When people’s perspectives on the mRNA vaccines were clouded by fear and political biases coming from every angle, our Nurse of the Week stood up for non-immunocompromised nurses everywhere when she rolled up a sleeve and said, “I trust science.” The Jamaican-born nurse with many letters after her name is an important symbol and one that should be remembered. Nursing is about caring, but it is also about leadership, science, lots of hard work, and engaging in an endless war against ignorance.
So, what has Sandra Lindsay, DHSc, MS, MBA, RN, CCRN-K, NE-BC done in 2021? Well, she received her booster shot in January… We’re not certain about anything particular she did February through May, but she was probably preoccupied with her job as Director of Nursing at the Northwell Health Long Island Jewish Medical Center, waiting for the daily SARS-CoV-2 case rate to fall, and—because she really does trust science—preparing to add a Doctor of Health Sciences (DHSc) degree to her cv.
Then, this month, Dr. Lindsay responded to the request of a determined new grad, Tracey Smith, president of the Borough of Manhattan Community College (BMCC-SUNY) Nursing Students’ Association. Smith, who describes Lindsay as “the face of the Covid-19 vaccine,” was bent on getting the iconic nurse to speak at the pinning ceremony at the school, which is where she had earned her own first nursing degree in 1994 (and was valedictorian of her class, of course). “She can attest to the safety of the vaccine,” said Smith, who plans to earn a Master’s Degree in Pediatric Nursing. “She can help our new graduate nurses and the BMCC community at large to understand how this vaccine is working to protect us and the importance of mass vaccinations nationwide.”
After somehow finding time for her own new pinning, Lindsay spoke to Smith and the other BMCC nursing grads. She more than fulfilled Smith’s hopes: “It should be the natural choice for us to get vaccinated because it’s how we look out for each other. It gives us a chance to protect ourselves, our healthcare workers and our family and friends. It’s an opportunity to grab onto a much brighter future after a very dark year.”
During commencement, Dr. Lindsay was also awarded the BMCC President’s Medal for 2021, “which expresses the College’s admiration and appreciation for extraordinary service and leadership.”
At the ceremony, Lindsay said of Covid-19, “It’s not gone. I was vaccinated back in December and here I am today, feeling well, doing well. All BMCC graduates are role models. Nurses going out into the field are role models for patients who will look up to you as you model the behavior you want to see in the world.”
Syracuse, NY – State University of New York Chancellor Jim Malatras announced that SUNY System Administration approved an annual pay and benefits increase for the 1,648 teaching and research center nurses at Upstate Medical University. Recognizing the tireless commitment of the nursing staff, SUNY and Upstate Medical University worked closely with the New York State Public Employees Federation to finalize the agreement. Chancellor Malatras, Upstate Medical President Dr. Mantosh Dewan, and PEF President Wayne Spence celebrated the achievements of the nursing team as they announced the raise.
Under the leadership of Chief Nursing Officer Nancy Page, Upstate Medical’s team went above and beyond the call of duty during New York State’s battle again the pandemic, some traveling to those hardest-hit locations in New York City and Long Island for long stretches of time. In April 2020, 46 nurses helped SUNY’s hospital in Stony Brook University as more patients needed care from the disease. As cases increased in the Central New York region later on it was all-hands-on-deck helping patients, testing individuals, and eventually providing the life-saving COVID-19 vaccines as they became available.
“During the pandemic, Upstate demonstrated why SUNY has the most talented health professionals in the world, especially our nurses,” said Chancellor Malatras. “The nurses at Upstate Medical are our heroes every day, and we can’t thank them enough—they are the heartbeat of healthcare. And, while we are pleased to provide this annual pay and benefits increase, we will continue to seek ways to reward their excellence. My thanks to President Dewan and PEF President Spence for their partnership in making that happen.”
The increase in compensation is part of SUNY’s and Upstate Medical’s efforts to increase the retention of nurses, and thereby continue the hospital’s high-level of care. The raise provides between $2,000 and $3,500 additional compensation a year for nurses.
Upstate Medical President Dewan, MD, said, “Our nurses were and continue to be on the frontlines of this historic pandemic and have been the backbone of our care. Not only have they provided medical treatment, but they have been at the bedside to calm and comfort—and in many ways to stand in for families who could not visit their loved ones.“
PEF President Spence said,“We are grateful to SUNY leadership for their partnership in helping us reward our tireless PEF nurses, who acted so selflessly to care for others during this pandemic. I especially appreciate SUNY for stepping up and just doing it—we didn’t have to convince them. They did it because it’s right and because nurses deserve it. They are the true heroes of COVID-19 and we simply can’t thank them enough for putting patients first when the need for care was so great.”
Since 2014, Chief Nursing Officer Page has served as the nursing team’s top officer, rising in the ranks since joining Upstate Medical in 1982 in the Pediatric Intensive Care Unit. Chief Nursing Officer Page earned her bachelor’s in nursing from SUNY’s medical university in Brooklyn, SUNY Downstate Health Sciences University.
Chief Nursing Office Page said, “This has been an amazing year for our nursing staff. We cared for COVID patients, helped our fellow nurses at Stonybrook, and achieved one of the highest accolades—Magnet designation—for our nursing care and quality. Nurses at Upstate have gone above and beyond every day with their time and commitment to Upstate and our patients.“
Michael Casey, RN, a PEF-represented nurse in pediatric hematology oncology, thanked PEF and Upstate leadership for the recognition and support, especially in such a trying year. “Recognition is nice and helpful, what motivates us most, and the reason we do what we do, is our patients,” he said.
In December 2020, Upstate Medical was chosen as a regional vaccination hub for Central New York and Chief Nursing Officer Page administered the first vaccines at the SUNY hospital to employees Kenzo Mukendi, Caprice Hibbler, and Suzanne Buck.
Upstate University Hospital Chief Executive Officer Dr. Robert Corona said, “Upstate’s success in caring for our COVID patients and keeping others safe is directly related to our outstanding nursing staff. As the situation grew more critical, these nurses never wavered in their role and commitment to providing the best possible care for their patients.”
While Upstate Medical served New Yorkers during the pandemic, the nursing staff applied for and earned the prestigious Magnet designation from the American Nurses Credentialing Center, the highest honor a healthcare organization can receive for nursing excellence and patient care. They were designated this distinction in January 2021.
As much as the team has been recognized, so have individuals. As recently as last week, three Upstate Medical University employees were honored by the Arnold P. Gold Foundation as Champions of Humanistic Care for going above and beyond during the COVID-19 pandemic. Honorees included nurses Diane Nanno, director of nursing for Upstate Transitional Care Services, and Crystal Marshall, assistant nurse manager of a COVID-19 floor at Upstate Medical’s downtown hospital.