Inmates’ Distrust of Prison Healthcare Fuels Vaccine Hesitancy

Inmates’ Distrust of Prison Healthcare Fuels Vaccine Hesitancy

One November night in a Missouri prison, Charles Graham woke his cellmate of more than a dozen years, Frank Flanders, saying he couldn’t breathe. Flanders pressed the call button. No one answered, so he kicked the door until a guard came.

Flanders, who recalled the incident during a phone interview, said he helped Graham, 61, get into a wheelchair so staff members could take him for a medical exam. Both inmates were then moved into a covid-19 quarantine unit. In the ensuing days, Flanders noticed the veins in Graham’s legs bulging, so he put towels in a crockpot of water and placed hot compresses on his legs. When Graham’s oxygen levels dropped dangerously low two days later, prison staff members took him to the hospital.

“That ended up being the last time that I seen him,” said Flanders, 45.

Graham died of covid on Dec. 18, alarming Flanders and other inmates at the Western Missouri Correctional Center in Cameron, about 50 minutes northeast of Kansas City. His death reinforced inmates’ concerns about their own safety and the adequacy of medical care at the prison. Such concerns are a major reason Flanders and many other inmates said they are wary of getting vaccinated against covid-19. Their hesitancy puts them at greater risk of suffering the same fate as Graham.

Inmates pointed to numerous covid deaths they considered preventable, staffing shortages and guards who don’t wear masks. While corrections officials defended their response to covid, Flanders said he’s apprehensive about how the department handles “most everything here recently,” which colors how he thinks about the vaccines.

Reluctance to get a covid vaccine is not unique to Missouri inmates. At a county jail in Massachusetts, nearly 60% of more than 400 people incarcerated said in January they would not agree to be vaccinated. At a federal prison in Connecticut, 212 of the 550 inmates offered the vaccines by early March declined the shots, including some who were medically vulnerable, The Associated Press reported.

The Missouri Department of Corrections said March 12 that more than 4,200 state inmates had received the vaccine out of 8,000 who were eligible because they were at least 65 years old or had certain medical conditions. Officials were still working to vaccinate 1,000 additional eligible inmates who had requested the shots. The department had not begun vaccinating the remaining 15,000 inmates or surveyed them to determine their interest in the vaccines. So far, about 18% of the total prison population has been vaccinated, which roughly tracks with the overall rate in Missouri even though inmates are at higher risk for covid than Missourians generally and should be easier to vaccinate given they are already in one place together.

Missouri placed the majority of inmates in its lowest vaccine priority group. It is one of 14 states to either do that or not specify when they will offer the vaccines to inmates, according to the COVID Prison Project, which tracks data on the virus in correctional facilities.

Another is Colorado, where Democratic Gov. Jared Polis moved inmates to the back of the vaccine line amid public pressure. The emergence of a more contagious variant of the virus at one prison, however, forced officials to adjust their plans and instead start vaccinating all inmates at that facility.

Lauren Brinkley-Rubinstein, prison project co-founder and professor of social medicine at the University of North Carolina, said that disregarding health officials’ recommendation to prioritize people living in tight quarters might make inmates less trustful of prison staff “when they come around and say, ‘Hey, it’s finally your turn. Let me inject you with this.’”

States cannot mandate that inmates take the vaccines. But Missouri officials have tried to encourage them by distributing safety information about it, including a videodebunking myths featuring a scientist from Washington University in St. Louis.

But persuasion is proving difficult at Western Missouri, given inmates’ longtime distrust of prison management. Flanders, Graham and others were transferred there from neighboring Crossroads Correctional Center following a 2018 riot that caused an estimated $1.3 million in damage and led to its closure. Inmates were angry that staff shortages had reduced time for recreation and other programming.

Officials acknowledge that staff shortages have persisted through the pandemic. “Corrections is not the most popular place to work right now,” Missouri corrections director Anne Precythe said at an early March NAACP town hall on covid and prisons.

Flanders, who is serving a life sentence for first-degree robbery, said the prison didn’t have enough nursing staffers to check on him during a bout with mild covid in November. He said other sick inmates also didn’t receive appropriate medical attention. Karen Pojmann, a corrections department spokesperson, said she could not comment on specific offenders’ medical issues.

Tim Cutt, executive director of the Missouri Corrections Officers Association, said he’s seen no evidence that Western Missouri even had a plan to contain covid. “They were quarantining for a while,” he said, “but it was a haphazard attempt.”

Also fueling skepticism of prison health care, inmates said, is the failure of many staff members to follow the corrections department’s mask mandate. Byron East, who is serving a life sentence for murder at South Central Correctional Center, two hours southwest of St. Louis, said in a phone interview that he has begged officers — many of whom live in conservative, rural areas where masks are less common — to wear face coverings.

“As an employee, your job is to protect, and we are not able to protect ourselves,” said East, 53. “You can catch something and then come in here and spread it to us.”

Amy Breihan, co-director of the Missouri office of the Roderick & Solange MacArthur Justice Center, a nonprofit civil rights law firm, said she didn’t see a single officer wearing a mask on Feb. 10 when she visited a correctional facility in Bonne Terre, Missouri.

Corrections Department Deputy Director Matt Sturm confirmed Breihan’s account at the NAACP town hall and said it has been addressed. He said the department expects staff members in all prisons to wear masks while inside when they can’t stay 6 feet apart from others.

“Right from the beginning, the Department of Corrections in Missouri has taken covid extremely serious,” Sturm said. The department deployed “everything we could get our hands on to help either prevent or contain covid,” including equipment for ventilation and disinfection.

Still, Missouri has reported at least 5,500 covid cases and 48 deaths among inmates at the state’s adult correctional institutions during the pandemic. The department doesn’t break down covid deaths by prison, but data from the advocacy group Missouri Prison Reform showed Western Missouri had 21 total deaths from covid or other causes last year, more than any other state prison even though its population isn’t the largest. Statistics on deaths in the previous year were not immediately available.

An automatic email reply from Eve Hutcherson, a former spokesperson for Corizon Health, which manages health care in Missouri prisons, directed a reporter to Steve Tomlin, senior vice president of business development, but he didn’t respond to questions. The company, one of the country’s largest for-profit correctional health care providers, faced more than 1,300 lawsuits over five years, according to a 2015 report from the financial research firm PrivCo. In Arizona, Corizon paid a $1.4 million fine for failing to comply with a 2014 settlement to improve inadequate health care for inmates.

Despite concerns about prison health care, however, some inmates have agreed to get the shot. East, who is Black, said he initially decided against it because he didn’t trust prison health and thought about the legacy of the Tuskegee experiments from 1932 to 1972, when researchers withheld treatment for Black men infected with syphilis. But he changed his mind after reading about how safe the vaccines are.

Flanders, meanwhile, is still weighing whether to get vaccinated as he mourns the death of his longtime cellmate Graham, a convicted murderer whom he considered a friend and father figure.

Flanders’ mother, Penny Kopp, said Graham helped Flanders manage his finances and kept him from gambling and getting involved with “inmates who are troublemakers.” Kopp, a former corrections officer in Indiana and Colorado, said she understands the challenges of working in a prison but wonders if enough was done to save her son’s cellmate.

Flanders said getting the shot would mean putting himself at the mercy of prison staffers, as Graham did — and that’s something he’s not ready to do.

School Districts Present TX Town With Duelling Mask Policies

School Districts Present TX Town With Duelling Mask Policies

The two school districts in this Central Texas town headed in opposite directions after Gov. Greg Abbott ended the statewide mask mandate, sparking heated debates over safety and government responsibility.

For locals and tourists, it’s hard to overstate the charm of New Braunfels, a place of spring-fed rivers, dance halls and German festivals.

Yet against this idyllic backdrop, the nation’s ongoing fight over mask-wearing has pitted neighbor against neighbor and put the region’s schoolchildren squarely in the middle of an overheated argument.

In what quickly became a conversation about science, personal liberty and the role of government, the town’s two school boards, New Braunfels Independent School District and Comal Independent School District, landed on opposite sides of the face-covering debate earlier this month after Gov. Greg Abbott announced the statewide mask mandate would end March 10.

In New Braunfels ISD, which serves more low-income and Latino students, the school board opted to survey parents, resulting in a vote to keep the school mask mandate. The Comal ISD board, representing whiter, more rural parts of Comal county, voted 5-2 in an eleventh-hour meeting to make masks voluntary after members touted personal responsibility and parental choice. One Comal ISD board member, Marty Bartlett, cited the arguments of well-known conspiracy theorists and vaccine skeptics who say masks are government overreach, not sound science.

The mask battle in New Braunfels clearly has political overtones, but this isn’t your typical liberal versus conservative fight. New Braunfels sits on the southeastern edge of Comal County, whose residents gave former President Donald Trump 70% of the vote in November.

In this case the fight is more about moderate conservatives versus those on the far right.

And Comal ISD’s political leanings are already affecting students and teachers in a big way as masks disappear from classrooms, Comal ISD parents and teachers say.

Students are facing peer pressure to abandon masks. Teachers don’t know whose parents prefer for them to wear the masks. Parents who don’t want their children in class or crowded hallways with unmasked people must decide whether to go back to remote learning.

“Teachers had no time to prepare,” said Comal ISD middle school teacher and parent Kate Fraser, adding that students showed up without masks the day after the board meeting. “You feel as a teacher you can’t do what you need to do to protect the kids.”

The fast-growing suburbs and exurbs of San Antonio and rural areas of the Texas Hill Country where children attend Comal ISD schools have pulled the county further to the right, while more moderate conservatives struggle to hold on to the city of New Braunfels.

“I’ve always been a conservative, still am, still vote the Republican party. But the shift has been further and further and further to the right,” said Doug Miller, who represented Comal County in the Texas Legislature before losing his seat to state Rep. Kyle Biedermann, a far-right conservative who attended the Trump rally in Washington, D.C., on the day of the Jan. 6 insurrection.

Trump won all but one precinct in Comal County in 2020, capturing up to 79% of the vote in some precincts. His margins were widest in the rural areas in Comal ISD and smaller in New Braunfels ISD.

The two districts, both headquartered in New Braunfels, the largest city in the county, have subtle but important differences: New Braunfels ISD is majority students of color (54%) to Comal ISD’s 48%; 38% of New Braunfels ISD students qualify for free and reduced lunch, while 30% qualify in Comal ISD.

The demographic differences between the two districts may seem small, but parents say Trumpism has had an impact on the county, and the way the two boards settled the mask debate is the perfect example. Anti-mask beliefs have become synonymous with far-right conservatism.

“I really think it was ideology and not anything else,” Valerie Garza Estes, a Comal ISD parent, said of the board vote. “Listening to the board meeting, that’s perfectly clear.”

After Trump, Comal parents and students with “privilege,” Estes said, “are willing to be louder and meaner and push their ideas or views without even feeling there would be consequences.”

Board members who voted to remove the mandate cited parental choice, while the two dissenting votes argued masks were critical for safe in-person learning.

“What the data shows is that after every break from school we have a lot of kids who come back who get exposed outside the school,” said trustee Russell Garner. The number goes down once kids are in school. With masks, the transmission rate is “almost zero,” he said.

During the board meeting, trustee Jason York argued it should be up to parents to decide how best to keep their children safe and voted to lift the mandate.

His daughter, York said, would be wearing one. If other parents want their children attending prom, graduation and other activities, he said, “then they’re going to continue to send their children with a mask.”

That may not be true.

Sandy Mathis, a parent of three elementary school students in Comal ISD, said her family respectfully complied with the mask requirement, even though they believed that wearing masks all day had a negative effect on their children’s health and distracted them from learning.

“Now that we have been given the gift of parental choice, my kids will no longer be wearing a mask to school,” Mathis wrote in a message to The 74. Some at her children’s school have kept the masks; others have not. Some children are wearing them for a few weeks out of caution as spring-breakers return.

Removing the mask mandate gives parents a choice, but not teachers who may now have to spend entire days with maskless students, trustee Tim Hennessee argued during the board meeting. He voted to keep the mask mandate. “I think this shows a total lack of respect to the teachers.”

Of the schools he represents — in a suburban part of the district with the highest population of people of color — three quarters wanted to keep the mask mandate, he said. York countered by saying three quarters of the campuses he represents — which are in the most rural part of the district with the highest white population — wanted to be able to choose.

A Facebook group called Open Comal County Schools Safely conducted its own survey and plans to present the results to the board at its Thursday meeting.

When asked about the overall preferences of the district, Superintendent Andrew Kim said most teachers and principals indicated they would continue to wear masks.

“It varies by certain areas of our school district, I will say that,” Kim said.

His comment — and the feedback from Hennessee’s and York’s districts — suggests the tension between conservative and ultraconservative viewpoints exists not just between New Braunfels ISD and Comal ISD, but within Comal ISD as well.

Estes said that Trump’s racist and xenophobic rhetoric immediately showed up in Comal ISD schools in 2016, when classmates began to taunt her son about his Latina mother. During the pandemic, some students echoed Trump’s cavalier attitude, she said.

In August, board President David Drastata referred to COVID-19 using Trump’s racist “China virus” epithet in an athletic booster club email. He later apologized.

Miller described the new conservatism as uncompromising and domineering. “Their position is: If you disagree with me, you’re wrong.”

Kim expressed concern that emboldened parents with strong anti-mask views would become a distraction for teachers and principals if the district kept its own mandate without the state mandate backing it up.

“I think the last thing I would like to see is our administrators having a protracted philosophical conversation with our parents in the hallways,” Kim said.

The answer, the board decided, was simply to let those parents have their way.

Why You Should Take Periodic “Pandemic News” Breaks

Why You Should Take Periodic “Pandemic News” Breaks

Since the pandemic began, anxiety rates in the U.S. have tripled; the rate of depression has quadrupled. Now research is suggesting the media is part of the problem. Constantly watching and reading news about COVID-19 may be hazardous for your mental health. 

We are professors who study the psychological effects on people caught up in crisis, violence and natural disasters. COVID-19 surely qualifies as a crisis, and our survey of more than 1,500 U.S. adults clearly showed that those experiencing the most media exposure about the pandemic had more stress and depression. 

It’s understandable. The intimations of death and suffering, and the images of overwhelmed hospitals and intubated patients can be terrifying. COVID-19 has created an infodemic; members of the public are overwhelmed with more information than they can manage. And much of that information, especially online, includes disturbing rumors, conspiracy theories and unsubstantiated statements that confuse, mislead and frighten. 

Stress worse for some than others

A June 2020 study of 5,412 U.S. adults says 40% of respondents reported struggling with mental health or substance use issues. This finding did not address whether respondents had COVID-19. Since then, some people who had COVID-19 are now reporting mental health issues that appeared within 90 days after their illness subsided. 

Taking care of a relative or friend with the virus might result in mental health problems, and even just knowing someone with COVID-19 can be stressful. And if a family member or friend dies from it, anxiety and depression often follow the grief. This is even more likely if the individual dies alone – or if a memorial isn’t possible because of the pandemic.

Essential workers, from hospitals to grocery stores, have a higher risk for COVID-related mental health problems. This is particularly true for health care workers caring for patients who ultimately died from the virus. 

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Black and Hispanic adults also report more mental health issues, including substance abuse and thoughts of suicide. Having access to fewer resources and experiencing the systemic racism running through much of U.S. health care may be two of the factors. The COVID-19 pandemic also intersected with episodes of police violence toward Black Americans. This alone may have exacerbated mental health problems.

Children, young adults and college students also show comparatively worse mental health reactions. This could be due to the disconnect they feel, brought on by the isolation from peers, the loss of support from teachers and the disappearance of daily structure. 

Setting limits essential

Staying informed is critical, of course. But monitor how much media you’re consuming, and assess how it affects you. If you are constantly worrying, feeling overwhelmed, or having difficulty sleeping, you may be taking in too much COVID media. If this is happening to you, take a break from the news and do other things to help calm your mind

Parents should frequently check in with children to see how they are affected. Listening to and validating their concerns – and then providing honest responses to their questions – can be enormously helpful. If a child is having difficulty talking about it, the adult can start with open-ended questions (“How do you feel about what is happening?”). Reassure children that everything is being done to protect them and discuss ways to stay safe: Wear a mask, socially distance, wash hands. 

Finally, you can model and encourage good coping skills for your children. Remind young people that good things are still happening in the world. Work together to list healthy ways to cope with COVID-19 stress. Then do them. These activities will help your children cope – and it will be good for you too.

Turnabout: Strangers Rescue Nurse! Nurse of the Week Ericka Cosby’s Worst Commute Ever

Turnabout: Strangers Rescue Nurse! Nurse of the Week Ericka Cosby’s Worst Commute Ever

For a change of pace, this Nurse of the Week was on the receiving side of a rescue—and, instead of driving her car to work, she ended up riding there in an ambulance. The off-duty nurses who (in these stories) usually play the role of impromptu first responders were occupied elsewhere that evening, but fortunately, two strangers pulled over and filled in—which is a relief, since sometimes, nurses need to be saved too.

It happened in the blink of an eye. Pendleton, Indiana RN Ericka Cosby was driving to her evening shift, her mind probably on the pending handover. As she rode over a bump in the rural road, the jolt dislodged her mobile phone, which slid to the floor. Without thinking, she reached down to retrieve it before it could become lost under the seats. As Cosby started to lower her arm, her mind cut in and arrested her movement, but it was already too late.

Describing her ordeal to a local news station, Cosby said, “I didn’t even make it to pick it up before I was heading straight into the guardrail. The police officer said I rode down the guardrail for about 10 feet and flipped down the hill two to three times—not sure how many—but I landed upside down, half in the creek and half on the grass.” When her car finally came to a rest, Cosby found herself upside-down and trapped by an inflated airbag. Being tumbled about inside the auto as it fell 10 feet and flipped repeatedly did not leave her unscathed: she broke her nose, fractured an orbital, and suffered various contusions; the airbag did its part by burning her in various places while it trapped her. Cosby was also phoneless, of course, and as luck would have it, she could not reach the button to activate her On-Star service.

The injured nurse was able to reach the horn, and—to attract attention on the quiet country road—she pressed down and honked repeatedly at intervals. The upside-down car’s lights were still on, and smoke began to creep out from under the hood. Now, though, luck started turning her way. Two passersby—a woman and a man—noticed the smoke and lights and pulled their cars over to offer help. The efforts of Cosby’s Samaritans, however, were hampered by difficulties posed by unfastening her seatbelt as she hung inside the overturned car. “I was very afraid if I unbuckled the seat belt, I was just going to land straight on my face… because I couldn’t bend my knees to get them out anywhere [and] there was glass,” Cosby recalled.

Nurse Ericka Cosby talks to rescuer Robert Wilson.
Ericka Cosby talks to rescuer Robert Wilson. (Fox59, Indiana)

The rescuers were determined, though, and the male bystander, she says, “actually crawled into my car on all fours and acted like a tabletop for me. That man didn’t know me, and he literally let me fall onto him.” As the man held her, the unknown woman quickly unlatched the seatbelt, and the two pulled her out of the car. Then—in one of those Hollywood moments that no one wants to pop up in real life—while they helped her away from the auto, it burst into flames (Really. Take another look at that Twitter photo.).

Now recovering in the hospital, Cosby expects to be discharged soon (so she can go to work in her preferred fashion). She told local reporters that the two strangers were her “guardian angels.” The male angel, Robert Wilson, said, “I don’t feel like I did anything that someone else wouldn’t do. I was brought up to help people.”

For more details on this story, go to Fox 59 in Indiana.

Do Painless Glucose Monitors Really Help Most Diabetes Patients?

Do Painless Glucose Monitors Really Help Most Diabetes Patients?

In the nation’s battle against the diabetes epidemic, the go-to weapon being aggressively promoted to patients is as small as a quarter and worn on the belly or arm.

A continuous glucose monitor holds a tiny sensor that’s inserted just under the skin, alleviating the need for patients to prick their fingers every day to check blood sugar. The monitor tracks glucose levels all the time, sends readings to patients’ cellphone and doctor, and alerts patients when readings are headed too high or too low.

Kaiser Health News
Originally Published in Kaiser Health News

Nearly 2 million people with diabetes wear the monitors today, twice the number in 2019, according to the investment firm Baird.

There’s little evidence continuous glucose monitoring (CGM) leads to better outcomes for most people with diabetes — the estimated 25 million U.S. patients with Type 2 disease who don’t inject insulin to regulate their blood sugar, health experts say. Still, manufacturers, as well as some physicians and insurers, say the devices help patients control their diabetes by providing near-instant feedback to change diet and exercise compared with once-a-day fingerstick tests. And they say that can reduce costly complications of the disease, such as heart attacks and strokes.

Continuous glucose monitors are not cost-effective for Type 2 diabetes patients who do not use insulin, said Dr. Silvio Inzucchi, director of the Yale Diabetes Center.

Sure, it’s easier to pop a device onto the arm once every two weeks than do multiple finger sticks, which cost less than a $1 a day, he said. But “the price point for these devices is not justifiable for routine use for the average person with Type 2 diabetes.”

Without insurance, the annual cost of using a continuous glucose monitor ranges from nearly $1,000 to $3,000.

Lower Prices Help Propel Use

People with Type I diabetes — who make no insulin — need the frequent data from the monitors in order to inject the proper dose of a synthetic version of the hormone, via a pump or syringe. Because insulin injections can cause life-threatening drops in their blood sugar, the devices also provide a warning to patients when this is happening, particularly helpful while sleeping.

People with Type 2 diabetes, a different disease, do make insulin to control the upswings after eating, but their bodies don’t respond as vigorously as people without the disease. About 20% of Type 2 patients still inject insulin because their bodies don’t make enough and oral medications can’t control their diabetes.

Doctors often recommend that diabetes patients test their glucose at home to track whether they are reaching treatment goals and learn how medications, diet, exercise and stress affect blood sugar levels.

The crucial blood test doctors use, however, to monitor diabetes for people with Type 2 disease is called hemoglobin A1c, which measures average blood glucose levels over long periods of time. Neither finger-prick tests nor glucose monitors look at A1c. They can’t since this test involves a larger amount of blood and must be done in a lab.

The continuous glucose monitors also don’t assess blood glucose. Instead they measure the interstitial glucose level, which is the sugar level found in the fluid between the cells.

Companies seem determined to sell the monitors to people with Type 2 diabetes — those who inject insulin and those who don’t — because it’s a market of more than 30 million people. In contrast, about 1.6 million people have Type 1 diabetes.

Helping to fuel the uptake in demand for the monitors has been a drop in prices. The Abbott FreeStyle Libre, one of the leading and lowest-priced brands, costs $70 for the device and about $75 a month for sensors, which must be replaced every two weeks.

Another factor has been the expansion in insurance coverage.

Nearly all insurers cover continuous glucose monitors for people with Type 1 diabetes, for whom it’s a proven lifesaver. Today, nearly half of people with Type 1 diabetes use a monitor, according to Baird.

A small but growing number of insurers are beginning to cover the device for some Type 2 patients who don’t use insulin, including UnitedHealthcare and Maryland-based CareFirst BlueCross BlueShield. These insurers say they have seen initial success among members using the monitors along with health coaches to help keep their diabetes under control.

The few studies — mostly small and paid for by device-makers — examining the impact of the monitors on patient’s health show conflicting results in lowering hemoglobin A1c.

Still, Inzucchi said, the monitors have helped some of his patients who don’t require insulin — and don’t like to prick their fingers — change their diets and lower their glucose levels. Doctors said they’ve seen no proof that the readings get patients to make lasting changes in their diet and exercise routines. They said many patients who don’t use insulin may be better off taking a diabetes education class, joining a gym or seeing a nutritionist.

“I don’t see the extra value with CGM in this population with current evidence we have,” said Dr. Katrina Donahue, director of research at the University of North Carolina Department of Family Medicine. “I’m not sure if more technology is the right answer for most patients.”

Donahue was co-author of a landmark 2017 study in JAMA Internal Medicine that showed no benefit to lowering hemoglobin A1c after one year regularly checking glucose levels through finger-stick testing for people with Type 2 diabetes.

She presumes the measurements did little to change patients’ eating and exercise habits over the long term — which is probably also true of continuous glucose monitors.

“We need to be judicious how we use CGM,” said Veronica Brady, a certified diabetes educator at the University of Texas Health Science Center and spokesperson for the Association of Diabetes Care & Education Specialists. The monitors make sense if used for a few weeks when people are changing medications that can affect their blood sugar levels, she said, or for people who don’t have the dexterity to do finger-stick tests.

Yet, some patients like Trevis Hall credit the monitors for helping them get their disease under control.

Last year, Hall’s health plan, UnitedHealthcare, gave him a monitor at no cost as part of a program to help control his diabetes. He said it doesn’t hurt when he attaches the monitor to his belly twice a month.

The data showed Hall, 53, of Fort Washington, Maryland, that his glucose was reaching dangerous levels several times a day. “It was alarming at first,” he said of the alerts the device would send to his phone.

Over months, the readings helped him change his diet and exercise routine to avert those spikes and bring the disease under control. These days, that means taking a brisk walk after a meal or having a vegetable with dinner.

“It’s made a big difference in my health,” said Hall.

This Market ‘Is Going to Explode’

Makers of the devices increasingly promote them as a way to motivate healthier eating and exercise.

The manufacturers spend millions of dollars pushing doctors to prescribe continuous glucose monitors, and they’re advertising directly to patients on the internet and in TV ads, including a spot starring singer Nick Jonas during this year’s Super Bowl.

Kevin Sayer, CEO of Dexcom, one of the leading makers of the monitors, told analysts last year that the noninsulin Type 2 market is the future. “I’m frequently told by our team that, when this market goes, it is going to explode. It’s not going to be small, and it’s not going to be slow,” he said.

“I believe, personally, at the right price with the right solution, patients will use it all the time,” he added.

Top Trauma Nurse Julie Donnelly, MSN, RN, TCRN Earns 2021 BCEN Award

Top Trauma Nurse Julie Donnelly, MSN, RN, TCRN Earns 2021 BCEN Award

Held by nearly 6,200 nurses and introduced just five years ago, the Trauma Certified Registered Nurse (TCRN) is trauma nursing’s highest professional credential. Nurses who earn the TCRN must demonstrate advanced clinical knowledge and expertise across the continuum of trauma care from injury prevention to acute care to rehabilitation. Trauma is a major public health issue, and trauma nurses play a leading and highly collaborative role in trauma care. 

“Julie’s phenomenal success in supporting nurses to earn their TCRN trauma certification sets a prime example of how specialty certification contributes to better trauma nursing and better trauma patient care,” said BCEN CEO Janie Schumaker, MBA, BSN, RN, CEN, CENP, CPHQ, FABC. “She is a true champion for trauma excellence.” 

Trauma nurse Julie Donnelly, MSN, RN, TCRN won the 2021 BCEN TCRN award.
Trauma nurse Julie Donnelly, MSN, RN, TCRN

Led and spurred by Julie’s work, the certification rate of Thomas Jefferson University Hospital emergency department nurses with at least three years of experience has increased from 38% to 100%, and the certification rates in all of the hospital’s trauma-designated units consistently exceed the average certification rate across all nursing units. Thomas Jefferson University Hospital (TJUH) is an accredited Level I Regional Resource Trauma Center. 

“When the TCRN was introduced, we were so excited to have a certification just for trauma that we could offer to nurses in the trauma bay and in our intermediate and ICU trauma-designated units,” said Donnelly. “I am truly honored to receive this award. I see it as a team award for Jefferson and all of the trauma nurses here, not just me.” 

Read more about Julie in the “Meet the Winner” Q&A at

“Julie has demonstrated remarkable leadership and been a fierce advocate to improve trauma patient care and advance nurse education. This recognition by the Board of Certification for Emergency Nursing is an honor that both reflects her talent for elevating nurse professionalism in all the TJUH units involved in the care of trauma patients and supporting our system focus on improving lives,” said Kate FitzPatrick, DNP, RN, ACNP, FAAN, NEA-BC, System Chief Nurse Executive Officer, Jefferson Health. 

Donnelly was recognized via a virtual tribute by BCEN’s Schumaker on Friday, March 26, during TraumaCon 2021, the Society of Trauma Nurses‘ (STN) annual conference. The event is being held virtually this year due to the COVID-19 pandemic. The winner of this year’s BCEN Distinguished TCRN Award was determined by a selection committee consisting of BCEN board members, staff and volunteer subject matter experts as well as a representative from the Society of Trauma Nurses. 

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