ProPublica: States Need to Counter Vaccine Hesitancy Among People of Color

ProPublica: States Need to Counter Vaccine Hesitancy Among People of Color

Though African Americans are being hospitalized for COVID-19 at more than triple the rate of white Americans, wariness of the new vaccine is higher in the Black population than in most communities. The U.S. Centers for Disease Control and Prevention highlighted communities of color as a “critical population” to vaccinate. But ProPublica found little in the way of concrete action to make sure that happens.

Originally published by ProPublica

It will be up to states to make sure residents get the vaccine, but ProPublica reviewed the distribution plans of the nine states with the most Black residents and found that many have barely invested in overcoming historic mistrust of the medical establishment and high levels of vaccine hesitancy in the Black community. Few states could articulate specific measures they are taking to address the vaccine skepticism.

And it could be hard to track which populations are getting the vaccine. While the CDC has asked states to report the race and ethnicity of every recipient, along with other demographic information like age and sex, the agency doesn’t appear ready to apply any downward pressure to ensure that such information will be collected.

In state vaccination registries, race and ethnicity fields are simply considered “nice to have,” explained Mitchel Rothholz, chief of governance and state affiliates for the American Pharmacists Association. While other fields are mandatory, such as the patient’s contact information and date of birth, leaving race and ethnicity blank “won’t keep a provider from submitting the data if they don’t have it.”

In the initial stages, vaccines will go to people who are easy to find, like health care workers and nursing home residents. But barriers will increase when distribution moves to the next tier — which includes essential workers, a far larger and more amorphous group. Instead of bringing the vaccine to them, it’s more likely that workers will have to seek out the vaccine, so hesitancy and lack of access will become important factors in who gets the shots and who misses out.

“There are individuals who are required to be on the front line to serve in their jobs but perhaps don’t have equitable access to health care services or have insurance but it’s a challenge to access care,” said Dr. Grace Lee, a professor of pediatrics at Stanford University School of Medicine and member of the CDC’s Advisory Committee on Immunization Practices, which is tasked with issuing guidance on the prioritization of COVID-19 vaccine distribution. “We can build equity into our recommendations, but implementation is where the rubber meets the road.”

Hesitancy is Rooted in Medical Exploitation and Mistreatment

About a quarter of the public feels hesitant about a COVID-19 vaccine, meaning they probably or definitely would not get it, according to a December poll by the Kaiser Family Foundation. Hesitancy was higher than average among Black adults in the survey, with 35% saying that they definitely or probably would not get vaccinated.

Mistrust of the medical community among people of color is well-founded, stemming from a history of unscrupulous medical experimentation. The infamous Tuskegee study, conducted from 1932 to 1972 by the U.S. Public Health Service, still looms large in the memories of many Black Americans, who remember how researchers knowingly withheld treatment from African American sharecroppers with syphilis in order to study the disease’s progression.

But the injustices aren’t confined to the past. The National Academies’ Institute of Medicine has found that minorities tend to receive lower-quality health care than white counterparts, even when adjusting for age, income, insurance and severity of condition. Black Americans are also more likely to be uninsured and utilize primary care services less often than white Americans.

“It’s not just about history. It’s about the here and now,” said Dr. Bisola Ojikutu, an infectious disease physician at Massachusetts General Hospital. “People point to racial injustice across the system. It’s not just hospitals; people don’t trust the government, or they ask about the pharmaceutical industry’s profit motive. From the very beginning, Black and brown people are marginalized from the enterprise of research. They think: ‘So few people look like us in research, industry and academia, why should we trust that someone at that table is thinking of our interest?’”

When it comes to vaccinations, the consequences can be grave. Black and Hispanic people are less likely to get the flu shot than white people, according to the CDC. At the same time, Black Americans have the highest rate of flu-associated hospitalizations, at 68 people per 100,000 population, compared to 38 people per 100,000 in the non-Hispanic white population.

Health officials have tried to assuage vaccine concerns in the traditional way, by publicizing specific individuals receiving the shot. The U.S. began its mass immunization effort by injecting a dose of the Pfizer-BioNTech vaccine into the left upper-arm of Sandra Lindsay, a Black woman and critical care nurse in New York.

Meanwhile, an onslaught of memes and conspiracy theories characterizing the vaccine as harmful are making the rounds on social media. One reads, “Just had the covid-19 vaccine. Feeling great,” along with the picture of the character from the 1980 movie “The Elephant Man.” Another image circulating on Twitter features the photos of three Black people and claims they are suffering from Bell’s palsy due to the vaccine. The Twitter user who shared the image asked followers, “still want those Tuskegee 2.0 genocide vaccines?”

It may only take one or two negative headlines to further sow fear, said Komal Patel, who has 16 years of experience as a pharmacist in California. After two health care workers in the United Kingdom experienced allergic reactions to Pfizer’s vaccine, Patel said she saw anxiety spike on social media, even though regulators have said that only people with a history of anaphylaxis — a severe or life threatening immune reaction — to ingredients in the vaccine need to avoid taking the shot. “Just two patients, and here we go, there’s all this chatter.”

Key States Lack Concrete Plans to Promote Vaccines in Black Communities

It falls to states to make sure their residents of color are vaccinated. But the speed at which the vaccine needs to be disseminated means that states haven’t had much time to plan communications efforts, said Lee, from CDC’s advisory group. “How do we make sure messaging is appropriate? You may want to emphasize different messages for different communities. We don’t have the time for that.”

ProPublica found that few states can articulate specifically what they are doing to address vaccine skepticism in the Black community.

TexasGeorgia and Illinois’ state plans make no mention of how they plan to reach and reassure their Black residents. Black communities make up between 13% and 33% of the population in the three states, according to data from the U.S. Census Bureau. None of the three states’ health departments responded to requests for comment.

California’s state plan includes “a public information campaign … to support vaccine confidence,” but does not provide details apart from the state’s intention to use social media, broadcast outlets and word of mouth. In an email, the California Department of Public Health did not provide additional information about outreach to Black residents, only saying, “this is an important issue we continue to work on.”

A spokesman for New York’s Department of Public Health said the state has been working since September to overcome hesitancy with expert panels and events like Gov. Andrew Cuomo’s November meeting with community leaders in Harlem to discuss concerns with the Trump administration’s vaccine plan, specifically for communities of color.

“Governor Cuomo has been leading the national effort to ensure…black, brown and underserved communities have equal access to, and confidence in, the vaccine,” a Saturday statement said.

Dr. Georges Benjamin, executive director of the American Public Health Association, said: “Media outreach is not enough. TV ads are one thing, but usually public service announcements are at midnight when nobody is listening, because that’s when they’re free.” Normally, public health officials go to barber shops, beauty salons, bowling alleys and other popular locales to hand out flyers and answer questions, but due to the pandemic and limits on congregating, that’s not an option, Benjamin said, so officials need to plan a serious social media strategy. That could involve partnering with “influencers” like sports figures and music stars by having them interview public health figures, Benjamin suggested.

Dr. Mark Kittleson, chair of the Department of Public Health at New York Medical College, said he’s not surprised to hear how vague some of the state health plans are, because states often focus on providing high-level guidance while county or regional level health departments are left to execute the plan. But he said specific efforts need to be undertaken to reach residents of color. “Spokespeople for the vaccination need to be a diverse group,” Kittleson said. “Dr. Tony Fauci is fantastic, but every state needs to find the leading health care experts that represent the diversity in their own state, whether it’s Native American, African American or Latino.” Kittleson also suggested partnering with churches.“Especially in the African American community, when the minister stands up and says, ‘Folks, you need to take your blood pressure medication and take care of yourself,’ people listen to that,” he said. “The church needs to be brought into the fold.”

Maryland’s state plan acknowledges the distrust among Black and Latino communities as well as rural residents, and says it will aim to tailor communication to each group by working with trusted community partners and representatives of vulnerable groups. A Department of Health spokesperson said in an email that “as vaccination distribution continues to ramp up, we urge all individuals to get the vaccine.”

Florida’s written plan includes a messaging strategy for everyone in the state, but does not specifically address the Black community. A “thorough vaccination communication plan continues to be developed in order to combat vaccine hesitancy,” a spokesperson for the Florida Department of Health said in response to ProPublica’s queries.

In North Carolina and Virginia, however, health officials started preparing months ago to reassure residents about potential vaccines. North Carolina formed a committee in May with leaders from marginalized communities to guide the state’s overall response to the pandemic. Vaccine concerns were a priority, said Benjamin Money, deputy secretary of health services for North Carolina’s Department of Health and Human Services.

The politicization of the pandemic has mobilized the Black and brown medical scientific community to dig into the research and how the vaccines work, Money said, “so that they can feel assured that the vaccine’s safe and it’s effective and they can convey the message to their patients and to their community constituents.”

The committee is advising North Carolina officials on their vaccine messaging and hosting a webinar for Black religious leaders. Similarly, the Virginia Department of Health has staff devoted to health equity across racial and ethnic groups and is putting on a series of town hall-style meetings speaking to specific communities of color.

Black residents in Virginia have expressed concerns about how rapidly the early vaccines were developed, said Dr. Norman Oliver, Virginia’s state health commissioner.

“It all boils down to telling people the truth,” Oliver said. “The first thing to let folks know is that one of the reasons why these vaccines were developed so quickly is because of the advances in technology since the last time we did vaccines; we’re not trying to grow live virus and keep it under control or do attenuated virus and develop a vaccine this way.”

In addition to promoting reliable information, Virginia health officials hired a company to monitor the spread of vaccine misinformation in the state and to locate where falsehoods appear to be taking hold, Oliver said. The state hopes to target its communications in places where distrust is most intense.

The CDC has set aside $6.5 million to support 10 national organizations, according to spokesperson Kristen Nordlund. The funds are “to be disbursed by each organization to their affiliates and chapters across the country so they may do immunization-focused community engagement in the local communities they serve,” Nordlund said in an email. She didn’t respond to questions on whether the funds had already been disbursed and to which organizations.

Data Collection on the Race of Vaccine Recipients is Likely to be Incomplete

Every state has a vaccination registry, where data on administered shots is routinely reported, from childhood vaccinations to the flu shot. What’s new in this pandemic is that the CDC has requested all the data be funneled up to the federal level, so it can track vaccination progress across the nation.

“Race and ethnicity data should be recorded in states’ immunization data, but we do not know how reliably it is collected,” said Mary Beth Kurilo, senior director of health informatics at the American Immunization Registry Association. “We really don’t have good data on how well it’s captured out there across the country.”

Many immunization records are fed into the state’s registry directly from a doctor’s electronic health record system, Kurilo said, which can present technological stumbling blocks: “Is [the data] routinely captured as part of the registration process? Can they capture multiple races, which I think is something that’s become increasingly important going forward?”

When asked about historic rates of compliance and how they planned to gather information on race and ethnicity of vaccine recipients this time, health departments from Georgia, Texas, Illinois, Florida and California didn’t respond.

Maryland’s state plans indicate it intends to use information gathered through its vaccine appointment scheduling system, including demographic data gathered from recipients, to direct its communication outreach efforts. The Maryland Department of Health, which didn’t provide more detailed information, said it is “currently exploring all options as far as vaccine data reporting.”

North Carolina’s immunization records system routinely collects race and ethnicity information, and a spokesperson told ProPublica it has that type of demographic data for 71% of people in the system. Stephanie Wheawill, director of pharmacy services at the Virginia Department of Health, said that providers will be “asked to record that information” but didn’t elaborate on how the department planned to encourage or enforce compliance.

Data fields for vaccine recipients’ race and ethnicity are standard in New York, a spokesman said. But the state didn’t provide any details about rates of compliance in supplying that data.

“You’ve got to have the data to compare,” said Martha Dawson, president of the National Black Nurses Association and an associate professor at the University of Alabama at Birmingham’s nursing school. “Because if you don’t have the data, then we’re just guessing. There’s no way to know who received it if you don’t take the data.”

There is tension between gathering enough data to understand the extent of the rollout and the possibility that asking for too much information will scare away people who are already leery of the vaccine.

“The biggest concern people have is how will this information be used?” said Lee, from the CDC’s advisory group. “People need to trust that the data will be used with a good intent. “

Rothholz, with the American Pharmacists Association, said there could be ways apart from state registries to estimate vaccine uptake among minorities. “If I’m a community pharmacy in a predominantly African American community, if I’m giving away 900 or 1000 vaccines, you can track penetration that way,” he said. Geographic-based analysis, however, would depend on the shots being distributed via community pharmacies rather than by mass vaccination sites — a less likely scenario for the Pfizer vaccine, the first to be administered, which requires ultracold storage that will be difficult for many small pharmacies to manage.

It Will Be Up to Doctors and Community Leaders to Encourage Trust

The best way to help a worried individual, whether scared about data collection or the vaccine itself, is a conversation with a trusted caregiver, according to Dr. Susan Bailey, president of the American Medical Association.

“Time and again it’s been shown that one of the most valuable things to encourage a patient to undertake a change, whether it’s stopping smoking or losing weight, is a one-on-one conversation with a trusted caregiver — having your physician saying, ‘I took it and I really want you to take it too,” she said. “But patients have to have the opportunity to ask questions, and not to be blown off or belittled or feel troublesome for asking all their questions.”

“If someone says that they’re afraid of being a guinea pig, maybe drill a bit deeper,” Bailey suggested. “Ask, ‘What are you concerned about? Are you concerned about side effects? Are you concerned that not enough people have taken it?’”

The American Academy of Family Physicians uses the mnemonic “ACT” to guide their members in conversations with patients of color, president Dr. Ada Stewart said in an email: “Be Accountable and Acknowledge both historical and contemporary transgressions against Black, brown and Indigenous communities. … Communicate safety, efficacy and harms such that individuals can weigh their own personal risk to potential benefits, and exercise Transparency with regard to the development of vaccines and the distribution process.”

David Hodge, associate director of education at Tuskegee University’s National Center for Bioethics in Research and Health Care, urges Black and brown leaders such as pastors and community organizers to take control of the messaging right now and not wait for their local governments to tackle the issue.

“We’re not in a position right now to be patient. We’re not in a position to sit on the sidelines, we have to make it happen.”

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Originally published by ProPublica

Nurse of the Week: NP Icon Loretta C. Ford Awarded Surgeon General’s Medallion

Nurse of the Week: NP Icon Loretta C. Ford Awarded Surgeon General’s Medallion

Our first Nurse of the Week in 2021 is a nursing icon. On December 27—the day before her 100th birthday—AAN Living Legend Loretta C. Ford, EdD, RN, PNP, NP-C, CRNP, FAAN, FAANP was awarded the Surgeon General’s Medallion for exceptional achievement in the cause of public health and medicine.

Dr. Ford, who helped to create the first NP program at the University of Colorado in 1965, is regarded as a co-founder of the Nurse Practitioner (NP) profession. As a public health nurse in the 1940s and 1950s, she became concerned about Colorado’s underserved rural communities, and came to believe that with specialized training, nurses could help to fill the gap. Ultimately, Ford and pediatrician Henry Silver joined forces to found the University of Colorado pediatric NP program and the NP profession itself. Ford’s pathblazing role has led to numerous honors. She was the inaugural member of the Fellows of the AANP (FAANP), a special title reserved for providers that have made a lasting impact on the NP profession, and in 2003, she received a Lifetime Achievement Award from the journal Nurse Practitioner. In 2011, she was inducted into the National Women’s Hall of Fame, which acclaimed her for having “transformed the profession of nursing and made health care more accessible to the general public.”

NP cofounder Loretta Ford received the Surgeon General's Medallion on December 27, 2020.
The Surgeon General’s Medallion

Ford’s latest award, the Surgeon General’s Medallion, is the highest honor granted to a civilian by the Public Health Service and the U.S. Public Health Service Commissioned Corps. AANP President, Sophia L. Thomas, DNP, APRN, FNP-BC, PPCNP-BC, FNAP, FAANP commented, “Dr. Ford has received this recognition for her vision and commitment to the health of our nation. Thanks to her trailblazing efforts, millions of patients have access to high-quality health care from NPs, the provider of their choice, and the profession has grown to more than 290,000 strong.”

David Hebert, JD, Chief Executive Officer of AANP, added, “As we celebrate Dr. Ford’s 100th birthday, I can’t think of a more fitting tribute to this titan of American health care. From co-creating the NP profession to advocating for patient access to NP care, she has played a profound role in strengthening health care access and choice for America’s patients.”

For more details on Ford’s life and achievements, see this article in Scrubs magazine.

Still “Glad to be a Nurse” Despite Furloughs and Fears? A Look at Medscape’s 2020 Job Satisfaction Survey

Still “Glad to be a Nurse” Despite Furloughs and Fears? A Look at Medscape’s 2020 Job Satisfaction Survey

The Medscape 2020 nurse job satisfaction survey dove into fears, PPE woes, and other highs and lows of life in the workplace during the pandemic. Medscape surveyed 10,400 nurses across all regions of the US and analyzed responses from 5130 RNs, 2002 NPs, 2000 LPNs, 500 clinical nurse specialists (CNS), 401 nurse-midwives (NMs), and 391 CRNAs. Most respondents fell within the 35-54-year-old age group.

Despite the hardships of 2020, most respondents are still quite happy with their choice of career. A full 98% of NMs and CRNAs are glad they chose nursing, closely followed by 96% of CNS, 95% of LPNs and NPs, and 93% of RNs.

Given the chance of a do-over, though, some are not sure they would make the same choice. 85% of NMs and CNS say they would pick nursing again. Among RNs and CRNAs, 76% and 78% would stick with nursing.

The Impact of Covid-19

Among CRNAs, 73% have treated Covid-19 patients. Midwives came in second, with 60% of NMs saying they had treated Covid patients, followed by NPs (57%), RNs (53%), LPNs (50%), and CNS (38%). Have they had sufficient PPE? Responses were almost evenly divided, with a majority of LPNs (59%) and RNs (56%) affirming that they have enough PPE.

Who was furloughed? CRNAs were at the front of the line, with 34% saying they had been furloughed during the pandemic. NPs came in second, at 18%, followed by LPNs (15%) and RNs (14%). On average over 30% of the nurses surveyed lost income last year, but CRNAs took the biggest hit, with 59% saying they lost money in 2020.

Telehealth is becoming routine for nurse-midwives and NPs. In the 2020 survey, 77% of NMs and 75% of NPs told Medscape that they met with patients online or by phone, and 53% of the LPNs surveyed made virtual visits.

Fears and worries during this scary year were to be expected, of course. Nurses’ greatest concerns during the pandemic were concentrated on the fear of transmitting Covid to family and oneself, but 38% singled out the discomfort of wearing extra PPE as their main woe, and 23% worried most about higher patient loads.

Best and Worst Parts of the Job

Asked about their main source of job satisfaction, nurses offered a range of answers, but helping people and making a difference in their lives was the top choice for RNs, LPNs, and APRNs (click charts to enlarge).

Sources of job satisfaction among RNs and LPNs in 2020

Least satisfying aspect of the job: Workplace politics ranked first for RNs and LPNs at 23% and 21% respectively, and for 26% of CNS’s. LPNs also pointed to their paychecks as a source of dissatisfaction.

See the full report on Medscape.

Covid in San Francisco: “We’ve Been Very Lucky” Despite “Hassles and Discomforts”

Covid in San Francisco: “We’ve Been Very Lucky” Despite “Hassles and Discomforts”

In March, during the first week of the San Francisco Bay Area’s first-in-the-nation stay-at-home order, Kaiser Health News spoke with emergency department physicians working on the front lines of the burgeoning COVID-19 pandemic. At the time, these doctors reported dire shortages of personal protective equipment and testing supplies. Health officials had no idea how widespread the virus was, and some experts warned hospitals would be overwhelmed by critically ill patients.

In the end, due to both the early sweeping shutdown order and a state-sponsored effort to bolster the supply chain, Bay Area hospitals were able to avert that catastrophe. The region so far has fared much better than most other U.S. metro regions when it comes to rates of COVID infection and death. Even so, with intensive care unit capacity dwindling to critical levels statewide, San Francisco on Thursday issued another drastic order, announcing a mandatory 10-day quarantine for anyone returning to the city who has spent time outside the region.

Amid this fierce second surge, we circled back last week to check in with Dr. Jeanne Noble, director of the COVID response at the University of California-San Francisco medical center emergency department, to get her reflections on the Bay Area’s experience. She explained how even as her hospital has made so many improvements, including recently launching universal testing so that everyone who comes to the emergency room is tested for COVID-19, the lockdown and burnout are wearing on her and her colleagues. The conversation has been edited for length.

Q: How are you doing at UCSF right now? 

We’re OK in terms of our numbers. We have our ICU capacity; today’s numbers are 74% occupied. Acute care is a little bit tighter; the emergency department is seeing an increase in patients. [Editor’s note: As of Sunday, ICU capacity had dropped to 13%.]

We did have a period of time before this last surge where we often had a few days with no COVID patients. That was great. That ended in late September. This morning we have 11 patients on ventilators in the ICU.

I think we’re the first hospital in the state for universal testing. Everyone who comes to the ER gets tested. I’ve been working on this for months, but it’s new this week. Now we have testing, so we don’t have to do so much guesswork.

Q: When we spoke during the week of the first stay-at-home order, back in March, you were very worried. How do things compare now?

The supply [of masks] is just much better than it was back in March. In March, we had furloughed engineers from our local museum, the Exploratorium, making us face shields, and we started a makers lab in the library across the street to make supplies. It doesn’t feel like that this time around. We have a longer horizon.

I think in terms of our COVID care and our hospital capacity, we are fine. But my own sort of perspective on all of this is: When are we going to be done with this? Because even though things are smoother — we have PPE, we have testing — it’s a tremendous amount of work and stress. Frankly, the fact that my children have not been in school since March is one of my major sources of stress.

We’re all working way more than we ever have before. And nine months into it, the adrenaline is gone and it’s just purely exhausting.

Q: Can you tell me more about that, the physical and emotional toll on the hospital staff?

We don’t allow eating in the ED anymore, so we don’t have break rooms. Especially if you’re the supervising doctor, you need to do this elaborate handoff to another doctor if you need to eat. You know, it’s 10 hours into your shift and you want a cup of coffee.

The hassles and the discomforts. Wearing an N95 day after day is really uncomfortable. A lot of us have ulcers on our noses. They become painful.

And the lack of being able to socialize with colleagues is hard. The ED has always been a pretty intense environment. That’s offset by this closeness and being a team. All of this emotional intensity, treating people day after day at these incredible junctures in their lives — a lot of the camaraderie and morale comes from being able to debrief together. When you’re not supposed to be closer than a few feet from one another and you don’t take off your masks, it’s a lot of strain.

People are much less worried about coming home to their families. It hasn’t been the fomite disease we were all worried about initially, worried we’d give our kids COVID from our shoes. But there’s still the concern. Every time you get a runny nose or a sore throat you need to get tested, and you worry about what if you infected your family.

Q: So will you and your colleagues be able to take a break over the holidays?

We’ll see what happens. We’re just now starting to feel like we’re seeing the post-Thanksgiving numbers. But I think that even without having to do extra shifts in the ED, certainly for someone like me doing COVID response, there’s always a huge number of issues to work through. We just got the monoclonal antibodies, which is great, but that’s a whole new workflow.

I think what is going to bother people the most is that we are in lockdown. Kind of longing for that relaxation and time with family that we’re all kind of craving.

Q: It sounds like things are hard, but the hospital is in a relatively good place.

I was deployed to the Navajo Nation and helped with their surge in May in Gallup, New Mexico, and that is much, much harder than what we’ve faced in the Bay Area. In Gallup, at Indian Health Service, they were incredible in just the can-do attitude with way fewer resources than we have here. As of this summer, they had had the worst per capita surge in the country. They redesigned their ED essentially by cutting every room in half, hanging plastic on hooks you would use to hang your bicycle wheel. They hung thick plastic and right there doubled their capacity of patients they could see.

Our tents at UCSF are these blue medical tents with HVAC systems, heaters, negative pressure. They are really nice. There they had what looked like beach cabanas — open walls with just a tent overhead. In March and April they were taking care of patients in the snow. In the summer, it was hot and windy. When I was there, almost every single one of my patients had COVID.

That level of intensity was not something we had to go through in the Bay Area. Not to say that it’s easy [here]; I just told you all the ways it’s hard. But everything is relative. In terms of the COVID landscape, we have been very lucky.

Q: The Bay Area was early to close and has had stricter regulations than many parts of the country. As someone directly affected, what do you think of the response?

I think that we have benefited from early closures, unquestionably, when we did our shelter-in-place in March and probably saved 80,000 lives. It was really a tremendous and a bold move.

We’ve done some things well and other things not so well. We were very late to implement closures in a targeted fashion. Restaurants and dining reopened this summer, and a lot of us couldn’t figure out why indoor dining was open. Why is indoor dining something we need to even be considering when we’ve just barely flattened our curve? It was very predictable that cases would go up when dining happened. And they did.

We need to evaluate what is more important for our society and well-being, and to say what is the risk associated with that activity. Schools are of high social value. And [the closures are] really hard for kids. We’re seeing a lot of adolescents with suicidal ideation brought to the emergency department, which is related to school closure. I would put dining and restaurants as being of minimal social importance and very high risk.

We could have done this better. Closing [down society] when numbers go up is reasonable and that saves lives. But I think we know enough that it should not be an across-the-board closing. I mean, with this latest order, they temporarily closed [park playgrounds]. And we’ve been telling people to go outside. It’s like, what? Are you kidding?

This story was republished courtesy of KHN, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

Gallup 2020: America Trusts the Most Trusted Profession More Than Ever

Gallup 2020: America Trusts the Most Trusted Profession More Than Ever

Yes, in 2021 we can continue to cite nurses as the most trusted professionals in the United States. It should come as little surprise that the events of 2020 elevated trust in nurses to a record high. This year, not only did nurses top the results of the annual Gallup Poll for 2020; their position rose by 4 percentage points since the 2019 poll.

According to the December 1-17 poll, Americans were asked to rate various professions with regard to honesty and ethical standards. Respondents gave nurses an 89% “high or very high” trust rating, securing the position of nursing at the top of the list. Doctors took second place, at 77%, grade school teachers, at 75%, were in third place, and pharmacists—who are on an upswing after falling in the rankings after 2012—drew 71%, making them the fourth most trusted profession.

ANA president President Ernest Grant, PHD, RN, FAAN said of the new poll, “I am extremely proud of my fellow nurses. Nurses have been tested in every way imaginable during 2020. The world watched as nurses lost numerous patients and colleagues to a highly communicable, deadly virus while trying to protect and preserve their communities with limited resources and support. Nevertheless, through it all, nurses have consistently proven they are resilient, selfless, and compassionate, risking their health and safety for the common good. Therefore, nurses are undoubtedly deserving of the public’s unwavering trust.”

The usual suspects haunted the lower end of the trust spectrum for 2020. Professions receiving a high trust rating from fewer than 30% of those polled included bankers (29%), journalists (28%), and lawyers (21%). Perennial objects of mistrust populated the bottom of the graph: members of Congress and car salespeople tied for an 8% trust ranking.

The December 2020 poll asked a random sample of over 1000 people in all 50 states and the District of Columbia to rate the honesty and ethical standards of people in different fields, with options ranging from very high, high, average, low, or very low. Here were the overall results:

2020 Gallup poll shows nurses are still the most trusted professionals.
Click to enlarge.

For full details on this year’s poll, visit the story on Gallup News.

Looking Back at 2020: Three Lessons to Take Forward

Looking Back at 2020: Three Lessons to Take Forward

What a whirlwind this year has been! In just a few dramatic months, the world has changed drastically. Once upon a time, masks and scrubs were only worn by medical professionals and other individuals required to don them by rules of dress code. Nowadays, pretty much every person you see on the street is wearing a mask, or a face shield of some sort, and teachers are shopping for nursing scrubs! Just a year ago, no one would have dreamed that there wouldn’t be enough medical supplies to go around. No one could have foretold how our lives and our society would be transformed.

And here we are, at the threshold of 2021. Our society has changed, but we have, too. This year has taught us many lessons. Here are just a few to contemplate.

1: Self-Care isn’t Selfish

Caring for others is important. Who knows that better than nurses who have chosen to spend countless hours doing what they can to help people heal? But COVID-19 is showing us that sometimes, by caring for ourselves, we’re caring for others, too. One instance of this would be wearing a mask. By wearing a mask, I’m caring for myself, but I’m also protecting others. Self-care isn’t selfish. It never is. In this article from Becker’s Hospital Review, you can learn self-care tips from other nurses working on the front lines.

2: Nothing Lasts Forever

There’s a famous saying, “This too shall pass.” When we’re in the thick of something, the situation can cloud our vision, not allowing us to focus on anything else. For instance, if you remember way back in March, all people could think about was COVID-19. But with time everything passes; it’s the way of life. Nothing lasts forever. There was a time before the pandemic, and there will be time after. It’s an encouraging lesson for life: You may feel stuck, and you can’t get your mind off of something for weeks on end. And that thing can be a major force in your life at that time! But even while you’re in the thick of a crisis, always remember that there will be an end. There is always a light at the end of the tunnel.

3. You’re Not in Control

Sometimes, we feel we have life under control. The problem with that is that as soon as something doesn’t work out, we can get extremely frustrated. COVID-19 has shown us that we’re not in control. We can do what’s within our ability, but that’s it. Once we’re aware that it’s not up to us, it’s much easier to relax, and accept reality instead of trying to fight what we can’t change.

Sometimes, it’s hard to focus on the positive when things as a whole look so bleak and bleary. But there are silver linings to everything, if we only dare to look carefully, and let ourselves focus on finding them.

This year wasn’t easy for any medical professional; no one will deny that. But finally, the vaccines are coming, hopefully heralding a happier, healthier new year!

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