UT Physicians HIV medicine expert Robin Hardwicke, PhD, FNP-C, was recently honored for the second time by the Association of Nurses in AIDS Care (ANAC), receiving the Joanne Ruiz Achievement for Excellence in Clinical Practice in HIV Award, honoring an outstanding nurse clinician who brings knowledge and care to people infected with the disease.
Hardwicke was nominated for the award by Diane M. Santa Maria, DrPH, RN, FAAN, dean of the Cizik School of Nursing at UTHealth Houston, Jane, and Robert Cizik Distinguished Chair, and Huffington Foundation Endowed Chair in Nursing Education Leadership at Cizik School of Nursing.
“Nominating Dr. Hardwicke was an easy choice for me. She is the go-to HIV care provider in our community,” says Santa Maria. “Not only does she provide exceptional care to our patients, but she is a resource for providers across Houston and the nation.”
For nearly 25 years, Hardwicke has been a passionate nurse practitioner committed to HIV/AIDS research, advocating for patients’ rights, educating the next generation of nurses and physicians, and challenging preconceived notions concerning the disease.
Daily Nurse is proud to honor Dr. Hardwicke as the Nurse of the Week as a passionate nurse practitioner committed to HIV/AIDS research for more than 25 years, advocating for patient’s rights, the education of the next generation of nurses and physicians, and challenging preconceived notions concerning the disease.
“While science and appropriate treatment options have allowed those with HIV to live longer and vibrant lives, there is still work to do to reduce the discrimination, persecution, and fear associated with the diagnosis. There are few afflictions, if any, which carry the same level of stigma,” says Hardwicke. “Your neighbor, coworker, or friend may tell you about a diagnosis of cancer or diabetes, but they would unlikely disclose an HIV diagnosis.”
Hardwicke’s affiliation with ANAC has spanned two decades. On a regional level, she currently serves as the president of ANAC’s Houston Gulf Coast Chapter and is a founding member.
For the 2023 conference, the chapter will receive ANAC’s Chapter Recognition Award.
“I am proud to see the Houston Gulf Coast chapter being recognized as the ANAC’s chapter of the year – now for the second time in our group’s history. With our membership continuing to grow, we are as strong as ever,” Hardwicke says. “Through continuing education, networking, and scholarship, we aim to be inclusive of all healthcare professionals interested in HIV/AIDS care. These efforts help ensure our local representation of nurses are the strongest advocates, clinicians, researchers, and educators in the county in the field of HIV.”
Nominate a Nurse of the Week! Every Wednesday, DailyNurse.com features a nurse making a difference in the lives of their patients, students, and colleagues. We encourage you to nominate a nurse who has impacted your life as the next Nurse of the Week, and we’ll feature them online and in our weekly newsletter.
Courtney Miller, an Ortho/Neuro OR Manager with Intermountain Health, saves lives at the same hospital that once saved hers.
“I knew as a kid I wanted to do something in the medical field,” says Miller
In July 2007, at just 16 years old, Miller was diagnosed with a blood vessel malformation and needed brain surgery.
“The OR is very overwhelming — it’s bright, it’s big, there are scary-looking instruments and people you’ve never seen before. And as they brought me into the room, I remember staring at the ceiling and thinking, what is my outcome?”
While her vision of her future became blurry, clarity returned.
“It did solidify that this is what I want to do.”
Daily Nurse is proud to honor Miller as our Nurse of the Week for saving people’s lives in the place that saved hers.
From the outside looking in, Miller may seem like every other neurology and orthopedics nurse.
“As a kid, I heard my mom tell her stories of caring for patients and thought that was just the coolest thing — spending your life serving others.”
Growing up in the Beehive State, the vision of her future goals was clear from a young age. She pursued a career in nursing that eventually took her out of state, but after creating a family of her own, she realized it was time to head back to Utah.
“The first listing to show up was assistant nurse manager, ortho/neuro, Intermountain Medical Center,” Miller says. “And I was like, I think I’ve read that wrong.”
“In Courtney’s interview, we had this big panel, and she talked about how she had surgery at the medical center and how her life was saved, and all of us were just like, ‘Oh my gosh. She’s it,’” says Chantay Stringham, a registered nurse with Intermountain Health.
Miller was the person.
“We listen to patients. We try to understand where they’re coming from and help sympathize with them, but you can’t do it unless you’ve been in that situation. And it’s cool knowing that Courtney can do that,” Stringham says.
Today, Miller does what she loves — saving people’s lives in the place that saved hers.
“It’s hard to be a nurse but also rewarding,” Miller says. “I can’t imagine doing anything but being a nurse for the rest of my life.”
Nominate a Nurse of the Week! Every Wednesday, DailyNurse.com features a nurse making a difference in the lives of their patients, students, and colleagues. We encourage you to nominate a nurse who has impacted your life as the next Nurse of the Week, and we’ll feature them online and in our weekly newsletter.
To help address the shortage of nurses in the state of Utah, the University of Utah College of Nursing will increase enrollment in its prelicensure track by 25% over the next year. College leaders say this increase addresses the rising need for registered nurses in the wake of COVID-19 and because of other factors that are reshaping the nursing profession.
“This initiative is a major undertaking, and it is the right thing to do given the contemporary challenges we face,” says Michael Good, M.D., CEO of University of Utah Health. “It’s vital that we educate, train, and deploy enough nurses in Utah and elsewhere in the Mountain West to provide the health care that residents of this region have come to expect and deserve. This new approach to nursing education will be beneficial to all. I am grateful to our nursing faculty for proactively addressing this challenge.”
To meet this commitment, U of U Health’s College of Nursing will accept an additional 36 prelicensure students each year, increasing its annual enrollment from 144 to 180 students. In the past, the College of Nursing accepted 72 students for either spring or fall semester enrollment. Now the college will accept 60 students three times a year by adding the option of summer semester enrollment.
“We can’t unilaterally solve the nursing shortage. We’re fully aware that a 25% increase in our enrollment will barely put a dent in it. But we care about the people of Utah who need health care, and we’re doing our best to be responsive.”
The college will commit more than $400,000 per year to achieve this goal. Additional personnel devoted to this increase in students will include full-time faculty adjunct faculty, a student advisor, a clinical placement coordinator, and patient simulation specialists, says Marla De Jong, Ph.D., RN, dean of the College of Nursing.
“It’s important that people in Utah, as well as the rest of the country, have an adequate number of nurses to meet their health care needs 24 hours a day, 7 days a week, 365 days a year,” says De Jong. “We are trying to graduate more registered nurses to meet the growing demand and, in particular, ensure that there are enough nurses in Utah to provide quality care for patients now and in the future.”
More than 2,500 unfilled registered nursing positions in the state
The change comes at a time when the profession is facing a potentially crippling shortage of nurses nationwide. In fact, the US Bureau of Labor Statistics projects nearly 176,000 new job openings a year for registered nurses through 2029.
In Utah alone, more than 2,500 registered nursing positions are currently unfilled, according to De Jong. This gap is particularly striking given that 88% of College of Nursing graduates live and work in Utah. It is also one of the major reasons the college is expanding its enrollment, she adds.
The severity of the shortfall hit home earlier this month, when 20 US Navy medical personnel, including 14 nurses, were deployed to University of Utah Hospital to help alleviate staffing shortages that had kept 52 beds out of service. The shortage led the hospital to defer hundreds of surgeries and limit acceptance of transfers from outlying hospitals.
However, this short-term solution will not resolve the long-term problem, according to Melody Krahulec, DNP, M.S., RN, assistant dean for Undergraduate Programs at the College of Nursing. Long hours, physical stress, and mental strain have taken their toll on nurses for decades, leading many of them to leave the profession. The COVID-19 pandemic has merely exacerbated that trend, with perhaps as many as one in five considering leaving nursing within the next two years.
Add to this that almost one in five Utah nurses are approaching retirement age, and the future of health care in the state could be challenging. “That’s why an influx of a new generation of highly trained and competent registered nurses is vital,” says De Jong.
“We can’t unilaterally solve the nursing shortage,” De Jong adds. “We’re fully aware that a 25% increase in our enrollment will barely put a dent in it. But we care about the people of Utah who need health care, and we’re doing our best to be responsive.”
In addition to new faculty, the College of Nursing will be seeking additional preceptors in community hospitals and clinics to oversee the 900 hours of clinical experience required for each nursing student prior to graduation.
“We’re grateful to our health care partners within the Salt Lake Valley for doing their best to accommodate the experiential aspects of our nursing education,” says Krahulec. “As we expand, their continued support in providing clinical placements that ensure our students are exposed to a multitude of caregiving situations is fundamental.”
Enrollment for the summer 2022 semester has been filled, and the fall 2022 application cycle is closed. Spring 2023 semester applications are due by September 1, 2022, and fall 2023 applications are due by February 1, 2023. The deadline for summer 2023 applications will be announced soon.
Park City, Utah — which comes alive during the winter ski season and annual Sundance Film Festival — is home to the Park City Hospital, which has 460 employees. As in countless hospitals across the country, the demands of covid-19 at times overwhelmed the facility and dramatically changed the way caregivers interact with patients.
“The last year and a half have taken a toll on us,” said Jodie Connelly, nurse manager of the intensive care unit at the hospital, which is part of the Intermountain Healthcare System based in Salt Lake City. “Nurses have pretty thick skins, but the pandemic has tested us in ways we’ve never really been tested before.”
The community the hospital serves noticed that strain and came up with a novel idea to help the hospital’s workers. Park City’s residents raised enough money — through contributions from more than a dozen residents and two large seed donors — to fund a pop-up grocery store out of a room in the hospital that had been a private dining area.
The hospital uses about $10,000 of the donations each month to stock the store, and all goods are free to any hospital employee.
At first, the store offered ready-made pasta, chicken and mashed potatoes, and other meals, including vegetarian options, that caregivers could take home or eat during their shift. Later, grocery basics such as milk and eggs were added for employees to stock their fridge. Today, the Park City Hospital store has expanded to include non-perishable items such as cereal, sugar, oatmeal and pasta, plus a variety of fresh produce options.
Connelly said she especially appreciates convenient access to fresh fruits and vegetables. “While I keep my pantry at home full of nonperishables, I would have to stop at the grocery store more often if I wasn’t able to take fresh produce home with me,” she said.
Selene Macotela-Garcia, a food service supervisor at the hospital who stocks the store, said she tries to find a variety of items to offer. “Everyone gets excited when we bring in new items,” she said. She recently added lemons, eggplant, beets and cabbage to the mix. “Having sweet potatoes before Thanksgiving was especially popular,” she said.
Macotela-Garcia explained that some employees pick up enough ready-made food to bring home a precooked meal for each family member instead of having to prepare something once they arrive.
The store allows the hospital’s staff to avoid public places where the risk of covid transmission is high, such as grocery stores, and helps them save money. “Finances have been tight; some of us need help more than people may realize,” said Gregoria Taboada, a food service worker at the hospital who frequents the store.
But the store has been useful in helping the hospital’s caregivers save on a commodity in especially short supply these days: time.
“It means so much to me that after a 13-hour shift I don’t have to stop at a grocery store to pick up the basics.”
Work-life balance is hard to maintain as the toll from pandemic care has driven some employees to quit and those remaining are often asked to pick up the slack.
“I started taking on extra shifts each week to help out,” said Katie Peabody, a nurse in the hospital’s intensive care unit. “I frequently work 50-plus hours a week doing work that has become so physically, emotionally and mentally taxing,” she said.
Grueling labor conditions are among many factors noted in a recent Mayo Clinic study showing why nurses have suicidal thoughts more frequently than people in other professions.
“Sometimes there are only two nurses in the ICU with no techs or secretaries to field phone calls or help out,” Peabody said.
While Utah is among the bottom half of fully vaccinated states, Park City’s Summit County is the most vaccinated in the state with 80% of its residents fully vaccinated. Because of the city’s high number of tourists, however, the county’s current transmission level is still rated in the highest category.
The store is also a boost to morale, workers said, especially as they cope with another change of late: patients who no longer trust or appreciate them. “None of us are looking to be a hero,” Connelly said, “but we used to have a great relationship with our patients and their families. That has changed in many cases during the pandemic.”
She noted that almost all the covid patients she’s treated this year are unvaccinated and most have very strong feelings about preventive measures such as the use of masks and vaccines. She said many patients believe what they see on social media over the treatment options the hospital staff recommends.
“Some don’t believe they have covid while we’re treating them for the disease,” she lamented. “Some refuse to even wear their oxygen [mask]; they argue with us about everything. … Some people are downright mean.”
Although such patients may be the exception, negative interactions take a toll that staff members said the store helps make up for.
“The hospital store is evidence that we are valued,” Peabody added. “Even when some patients tell us otherwise, every time I visit the store I’m reminded that there are people out there who appreciate me and are trying to take care of me just like I’m trying to take care of others.”
For more on Park City community support for the hospital see this story in the Park Record.
KHN (Kaiser Health News) is 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.
National Nurses United (NNU), the largest union of registered nurses in the United States, today applauded the Occupational Safety and Health Administration (OSHA) for taking a critical step in protecting health care workers in Arizona, South Carolina, and Utah who had been left behind when their states failed to adopt the OSHA Emergency Temporary Standard (ETS) on Covid-19 in Health Care issued in June. The OSHA ETS on Covid-19 mandates optimal PPE and other critical protections for health care workers.
Twenty-two states across the country that have state-based OSHA programs are legally required to have those state plans be at least as effective as federal OSHA. When Arizona, South Carolina, and Utah failed to implement the Covid-19 ETS in their state plans, however, they abrogated their legal requirements. Federal OSHA announced today that it is reconsidering and potentially revoking the final approval for these three noncompliant states.
“It’s unconscionable that some states think they can just ignore their responsibility to protect health care workers. Registered nurses had been demanding the OSHA ETS since day one of this pandemic, and we finally won our fight in June of 2021. At that point, Arizona, South Carolina, and Utah had the duty—legally and morally—to come into compliance and protect workers. They did not, and we could not be more proud that OSHA is standing up to hold them accountable today,” said NNU President Deborah Burger, RN. “We are beyond grateful to OSHA for the work they are already doing to enforce this standard, and to the Biden administration for standing up for nurses on the front lines of this pandemic.”
After leading the campaign to win the OSHA ETS, NNU has been campaigning to ensure health care employers across the country comply. When NNU nurses in Arizona filed complaints about their hospitals’ non-compliance, Arizona’s state OSHA plan stated they will not enforce the requirements of the federal OSHA ETS. So NNU nurses testified at the most recent meeting of the Industrial Commission of Arizona (ICA). The ICA voted against emergency rulemaking needed to protect nurses and other health care workers, and NNU filed a Complaint About State Plan Administration (CAPSA) with federal OSHA.
“Nurses and other health care workers in Arizona, Utah, and South Carolina must be assured the same protections as they would receive in other states that have already adopted and begun enforcing the ETS,” said Burger. “We urge federal OSHA to act expeditiously to put in place the necessary elements for federal OSHA to resume enforcement in Arizona, Utah, South Carolina, and any other states which fail to enforce the ETS to ensure protections for health care workers. We will never emerge from this pandemic if we don’t make sure nurses and health care workers are safe at work.”
National Nurses United is the largest and fastest-growing union of registered nurses in the United States with more than 175,000 members nationwide.
A dozen states are reporting drops of 25% or more in new covid-19 cases and more than 1,200 counties have seen the same, federal data released Wednesday (January 27) shows. Experts say the plunge may relate to growing fear of the virus after it reached record-high levels, as well as soaring hopes of getting vaccinated soon.
Nationally, new cases have dropped 21% from the prior week, according to Department of Health and Human Services data, reflecting slightly more than 3,000 counties. Corresponding declines in hospitalization and death may take days or weeks to arrive, and the battle against the deadly virus rages on at record levels in many places.
Health officials, data modeling experts and epidemiologists agreed it’s too early to see a bump from the vaccine rollout that started with health care workers in late December and has, in many states, moved on to include older Americans.
Instead, they said, the factors involved are more likely behavior-driven, with people settling back home after the holidays, or reacting to news of hospital beds running out in places like Los Angeles. Others are finding the resolve to wear masks and physically distance with the prospect of a vaccine becoming more immediate.
A single reason is hard to pinpoint, said Adriane Casalotti, chief of government and public affairs for the National Association of County and City Health Officials. She said it may be due in part to people hoping to avoid the new, more contagious variants of the virus, which some experts say appear to be deadlier as well.
She also said so many people got sick in the last surge that more people may be taking precautions: “There’s a better chance you know someone who had it,” Casalotti said.
Dropping in California, but it’s “An Unstable Equilibrium”
Eva Lee, a mathematician and engineering professor at the Georgia Institute of Technology, works on models predicting covid patterns. She said in an email that the decline reflects the natural course of the virus as it infects a social web of people, exhausts that cluster, dies down and then emerges in new groups.
She also said the national trend, with even steeper drops in California, also reflects restrictions in that state, which included closing indoor dining and a 10 p.m. curfew in hard-hit regions. She said those measures take a few weeks to show up in new-case data.
“It is a very unstable equilibrium at the moment,” Lee wrote in the email. “So any premature celebration would lead to another spike, as we have seen it time and again in the US.”
Four California counties were among the five large U.S. counties seeing the steepest case drops, including Los Angeles County, where new cases declined nearly 40% in the week ending Jan. 25, compared with the week before.
Dr. Karin Michels, chair of epidemiology at the UCLA Fielding School of Public Health, said the lower numbers in L.A. after the virus infected 1 in 8 county residents likely mirror what happened after New York City’s surge: People got very scared and changed their behavior.
“People are beginning to understand we really need to get our act together in L.A., so that helps,” she said. “The big fear [now] is ‘Is it really going in this direction, is it plateauing, or where is it going to go?’ We need to go further down, because it is really high.”
Michels said herd immunity would not explain the declines, since we’re nowhere near the level of 70% of the population having had the disease or been vaccinated. She said the declines may also reflect a drop in testing, as Dodger Stadium has been converted from a mass testing site to a mass vaccination center.
Officials with the California Department of Public Health acknowledged that testing has fallen off, but overall rates of positive covid tests are falling, suggesting the change is real.
Covid Cases Dropping in Other Western States
New cases also fell significantly in Wyoming, Oregon, South Dakota and Utah, with each state recording at least 30% fewer new cases. Each of those states reported having vaccinated 8% or more of their adult population by Tuesday, putting them among the top 20 states in terms of vaccination rate.
Alaska leads the states currently, at nearly 15%, according to HHS. It’s also logged a new-case drop of 24% in recent days.
Yet experts aren’t willing to say yet that the vaccines are driving cases down.
“Most people in public health don’t think we’ll see the benefit of the vaccine until a few months from now,” said Dr. Marcus Plescia, chief medical officer of the Association of State and Territorial Health Officials.
The number of deaths continues to remain high weeks after high case rates as the virus variably attacks the heart, kidneys, lungs and nervous system. Many patients remain unconscious and on a ventilator for weeks as doctors search for signs of improvement.
The death rate fell by only 5% in the data posted Wednesday, reflecting 21,790 patients who died of the virus Jan. 19-25.
Anxiety about new strains of the virus from the U.K., Brazil and South Africa remains high in Portland’s Multnomah County, Oregon, which saw a drastic 43% new-case decline in recent days.
“The concern is that everything could change,” said Kate Yeiser, spokesperson for the Multnomah County Health Department.
Shoshana Dubnow contributed to this story.
Published courtesy of KHN (Kaiser Health News), a nonprofit news service covering health issues. It is an editorially independent program of KFF (Kaiser Family Foundation), which is not affiliated with Kaiser Permanente.
