As Covid-19 cases spike all over the country, many healthcare systems are in desperate straits. States that proudly saw thousands of their nurses fly out this spring to “frontline” hotspots like New York City, Seattle, New Orleans, and Boston are now starved for resources themselves. With the latest stage of the pandemic coursing through 48 states, the frontlines are often in smaller cities and rural states that tend to lack the amenities common at metropolitian hospitals. Local and state health care systems are struggling to treat patients amid dire shortages of staff, beds, and equipment.
Under the strain of the present surge, healthcare systems are assigning non-Covid patients to beds in convention centers, hospitals are canceling elective surgeries, ICU nurses are working 60-hour weeks, and nurses who sped to New York in April are now working overtime to treat Covid patients in their hometowns. Areas that are especially overwhelmed, such as El Paso, store their dead in mobile cooling units staffed by jail inmates, and airlift non-Covid patients to hospitals in cities that for the present have escaped the new surge. In addition to seeking aid from National Guard medics, the American Hospital Association’s vice president of quality and patient safety, Nancy Fosterome, told Stat News that some hospitals are even turning to local dentists, Red Cross volunteers, and people with basic health experience to help with tasks that require less training.
In North Dakota, the weight of the Covid caseload—currently the worst in the country and, per capita, one of the worst in the world—has effectively broken the state’s contact tracing system. Kailee Lingang, a University of North Dakota nursing student now helping with contact tracing in the state, told the Washington Post that “Test and trace went by the wayside. Even if we had enough staff to call up everyone’s workplace and contact, there are so many new infections that it wouldn’t be as effective. At this point, the government has given up on following the virus’s path through the state. All we can do is notify people, as quickly as we can, that they have the virus.”
In Indiana, the state and local healthcare systems are sputtering in the wake of a 60% increase in hospitalizations. One doctor in the state, Timothy Mullinder, told MedPage Today that patients “who need to go to the ICU have been stuck in the ER for 24 hours because there are no beds available. Post-operative patients are stuck in the PACU recovery area well over 24 hours because there are no beds available.”
With the entire state out of staffed hospital beds, Iowa’s healthcare system is also overwhelmed. Whitney Neville, an Iowa nurse, told the Atlantic on November 13, “Last Monday we had 25 patients waiting in the emergency department. They had been admitted but there was no one to take care of them.” The strain on the system, combined with the state’s relaxed social distancing policies, prompted one infectious disease doctor to speak in near-apocalyptic tones: “The wave hasn’t even crashed down on us yet. It keeps rising and rising, and we’re all running on fear. The health-care system in Iowa is going to collapse, no question.” The problem, however, extends well beyond North Dakota, Texas, and Iowa. A November 17 Atlantic article found that 22% of all US hospitals are facing staffing shortages, and added, “More than 35 percent of hospitals in Arkansas, Missouri, North Dakota, New Mexico, Oklahoma, South Carolina, Virginia, and Wisconsin are anticipating a staffing shortage this week.”
At the center of the system, nurses and other healthcare workers are working as many shifts as they can, while doing their best to attend to waves of incoming patients. The latest surge, however, has driven a growing number of nurses to express their frustration with incoherent policies and public intransigence on the matter of masking, social distancing, and incredulity over the very existence of the virus. Michelle Cavanaugh, a nurse at the Nebraska Medicine Medical Center, spoke for many when she told a Utah reporter, “We’re seeing the worst of the worst and these patients are dying, and you go home at the end of the night and you drive by bars and you drive by restaurants and they’re packed full and people aren’t wearing masks. I wish that I could get people to see COVID through my eyes.”
Enterprise High School students refused to allow anti-mask protesters to disrupt the start of the new school year. Senior Dalee Cobb, a cheerleader and javelin thrower, declared, “I feel like the opinion of parents and adults in general right now are just a big part of that problem.” Prior to a football game in late August, Cobb and other student athletes at the Utah school urged their community to take a stand against a growing anti-mask movement that threatened to postpone local school reopenings: “We, of all people, know that wearing a mask is not fun, “Cobb said. “Neither is wearing a seat belt or a life jacket or pads for football, but we do all these things so we have a future.” (As of September 1, there have been over 52,000 COVID-19 cases in the state).
As the public becomes accustomed to the ebb and flow of COVID outbreaks, a resurgence of protests against the state mask-wearing mandate came into conflict with the reopening of Utah’s public schools. Students became alarmed when hundreds of parents demonstrated outside the school district administration office and circulated threats to engage in a #NoMaskMonday. Enterprise students decided to use the football game as a platform to take action to protect their own health—and persude parents to send their kids to school in masks so they would be able to resume classes. “We ask that you put your mask on so we can get our game on,” Cobb said, as she urged local football fans to look out for the best interests of their community.
That weekend, Enterprise students also made use of social media to counter parents attempting to organize a #NoMaskMonday protest. Cobb told the Deseret News, “It’s sad to say, but the parents that are doing this, they aren’t us.” School Principal Calvin Holt supported students’ efforts and remarked, “[Students] were concerned about what a rebellion against masks was going to do to their opportunities for school and other activities.”
When schools did open, according to Deseret News, “Most students complied with the mask order, though the school district received some phone calls from concerned parents who got calls or messages from their children that not all students were wearing their masks all the time inside school buildings.” By the end of the first day, the local school district reported that no more than six students had been sent home for refusing to wear masks.
Anti-mask protesters cite a variety of reasons for their refusal to wear a mask. Some refer to the mixed messages that prevailed in the early stages of the pandemic; some are vehemently opposed to statewide mask mandates (at present 34 states require that masks be worn in many public settings); others say that they are still dubious about the severity of COVID-19 and have adopted various conspiracy theories promulgated on social media; a large contingent of anti-mask protesters, of course, use all of these arguments.
Our
Nurse of the Week is Mady
Howard, an intensive care unit (ICU) nurse at Intermountain Healthcare’s
Dixie Regional Medical Center in St. George, Utah, who says the unpredictable
nature of working in the ICU helped her train to be on ‘American
Ninja Warrior.’
Howard
advanced to the ‘American Ninja Warrior’ finals in Las Vegas during filming in
August, and competed to win the $1 million grand prize. The final four episodes
aired throughout September, and although Howard didn’t win, she says she will
be back for more in the future.
Her
collegiate career as a gymnast helped Howard prepare physically, but she says
the intensity of being an ICU nurse has prepared her mentally for the challenge
of competing on a reality competition show. Contestants aren’t allowed to
practice on the ninja warrior course so their first time on the course is in
front of an audience as they make split-second decisions in high-pressure
situations on an unfamiliar course. To Howard, it feels much like her day-to-day
job in the ICU.
Howard tells modernhealthcare.com, “Life can change so quickly and it motivated me to not stand still and be grateful for every moment I have.”
Finding a passion outside of her demanding 12-hour shifts in the
ICU has also helped Howard become a better healthcare provider. She finds fulfillment
in the training and it makes her a more confident provider for her vulnerable
patients.
To learn more about Mady Howard, an ICU nurse who says the
unpredictable nature of working in the ICU helped her train to be on ‘American
Ninja Warrior,’ visit here.
A recent encounter between Nurse Alex Wubbels and a police officer who arrested Wubbels for refusing to let the officer draw blood from an unconscious crash victim led the Utah hospital to make changes to their protocol. According to The New York Times, nurses at the hospital will no longer deal directly with law enforcement officers as part of the new policy. Officers will be asked to check in at the front desk and interact with a supervisor who is trained in law and hospital policy.
“What I can say is that I stood my ground. I stood for what was right, which was to protect the patient. As a nurse, any nurse, I think, would have done exactly what I did.”
Wubbels was the charge nurse on the burn unit at the University of Utah Hospital where the unconscious crash victim was being treated. The man was not a suspect in the wreck which killed another driver, but police asked for his blood to be drawn. Hospital policy states that police need a judge’s order or the patient’s consent, or the patient must be under arrest before obtaining a blood sample. After citing hospital policy and refusing to allow police to draw blood from the patient, Detective Jeff Payne handcuffed Wubbels and placed her in a police car. Wubbels was later released without charge.
The arrest was captured on body-cam video and has prompted apologies from the Salt Lake City mayor and police department. The new hospital protocol regarding nurse interactions with law enforcement was announced this week by Margaret Pearce, chief nursing officer at the hospital, hospital leadership, and the university’s police chief. Pearce tells MSN.com, “I need to make sure this never, ever, ever happens to another one of our care providers again.”
The change in hospital policy will allow nurses to focus on caring for their patients, and 2,500 nurses have since been trained on the new protocol. University of Utah Hospital CEO Gordon Crabtree praised Wubbels for acting with integrity and professionalism while risking her own safety to ensure the privacy of her patient. Discussing the incident with MSN.com, Wubbels recalls: “What I can say is that I stood my ground. I stood for what was right, which was to protect the patient. As a nurse, any nurse, I think, would have done exactly what I did.”
To learn more about the hospital’s decision to change their protocol following Wubbels’ arrest, visit here.
Our Nurse of the Week is Michelle Peterson who decided to become a nurse in 2010 after asking an academic advisor at Utah State University (USU), “I like to help people. What should I do?” Before pursuing nursing, Peterson was working as the victim advocate for Grand County, Utah. However, she later decided that nursing would be a better fit, and attended nursing school at USU-Moab from 2012 to 2014. Now, Peterson works as the operating room nurse manager at Moab Regional Hospital.
Although working as a victim advocate was a rewarding job, it also took its toll on Peterson and offered very little job security. Peterson was in her 20s when she became a victim advocate, and after growing up with a stable childhood, she was shocked by the victims she helped who had witnessed domestic violence, child abuse, and other ugly crimes. Now graduated and a working nurse, Peterson tells MoabTimes.com:
“Nursing is the best decision I ever made so even on hard days, there are still so many good things that come out. It’s a high demand, stressful job and that’s why not everybody’s doing it but the benefits outweigh the negatives.”
Being a nurse is a rewarding job for Peterson and she loves helping locals who come to the hospital from babies being born to elderly patients who are dying, and everything in between including preventative care. Vicki Gigliotti, Moab Regional Hospital Chief Clinical Officer, praises Peterson’s nursing management style saying, “She is smart and always willing to learn. As a young nurse manager, she is constantly assuring that her staff members and physicians have the needed resources to provide truly high quality care. Our hospital is grateful to have Michelle, her skill set, and her attitude moving into the future.”
To learn more about Michelle Peterson’s path to nursing and love for the rewarding profession, visit here.
A new Master’s in Nursing Informatics program is being launched at Western Governor’s University (WGU) in Salt Lake City, UT. The program is being offered through the College of Health Professions to train students to prepare, gather, document, and analyze data to serve as a foundation for data-driven decisions.
The MSN-Nursing Informatics program will be offered online like all other degree programs at WGU. Registered nurses (RNs) and graduates who hold Bachelor of Science in Nursing (BSN) degrees are eligible for the advanced training program to become career specialists in the field of nursing informatics. With the competency-based program held entirely online, working nurses can go through the coursework on their own time and complete courses as soon as they demonstrate proficiency. Dr. Jan Jones-Schenk, WGU’s National Director of Nursing, tells PRNewswire.com:
“In today’s healthcare industry, there is an increased need for nurses who understand clinical practice and how to integrate that knowledge into information systems to support the delivery of safe, efficient, and quality healthcare.”
Students in the program will learn how to apply their coursework in nursing informatics to real-world situations, helping them rely on information and communication technologies to deliver and coordinate care across multiple settings. There are two academic tracks available: RN to MSN or BSN to MSN. Applications are currently being accepted and students can begin either track starting February 1, 2017.
