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  1. The profession of nursing has traditionally been regarded as the most trusted (Milton, 2018). Nursing continues to be named in the Gallup poll as the most trusted profession as well (Kennedy, Maureen & Shawn, 2017). During the COVID-19 pandemic, nurses rose up to the occasion, stepping in to care for the COVID-19 patients, placing their lives and families on the line, and some ultimately sacrificed with their lives. They never left nor abandoned the patients; many so sick and helpless, but nurses stayed at the bedside despite difficult and challenging times. This article can be found in our allnurses® Magazine Fall issue. Download allnurses® Magazine Themes from Obituaries Currently, there are no accurate statistics on the exact number of nurses who have died from COVID-19. It could be that the virus is still peaking in some states, although it has been contained in New York, New Jersey, Connecticut, and Massachusetts. It has been my mandate to read the obituaries of at least 200 health-care workers, and each time, know that it could have been me or my colleagues. The age ranges from eighteen to at least 75 years with nationalities from around the world. One young mother had a newborn and left three young kids. Retirements, as well as travel plans, were postponed. Themes emerged such as: dedication selflessness a higher calling a purpose greater than life a sense of mission never apprehensive putting patients first super-heroes mentors legends optimistic FACT: ... but above all, they had grit According to the Farlex Dictionary (2015), grit means true resolve, determination, or strength of character. The Collins Dictionary states that grit is: courage, spirit, resolution, determination, nerve, guts (informal), balls (taboo slang), pluck, backbone, fortitude, toughness, tenacity, perseverance, mettle, doggedness, hardihood. Grit Nurses looked at the coronavirus in the eye and fought like lions. And, the battle is still raging. For those who succumbed to the virus, they will be memorialized as heroes who had grit. Grit is important in making people persist on difficult tasks (Charlton, 2019). When corona touched down in America, health-care facilities and hospitals operated in a crisis mode. Nurse patient ratios, Personal Protective Equipment (PPE) protocols changed and nurses could be fired for abandonment if they refused to take care of COVID-19 patients. Nurses were mandated to work in Intensive Care Units (ICU) even if they were not trained for such high acuity patients. However, nurses were not perturbed, discouraged nor frightened. PPE was in short supply. In the beginning of March, some health institutions only had surgical masks without N95s, some none at all. In desperation nurses wore plastic garbage bags for protection (Bowden, Campanile, Golding, 2020). Lack of Testing for Nurses When nurses displayed various symptoms, some went to their hospitals and were denied testing. Some were turned away and told to go to work if symptoms were not severe enough. For those who were severe, they were not provided paid sick time forcing some to return to work before recuperating. The families interviewed stated that healthcare institutions denied that they did not have enough PPE. They also denied that the nurses contracted COVID-19 at their facilities. Unfortunately, once send home, some nurses died alone in their homes or apartments. A travelling nurse in New York city was located five days after succumbing to COVID-19. A couple of nurses wrote their own obituaries. Why is it that professional athletes and politicians have testing available compared to nurses and other Healthcare Personnel (HCP) who are in direct contact with patients? Six months later, PPE is still in short supply and nurses are still dying. Conclusion Communities rallied together to bring food and dessert during the pandemic. Nurses were depicted as superheroes; we were the last contact with patients before they died. Children drew pictures and wrote cards with words of encouragement. Our trustworthiness did not waiver and we stood strong and worked together as a team. Nurses sacrificed their lives and that of their families, yet kept doing what they love ... taking care of patients until the end. Gone but will never will be forgotten. Read the names of the healthcare professionals who have passed away due to COVID-19 in allnurses Magazine. Click to download it for free. References Bowden, E., Campanile, C., Golding, B (2020). Worker at NYC hospital where nurses wear trash bags as protection dies from coronavirus. New York Post retrieved August 4, 2020. Charlton, J. (2019). Angela Duckworth finds grit is not always the best predictor of success in new research. Daily Pennsylvanian Grit. (n.d.) Collins English Dictionary – Complete and Unabridged, 12th Edition 2014. (1991, 1994, 1998, 2000, 2003, 2006, 2007, 2009, 2011, 2014). Retrieved August 4 2020 from https://www.thefreedictionary.com/grit grit. (n.d.) Farlex Dictionary of Idioms. (2015). Retrieved August 4 2020 from https://idioms.thefreedictionary.com/grit Kennedy, Maureen & Shawn MA, RN. (2017). It's Time to Earn the Public's Trust. AJN, American Journal of Nursing, 117, 7. https://doi.org/10.1097/01.NAJ.0000513263.21108.4f Milton, C. L. (2018). Will Nursing Continue as the Most Trusted Profession? An Ethical Overview. Nursing Science Quarterly, 31(1), 15–16. https://doi.org/10.1177/0894318417741099
  2. nikkulele77

    Nurses Wanted

    Nurses Wanted at Saint Joseph's Hospital (Job posted 287 days ago) Rediscover the art of bedside nursing at Saint Joseph’s Hospital and join a team of dedicated professionals in the post-Covid healthcare crisis. Multiple positions open on multiple floors. All shifts needed. Are you a former nurse looking to get back into the field? Do you dream of those days before Covid and the mass nurse exodus? Do you long for the days of being part of a competent team, working in a safe environment, and bringing positive change into the lives of your patients? Then Saint Joseph’s is for you! Featured in the allnurses® Fall 2020 issue... allnurses® Magazine Library Saint Joseph’s is committed to providing nurses with the safety and peace of mind needed so they can focus on patient care. Our staffing ratio is unheard of anywhere else in the country. ICU: 3:1 Stepdown: 5:1 MedSurg: 8:1 Benefits 1 - We provide competitive pay and excellent benefits so that our nurses are confident they are being well compensated. After a minimum of three years on the floor, you will be considered for transfer to our telehealth units. 2 - No more weekly mandatory overtime! We require only 2 weeks of mandatory overtime per pay schedule. You are welcome. Extra incentive shifts are always available and encouraged for those nurses who would like to work a little extra. 3 - Yes, we allow travel! Annual earned leave includes free testing after travel and isolation days if necessary (from employees PTO bank). We take the guesswork out of your destination. Our HR team, in collaboration with epidemiologists, have put together a US map detailing safe, permissible travel destinations. The map is updated daily and the HR team contacts you personally with travel details, including possible cancellations. In order to ensure adequate staffing, employees are provided with 3 choices for the time of year in which they will be able to take their earned leave. 4 - Our Employee Assistance Program (EAP) offers 2 free phone sessions per year plus a hotline for crises. Zoom meetings with a counselor can be arranged at an employee discount. We encourage employees to utilize EAP so that they can successfully deal with and prevent burnout. The mental health of our employees is of utmost importance to us. 5 - Personal protective equipment (PPE) is vital for our nurses to perform quality work. Saint Joseph’s provides the staff with daily surgical masks to be worn at all times on hospital premises. Additionally, select employees are provided with N95 masks that are sterilized using UV radiation. Extra ear loops are also provided for when the seal is compromised (employees are trained on how to effectively attach these). Staff is asked to provide their own approved eyewear (face shield or goggles). Our staff members enjoy some of the best and most adequate PPE anywhere! 6 - Has your nursing license lapsed? No problem. Saint Joseph’s uses a specialized team to get former nurses back on track. We offer a unique 4-week program* that will bring nurses up to snuff on the basics of healthcare, with an additional 2 weeks of area-specific study depending on their chosen specialty. With our rigorous course, nurses can rest assured they will be able to pass the NCREX (National Council Re-licensure Examination) and be ready to enter the healthcare workforce with up-to-date knowledge and mastery of skill. 7 - Ongoing education is required for our nursing staff. We make every attempt at Saint Joseph’s to ensure you have ample opportunity to expand your education with pertinent and applicable courses and lectures you will be able to take right to the bedside. And, because we know you value your time, 90% of education is contained on our online platform, HealthSteam. Easy to access, real-world application courses are available to you 24/7. Full Steam Ahead! Education hours do not count toward mandatory OT. 8 - We know that your number one priority is your family. That is why Saint Joseph’s established Joe’s Daycare and Academy.** Are you concerned your child will not stay on task if you are not there to monitor their online schooling? Then let our tutors take over. Joe’s Daycare and Academy is a 3-story facility complete with computer stations and access to the entire city school district's online platforms. At an extra minimal fee, we offer tutoring to those students struggling with online content. Our daycare is clean, well-maintained, and offers socially distant playtime for toddlers and preschoolers starting at age 2 (must be potty-trained). Join Our Team So what are you waiting for? An exciting, prestigious career in nursing awaits you! At Saint Joseph’s, we value our nurses and recognize their important contributions to the health of our patients and community. Be a positive part of the Covid history and join the Saint Joseph’s team today. Our family welcomes you with open arms! *The program is limited in number of participants, so please inquire early in the application process. **Due to social distancing requirements, there is currently a waitlist for certain age groups at Joe’s Daycare and Academy.
  3. Mywords1

    My Covid Crystal Ball

    A vaccine will not entirely end the COVID disease because it will be considerably less than 100% effective and not everyone will take it. Healthcare workers, high-risk individuals, and most seniors will comply. A certain cure is a better goal, a sure thing, but that may be years from now or never (no cures for AIDS and the flu exist either). Eventually, general immunity should limit COVID from spreading as much and like a bad horror movie, one day it will end. Featured in the allnurses® Fall 2020 issue... allnurses® Magazine Library I came very close to getting the coronavirus. One day in mid- March, I was invited to a social meeting of old colleagues from work. I wondered whether to go, partly because state residents were recommended to stay home. I had nothing else to do so I decided to go. When I arrived, the host wanted to introduce me to a newcomer in my field. I shook hands with him as my cell rang persistently, and thinking it was important, I stepped away to answer it but it was only a sales call. When I returned, the guest was already involved in another conversation. I moved on and hardly spoke to him. Two weeks later, I called the host and she told me that the guest I was supposed to meet realized later that he probably had the virus at the meeting. He was hospitalized and very sick. I shook his hand! I was two feet away. That phone call may have saved my life! I remain healthy and grateful for this. Social Issues In the next two years or so, or while people are confined at home, more divorces and separations, breakups of couples and families will occur— due to personal conflicts, lost jobs, and increased domestic violence. Some who are unable to cope are taking more opioids and other narcotics and dying by overdose. Facial coverings, social distancing and the closure of meeting places discourage seeking out possible marriage partners and new friends of both genders, showing affection and physical contact. Thus, we should expect less dating and marriages in the near future, especially those over 40 years. Naive and careless people, especially the young, will ignore social distancing rules and attend busy parties, social gatherings and restaurants. Faces are deeply personal—your outer self, but masks level the difference between the beautiful (or handsome) with unattractive faces and everyone else. No one can see who is smiling at you or grimacing with them on. I have seen fear and deep worry among customers in stores as if they feel that everyone has the virus and they will die without a mask. However, their chances are actually extremely low: in the United States, 015% have been infected, and .0005% died as of mid-August. (New York Times); including high-risk and elderly. I am not advocating that we take COVID less seriously, but we need to understand the larger picture. Christians often believe that diseases and calamities bring out good virtues in people, such as sympathy, empathy, and caring. In healthcare workers, perhaps yes, in everyone else, not likely. Studies indicate that people tend to be sympathetic mainly to those who are like themselves (same religion, ethnicity, or race) and geographically. We are dismayed when Americans die, especially in the same state or city. Did you care what happened in Wuhan, China? I believe that everyone, basically, pursues and is interested in their own self-interests. With the exception of medical or health professionals at work, but in their private lives, who knows? For our stoical peace of mind, indifference prevails, and admit it, most of us are rather apathetic toward people we don’t know or care to know. True empathy is much rarer than we think. The big pharma companies are not racing to discover a cure or vaccine out of human kindness. A huge stock-raising profit is at stake. Politicians desire to enhance their reputations and fear lawsuits. Top medical scientists seem heroic, yet their recommendations are founded on science, not compassion or pure altruism. Sadly, the routine things we took for granted, small pleasures, and ordinary freedoms are gradually vanishing, gone with the wind. Will these liberties become merely nostalgic? Public drinking fountains are as extinct as pay telephones. Vacant movie theaters will sell popcorn but no tickets. Social distancing rules, nationwide, will greatly eliminate crowds and large organized functions, possibly for years. The internet will occupy significantly more of our leisure time. Virtual reality, which already substitutes for real life, will become the future commonality. The image replaces the real, indefinitely, and everyone is expected to accept this imitation of life. Higher Education I taught college classes, online also, for over 20 years as a professor, and am knowledgeable about the management agendas and issues in student learning. Administrators often fail to have the best ideas for making future academic plans. Online and hybrid learning is the future, for several years, and students will not look forward to this replacement of real classes. Online (zoom) tutoring and seminars will be common. The problems in higher education will worsen, as students settle for hybrid or internet classes, and lose the social and intellectual benefits of campus life. Multitudes of students may never see the inside of a classroom and will miss the interaction—or never know what they missed. In some colleges their achievements might be harder, though unbeknownst to them, and because online degrees and some courses have a lower reputation, (perhaps less merit) than traditional ones. High drop-out rates from distance learning is a well-known trend. Also, it is easier to be dishonest by plagiarizing or getting someone else to do the work. This may likely increase and become more widespread, and the precautions and safeguards might not always work. Happily, students who are home-bound, without transportation, or with busy parenting or work schedules, will be glad to take these classes who could not do so before. They will enjoy or be satisfied with online courses, such as accounting or physiology, that do not require live discussion. I think that medical students benefit more from regular well-taught classrooms. Unmotivated and weaker students will struggle or fail, but the best students will continue to excel. Beginners with computers such as ESL students will have more difficulties. Grade inflation, which has been commonplace for decades, might increase and become more widespread. Actual grades will not reflect, necessarily, the quality of work. Administrators and board trustees are uninterested in these details. To them, the major goal of higher education is money, making students happy, higher enrollment and enhancing the college’s reputation or status. In the humanities, social sciences and courses that are deemed “ irrelevant”, grades are important but not learning so much. For non-majors and nursing students, these courses are comparable to a side at dinner. (Eat the steak, not the carrots.) Working adults and nursing students often feel entitled to an A so their employers will pay for the course. To deans and higher-ups, coursework is not as important as enrollment, higher status and saving money. Class sizes will be expanded without physical space confinements, and thus fewer educators will be necessary and, therefore, out of work. For a while, they will enjoy working from home, but their workload will likely increase with significantly larger and more classes. This situation is nicely suitable for introverted or isolated students and faculty, who can put in as much or as little time as they wish. It is much easier to close the doors and say No One Admitted, rather than work to develop plans and find a better alternative that welcomes everyone. Future State Paternalism This is the view that governments have the right and duty to restrict individual liberty by law for the health and well-being of individuals and businesses. The restrictions are justified when the benefits of the laws outweigh and exceed the freedoms that are reduced or eliminated. Examples are the unpopular sugary soda taxes, prescription medicines, illegal drugs, and required motorcycle helmets. It also is promoted for property, life-death issues, and safety. The pandemic has brought forth strong paternalistic laws that this nation has rarely witnessed. Governors acting alone, without regard to the state constitution, legalize mandates without approval from state legislators. City mayors will close anything they consider “non-essential”, including parks and libraries. Paternalism and individual liberty are a see-saw balance, controversial in social laws and governmental policy-making. The big idea is that our government knows more than we do about our own well-being, and laws should protect individuals from harming themselves. This implied principle, taken for granted, will be heralded and enforced by governments throughout the world, indefinitely. Protestors will try to fight it to no avail. We must find the wisest compromise between the state and its opponents on this issue. I hate that our everyday choices are so very restricted or eliminated. Although countless lives have been saved so far, the stay at home orders, notably in the safest states and nations, probably do not justify the loss of billions of dollars, jobs, and detrimental psychological effects. Contrary to common beliefs, millions of people worldwide have scarcely been affected by COVID. Personally, I know many individuals over 50 whose entire lifestyle means staying home alone or with a spouse, minimizing time with others, and leaving home only when necessary. This will remain unchanged in the future. Mass conformity will become strict law in hard-hit states, and greater power for governors and mayors, who eagerly enhance and force their authority over our personal lives. The growing realistic fear is that governmental power will unjustly expand with well-meaning laws that are unnecessary or wrongly advised. For instance, some governors impose two-week quarantines on non-residents traveling to their states, even when these regions have low numbers of COVID cases and little suffering. Two hundred COVID-free visitors will hardly matter. What if the laws are enacted across the nation and the world? Entire lifestyles and free choices will be stymied. In the past, and possibly future, governments use public health and safety, patriotism, or security to justify new laws as a disguise for benefitting citizens. Pardon the pessimism. But, two years ago, if you said a pandemic will end 700,000 lives in the world, everyone would say you were crazy or off the deep end. Studies show that optimists are more likely to be happy but wrong about the future, and pessimists are likely to be unhappy, but more realistic about the future. Optimists will adjust the best and remain so, without letting COVID and the restrictions diminish their cheerful outlook. Let Us ... ... hope for a great future but keep expectations lower toward a medium point-- certainly not the worst future, or the “ normal” we all took for granted.
  4. Even though COVID-19 has infected and killed Americans from every age bracket, the most vulnerable population has remained the same. Persons at highest risk for having a poor outcome if infected with COVID-19 are older adults and those with underlying medical conditions. Chronic conditions, including diabetes, hypertension, obesity, chronic obstructive pulmonary disease and heart disease, affect more than half of the U.S. population and are key drivers in our nation’s rising healthcare costs. The World Health Organization considers preventing chronic disease “a vital investment”. The current pandemic shines a light on chronic disease as a serious issue that is worth everyone’s attention. The Elephant In The Room Is the 2020 pandemic a wake-up call? Americans are ailing and vulnerable, and many of the chronic illnesses that plague our countrymen are of our own doing. Americans are less physically active than they were 50 years ago. Currently, only 20% of U.S. jobs require at least moderate physical activity, compared to about 50% just 60 years ago. The American diet has shifted from the pre-World War I consumption of food that could be grown or hunted, to the present day pre-packaged and heavily processed food products. A study published in 2017 found that nearly 60% of the calories consumed by the typical American came from ultra-processed foods. A nutritionally-deficient diet and an inactive lifestyle, especially when combined with other harmful lifestyle habits such as smoking, excessive alcohol intake and the use of pesticides and other harmful chemicals, can result in the development of chronic conditions. These are the same chronic conditions that put American people at increased risk for higher morbidity and mortality if they become infected with COVID-19. Does the U.S. have a high number of COVID-19 fatalities solely due to inadequate masking, social distancing, and shut-downs? Or does the U.S. have a high number of COVID-19 fatalities because 60% of Americans have at least one chronic condition and our healthcare system prioritizes managing chronic illness over preventing chronic illness? We will start talking about improving the health of the nation. Creating Change To be fair, we are trying to change. Farmer’s markets are multiplying, community gardens are birthed alongside farm to table restaurants, and wearable fitness trackers are a fashion statement. It seems America has begun to embrace healthy lifestyle choices, but are we doing enough? These trends are healthy, but are they targeting the right populations? Can low-income families afford fitness trackers or eating out? Do they have easy access to a farmer’s market on the bus line? Do they know how to prepare healthy meals using whole foods? Instilling healthy lifestyle habits will involve policy changes at the national level. Our media outlets will stop marketing unhealthy products citizens who take their cues from television and online ads. Our leaders will spend money on advertising to promote farmer’s markets, as well as classes on gardening, cooking, and long-term storage of produce. Television and online ads will focus on healthy olive oils and the appropriate amount to use in sauteeing, instead of targeting children with flashy commercials promoting the sweet taste of processed cereals. We’ve seen the power of the healthcare industry when lives are at stake. The tobacco industry was forever changed when cigarette commercials were pulled from television and replaced with ads depicting a nicotine addict smoking a cigarette through a tracheostomy and speaking through an artificial voice box after surgery for throat cancer. Changing a collective mindset is not easy or quick, but American healthcare providers will speak for the people and demand government action to prevent unnecessary deaths. Healthy Habits Start in Early Childhood All children will be required to attend classes that focus on preparing meals using only whole, natural foods, as well as classes on natural activities that promote wellness, such as walking and biking. Home-economic classes will incorporate education on budgeting, purchasing habits and growing produce, and will be required at all grade levels so as to create a sense of community built around healthy habits. Physical education classes will focus not only on sports but on movement activities that can be accomplished solo or in groups. These activities will include gardening, landscaping, hiking and other outdoor activities. Children are malleable and act as sponges, soaking up ideas voiced by adults they trust. Our children will become parents, leaders and educators who will pass down wisdom and learned skills to the next generation. What wisdom and skills do we want future generations to learn from our children? What legacy do we strive to leave to our grandchildren? Nurses Are The Face of Change The promotion of healthy lifestyle changes will require nurses to take on unique and rewarding roles. Nurses are poised to make a positive difference in people’s lives as community providers, health coaches and case managers. Community health practices are at a crossroads, as many general practitioners are retiring and there are not enough general practice-trained physicians to replace them. Primary care providers are strategically positioned in communities, ready to embrace the whole person and their support system as a unit, knowing that change happens when it is championed by the unit, not just the part. Nurse practitioners and nurses will fill the shoes of retiring family practice providers and partner with communities in an effort to turn the tide of unhealthy lifestyle choices that have plagued consumers for too long. As the most trusted profession in America, nurses hold clout with consumers and will encourage the public to make changes to their daily lifestyle habits. As members of the community, nurses will direct consumers to community-based organizations that provide education, as well as to peer-led support groups that can provide foundational and progressive support. Nurses and other healthcare workers will demand their government representatives work for a healthier America by pushing for more funding for small farmers and a ban on the constant marketing of unhealthy products to their constituents. Will the next generation continue the downhill slide into a pool of chronic conditions that result in sickness, disability and early death? Or will the next generation rise up to be forward-thinking leaders who instill healthy habits in their children and grandchildren, creating communities that support health and prosperous longevity? We can change. We must change. We will change. Resources People Who Are at Increased Risk for Severe Illness Chronic Diseases in America Preventing CHRONIC DISEASES a vital investment Sitting Disease: How a Sedentary Lifestyle Affects Heart Health The share of ultra-processed foods and the overall nutritional quality of diets in the US: evidence from a nationally representative cross-sectional study
  5. allnurses

    Fall 2020

    Version Fall 2020

    The previous issue, Spring 2020, focused on the Coronavirus as it was first evolving. Who knew at that time we would still be in the thick of the virus now with so many increasing uncertainties for the future. In the Fall 2020 issue, several allnurses members share their thoughts about the continuing Pandemic and interesting ideas on what the future holds. In this issue, you can read about what it was/is like in the day of the life of one nurse at ground zero. Another nurse shares her Pandemic Memories 20 years from now, while another nurse discusses College Life Yesterday, Today, and Tomorrow, and how these changes are affecting her college-age twin daughters and other students. Don’t miss this issue filled with COVID discussion from nurses. What are your ideas regarding the New Normal?   College Life Yesterday, Today and Tomorrow COVID-19 has affected almost every facet of our lives. For college students, the campus and classes look different today than yesterday, and some of these temporary changes may end up being permanent.…   The New Normal It's hard to know what the future holds for us after COVID-19.   My Covid Crystal Ball I discuss some social issues stemming from the Covid, problems with distance learning courses in higher education, and implications for state laws and restrictions on our lives   My Memories of the Pandemic 20 Years Down the Memory Lane As a nurse, dealing with increased pressure was nothing new. As a nurse, I have been trained to maintain focus, take instant decisions, and perform complicated procedures while responding to heart at…   Nurses Wanted A framed article in the form of a job posting that reveals what the state of nursing may be like in the future post-Covid world after nurses have left the profession in droves. A satirical piece.   A Day in the Life of a Nurse at Ground Zero A bedside travel nurse reflects on her latest assignment at a Seattle-area hospital during the height of the Covid-19 pandemic.   Memorialization of Nurses Who Died From COVID-19: They Had Grit Nurses spent 60% of the time with patients when COVID-19 came. Nurses were sent to war without ammunition and were dodging invisible bullets. Lack of PPE early in the pandemic caused many nurses and o…   Five Months Later, Where is the PPE? Billions of dollars have been spent by way of the Defense Production Act in the past few months. Let's take a look at how well (or poorly) the money has been spent.   School nurses facing a pandemic head-on allnurses recently spoke with a school nurses as she prepared for the 2020-21 school year. Along with concerns are messages of hope and encouragement from a sometimes overlooked healthcare professiona…

    Free

  6. Unsung Hero Story

    New Normal After the Pandemic

    Every so often, our lives change. Kids grow up, strangers become friends, jobs turn into careers, etc. It’s usually the big changes in our lives that go unnoticed until much later when we look back over the years and reflect on how much has changed. Enter COVID19 This year has been full of opportunities for reflection; not only of the past, but also the present, and definitely the future. A year that had recently begun with hope and new years’ resolutions, suddenly became something to fear. In an instant, change took over our lives in almost every way possible. Schools were canceled, commutes were abandoned, businesses closed, and our loved ones fell ill. After almost six months behind locked doors, we have somehow settled into this new reality. We’ve adapted to change and watched it run through our lives in real time. However, the biggest change of all is still undefined. What will the future look like? Despite all of the chaos and uncertainty this pandemic has brought on, I still have hope that the future will be less dull. Hopefully, the many changes we’ve lived through this year have led us to thoughtful reflection, and those reflections have turned to valuable lessons. I see the future following this pandemic as one of renewed values and even more changes in our lives. But this time for the better. Empathy In the new normal following COVID19, we will all be more empathetic individuals. Maybe it’s wishful thinking or maybe it’s an optimist's perception, but one of the biggest lessons we’ve learned during this pandemic is to think of others. As a group, we put many of our needs on the back burner to help protect those at risk. We gave up our social needs and lifestyle privileges to help protect the elderly, the sick, and those at the frontlines. We saw the tired faces of our frontline workers, covered in masks and PPE. Exhausted, overworked, burned out. We learned what it means to be a nurse and the sacrifice behind their work. We heard the stories of labored breathing, fevered nights, and intubation. And we learned what it’s like to lose someone you love unexpectedly. Collectively as humans, not individuals, we experienced this pandemic. We understood the pain and fear of those thousands of miles away from us, as we were soon facing it ourselves. In the future, we’ll remember that we all experience sickness, health, love, loss, fear, and hope. Just like we all experienced COVID. Self Aware In the future, we’ll all be more aware of how our actions impact others. For months, we’ve stayed home so others could do their jobs. We’ve worn masks so others wouldn’t get sick. We’ve shopped local so others’ businesses wouldn’t fail. We learned that we can all be part of the solution or the problem. We heard about “the curve” all over the news. How we needed to help flatten it. For some of us, we also watched it grow in our own cities. We soon realized that this curve was a reflection of our actions. What happened in the world soon became directly related to what we did today. Our decision to stay home, wash our hands, and wear a mask could impact everyone around us. Our actions, as small as they were, could spread (pun intended!) to everyone we knew or help protect as many people as possible. Our lives do not impact us alone, no matter how isolated or socially distant we are. Self-awareness will be part of the new normal. Maybe just as much as washing our hands! Gratitude Before the pandemic, two worlds existed: inside hospital walls and outside of them. Unless we had some direct connection to someone working in healthcare, or we were healthcare workers ourselves, many were not aware of the amount of sacrifice required in nursing work. The pandemic gave us a view into this world of heroes. We saw their tired sleepless eyes and bruised faces, covered in exhaustion, fear, and sometimes, defeat. And we learned to be grateful. Grateful that we have these brave men and women in our lives to protect us. Grateful that every day they wake up and walk straight into the line of fire to keep us and our loved ones alive. We are grateful for their dedication, their perseverance, their service, their care, their strength and their hope. Nurses have always been unsung heroes. Working behind the limelight, they care for, protect, and heal, often with little to no recognition. In the future, I hope we do not forget them. That we continue to share our gratitude to their crucial role in our lives. Our lives have changed. From one moment to the next right in front of our eyes. We no longer think of change as a thing of the past but as a present phenomenon running our lives. And we see it well into our future. We know things will change, but how is the question. We might not know the exact answer to that question but we can try to guess. We can use the many lessons this pandemic has taught us and carry them with us into whatever future awaits us. As this pandemic has well taught us, we cannot predict what will happen in a year or even months from today, but we can at least imagine. I imagine futures filled with empathy, self-awareness, and gratitude. What do you imagine?
  7. Lightning Rose

    What will nursing look like after COVID-19?

    Many people are asking when will life return to the way it was before COVID-19. Spoiler alert: It won’t. After World War II, people wanted to forget the hardships of the past decade and tried to go back to the way things were, or believed should be, only to find the world and themselves forever changed. History has a tendency to repeat itself. Life post-COVID will change lots of things, especially nursing. The Final StrawNursing has always had problems, from chronic short-staffing to disagreeable patients and family members to management fussing over petty details, just to name a few. For many nurses, COVID is the final straw. This pandemic is burning both ends of the candle too quickly for too many bedside nurses, having to enter a COVID patient’s room without proper equipment and even becoming sick with COVID themselves. As of writing, eight of my co-workers are sick with COVID, those who are not on a ventilator are likely asking themselves some very tough questions: Did I accidentally give COVID to my loved ones? Will I make it through this pandemic intact? Why did I become a nurse in the first place? Will I stay at the bedside when this is over?To Stay or Not to Stay at the BedsideEven if they aren’t sick, many nurses are beginning to seriously question whether or not they will remain at the bedside. I predict an exodus of bedside nurses, at least 20% if not more, during and after COVID. The treats and notes from the public are appreciated, as are the compliments from administration, but for many, it is too little, too late. But that doesn’t mean nobody will be left to care at the bedside. A lot of brand new nurses, particularly those who have lost their jobs due to COVID, will enter the workforce. They will have been told nursing provides guaranteed employment and a decent salary and is a promising career in general. They may have been warned of the incredible difficulties, or they may have not. A lot will just be glad to have a job and not worry about losing their homes or their children going hungry. Whatever their knowledge, whatever their reasons, it is up to the experienced nurses to guide the next generation. Better Equipped Those at the bedside after COVID will be better equipped. Masks, gowns, gloves, and Clorox wipes will be better stocked in case another pandemic occurs. Post-9/11, airport security heightened and has remained this way, the same will be for hospitals. They will be a lot pickier about who comes in, likely still taking temperatures and limiting visitors (this can be a good thing!). Administration will learn from the post-COVID exodus of nurses and will do more to make nurses’ jobs easier, such as setting clear boundaries for unacceptable behavior from patients (of sound mind) and family members. I believe they will make more of an effort to staff their nurses fairly, but it is a budgeting issue and hospitals technically are a business, this will require quite a lot of work. Maybe administration and the public will be more appreciative of what those on the front lines do, how we put our own health and well-being on the line for the sake of others. Greater Variety of Job OpportunitiesNursing will have more variety of job opportunities. Burned-out nurses will be (and most likely already are) looking for opportunities away from the bedside, even creating them. They are making face masks, building businesses for nurse products on Etsy, blogging about nursing, and writing articles. As nurses, we wear many hats. We are not only healers, but we are also teachers, counselors to patients and family members, mentors to nurses learning the ropes, innovators (how many times has a piece of equipment went missing or malfunctioned and you had to be creative with what you had?) and leaders. We are StrongWe are strong. We are adaptive. We are resilient. We are capable of so much more than we think. Borrowing from the Marine Corps mantra: we improvise, we adapt, and we overcome. Things cannot go back to the way they were, and judging from the past difficulties, we shouldn’t want them to. The best we can do is move forward. There are better times ahead. The best is yet to come. Whether you’ve been on the front lines for three months or forty years, thank you. Whether you’re a student, a newbie, or you’ve been around the block more than a few times, thank you. You are a hero in real life.
  8. We've had numerous article contests in the past, but this one was somewhat different. With this article contest, we asked our readers to share their COVID stories and ideas of the future with us. And WOW!! We received so many inspiring and heartfelt articles, all of which are awesome! Thanks to all who shared your articles with us. The task of selecting just five winners was very difficult. Featured in the allnurses® Fall 2020 issue... allnurses® Magazine Library Five winning articles were selected from the contest entries and are featured in Fall allnurses Magazine, along with a few of other articles. Each winner will receive a $200 Visa or MasterCard gift card. All submitted articles will be published in the Disaster /COVID Forum on the allnurses site so you can read them all. I think you will be inspired - Hopefully many of you will submit articles for future contests. And the 5 winners are: Nurses Wanted by nikkulele77 My Memories of the Pandemic 20 Years Down Memory Lane by ambitious nurse My COVID Crystal Ball by Mywords College Life Yesterday, Today, and Tomorrow by Maureen Bonatch The New Normal by Beth Hawkes Watch for a Private Message with instructions on how to retrieve your prize. CONGRATULATIONS! Be sure to download our new Fall 2020 allnurses Magazine - COVID-19: The Search for a New Normal. You will find all of the winning articles there, and more... Stats, graphs, more content from our members, all about COVID. COVID is going to be around for a while, but we are all in this together, and together we will win! We would love to hear your comments about the magazine and features you would like to see.
  9. Nurse Beth

    The New Normal

    By definition, it’s hard to imagine the unimaginable. At least it is for me. I never could have predicted or imagined the world we’re in now. With the exception of 9/11, I was raised in a peaceful, non-warring period of time in an affluent society...which gave me and my generation a feeling of security. After all, we are American citizens, safe and untouchable….right? But then COVID happened. If this unimaginable pandemic could happen….then what else could happen? Biblical plagues? Economic collapse? The end of life as we know it? Featured in the allnurses® Fall 2020 issue... allnurses® Magazine Library Because of this pandemic, we now know that we’re vulnerable and nothing is guaranteed. It really never has been, but we’ve been in a comfortable bubble. There are so many things we may never again take for granted, like unlimited supplies of everything we ever wanted. Like financial security and health. We are not in control and we have to reassess our values and challenge our basic assumptions. In the here and now, there are a lot of losses. Personal Pandemic Losses My heart goes out to graduating teens who never had a 2020 prom. Youngsters who weren’t able to go off to normal dormitory college life, who can’t congregate as kids love to do, and who had normal stolen from them. The same is true for couples getting married during COVID, for anniversary celebrations, for funerals that couldn’t take place. Surely the worst of all, patients who died alone and their loved ones who were forced to stay away from their side. There have been losses upon losses. We have to identify the losses and grieve them. Mine, by comparison to many, are minor. Like not knowing if I can get my hair highlighted when I want. Like giving up any foreseeable plans to travel to Italy. Or Alaska. Or anywhere. Bob and I hardly ever go to the movies, but now it’s not an option and I want to go. I can’t wear lipstick or makeup under my mask at work and my skin is breaking out around my nose. It’s all rather trite but I am not in control. Fear It’s scary, too. It’s strange to be wary of your own friends and family. Like wondering if my own grown children may expose me to COVID. What about the teenagers in our family? Are they really wearing masks and being careful when we don’t see them? Doubtful. Teenagers are notorious for feeling invincible. Family gatherings can be scary and awkward. A co-worker announced to her family that she was moving forward with plans to host a pool party and barbecue to celebrate her child’s high school graduation but that she would be enforcing social distancing. She said that her own immediate family would sit at one table, but that another family sub-group would sit at another table in a different room. You can only imagine all the ruffled feathers around that announcement. What actually happened was that hugs and beers were freely shared within minutes of the party starting and everyone ended up in the pool together because social distancing among family members is just difficult. Future Some things will never go back to pre-COVID. Masks and infrared sensors are here to stay. I hear drones from Amazon will drop dog food into my front yard. Work and private lives will blur as many of us work from home. There are changes to how we eat, how we worship, how we workout, how we connect. In healthcare, the Hospital at Home model will gain traction and MedSurg patients will be cared for in their own homes. There will be more telephonic care delivery. Hospitals will essentially be big ICU units. Primary school classrooms will re-open but will be re-configured for social distancing. We don’t know the social effects on children yet. How will they play with others? We’ll stand in lines to get on elevators where only 2-3 people will be allowed at a time. Subways, buses, and trains will be less crowded as people avoid dense crowds and freeways will be more crowded as everyone drives themselves. The infrastructure of cities will change to accommodate social distancing. Infection Awareness Plexiglass barriers in drug stores and banks are here to stay. We will all be even more conscientious about handwashing, masking, and coughing into our elbows. Handshakes will become a thing of the past, and future generations will be shocked to hear that we used to touch strangers so casually without thought of disease transmission. We’ll see more of the “grasp and greet” where you clasp your hands together and place them over your heart to show warmth. We might find ourselves giving a thumbs up to accompany a smile that can’t be seen beneath our masks. I try to smile with my eyes but I don’t know if it’s working. I hope so. Social Injustice It’d be wishful to think that this pandemic will serve as a catalyst for us all to unite, for inclusiveness, but instead, class differences, racial division, and injustice may increase. Is it a coincidence that protests against systemic racism happened alongside the pandemic? Or is a heightened intolerance for intolerance somehow connected to the pandemic we’re going through? Minorities and low-income groups have taken the hardest hit. Field workers picking broccoli in the Salinas Valley can’t afford to take so much as a half-day off of work. Social distancing is impossible and field workers travel to work packed into overcrowded vans. Front line service workers are bearing the brunt of COVID. Estimates say a half billion people will be pushed into poverty. Systemic health disparities are glaringly exposed. Professionals can work from home, but day workers don’t have access to wi-fi or laptops. Telemedicine doesn’t benefit cyber have-nots. Positivity Despite everything, I believe we are amazingly resilient and adaptable. In healthcare, we’ll change to be faster and more flexible. We will see unheard-of advances in technology, in artificial intelligence. We have a deep resolve to live and thrive, and to live meaningfully. I don't know what the future looks like, but I believe in us.
  10. As I recall the fear and anxiety surrounding the onset of AIDS decades ago, I wonder what would I remember the most about the current pandemic plaguing the globe. How will I remember this pandemic 20 years down the memory lane? Will I remember the fear and uncertainty, the moral and ethical distress of infecting myself and my family by being an essential worker? Will I remember the stigma of working with COVID-19 patients, the abuse and aggression from the members of the public, including the extended family members? Featured in the allnurses® Fall 2020 issue... allnurses® Magazine Library Will I remember the childcare challenges faced by the healthcare workers as their jobs were deemed essential while the uncertainty of their children’s safety loomed large on their minds? During times of crisis, people have often risen to the occasion and have overcome obstacles they would never have thought possible otherwise. Covid-19 will not be any different. I am sure. But for now, I deal with the added stress of working as a mental health nurse. I keep waiting for a wave, a wave of unknown height and unknown force to hit the hospital, bringing chaos and confusion all over. As a nurse, I have been trained to maintain focus, make instant decisions, and perform complicated procedures while responding to heart attacks, and patients coding. Yet, the COVID-19 pandemic has posed a new challenge for which I feel helpless and ill-prepared. Each person will remember this pandemic differently. They may or may not remember the stimulus checks or the unemployment benefits, but they will most certainly remember the stress, the fear, and the uncertainty pertaining to the future. Nurses most definitely will continue to remember and honor the memory of their co-workers whose lives were lost during this crisis. We will recall with pride that they never gave up but chose to serve until death took them apart. I know I will most certainly remember the anxiety and the over-work, the burnout, and the mental fatigue as I wake up in the middle of the night, with nightmares of dying patients and overflowing morgues, having given in to PTSD and lack of mental support. Or perhaps these memories will change down the memory lane. Our brains will have molded the experience, just like they usually do after childbirth; remembering the Year of the Nurse 2020, as the most heroic experience of our lives, the memories of how each one braved the storm. Perhaps we will have that rosy, idyllic glow as we remember using our critical thinking to implement alternative strategies to protect ourselves and our families during the pandemic. Certain behaviors adapted during the pandemic will soon become a habit, including changing out of work scrubs before entering our homes, meticulous hand washing, showering immediately after work, and maintaining safe boundaries in the name of social distancing. However, for the sake of my family, I hope I’m the only one who remembers the fear, the pain, and the horror. I hope I am the only one who panics at the thought of someone dying a lonely death, of having to reuse a disposable mask for days together as we hoped to get a new supply somewhere in the uncertain future. I hope I will be the only one to remember the tear strained faces of my co-workers struggling to maintain a work-home balance while dealing with their own personal demons. I hope that my children will continue life with bittersweet memories of the lock-down, the video conferencing bedtime stories from grandparents from across the globe, the barbecue family dinners in the backyard, and an extensively decorated home with 'happy birthday' signs all around, to make up for the peer parties with their buddies. I do sincerely hope that they remember the blooms we had during the pandemic, hours spent getting their hands dirty in that garden while the world was shut down, and the movie nights at home as they delved deep into the Netflix and Disney worlds. The memories of continued economic suffering, the news reports threatening increased poverty and isolation, and the conservatives fighting for freedom from wearing masks would soon be forgotten. The insanity of hoarding toilet paper and the empty racks at the local Walmart and Target will be a story for household gatherings and dinners. Yes, we will choose to remember the happier times. We will continue to remember the silent heroes of our community. And, those who sewed masks for us, those furloughed from their jobs and who chose to deliver groceries and essential items for the essential workers. We will continue to remember with fondness those businesses who delivered sweet treats to the hospitals to keep our morale strong. And we will continue to remember members of the voluntary organizations who served selflessly in trying times. We will continue to hold on to all the lessons the pandemic has taught us and to appreciate every little moment that we have; making the most of it. We will practice gratitude and love and remain in touch with our neighbors. We will show love and concern for our long-distance relatives. And, we will remember that tomorrow is never promised. Even as I write this, we have grave decisions to make. To continue with online schooling or to opt for a blended version. Or, to plan for day trips or to research some safe vacation practices. No matter what choices we make, we will continue to hope. We shall rise again.
  11. spotangel

    The New Normal: A Stronger Savvy Nurse!

    So many things have changed in a blink of an eye. The Covid pandemic took and shook lives left, right, and center. Along with most others, my life changed. FamilyMy children were in an uproar. My 14-year daughter, Angela, was crying and shouting, “You don’t trust me!” We were discussing the new school options due to Covid restrictions. I was in favor of the hybrid program 2 days a week in class and three online days. The kids wanted an online program only. Some of their arguments were: Mom, her classmates are not going to be socially distant!How do they know if the class is clean?What if they have to move from one class to the other? The hallways are going to be crowded and the next classroom may not be clean?She has asthma. If she gets it she could die or bring it home!My side of the argument went like this: You are up all night and sleep all day! There is no one to wake you up in the morning!What if you miss class and get a zero in your grade! These marks are looked at as you are a high school kid.If your dad, who worked all night, has to stay awake after work to wake you up, he could get sleep deprived, have an accident, die or kill someone accidentally.Just look at yesterday, it was time for mass and you were still sleeping. How can I trust you as you sleep through every alarm and refuse to get up even when someone comes to wake you! “To date, I am not sure if I will send her for an in-person or online class but here is my wish list for in-person school. Do a daily questionnaire online/on the phone for Covid symptoms exposure. Green for good. Have a plan for red-if symptomatic/exposed to Covid pts.Temperature checks in school and designated markings while entering school and in hallways. This needs to be monitored.Mandatory masking and hand sanitization at the entrance. Masks offered at the entrance if you have forgotten to bring one.Keeps kids in the same class. Let the teacher come into the class, instead of the students moving from class to class.Keep masks, tissues, and hand sanitizer at the teacher’s desk.Have a Covid hotline number for students, staff, and parents to call during working hours preferably manned by a nurse.Involve the PTA for a parent Covid resource team for parents with questions.Have flexibility and a backup plan for classes if any issues.Monitor the flow of entry and exit. Designate one class at a time to avoid overcrowding.Shower as soon as one comes home.My older two kids are in college. Alex is doing online classes but struggling to find sites for an internship. Annie will have online classes but on-site labs. I would recommend the same rules as schools but would also emphasize “no parties and social hours”. That seems to be a surefire way of getting into Covid exposure. As a parent, I worry, but here is the silver lining: Infection control will be on everyone’s mind and so will public health and safety!It may teach my kids to become more independent, self-sufficient, minimalistic, and improve their time management skills. All these will help prepare "the child for the road and not the road for the child” which is what many Helicopter parents do.People are looking at world trends and making decisions based on other’s experiences instead of in a vacuum.Many kids have become inventive and have made/patented Velcro lining masks that fold and stick to your clothes while not in use and shields from 3D material and hairbands!I appreciate my family and am thankful for each day, good health, a home to stay, food to eat, and a job that can help support my family and others in need.I have had frank conversations with the kids, just in case something happens to my husband and I since we both work in healthcare and with Covid Positive patients!WorkMy husband works as a social worker in a trauma 1 ED at night. He has had many one-on-one conversations with patients who have Covid and are trying to arrange the home front or dealing with other issues. It does involve a lot of near contact. I work in a clinic but was deployed to my main hospital to work with Covid positive patients. I don’t want to go into the daily horrors of watching patients die in large numbers daily in New York, the feeling of helplessness when we did not code dying patients due to the risk of spreading the virus during chest compression and intubation, holding a dying patient’s hand, getting their family on Facetime on my personal phone as they didn’t have any other ways available in the hospital, worrying if I would infect my family, the exhaustion physically and mentally, feeling the heat of the PPEs as I sweated profusely, trying not to use the restroom as I would have to disrobe while conserving my PPEs----sufficient to say was a nightmare. I had anxious nights when I could not sleep and dreaded going to work the next day, painful calluses from being on my feet for 12.5 hours, wheezing from the N95 that smelled funny, skin breaks especially behind my ears, and unexpected bouts of crying and anger. Was it PTSD? So what did I learn for the future and how would I prepare for the next wave of the pandemic whenever it came? Here are some of my strategies: Always be prepared. Do not compromise on PPEs. Insist on N95 for close patient contact.Speak up for what is right; for yourself or even a coworker.Follow infection control guidelines on handwashing, cleaning equipment used, and PPEs cleaning especially goggles and face shields. Wipe down rooms used for patients before and after.Avoid sitting in breakrooms unless you are alone. Bring your own food to avoid lines. Use your car in the parking lot if you need to during lunch hours.Space everyone out during shift report and speak up if teams are not following protocols such as an MD walking into the Nurse’s station wearing a used mask or face shield without removing it wiping down and hand hygiene.Insist on getting fit tested, so that you have the proper fit. Put it in writing to your manager.Be there for each other and check in with your coworkers. We are all in this together. Many have lost family and friends or are struggling to make ends meet.Follow a strict protocol to wipe down IDs & pens, discard hair covers, shoe covers, masks, change clothes and launder, and shower off before greeting your family. This was what kept us Covid free during the height of the pandemic.Acknowledge when you are emotionally down and then get help. Most workplaces offer phone counseling or, talk to a trusted friend or family member freely. I felt like I was at war as all I saw was death!Find positives at work and laugh a lot by sharing funny videos, jokes, etc. During huddles check in with your team to make sure everyone is starting the day OK. Be there for each other.Make sure you have enough supplies ahead of time and conserve PPEs when you can.Keep up-to-date with the latest protocols and inform each other and patients. CommunityYour community may be reeling from the effects of this pandemic. Keep your eyes open and see where you can help. Share what you can. Money, food, a cooked meal, a phone conversation.Volunteer to help in the church to sanitize it after mass.Help cook meals or buy groceries for someone who is at risk and does not want to go out to the supermarket.Check in via phone, face time, zoom meetings.Keep abreast of local politics and decisions especially for schools, hospitals, and neighborhood stores.Be mindful of social distancing and using a mask when outside. Walk early or late during the day mask-less if the street is empty but always keep a mask handy. Avoid using an N95 unless you are in a clinical setting.Be a resource as a nurse to your local community and neighborhood. You are to dispel myths, ally fears, and bring science-backed solutions so that people can make informed decisions.Nursing StudentsI recently taught an online Zoom class on leadership for Nurse Practitioner students this Summer. I made sure I got a sense of where they were starting from. This class was to be an in-person class and so there was a lot of disappointment. The class was also changed from a 15-week class to a 7-week class, so there was a lot of material to cover. They also had another class before mine and so I was mindful to make the time meaningful and useful to them. I divided them into teams and had their assignments as team projects. They were given an opportunity to present as a team and that helped their confidence level. I also got real-life leaders to come in as Zoom guest speakers to discuss their daily routines, challenges during the pandemic and solutions they came up with. Being creative to keep the class relevant helped the students tremendously and they stated that they really learned from this class. Another thing I did was to check in with them during the Zoom meetings and also in between through group emails to provide them with gentle reminders on upcoming deadlines. I kept in mind that many were working under tremendous stress in Covid units and providing care for elderly parents and young children, along with being a student, wage earner, and parent. They were very appreciative of the caring and responded by studying and excelling in my class! I was able to help them discover their own leadership skills and areas of improvement that they could work on! The importance of advocacy was stressed. I believe that college is going to be more online except when you need a one-on-one class like a skillset lab during this pandemic. Political LandscapeIt is important to keep an eye and ear out for all the new legislation that is put out from each state and find out what your local politician’s stand is on issues that are important to you. This should help you when you cast your vote. Legislation on worker safety, PPEs, Infection control measures, etc., should be looked at carefully. Know your union rights if you have a nurse’s union and know the safety policies of your workplace. Volunteer to be on committees at the workplace and know your union representatives by name. Exercise your right to vote. You can help make history and protect your patients and your own rights when you are an informed and savvy voter. Memory LaneNever forget colleagues that lost their lives working on the frontlines. Some of their stories are heartbreaking. A nurse that I mentored, came down with Covid symptoms in the ED, begged to be tested, was refused, and sent home on antibiotics. Two days later, she was admitted to a neighboring hospital where she ended up going into respiratory arrest, was intubated, and died the next day. The rage and anger are real for her coworkers. The knowledge that the very hospital she worked for failed to provide her with safe care. In her memory and others who died in the line of duty, let us strive to speak up, advocate and garner support from the community we serve to stay protected, and to protect our patients by providing safe and equitable care. Mental HealthAnyone who worked the frontline would tell you that the pandemic challenged them mentally and physically. When everything fell on the nurse including being put in an unfamiliar environment with inadequate skillsets in place to take care of critically ill patients with minimal to no supplies and inadequate PPEs, it took a toll daily. Two months at the frontlines gave me PTSD and I still cannot talk about those days without breaking down and crying. Even though I was down, I tried to help the brand new nurses that were breaking down daily and tried to encourage them even though I was broken on the inside. I kept telling myself that I would cry when I got home. When I reached home, I would try and be cheery in front of my worried family. At 3 am, I would awaken and cry into my pillow. By 6 am I was up and out the door for my 7 am shift. After coming back to the clinic “post-deployment”, I had an opportunity to speak to a psychologist on the phone twice but could not say much without crying. I still found those sessions helpful. Many hospital systems have put in help lines for staff to call but to me, it’s still fresh in my mind and I find it hard to share my experiences. One of the things I found helpful was to quietly help others who are struggling. It gives me the feeling of hopefulness, unlike the helplessness I felt before. Be aware of your coworkers and administrators. Many are struggling at this point and may need a helping hand. Meanwhile, the patients who struggle the most already have underlying anxiety issues. I tend to ask them how Covid affected them and sometimes it's like a dam broke! My New NormalPPEs: I do not leave the house without a mask and have extra masks in my car. I always use an N95 and a surgical mask over it when I see patients. Goggles, shields, and gowns, I use if needed. I do not let my guard down and am careful during interactions with patients and staff.Before I leave home for work, I do my Covid Safe work survey on my phone and get my “green pass” on my phone. Once I show my pass, the PCT takes my temperature, gives me a surgical mask and I go upstairs to my clinic. Every Monday, I get my N95 (one per week). I conserve my N95.I speak to most of my patients on the phone. I see only 30% of my patients in person. The clinic has converted to 60% video visits, 30% phone visit, and 10% in-person visits.I make time for my team and check on them frequently.At home, I spend time with my family and savor the fact that we are all alive by the Grace of God!Constant reminders to the kids to take their masks!I speak to my doctor on the phone. My daughter recently had her physical via a video call!I am on my church volunteer group to sanitize the church after mass.I am still debating online versus in-person schooling for my youngest!At the end of the day going through this pandemic has made me stronger and more appreciative of life! God keep you safe in these tough times! We are nurses! We are here to stay and save, Covid or no Covid!
  12. Carol Ebert

    SMALL is the New BIG

    Right now in order to survive this pandemic we have to avoid crowded offices, crowded events, crowded restaurants, crowded classrooms, crowded churches, crowded public transportation, clinics and hospitals, and even our friends and other people who aren’t related to us. That means the old ways of doing things aren’t safe anymore and we need to unleash our creativity so we can re-imagine our lives from the ground up. I know in a forward-thinking nation it is not popular to look back and yearn for our past ways of living, but there are lessons to be learned and models to follow that might be useful right now. For example, when I was young awhile ago, these are the things I was used to: lots of exercise fresh air safe neighborhoods with kids playing outside at each other’s houses families sitting out on their porches and visiting small class sizes no crowds home visits by my doctor to keep me out of his clinic when I was contagious with the measles I walked everywhere to shop, visit, go to school, play in the park. There were neighborhood shops dotted everywhere so I could get whatever I needed as long as I walked there. So what ideas can we borrow from the past that worked so well then? Could they work again now? For me, the easiest way to begin is to look at the big picture and create a system of manageable-sized neighborhoods whether in the inner city, in the suburbs or in small towns. Because the need for social distancing is a priority right now and moving forward, we need to think smaller and less crowded. FACT: We need to redesign our neighborhoods to create a “community feeling” once again and provide basic services easily accessible and affordable. Following this model means that if an outbreak were to occur (and it probably will again) we can manage it more effectively because the neighborhoods have their own identity and support system to do effective contact tracing and isolation. In other words, we can control potential breakouts much easier, one community at a time. In addition, building healthy communities improves immunity! Social engagement is associated with a stronger immune system, especially for older adults. This means that you are better able to fight off colds, the flu, and even some types of cancer. So it is time to pull out all the stops and start thinking more creatively about how we can reimagine a country that is focused on optimal health and not optimal wealth. Here are some of my thoughts. Healthcare What was Hospital and clinic appointments required for everyone. What could be Keep patients out of the hospital unless for emergencies and procedures and deliver quality care close to home. Design each neighborhood to foster a sense of community and trust by providing the following services: Create small neighborhood clinics staffed by a Nurse Practitioner, Pharmacy tech, and a Wellness professional in a neighborhood building that already exists so it only requires outfitting and not building a new facility. I remember when we had a small clinic like this example staffed by a very popular General Practitioner in one of our neighborhoods that had a street of small businesses convenient to the residents but of course, it was shut down and everyone had to go to the “big house” to be seen. A mobile van assigned to different areas each day to do basic screenings and exams, including a Food Shelf to provide healthy food to those in need and provide a small book lending library. A visiting nurse/health corps making home visits annually for all children 1-5 (similar to how England manages the health of children) and also checks on the health of other family members. This could be a jobs program for student nurses, nursing assistants, health corps workers like the Peace Corps, wellness specialists. Provide WIFI in every home to make Telemedicine available to each home from both the neighborhood clinic and the main campus Education What was School Classrooms that were overcrowded and teachers had trouble meeting the needs of all students, which often led to discipline problems and kids dropping out What could be In the past, there were more small towns serving farming communities with one-room schools and very few students. Perhaps we could create small schools in each neighborhood just like Daycare Centers serve small groups of younger children. Improves the mental and physical health of students Everyone knows each other, can walk to school together and get exercise No need for crowded school buses. Builds a support system for each other; it takes a village to raise healthy children and this would create that village. Class sizes would be smaller so teachers can provide more attention to students to improve learning and prevent dropping out Windows that open and let in fresh air Consider teaching students outdoors full-time based on successful models already in place Socialization What was Large facilities for crowded group gatherings What could be Small community facilities in each neighborhood within walking distance. Repurpose a parking lot or field into an open-air multipurpose facility with a roof and sides that open for fresh air to accommodate community activities for all different age groups. Create more open-air green spaces called “pocket parks” for socializing and group activities. If we can find space for dog-parks, we can create small people parks too! Close some streets and let businesses expand into the open air. Times Square in New York City has done this successfully. Encourage small shops and restaurants to open in neighborhoods with staggering hours to meet the needs of different demographics and sliding glass doors leading to outdoor seating to allow fresh air to circulate. Like Japanese homes. Repurpose closed big box stores or shopping malls to be open-air farmers markets which in turn support local farmers. Did you notice that some of my ideas have already been created and used, but many have been sidelined in our quest to consolidate and grow bigger? Maybe we need to dust them off and bring them out of storage! I hope you enjoyed my trip down memory lane. Just because I am suggesting a return to the past or “Back to the Future” doesn’t mean we have to do it their way. With all of our technological advancements, we can take the benefits of this down-sized way of life and make it even better and more relevant while retaining all of their benefits. Stay tuned. The best is yet to come. “It’s a Small World After All”. Resources The Health Benefits of Socializing Schools Beat Earlier Plagues With Outdoor Classes. We Should, Too In Sweden, Teaching Outside Is In 10 Iconic Streets and Spots in NYC Open For Outdoor Dining
  13. Chizoba Nwokeleme P

    New Normal After the Pandemic

    The dreadful COVID 19 has caused people to live in fear - fear of the unknown, as everyone wishes to know what the future holds. A pandemic with diverse meaning to each individual. While most people believe geriatrics are more exposed and at higher risk, others think the number of people on the announcements are forged and therefore a hoax. Amongst these fears and doubts, when will the world be free as before? It's obvious everyone is anticipating the arrival of that wonderful and amazing moment, but certainly this pandemic will not be eradicated without leaving an impact. I recall when a patient coughed on my face; I was agitated but was comforted by the fact that I was wearing my face mask. Indeed, the new normal would have some people like me and other health care workers including face masks to be part of their uniform as they seem to recognize its importance lately. It was unfortunate that the first death case of coronavirus recorded in my country was admitted in my ward and during my shift. I have always heard that there would be a time in the life of a Nurse when one would question his or her career choice. To be frank, it was at my quarantine center I asked myself if I happen to escape contracting this virus, would I still be in this profession for a lifetime? I kept watching and listening to global news covering the deaths and the helpless situation, and, of course, I continued to be demoralized and depressed. A lot of questions I did not have answers to went through my mind. To cut a long story short, I was actually physically asymptomatic but psychologically symptomatic throughout my stay there. Fortunately, my result turned out negative eventually. It was needless for me to imagine the impact of this experience as regards going back to work because I completely changed to 'my new self' as I became overly cautious and a PPE-wearing maniac. Furthermore, before the pandemic, some technologies aimed to make it easier and facilitate communication have all this while being over sighted and ignored by most people. However, individuals seem to have discovered the effectiveness of these digital aids like video conferencing, where students can easily learn online. Work colleagues can have a productive meeting since the establishment of lockdown and movement restrictions. In the future, people would tend to adapt to the convenience of this new discovery and may continue for an extended period of time When the situation stabilizes, there would be more of freelancers because people have now seen and believed that one can actually work from home with less stress to worry about People are likely to keep up with the habit of hand washing, proper etiquette and precautions as a result of realizing the need of preventive and safety measures. Indeed, a better world is imminent as individuals collaborate to end Coronavirus.