RECOGNIZING NURSES ON THE FRONTLINES OF COVID-19 NURSES WEEK SPECIAL ISSUE
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Table of Contents
In This Issue 3
Editor’s Notebook By Megan Larkin
Features 4
COVID-19 From the Bedside By Sheila Pierre-Louis, BSN, RN, CCRN-CMC, SCRN
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Health Care in the Time of the Coronavirus By Spencer Miller, RN
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Enabling Nursing Students to Assist With COVID-19 Response By Louis Pilla
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VA Asking Retired Federal Health Care Providers to Come Back to Work By U.S. Department of Veterans Affairs
Healthcare workers, we are still here because of you. Thank you.
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Nurses Week Special Issue | May 2020
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Editor’s Notebook Remember to #ThankaNurse
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urses everywhere—from nursing students to retirees—are answering the call to step up and help our nation get through the current COVID-19 pandemic. The next time you complain about how inconvenient it is because you are on “stay at home” orders for an indeterminate amount of time, I ask you to reflect on all the blood, sweat, and tears that every nurse, doctor, and other essential worker are shedding right now as they work inhuman hours, comfort our loved ones, and face some very hard choices. For this year’s National Nurses Week, we chose to honor our nurses working the front lines and, quite frankly, risking their lives to help our parents, siblings, children, and relatives get through this crisis. As you read through this special issue, please take a moment to thank a nurse in your own life, whether it’s through donating to SONSIEL’s GoFundMe campaign for masks and PPE supplies, singing their praises on social media via #ThankaNurse, or simply joining the nation’s “We Clap Because We Care” movement and clap for health care workers outside your window nightly at 7 p.m.
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As Louis Pilla says, overcoming COVID-19 will take an “all hands on deck” approach to bounce back, but if we stand together, we can—and will—survive this and be a stronger nation for it.
National Sales Manager Andrew Bennie 212-845-9933 abennie@springerpub.com
And when this crisis is in the rearview mirror, let’s not forget that nurses have always been our strongest advocates for patient health and help them achieve the safe nursepatient ratios they’ve been asking for all along. —Megan Larkin
For editorial inquiries and submissions: editor@minoritynurse.com For subscription inquiries and address changes: © Copyright 2020 Springer Publishing Company, LLC. All rights reserved. Reproduction, distribution, or translation without express written permission is strictly prohibited.
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COVID-19 FROM THE BEDSIDE
ARE WE “JUST NURSES” NOW BY SHEILA PIERRE-LOUIS, BSN, RN, CCRN-CMC, SCRN
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Nurses Week Special Issue | May 2020
Just nurses… > that pray in the car before, during, and after every shift because their risk exposure is high.
> that have had to send their little one to stay with a relative for an unknown amount of time to keep them safe.
> that have to watch their toddler cry over videocall because they want their “mommy/daddy” home.
> that may still be struggling to find childcare because they still have to work.
> that have to worry about cross-contamination as they doff, clean, and reuse their PPE.
> that were unintentionally exposed to COVID-19
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because the patient did not present with “textbook symptoms.”
> that have anxiety about exposing their household. > that are told they will not get tested unless they exhibit symptoms.
> that finally got tested after they showed symptoms and are anxiously waiting for results.
> that tested positive and now stress about how bills
will get paid because they have exhausted their PTO.
> that are selflessly working overtime to meet the critical demands.
> that are faced with the sudden hazards of their everyday job without hazard pay.
> that get death stares if they are out in clean scrubs. > that have returned to the bedside to answer their calling.
> that have taken on a job at the bedside because their department isn’t seeing patients.
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> that have to change their mindset from using all resources to save everyone, to using resources on those who “have a chance.”
> that go above and beyond to keep patients company during visitor restrictions.
> that still treat their patients like PEOPLE and not like “cases”.
> that through this all, still have a smile on our faces as
we make a difference in the lives of your loved ones, despite the uncertainty of what lies ahead.
Y
ou see, although this isn’t an all-inclusive list of what bedside nurses are experiencing around the nation, it is just a fragment of how our career has tragically changed our lives in a matter of a few months. What once was a local outbreak in December rapidly became a global pandemic that would change the nursing profession forever.
As confirmed cases continue to rapidly increase in the United States, the public is engulfed by stress and anxiety, and so are nurses. Many nurses have experienced stress and exhaustion before, but the physical, mental, and emotional fatigue that has been brought on by this pandemic is distinctively different. The COVID-19 pandemic has severely impacted the entire world in many different ways and many health care professionals have taken to their social media platforms to share their stories. You may have seen nurses sharing their “battle marks” (or bruises and scars from their respirators), to stories of limited PPE, unethical practices, exposure stories, or sadly, the death of a
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NIH Funding
colleague. From reading these numerous stories and experiencing it firsthand, I have one thing to say... THANK YOU NURSES for selflessly risking your lives to save someone else’s. Although we will still be at war with COVID-19 during National Nurses Week, know that our hard work will never go unnoticed and we will never hear that we are “just nurses” again. HAPPY NURSES WEEK, superheroes! Stay safe and healthy! Lastly, much gratitude to the outpour of love and support shown by everyone during this tragic time, because even the smallest gesture can make a difference!
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DNP in leadership 2019-2020
The Veterans Health Administration (VHA) is directly contacting retired VA and Federal clinicians to join them in the ongoing effort to combat the coronavirus pandemic.
VA
VA Asking Retired Federal Health Care Providers to Come Back to Work BY THE U.S. DEPARTMENT OF VETERANS AFFAIRS
needs experienced patient-care providers during the crisis to help those already providing the best care to our Veterans at VA medical centers, outpatient clinics, and community living centers. The department is reaching out to retired VA and Federal health care providers through social media, massive postcard mailings, email, and word of mouth. VA staff are currently working the phones to ask if former colleagues are interested in coming back for a 120-day assignment, renewable up to one year. “The nation’s health care system is dealing with an unprecedented crisis,” says Richard Stone, MD, Executive In Charge, VHA. “Beyond VHA’s primary mission of providing care for our Veterans, we have a fourth mission, which is to be the safety net for our nation’s
“Beyond VHA’s primary mission of providing care for our Veterans, we have a fourth mission, which is to be the safety net for our nation’s health care system. We need everyone to join us in this fight, and recently retired health care professionals can come in and make an immediate impact.” health care system. We need everyone to join us in this fight, and recently retired health care professionals can come in and make an immediate impact.”
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Stepping Up After retiring in 2014, former VHA Chief Nursing Officer and Senior Nurse Executive Catherine Rick has answered the call and is awaiting her assignment from VA. “I could work virtually from home or I could travel. I’m healthy and I’m tech-savvy,” says Rick, who lives in the Phoenix area. Rick said her high regard for VA staff and her experience in hurricane emergency response made her want to step up during the current health crisis. “In my 22 years of experience with VA, I can say I have the highest regard for everything VA does—and can do. There is an extremely talented staff across the VA system, and the work the emergency relief staff does made me think about what they’re going through. I knew their wheels must be spinning in overtime.” VA is especially looking for nurses and other health care providers, including physicians, pharmacists, laboratory technicians, and respiratory therapists, with interest and expertise in: • Direct patient care/support (at a VA medical center and/ or outpatient clinic) • Tele/virtual care • Travel Nurse Corps On March 19, 2020, the U.S. Office of Personnel Management (OPM), approved a VA request to waive a section of Federal law to make it easier for the department to rehire retired VA health care providers. As re-employed annuitants, employees will receive their Civil Service Retirement System (CSRS) or Federal Employee
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Retirement System (FERS) annuities, as well as a paycheck as a Federal employee, without any offset to their retirement income. OPM instituted the waiver through March 31, 2021. Expanding VA’s workforce helps the department better fulfill its mission of caring for our nation’s heroes and supporting the Federal government in our public health mission during a pandemic.
Call to Action VA needs you! If you would like to join your fellow health care providers in caring for our Veterans and support the national effort to combat the coronavirus, please do the following: • Register online if you are a retired nurse or health care provider interested in joining VA as a re-employed annuitant. Or email your availability and resume to vacareers@ va.gov. • Visit vacareers.va.gov if you are a registered nurse, nurse practitioner, physician’s assistant, or certified registered nurse anesthetist interested in joining the Travel Nurse Corps, providing telehealth, or being assigned to a VA Medical Center. • Call retired nurses and other health care providers and share information about VA’s recruitment needs and efforts, including the: • Social media posts at our Facebook, Twitter, Instagram and LinkedIn pages. • VAntage Point blog. • VA Careers home page. • VA news release recruiting retired annuitants. You can also learn more about VA’s response to the coronavirus by visiting VA’s public health site.
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Nurses Week Special Issue | May 2020
Answering the Call Stories of Courage and Dedication
FNU celebrates all nurses and healthcare workers and their amazing dedication and perseverance in the battle against COVID-19. Many FNU nurse-midwife and nurse practitioner graduates and students are serving on the frontlines. Their courage and expertise is vital to the care and treatment of patients across the country. We are grateful for the invaluable work nurses are doing every day and incredibly proud of our graduates and students.
Read their stories at Frontier.edu/courage.
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Enabling Nursing Students
to Assist With COVID-19 Response By Louis PILLA 8
Nurses Week Special Issue | May 2020
Dealing with a pandemic the likes of COVID-19 requires an “all hands on deck” approach. That includes those who are approaching or just at the threshold of their careers—nursing students.
R
ecently, ten prestigious nursing organizations endorsed a policy brief supporting practice/academic partnerships to assist the nursing workforce during the COVID-19 pandemic. That includes the National League for Nursing (NLN), National Council of State Boards of Nursing (NCSBN), and the National Student Nurses’ Association, to name a few. The brief encourages health care facilities and nursing education programs to partner during the COVID-19 crisis. It also indicates that prelicensure RN
The brief encourages health care facilities and nursing education programs to partner during the COVID-19 crisis. students from diploma, associate degree, and baccalaureate degree nursing programs and PN/VN students from certificate nursing programs could augment and support nursing services in health care facilities. And it proposes that nursing students would be employed by the facility on a full- or parttime basis and would work in the role of a student nurse for compensation and, in conjunction with the student’s nursing education program, would receive academic credit toward meeting clinical requirements. The document was designed to address the need for students to gain clinical experience and the hospitals to get additional help during the COVID-19
crisis, says Maryann Alexander, PhD, RN, FAAN, Chief Officer, Nursing Regulation, NCSBN, who led the writing of the policy brief. “This model suggests that students are really prepared and able to do much more and can function in a supporting role to the nursing staff during the COVID crisis,” she says. “It’s an opportunity for students and it’s an opportunity for hospitals to have staff that you can trust and will have guidance from faculty.” Along the same lines, a document from the American Association of Colleges of Nursing (AACN) offers considerations for COVID-19 preparation and response in nursing schools. “For now, other than limiting direct care of COVID-19 patients, students in clinical settings may continue their roles as part of the care team,” it states. What’s more, it notes that “pandemic contingency staffing plans may include the potential use of nursing students should the outbreak accelerate to the point that our current national nursing workforce is unable to meet the demand for health care services.” A March 2020 report in Health Affairs notes that in Georgia, nursing students who have completed coursework but not taken licensing exams are eligible for temporary RN licenses during the pandemic. Similarly, the Governor of Indiana issued an emergency executive order allowing
recent nursing school graduates to apply for and receive a 90-day temporary license without having to take the NCLEX, according to Mary Carney, DNP, RN-BC, CNE, CCRN, State Director of Nursing for Western Governors University (WGU) Indiana. That license, she notes, can renew in 30-day increments for the duration of the declared emergency.
at drive-through and facilitybased COVID-19 screenings. With WGU’s preceptorship model, “I have every confidence in my graduates going out there,” Carney says.
A telling tale comes from Carney’s experience with the local VA hospital, which is one of the clinical sites used by WGU. The Richard L.
Malone, PhD, RN, FAAN, CEO of NLN. “There has to be some level of framing it within the community that the students are in. And that requires collaboration by the university, the school of nursing, and the hospitals that are involved,” she says. Students also need to be involved in the process, she says. Even before the COVID19 pandemic, says Malone, many were interested in nursing. Now, “I think there’ll be even more people who want to become nurses.”
Employing the skills of nursing students in a clinical setting needs to be a joint problem-solving process, says Beverly Malone, PhD, RN, FAAN, CEO of NLN. Roudebush Indianapolis VA Medical Center asked if WGU had any senior-level nursing students who were interested in immediate hire into a student nurse role. Other WGU clinical sites have used nursing students
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Collaboration is Key Employing the skills of nursing students in a clinical setting needs to be a joint problemsolving process, says Beverly
Louis Pilla is a seasoned publishing expert with over 20 years of experience in providing content and digital products to health care audiences.
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Health Care in the Time of the Coronavirus By Spencer MILLER, RN
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Nurses Week Special Issue | May 2020
I've been offered an RN job at the California Corrections Center in Stockton. Part of the on-boarding process is a physical. I went online to schedule an appointment with my doctor, but the online system has been taken down. When I called, I was triaged to the back of the line (appropriately). How about a telephone appointment? Great! I'll take it. After sending over the many forms, the doctor called me and said the nature of the questions (a rectal exam...of all things!) means I have to come to the office. So, I waited a month to get an in-person exam.
W
hen I arrived at the medical building in San Jose, there were two tables set up manned by personnel in full PPE—gown, gloves, mask, booties, and face shield. After having my temperature taken with a wand, I was passed through. An embarrassing half hour later I had my paperwork
So, how are local nurses reacting? As you might expect there is some trepidation. However, the ones I’ve spoken to are eager to participate in the emergency response. in hand, certified free from tuberculosis, inguinal hernias, and hemorrhoids. After this I decided to call some of my nurse friends and take the temperature, as it were, of this new method of health care. Here's what I found out about what's going on in Santa Clara County. First of all, I was lucky to get an appointment at all. Santa Clara Valley Medical Center is closing most of its primary care centers per its mass casualty plan. The county is going on an emergency footing. Ambulatory clinics in Sunnyvale, Milpitas, Downtown, and East Valley
are all closing except for emergency dental, adult, and pediatric urgent care. The county is using the term Influenza Like Illness (ILI) to describe potential coronavirus cases. East Valley Clinic will be open for nonILI phone consults and urgent care. The Downtown Clinic will accept ILI patients at its urgent care and will have a drive-through testing center. The Gilroy Clinic will be open as usual. Clinic nurses are all going into the labor pool. They are looking for any nurse with ICU experience even if it’s years old. Nurses with ICU experience will be assigned to ICU teams with experienced nurses. Depending on where the nurse worked before the emergency, they might get assigned to something similar but no guarantees. The choices are Skilled Nursing Facilities, Homeless Centers, Emergency Room, and Tent Rapid Medical Exam Centers. Rapid Medical Exam is basically triage with a doctor or PA/NP that can right away prescribe medicine and discharge or admit the patient as appropriate. The goal is to move as quickly through the
triage patients as possible to decrease clumping. The National Guard has set up a 250-bed facility at the San Jose Convention Center for less sick patients that can’t quarantine at home. They will accept patients from local hospitals and will staff the facility themselves. So, how are local nurses reacting? As you might expect
to avoid direct patient contact. The primary role of nursing is to be an advocate for the patient, the family, the group, and the community. Everyone wants to help within their capacity. Santa Clara County is not waiting for instructions from the Federal Government. We’ve been sheltering in place since March 17th. The roads
there is some trepidation. However, the ones I've spoken to are eager to participate in the emergency response. One of my friends is a 58-yearold charge nurse at a primary care clinic that is closing. She’s already gathering her emergency go-bag with extra scrubs, snacks, water, and toiletries just in case. Most of her experience is in ER so she’s ready to get back in the mix, though she admits she hopes it doesn’t last too long. Another nurse is sad that she will have to sit it out. She has underlying lung disease and two small children at home. She will try for a phone bank job, but failing that, will have
are devoid of traffic and people keep a respectful distance from each other at the supermarket. Safeway has installed sneeze guards in front of the cashiers. In a thousand little ways, we
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In a thousand little ways, we are working to flatten the curve of this pandemic and nurses are stepping up. are working to flatten the curve of this pandemic and nurses are stepping up. We are always at the bleeding edge of medical emergencies and this is no different.
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