DiversityNursing Blog

The COVID-19 pandemic has brought forward many new innovations and ways of delivering healthcare. New technology will give healthcare workers new opportunities to keep their patients and themselves safe.

According to Accenture, the use of artificial intelligence within the healthcare industry is expected to grow rapidly at an annual rate of 40% through 2021 – to $6.6 Billion, from approximately $600 Million in 2014.

Keeping hospitals more sanitary is a top priority. Hospitals have started to use LightStrike robots from Xenex Disinfection Services to decontaminate rooms. Each robot can sanitize a space in as little as 10 to 15 minutes without human contact by deploying wavelengths of germ-killing UV rays.

Another tool that is great for sanitizing is RFID technology. RFID tools use wireless communication to identify and keep tabs on items such as scrubs and people like newborn babies. But now these tools can be used to ensure frequent and thorough hand-washing.

According to a HealthTech magazine article, by installing an RFID reader at a hand-washing station that can read badges or tags on healthcare workers’ uniforms, leadership teams can use that information to track when and how often employees are washing their hands.

We need to free up hands now more than ever. Voice assisted technology like Dragon Medical One, will help healthcare workers enter real-time data into electronic health records (EHRs) by simply talking with the patient.

According to Becker's Healthcare, Saykara also launched a new voice assistant that operates both ambiently and autonomously, so it can listen to and understand the context of a patient-physician conversation without being prompted by voice commands.

Healthcare workers need ways of collecting vital signs and other data points from remote locations since more people are relying on telemedicine.  Remote patient monitoring (RPM) tools such as internet-connected blood pressure cuffs, scales, IoT glucose meters, IoT thermometers, the Blood Oxygen sensor in the Apple Watch Series 6, and sleep monitoring devices can provide patient data remotely.

Mobile health is continuing to advance.  According to an article from arkenea, Apple has launched its open source software frameworks like Carekit and Researchkit which are great platforms for app developers to build healthcare based medical apps and contribute to medical research.

Healthcare technology is always evolving and advancing and will continue to revolutionize the way care is provided.

Nurses are a critical part of healthcare and make up the largest section of the health profession. According to The American Nurses Association (ANA), more Registered Nurse jobs will be available through 2022 than any other profession in the United States.

As predicted by health officials, the United States is seeing surges of Coronavirus cases from the holiday season. As health systems and hospitals deal with the surges, they are worried about finding enough medical workers to meet the demand.

“What we see now is just the beginning of the post-Thanksgiving peak,” said Eric Toner, senior scholar with the Johns Hopkins Center for Health Security. “It’s going to be huge, and it’s going to be awful.”

The problem is especially dire in intensive care units which are overcrowded with a record number of critically ill patients.

An article from the New Yorker stated, at least half of all states are now facing staff shortages, and more than a third of hospitals in states such as Arkansas, Missouri, New Mexico, and Wisconsin are simply running out of staff. Usually, an ICU Nurse might care for two critically ill patients at a time. Now, some are caring for as many as eight patients at once.

In some situations, patients have been transported hundreds of miles for an open bed. Some patients have been moved from Texas to Arizona as well as central Missouri to Iowa.

According to ABC News, hospitals in some states are enlisting retired Nurses and Nursing students. In Alabama, more than 120 students and faculty members from the University of Alabama at Birmingham’s Nursing school began helping with care last week at UAB Hospital.

In some states, health officers have amended orders that allow health care workers who tested positive for COVID-19, but are asymptomatic to continue working.

To free up healthcare workers, hospitals are asking medical and Nursing students, firefighters, and EMTs to administer Coronavirus vaccines.

According to Reuters, nearly 10 million doses have been delivered across the country, but only about 1 million administered due to staffing shortages at hospitals and the special requirements for preparing the shots.

Nancy Foster, the American Hospital Association’s vice president of quality and patient safety, said she’s heard from two dozen hospital leaders over the past two weeks, warning her of staffing shortages.

Travel Nurses are usually a good option to help fill open positions, but the pool of available travel Nurses is drying up as demand for them jumped 44% over the last month.

Dr. Mark Ghaly, California’s Health and Human Services secretary, said the state is “lucky to get two-thirds” of its requests for travel Nurses fulfilled right now.

The main hope here is for cases to decrease by people following COVID-19 guidelines such as quarantining and wearing masks.

Rebecca Moses, the fashion designer and artist painted 46 portraits of Mount Sinai's Nurses and named the exhibition “Thank You, Mount Sinai Nurses.”.

The large-scale portraits can be seen at Mount Sinai’s Guggenheim Pavilion on upper Fifth Avenue in Manhattan.

2020 is designated the Year of the Nurse and Midwife by the World Health Organization in honor of the 200th anniversary of the birth of Florence Nightingale.

“To have all of our Nurses traumatized in the Year of The Nurse and not do anything about it, it was literally keeping me up at night,” Linda Valentino, the Vice President and Chief Nursing officer at Mount Sinai Health System said.

Rebecca Moses, mostly known for her fantastical and fashionable drawings teamed up with Ms. Valentino and Linda Levy, the President of the Fragrance Foundation and came up with the idea for the art project.

The designer would paint the Nurses' portraits and donate the original artworks to the hospital to be featured in an exhibition. Each Nurse would also receive a print. Linda Levy would donate 5,000 fragrance and beauty products, all filed under self-care, to those whose job is to care for others.

 

 

After labor and delivery Nurse, Vanessa Joseph saw her portrait she said she was “blown away that someone paid attention to me and wanted to paint me. I’m just a Nurse.”

Joseph said, “Sometimes you feel like you’re in the trenches. We put on the full P.P.E. and no one can even recognize you anymore. I’m just trying to guess what Rebecca saw, and it’s so much life and vibrancy. It gives people hope that we’re going to get back to that again.”

Only women were chosen for this project, it's nothing personal against men. Moses simply stated “I don’t draw men. It’s not my strength. I love men, but I don’t draw them well.”

This is a thoughtful and remarkable collaboration to honor the Nurses at Mount Sinai. Nurses all over the world are going through an extremely challenging time. We applaud all efforts in recognizing the invaluable service, professionalism, and kindness all Nurses give every day. Thank you!

LGBTQ+ health is a growing national concern due to increasing evidence of health care disparities experienced by the LGBTQ+ community.

LGBTQ+ people face many barriers within health care, including discrimination, ignorance, and fear. So it can be difficult for these patients to confide in and trust healthcare providers. However, there are things that can be done to make patients feel more comfortable.

According to a Johns Hopkins Nursing article by Alex Nava, small but powerful expressions of affirmation and acceptance of support like wearing a rainbow pin, tells the patient that you see them and they are welcome there.

Increasing your knowledge of LGBTQ+ health can help you provide more culturally sensitive care. There is plenty of educational content out there like the field guide published by the Joint Commission called, Advancing Effective Communication, Cultural Competency and Patient and Family-Centered Care for the LGBTQ+ Community. Healthy People 2020 is another great resource to check out.

You should be aware of using terms correctly and avoiding others that may offend someone. DiversityNursing.com offers a great glossary of terms to help you!

According to Nurse.org, a LGBTQ+ patient may “scan” an environment to determine if it is a safe place to reveal personal information. To make patients feel more at ease, they recommend your reception or waiting room area include:

• A visible nondiscrimination policy
• A rainbow flag, pink triangle, or other symbols of inclusiveness
• Availability of unisex restrooms
• Health education literature with diverse images and inclusive language, including information about LGBTQ+ health
• Posters announcing days of observance such as World AIDS Day, Pride, and National Transgender Day of Remembrance

Your health organization should also use gender-inclusive medical forms.

You should ask the patient what pronouns they use. It is also important that you correct other staff members who may address the patient incorrectly, even when the patient isn't around.

Ask open-ended questions such as “Tell me about yourself? Are you involved in a relationship?” But don't assume anything, let the information they share guide the rest of your interview.

According to the Hospital for Special Surgery (HSS), you should be aware of issues particular to, or different for, the LGBTQ+ population such as:

• Coming out
• Having children—reproduction or adoption
• Parenting and creating families
• Adolescence
• Aging
• Legal rights as parents and partners

Patients often feel better talking to someone they can relate to. Hiring members of the LGBTQ+ community as part of your staff is great for patients and the organization. These team members can become mentors for others.

We as Nurses can help LGBTQ+ patients feel safe and supported by implementing these suggestions.

The 2020 Nurse Salary Research Report,  by Nurse.com and Relias, surveyed more than 7,400 Nursing professionals nationwide.

Relias Vice President of Marketplaces, Darius Matthews, said "We hope Nurses will use these survey results to examine their individual career paths and how they can make an even bigger impact — from caring for their patients to connecting with their families at home to expanding their educations and career horizons. For employers, this data is a valuable look into how they can create and support a more equitable environment for Nursing staff."

According to the report, men continue to make more than women despite male RNs reporting less education and being less likely to be certified. The median salary for all RNs in the sample is $73,000, with $80,000 for male RNs and $72,703 for female RNs.

The report also examined demographic data and found for Registered Nurses, 78% are white, 6% Hispanic, 9% Black, 5% Asian, 1% American Indian/Alaskan Native, 1% Native Hawaiian/Pacific Islander, and 1% Other.

Data shows the highest-earning RN roles and median salaries are:

• Executive- $150,000
• Vice President- $150,000
• Director- $105,000
• Nurse Manager- $92,000
• Assistant Nurse Manager- $90,000
• Supervisor- $79,000

Case Manager- $78,000

More than 38% of all Nurses surveyed are considering additional training and education. Cost, flexibility, and online options were the 3 most important factors when choosing a Nursing program.

Nurses with a Master's degree have an opportunity to earn more money in their careers. According to the US Bureau of Labor Statistics, the median pay for Masters educated Nurses is $115,800/year or $55.80/hour. 

Research shows, the salary of Registered Nurses has grown, on average, by 1.51%/year since 2010.

When discussing Nursing salaries, it is important to consider the state and city. Some locations pay more due to the cost of living in that area.

According to Becker’s Hospital Review, the top 5 states paying Registered Nurses the most are California, Hawaii, Massachusetts, Alaska and Oregon.

More Universities and Colleges have considered hiring Chief Health Officers (CHO) as the COVID-19 pandemic rages on. Some responsibilities of the CHO would be to lead campus health and safety measures, create connections with state and local hospitals, and be the voice of information to students, employees and parents.

Dr. Preeti Malani has been CHO at the University of Michigan since 2017 and is a great role model for someone who is considering taking on this position.

Dr. Malani has been highly visible throughout this outbreak, sharing safety tips on social media, appearing in a number of interviews, and participating on coronavirus task forces.

When a school feels strongly about a certain topic, they create an executive role around it, like a Chief Diversity Officer for example. Now, health is an imperative issue that should be properly addressed.

“The mere appointment of a CHO would send a strong message about the school’s commitment not only to the well being of its students, faculty, and staff but also to the health of the public at large,” said Malani.

After the pandemic passes, Malani hopes her visibility at the University of Michigan will help her make progress on other college health issues like vaccines, health-care equity and student mental health.

Dr. Benoit Dubé is the Chief Wellness Officer (CWO) at The University of Pennsylvania. He’s part of a Recovery Planning group tasked with examining the elements needed to be in place to allow a safe return to more normal campus operations.

Dr. Dubé explains the best approach for reducing COVID-19 transmission is to follow a hybrid in-person and online semester model. The University is also mandating the flu vaccine this fall.

Ohio State University’s CWO, Bernadette Melnyk developed several anxiety-reducing strategies to use to help manage and prevent the spread of this infectious disease. She created a webinar video Key Strategies for Relieving Anxiety During the COVID-19 Pandemic.

Melnyk also created the acronym COPE COVID:

Control the things that you can, not the things you can't
Open up and share your feelings
Practice daily stress reduction tactics, including physical activity
Engage in mindfulness; be here now; worry will not help!

Count your blessings daily
Overturn negative thoughts to positive
Volunteer to help others
Identify helpful supports and resources
Do your part to prevent spread of the virus

Schools that don't have the resources to bring on a CHO can try other options, like working with local and state health agencies, hiring a health consultant, and partnering with close institutions or academic medical centers.

The Clinical Nurse Leader (CNL) role was created by the American Association of Colleges in Nursing (AACN) in 2003.

According to a journal from the US National Library of Medicine National Institutes of Health, The CNL understands microsystem issues and their relationship to larger organizational issues. This perspective provides a two-way flow of information to and from health system leaders as they direct an institutional response to the pandemic around issues such as assessing patterns of spread, patient acuity, appropriate staffing levels, and personal protective equipment utilization.

A successful CNL must be confident in their communication abilities. They're expected to provide the coaching and direction staff needs to adapt to frequent changes. Whether it be transforming hospital departments into COVID-19 units or creating sanitation and PPE protocols for staff.

Communication is also key in keeping staff informed and calm throughout the pandemic by addressing any questions or concerns they have. Nurses want to feel that management has their backs, and CNLs are the ones they will look to in times of need.

Leaders should be responsible for supporting the well-being and mental health of the healthcare team. CNLs should advocate for adequate programs and resources for Nurses to cope and deal with stress.

Not only should Nurse leaders advocate for their fellow Nurses, they should also be the voice for their patients.  According to NursingCenter, the CNL acts as a patient advocate by incorporating patients' unique values, desires, needs, and perspectives into patient care delivery.

Another way Nurse leaders advocate for patients during COVID-19 is providing a way for patients to communicate with their families. Because of the pandemic, visitation is prohibited. Leaders work with management to provide devices for patients to see and talk with loved ones.

Lastly, a successful Nurse leader must be resilient. Personal resilience is key and leaders can find it by…

• Letting go of what they can't control
• Leading with their head as well as their heart
• Showing strength through vulnerability

The CNL is a valuable member of the Nursing profession and team. They do their best to maintain safety while providing the best patient care possible during this extremely stressful pandemic.

Aside from skin cancer, breast cancer is the most common form of cancer affecting women in the U.S. The chance for a female to be diagnosed with breast cancer during her lifetime has increased from 1 in 11 women in 1975 to 1 in 8 women.

Increased emphasis on early detection and more effective treatments have decreased mortality rates in the white population. Although the mortality rates have declined in some ethnic populations, the overall cancer incidence among African American and Hispanic populations have continued to grow.

Research has shown that Black women are more likely to die from breast cancer than any other ethnic group. Black women:

• are more likely to be diagnosed with triple-negative breast cancer, which means the cancer has no receptors for the hormones estrogen and progesterone, as well as no receptors for the HER2 protein; this limits the medicines that can be used to treat the cancer
• are more likely to be diagnosed with later-stage disease than other women
• have the lowest survival rates in each stage of diagnosis

There are many factors that play a role in the disparities. Black women are more likely to have diabetes, heart disease, and obesity, and are less likely to breastfeed after childbirth, which are all risk factors for breast cancer. They are also more likely than white women to have inadequate health insurance or access to health care facilities, which may affect access to screening, follow-up care, and completion of therapy.

In order to close the breast cancer mortality gap, prevention programs must increase and policies need to improve.

Increasing screening rates, providing timely access to diagnostic testing, and improving access to comprehensive, quality healthcare coverage and cancer treatment care are all imperative.

That also includes increasing outreach to Black women so they're aware about their breast cancer risks and can seek preventive care.

Molecular geneticist and Associate Professor of cell and developmental biology research in surgery, Dr. Melissa Davis points out that part of the problem in addressing these disparities and, in turn, finding more effective medications to improve outcomes, is that minorities haven’t traditionally been included in adequate numbers in research studies or clinical trials. “A lot of breast cancer investigations that have resulted in advances in treatment have overwhelmingly involved white women,” she says. “So the treatments work better in those populations than in others. We’re trying to change that.”

The Center for Disease Control and Prevention’s (CDC) National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides uninsured and underinsured women access to no-cost screening, diagnostic, navigation, and education/outreach services, as well as a pathway to cancer treatment care.

All women regardless of age, ethnicity, economic status, or other health conditions deserve the best breast cancer care and the best prognosis possible.

Frontline healthcare workers face stressors during normal times, but especially now during a pandemic and hospitals are finding new ways to help their staff cope. 

Recently, University Hospitals in Ohio announced they would be trying out a 10-month pilot program that provides sleep pods for their teams. Doctors, Nurses and staff in the UH Cleveland Medical Center Emergency Department will have access to two HOHM units as a space to safely recharge.

Each 43.5 square-foot pod is designed to block out sound and features a twin-sized bed, a privacy and sound-blocking curtain, charging stations, and a tablet to control reservations. 

“Our UH Cleveland Medical Center Emergency Department frontline caregivers have been working tirelessly for months to combat the COVID-19 pandemic,” said Robyn Strosaker, MD,, University Hospitals Cleveland Medical Center Chief Operating Officer. “In the midst of all this trauma and stress, we’ve continuously looked for new ways to support our team, and HOHM sleep pods are a way we can help address their wellbeing.”

Some hospitals are making design changes to their break rooms as a way to try and help healthcare workers manage their stress throughout the day. 

Nurses may be reluctant to take breaks especially during times of crisis. But taking breaks during your shift can help prevent burnout. So when a Nurse does decide to take a break, there should be a space where they can fully decompress and have time to gather their thoughts and recharge. 

Research has found strong evidence between exposure to natural environments and recovery from physiological stress and mental fatigue. Break rooms are becoming a green space with plants and images on the walls of natural landscapes. Create a sitting space with cushioned chairs or ottomans by windows that have a nice view outside. Offer the option of listening to calming music or nature sounds inside the break room. 

Hospitals are also offering time for their staff to spend with support animals. 

Nonprofit organization Canine Companions for Independence provided Jordy, a lab/golden retriever cross to help frontline workers at Santa Rosa Memorial Hospital. 

“The science confirms what we already know, pets provide comfort and support during hard times,” said Jessica Lacanlale, MSN, Trauma Program Manager at Santa Rosa Memorial Hospital. “The stress of caring for patients and working long hours is intense; but spending a little time with Jordy lifts my spirits and helps me get through the long days.”

Health Systems like Yale New Haven Health are offering confidential well-being check-in programs. This offers employees an opportunity to meet with an expert social worker or clinician one-on-one to discuss their needs and access resources to manage stress and improve well-being.

“People often downplay their own needs, saying ‘I’m OK’ when asked how they are doing,” said Javi Alvarado, YNHHS’ director of social work and co-chair of the WELD Council. “These visits create an opportunity to be better than ‘OK’ and truly grow from recent challenges.” 

During this pandemic, it is critical hospitals and health systems recognize what stress looks like and takes steps to help their staff cope with it. Equally as important is that healthcare workers know where they can go for help. This means internal communications to staff is key to express your awareness of the stress and the assistance being offered.

An estimated 4%, or about 150,000, Nurses in the U.S. are Filipino, but comprise nearly a third of Registered Nurse deaths due to COVID-19.

Business Insider reported, Nurses of Filipino descent account for 31.5% of the workforce's COVID-19 deaths.

In California, where about 20% of Nurses identify as Filipino, they account for nearly 70% of COVID-19 deaths in the profession, according to the Mercury News. Statewide, Asian Americans make up about 5% of coronavirus cases and 11.7% of deaths, compared to their 15% of the population.

Zenei Cortez, an RN who works at Kaiser Permanente’s South San Francisco Medical Center and, as co-president of the California Nurses Association/National Nurses United worries that her fellow Filipino Nurses are less likely than other Nurses to demand workplace protections.

“Culturally, we don’t complain. We do not question authority,” Cortez said. Many Filipino Nurses feel a strong sense of group loyalty, or the importance of putting the welfare of the group over that of the individual; in Tagalog, the word is pakikisama. “We are so passionate about our profession and what we do, sometimes to the point of forgetting about our own welfare,” she said. “We treat our patients like they are our own family.”

It’s the lack of proper PPE that has pushed some Filipino Nurses to speak out, when in the past they stayed silent about their working conditions.

“What I am seeing now is that my colleagues who are of Filipino descent are starting to speak out,” Zenei said. “We love our jobs, but we love our families too.”

Catherine Ceniza Choy, a professor of ethnic studies at UC Berkeley whose work has focused on the history of Filipino American Nurses said, Filipino American Nurses are more likely to work in higher risk roles such as the intensive-care unit, emergency medicine or telemetry, putting them directly in the path of COVID-19.

“Filipino Nurses, here specifically in the U.S., are concentrated specifically in in-patient critical care services,” Choy said. “Many of them are also caregivers at home, not only of children, but also their parents and other elders. And so part of the problem with the pandemic is these multiple layers of vulnerability and exposure.”

Jollene Levid and other volunteers have been keeping track of Filipino health care workers who've died from the disease worldwide. Their website, Kanlungan.net, which means shelter or refuge, is an online memorial with pictures and stories of those who've been lost.

The website reads "KANLUNGAN is intended to be a memorial to the transnational people of Philippine ancestry who make up a huge sector of the global healthcare system. This is to remember them as human beings, not simply as a labor percentage, a disease statistic, or an immigration number. And since the Internet is forever, we hope that KANLUNGAN will keep reminding the world of the skills, dedication, and the self-sacrifice demanded of health care workers so humanity may be healed."