It’s possible that I shall make an ass of myself. But in that case one can always get out of it with a little dialectic. I have, of course, so worded my proposition as to be right either way (K.Marx, Letter to F.Engels on the Indian Mutiny)
As women march on International Working Women’s Day today, the theme for this year is the crisis of healthcare and care. They will demand universal healthcare, freedom from the ‘pandemic of patriarchy’, and a chance to live in a society that values our lives and bodies.
The writer a researcher in gender and digital rights.
ACCESS to healthcare is part of our basic right to a life of dignity. Despite its universality, healthcare and its denial are felt along lines of class, gender, sexuality, religion, race/ethnicity, (dis)ability — and often an intersection of all these. The healthcare system itself reproduces inequalities and systems of oppression that undergird society through inaccessibility and skewed priorities.
Throughout history, the centre of medical research and the reference point for medicine was men’s bodies. In clinical research, women are overwhelmingly underrepresented in trials for medicines and treatments. For instance, while women make up over half of the 35 million people living with HIV worldwide, most trials for treatments focus on men despite the fact that women respond differently to the infection as well as the drugs administered for treatment. This fundamental exclusion on the basis of sex at the starting point of healthcare, according to medical research, shows the rampant gender bias permeating the entire system. The specific needs of women are invisibilised not simply due to a lack of awareness but more as part of the dehumanisation and neglect that erases women from systems and institutions.
Despite society’s obsession with regulating women’s bodies, not enough attention is paid to the pain those bodies feel. Dianne Hoffman and Anita Tarzian point out in The Girl Who Cried Pain: A Bias against Women in the Treatment of Pain, women are more likely to be undertreated or inappropriately diagnosed for pain. Termed as the ‘gender pain gap’, women’s discomfort is being systematically undervalued by the medical profession. In countries like ours where patriarchal controls severely hamper women’s mobility, women are much less likely to visit a medical facility than men. This is underscored by the high cost of quality healthcare, with families prioritising limited resources for men’s treatment as opposed to women’s.
Women’s health is impacted deeply by their place within the patriarchal family system which translates into the lack of decision-making regarding their health. Women have little say in the question of having children and are often reduced to a child-bearing role within the family, exposing an inability to imagine their role beyond that of a mother. The maternal mortality rate, though improved from 276 deaths per 100,000 live births (Pakistan Demographic and Health Survey, 2006-7) to 186 (Pakistan Maternal Mortality Survey), is still too high. Women get insufficient nutrition because of the discrimination inside Pakistani households and are often the last to eat.
Gender bias permeates healthcare.
That is why healthcare must be imagined as a feminist issue, one that the feminist movement in Pakistan must address as it is the site where patriarchal oppression, violence and exclusions play out in the most visceral sense — denial or provision of inadequate healthcare on the basis of gender means the difference between life and death.
Gender-based violence, a central concern of the feminist movement, is also a healthcare issue as survivors of violence and abuse need access to gender-sensitive physical and mental health services. We carry the trauma of violence and patriarchy in our bodies, the manifestations of which are complex and debilitating. The pay gap of Lady Health Workers is an issue of gender discrimination as it is a direct result of the undervaluing of their work because of their gender and the gender of the communities they serve.
A feminist approach to healthcare will force us to centre the needs of marginalised bodies within the healthcare system, ranging from basic things like designing medical centres to be accessible to differently abled persons. It would also mean the government fulfilling its promise to “review medical curriculum and improve research for doctors and nursing staff to address specific health issues of transgender persons” under Section 12 of the Transgender Persons (Protection of Rights) Act, 2018. A feminist approach would ensure that these measures are not adopted as add-ons to the healthcare system, but are central to its very design.
Covid-19 has laid bare the stark structural inequalities of society and exposed the fragility of health systems worldwide. Pakistan’s health budget has been hovering around the one per cent mark, an indictment of the state’s priorities. A feminist vision of healthcare posits it as a matter of social justice and reframes it from an individual concern to a collective one. It is the responsibility of the state to provide universal healthcare, moving away from the privatisation model adopted by the incumbent government.
As women march on International Working Women’s Day today, the theme for this year is the crisis of healthcare and care. They will demand universal healthcare, freedom from the ‘pandemic of patriarchy’, and a chance to live in a society that values our lives and bodies.
The writer a researcher in gender and digital rights.
The medical product industry maintains an extensive network of financial and non-financial ties with all major healthcare parties and activities, reveals a study published by The BMJ today.
This network seems to be mostly unregulated and opaque, and the researchers call for enhanced oversight and transparency "to shieldpatient carefrom commercial influence and to preserve public trust in healthcare."
Although the medical product industry is a critical partner in advancing healthcare, particularly in developing new tests and treatments, their main objective is to ensure financial returns to shareholders.
In an influential 2009 report, the Institute of Medicine described a multifaceted healthcare ecosystem rife with industry influence.
Yet most studies of conflict of interests related to pharmaceutical, medical device, and biotechnology companies have focused on a single party (eg. healthcare professionals, hospitals, or journals) or a single activity (eg. research, education, or clinical care). The full extent of industry ties across the healthcare ecosystem is therefore still uncertain.
To address this gap, a team of US researchers set out to identify all known ties between the medical product industry and the healthcare ecosystem.
They searched the medical literature for evidence of ties between pharmaceutical, medical device, and biotechnology companies and parties (including hospitals, prescribers and professional societies) and activities (including research, health professional education and guideline development) in the healthcare ecosystem.
Data in 538 articles from 37 countries, along with expert input, was used to create a map depicting these ties. These ties were then verified, cataloged, and characterized to ascertain types of industry ties (financial, non-financial), applicable policies on conflict of interests, and publicly available data sources.
The results show an extensive network of medical product industry ties—often unregulated and non-transparent—to all major activities and parties in the healthcare ecosystem.
Key activities include research, healthcare education, guideline development, formulary selection (prescription drugs that are covered by a health plan or stocked by a healthcare facility), and clinical care.
Parties include non-profit entities (eg. foundations and advocacy groups), the healthcare profession, the market supply chain (eg. payers, purchasing and distribution agents), and government.
For example, the researchers describe how opioid manufacturers provided funding and other assets to prescribers, patients, public officials, advocacy organizations, and other healthcare parties, who, in turn, pressured regulators and public health agencies to quash or undermine opioid related guidelines and regulations.
And they warn that many other examples of harm from industry promoted products remain unexplored.
The results show that all party types have financial ties to medical product companies, with only payers and distribution agents lacking additional, non-financial ties.
They also show that policies for conflict of interests exist for some financial and a few non-financial ties, but publicly available data sources seldom describe or quantify these ties.
The researchers acknowledge that their findings are limited to known or documented industry ties, and that some data might have been missed. However, they say their strategy of systematic, duplicative searching and feedback from an international panel of experts is unlikely to have missed common or important ties.
As such, they conclude: "An extensive network of medical product industry ties to activities and parties exists in the healthcare ecosystem. Policies for conflict of interests and publicly available data are lacking, suggesting that enhanced oversight and transparency are needed to protect patients from commercial influence and to ensure public trust."
Home blood pressure monitoring saves lives, cuts costs, and reduces healthcare disparities
New research in the American Journal of Preventive Medicine confirms that regular self-testing better controls hypertension, especially among underserved patients
Ann Arbor, July 13, 2023 – Expanding home blood pressure monitoring among US adults with hypertension could substantially reduce the burden of cardiovascular disease and save healthcare costs in the long term, according to a new study in the American Journal of Preventive Medicine, published by Elsevier. The results of the study show that expanding home monitoring has the potential to address pervasive health disparities facing racial and ethnic minorities and rural residents because it would reduce cardiovascular events among US adults.
Co-lead investigator Yan Li, PhD, Professor, School of Public Health, Shanghai Jiao Tong University School of Medicine, explained, “Our study is among the first to assess the potential health and economic impact of adopting home blood pressure monitoring among American adults with hypertension. We found that it facilitates early detection, timely intervention, and prevention of complications, leading to improved control and better health outcomes.”
Analyzing data from the 2019 Behavioral Risk Factor Surveillance System (BRFSS), investigators projected that implementing home blood pressure monitoring, as opposed to traditional clinic-based care, could result in a reduction of myocardial infarction (MI) cases by 4.9% and stroke cases by 3.8% over 20 years.
Non-Hispanic Blacks, women, and rural residents had more averted cardiovascular events and greater cost savings related to adopting home blood pressure monitoring compared to non-Hispanic Whites, men, and urban residents. Adopting home blood pressure monitoring in rural areas would lead to a potential reduction of 21,278 MI cases per one million people compared to 11,012 MI cases per one million people in urban areas. Rural residents tend to have a higher prevalence of hypertension and uncontrolled hypertension than urban residents and often face additional barriers in accessing primary care services.
Estimating healthcare cost parameters based on actual healthcare payment data from the Medical Expenditure Panel Survey (MEPS), researchers projected an average of 4.4% per person annual savings and an average of $7,794 in healthcare costs per person over a span of 20 years in this population due to home blood pressure monitoring adoption and the subsequent reduced cardiovascular disease cases. Previous economic evaluations of home blood pressure monitoring have primarily focused on local health systems or conducted short-term, small-scale randomized controlled trials.
Hypertension -- systolic blood pressure (BP) greater than 130 mmHg or a diastolic BP greater than 80 mmHg or being on medication for it -- is a pressing public health challenge in the US, with significant implications for the development of heart disease and stroke and leads to substantial healthcare costs. Traditional clinic monitoring, the common method for BP measurement and hypertension diagnosis, has a number of drawbacks: Patients may not visit clinics often enough to pick up the problem, and when they do, accuracy may be compromised by the “white coat” (high office BP but normal BP on home measurements) or “masked” (normal/high normal BP in the office but elevated at home) effects.
Home blood pressure monitoring eliminates these impediments and provides more comprehensive and accurate data compared to sporadic measurements obtained during clinic visits. Yet, the highly effective practice has not been widely adopted in the US because of inadequate health insurance coverage, lack of investment in preventive services, and limited health promotion efforts provided by primary care physicians. However, the landscape has changed between 2020 and 2022 when home blood pressure monitoring attracted increasing attention due to healthcare disruptions caused by the COVID-19 pandemic.
Co-lead investigator Donglan Zhang, PhD, Associate Professor, Center for Population Health and Health Services Research, New York University Long Island School of Medicine, commented, “Given that almost half of all adults in the US (47%) are affected by high blood pressure, and considering the persistent health disparities in cardiovascular health, it is very important to advocate for the widespread adoption of effective and cost-saving strategies. Home blood pressure monitoring empowers patients to take a more active role in managing their chronic conditions. Our findings provide compelling evidence for healthcare systems and payers supporting the broader implementation of this intervention.”
ARLINGTON, Va. (July 11, 2023) — Five medical societies have published a set of recommendations for operationalizing strategies for infection prevention in acute care settings that account for conditions within the facility, including the culture and communications style of teams, hospital policies, resources available, leadership support and staff buy-in.
“There is no best way to implement a practice, but implementation need not be overly complex,” said Joshua Schaffzin, MD, a pediatric infectious disease physician and a senior author of Implementing Strategies to Prevent Infections in Acute Care Settings published as a new section of the Compendium, a set of guidelines for infection prevention. “This new section is a compilation of a number of options and practical tools you can use to find your best way to implement successfully. It’s a way to take the Compendium from paper to bedside to improve practices for patient safety.”
The new chapter summarizes seven models for implementing other Compendium recommendations for preventing common healthcare-associated infections. It is meant to help bridge the “knowing-doing” gap, a term that describes why healthcare practices often diverge from published evidence to prevent infections that harm patients.
The complexity of healthcare systems makes it difficult for healthcare teams to implement best practices in infection prevention. Understanding factors that promote and hinder adoption within a given setting is an important step to identifying the best framework to deploy in that setting.
“Spending time listening and exploring your context, including local factors such as operational support, informatics resources, familiarity and experience, willingness to change, and safety, is of tremendous value and will guide you to success,” Schaffzin said. “People are rarely eager to change. It’s ok to be discouraged, but don’t give up.”
Schaffzin compared establishing new infection prevention strategies to convincing a young child to try a new food. Sometimes it’s easy, and other times you have to try different tactics, but you can’t force new behaviors.
“Studies in implementation science make it clear that identifying effective interventions is a necessary first step before transferring them into real-world settings in an intentional process,” said Kavita Trivedi, M.D., Director of Clinical Guidance and Communicable Disease Controller at the Alameda County Public Health Department in California and the lead author of the chapter. “Here we provide the reader with the resources to think about implementation and evaluate the contextual determinants of behavior in order to design more successful, customized interventions.”
Implementing Strategies to Prevent Infections in Acute Care Settings is a new section to the Compendium, first published in 2008. The Compendium is sponsored by the Society for Healthcare Epidemiology (SHEA) and is the product of a collaborative effort led by SHEA, with the Infectious Diseases Society of America, the Association for Professionals in Infection Control and Epidemiology, the American Hospital Association, and The Joint Commission, with major contributions from representatives of several organizations and societies with content expertise. It is a multiyear, highly collaborative guidance-writing effort by over 100 experts from around the world.
An update of strategies to prevent catheter-associated urinary tract infections will be published in coming weeks. The societies also recently updated strategies for preventing methicillin-resistant Staphylococcus aureus infections, Clostridioides difficile infections, surgical site infections, central line-associated bloodstream infections, ventilator and non-ventilator associated pneumonia and events, and strategies to prevent healthcare-associated infections through hand hygiene.
Each Compendium article contains infection prevention strategies, performance measures, and approaches to implementation. Compendium recommendations are derived from a synthesis of systematic literature review, evaluation of the evidence, practical and implementation-based considerations, and expert consensus.
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About Infection Control & Hospital Epidemiology Published through a partnership between the Society for Healthcare Epidemiology of America and Cambridge University Press, Infection Control & Hospital Epidemiology provides original, peer-reviewed scientific articles for anyone involved with an infection control or epidemiology program in a hospital or healthcare facility. ICHE is ranked 24th out of 94 Infectious Disease Journals in the latest Web of Knowledge Journal Citation Reports from Thomson Reuters.
About the Society for Healthcare Epidemiology of America (SHEA)
The Society for Healthcare Epidemiology of America (SHEA) is a professional society representing more than 2,000 physicians and other healthcare professionals around the world who possess expertise and passion for healthcare epidemiology, infection prevention, and antimicrobial stewardship. The society’s work improves public health by establishing infection-prevention measures and supporting antibiotic stewardship among healthcare providers, hospitals, and health systems. This is accomplished by leading research studies, translating research into clinical practice, developing evidence-based policies, optimizing antibiotic stewardship, and advancing the field of healthcare epidemiology. SHEA and its members strive to improve patient outcomes and create a safer, healthier future for all. Visit SHEA online atshea-online.org,facebook.com/SHEApreventingHAIsandtwitter.com/SHEA_Epi.
JOURNAL
Infection Control and Hospital Epidemiology
METHOD OF RESEARCH
Literature review
SUBJECT OF RESEARCH
Not applicable
ARTICLE TITLE
Implementing Strategies to Prevent Infections in Acute Care Settings
ARTICLE PUBLICATION DATE
11-Jul-2023
Caesarean birth injury rates have risen for mums and babies but training and a new device could change that
IMAGE: FETAL PILLOW. IMAGE REPRODUCED COURTESY OF COOPER SURGICAL, INC.view more
CREDIT: BJOG: AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY
Over 34% of women in Australia have a caesarean birth, and a significant proportion of these happen in late labour when the fetal head is deep in the mother’s pelvis and can be impacted which makes delivering a baby challenging and poses serious risks to both the mother and the baby.
It’s estimated the baby’s head is wedged, known as impacted fetal head (IFH) in around 10% of all emergency caesarean births (CB). This makes it difficult for the doctor to get their hand below the baby’s head to deliver it, which leads to longer delivery times.
Recent statistics show that while the majority of babies born following IFH sustain minor damage, 2% of these infants die or suffer serious injuries with lifelong consequences.The NHS Resolution report in the UK states that 9% of avoidable brain injuries at birth are caused by impacted fetal head (IFH).
Complications for the mother include increased blood loss, an increased risk of infection, bladder and urinary tract damage, uterine tears that require repair and may cause issues in subsequent pregnancies, or even a hysterectomy. While complications for the baby include lacerations and bruising to the head and face, skull fractures, and haemorrhages, there have also been reports of eye injuries.
A Scientific Impact Paper published in BJOG: an International Journal of Obstetrics & Gynaecology by the Royal College of Obtsetricians & Gynaecologists in the UK and Professor Annette Briley at Flinders University has reported a significant rise in cases of IFH injuries in recent years, with maternity staff implementing varied approaches and no consensus regarding the definition or training regarding management to help deliver the baby during CB.
Approaches to managing this obstetric emergency include having an assistant push the baby's head up during birth, delivering the baby feet first, using an inflatable balloon device (Fetal Pillow) designed to elevate the baby’s head, and administering medication to relax the mother’s womb.
However, this scientific impact paper reviewed the available evidence, concluding there is currently no consensus on the best approach for these risky cases.
Various manoeuvres and some devices have been introduced to help with the delivery of the baby in this situation, but to date there is no consensus on which is best for mothers and babies or the training required for staff managing this emergency situation.
Most commonly, an assistant is asked to push up from below, although some evidence suggests reverse breech extraction may be associated with better outcomes. A UK-wide survey reported that more than half of obstetric registrars did not feel confident performing reverse breech extraction, and fewer than one in 10 are familiar with the Patwardhan technique.
"The aim of this scientific impact paper was to examine all the current available evidence regarding different manoeuvres and devices currently in use to manage IFH, with the results integrated into the findings of a systematic review commissioned by the National Guideline Alliance (UK)," says research co-author and midwife at Flinders University, Dr. Annette Briley.
The researchers say key steps need to be taken to improve standards:
• High-quality adequately powered RCTs comparing techniques to manage and prevent IFH are required. (Those currently available have significant weaknesses.) • A universally accepted definition of IFH would facilitate future research and education. • Women and their partners need to inform research around the language and management of IFH. • The development and implementation of an evidence-based multi-professional educational package would lead to consistent management of this obstetric emergency. • More research is required around the efficacy and cost-effectiveness of the Fetal Pillow
Dr Briley says the data clearly shows that there has been a significant rise in caesarean sections in late labour and associated cases of IFH-related injuries in recent years, and further education is needed to develop consistent management of this obstetric emergency.
"We’ve reviewed the existing evidence on strategies to identify, prevent, and manage the IFH during births to provide guidance and recommendations that improve outcomes for mothers and babies when this potentially serious complication occurs. It’s essential that clinicians use the best evidence to inform care for women and babies, including the optimal techniques to reduce the potentially devastating complications associated with IFH."
Dr Briley is also part of a research team developing and evaluating the Tydeman tube, an innovative single-use, hollow silicone tube inserted to elevate the baby’s head. Its designed to minimise applied pressure to the head and reduce any suction effect once access has been achieved.
"A minimal number of Tydeman Tubes have been used clinically; further research in a clinical setting, compared with appropriately trained and executed manual disimpaction, is required to investigate its efficacy and safety before use."
JOURNAL
International Journal of Obstetrics and Gynaecology
Management of Impacted Fetal Head at Caesarean Birth
Chagas Disease is also
underdiagnosed in Spain
A new study of nearly 3,000 Latin Americans who visited the Hospital Clinic over 17 years shows that 47% were infected with the parasite that causes the disease, and more than 10% had heart lesions
A high percentage of people from Latin America are infected with the parasite that causes Chagas disease. This is the conclusion of an analysis of nearly 3,000 people from countries where the disease is endemic and who attended the International Health Service at Barcelona’s Hospital Clinic, over a 17-year period. The study, published in PLOS Neglected Tropical Diseases, was led by the Barcelona Institute for Global Health (ISGlobal), an institution supported by "la Caixa" Foundation.
Nearly 7 million people in the world are estimated to be infected with Trypanosoma cruzi, the parasite that causes Chagas disease. Although the vector that transmits the parasite (the kissing bug) is endemic in 21 Latin American countries, the parasite has spread globally due to migratory flows. In non-endemic countries, the parasite can be transmitted vertically, from mother to child or, less commonly, through blood or organ donations. In 30-40% of cases, the infection ends up damaging the heart and digestive system, causing Chagas disease.
"It is therefore recommended that Latin Americans arriving in the country be tested in order to treat them if they are infected and, in the case of women of childbearing age, to prevent the vertical transmission of the parasite," explains Irene Losada, coordinator of the Chagas Initiative and first co-author of the study, along with Pedro Laynez-Roldán, ISGlobal researcher and physician at the ClÃnic’s International Health Service.
This retrospective study describes one of the largest samples of people at risk of infection in a non-endemic country: 2,820 Latin Americans, the vast majority from Bolivia, who attended the International Health Service of the Hospital Clinic of Barcelona between 2002 and 2019. Of the total number of people analysed, almost half (47%) were infected with T. cruzi and 17% had heart lesions typical of the disease. Although in most cases an electrocardiogram was sufficient to detect the lesions, an echocardiogram was needed in 10% of cases. "These results reinforce the importance of echocardiograms in the initial assessment of patients with T. cruzi infection," says Laynez-Roldán.
An underdiagnosis problem
The authors note that many people arriving from highly endemic regions of Latin America, such as Bolivia, had never been tested before. "The infection is clearly under-diagnosed even in Spain, one of the European countries with the highest diagnostic coverage," warns Maria Jesús Pinazo, last author of the study, former researcher at ISGlobal and currently at DNDi.
The majority of the cases are women of working age, reflecting the migratory flows of recent years, which allows for better targeting of screening and prevention programmes.
Characterization of Latin American migrants at risk for Trypanosoma cruzi infection in a non-endemic setting. Insights into initial evaluation of cardiac and digestive involvement
ARTICLE PUBLICATION DATE
13-Jul-2023
Friday, April 03, 2020
USA Nurses in multiple states protest over 'lack of preparedness' "Protecting our patients is our highest priority, but it becomes much harder when we don't have the safe protections," one nurse said. Nurses protest in front of Research Medical Center April 1, 2020 in Kansas City, Mo. The workers were among several groups nationwide protesting HCA Healthcare hospitals claiming the hospital chain put staff and patients at risk during the coronavirus pandemic because of a lack of personal protective equipment.Charlie Riedel / AP
April 2, 2020, By Janelle Griffith
Nurses at hospitals in multiple states are protesting what they describe as one of the nation's largest hospital chains' "lack of preparedness" amid the coronavirus pandemic.
The National Nurses Union, which represents 10,000 registered nurses at 19 hospitals managed by HCA Healthcare in California, Florida, Kansas, Missouri, Nevada and Texas, is demanding that the hospital chain provide optimal personal protective equipment (PPE) for nurses and other staff.
HCA Healthcare spokesman Harlow Sumerford the company is doing everything it can to equip patient care teams to provide safe, effective care to the people they serve.
"The National Nurses Union is trying to use this crisis to advance its own interest — organizing more members," Sumerford said in a statement to NBC News.
"The pandemic has strained the worldwide supply of personal protective equipment, including masks, face shields and gowns, a challenge that is not unique to HCA Healthcare or any other health system in the United States," Sumerford said, in part. "While we are doing everything in our power to secure additional supplies, and we are following CDC protocols for using and conserving PPE, the worldwide shortage is a reality that we are addressing with realistic, workable solutions."
Nurses at HCA’s Mission Hospital in Asheville, North Carolina, will deliver a petition to hospital managers on Thursday with their concerns about hospital preparedness in the battle against COVID-19, the disease caused by the coronavirus.
Some nurses at HCA hospitals have reported that they have had to work without proper protective equipment and are told to unsafely reuse masks. Nurses at Central Florida Regional Hospital in Sanford, Florida, said they were told they could not wear masks while working because it "scared the patients," according to Jean Ross, a registered nurse and president of National Nurses United.
HCA Healthcare's spokesman did not address specific allegations raised by the National Nurses Union in the company's statement Thursday.
NBC News reached out to Central Florida Regional Hospital for comment about this allegation but did not immediately hear back.
"Protecting our patients is our highest priority, but it becomes much harder when we don't have the safe protections which puts us in danger of becoming infected," Angela Davis, a registered nurse who works in a unit dedicated to treating coronavirus patients at Research Medical Center in Kansas City, Missouri, said in a statement. "If we are no longer able to be at the bedside, who will be there to care for our patients?"irus outbreak
The union president said HCA Healthcare can afford to properly prepare for the pandemic, noting that over the past decade, the hospital chain has made more than $23 billion.
"For the wealthiest hospital corporation in the United States to show such disregard for the health and safety of its caregivers, is disgraceful and unconscionable," Ross said.
Gary Mousseau, a registered nurse who works in endoscopy at Fawcett Memorial Hospital in Port Charlotte, Florida, said it has been "disheartening" for nurses across the country "to see HCA’s poor response" to their concerns while facing the gravest public health crisis in a century.
TWITTER POSTS
Naomi Klein@NaomiAKlein "The Poor, the Sick, the Homeless, the Children, the Low-Wage Workers": Moral Leaders Demand Coronavirus Relief for Most Vulnerable - https://t.co/sjAkJz59Gv via @commondreams Twitter 2020-04-02 3:37 p.m. toomas hendrik@IlvesToomas KC nurses protest lack of protective gear for coronavirus https://t.co/LrUQFYBDG8 Twitter 2020-04-01 9:28 p.m. David Middlecamp@DavidMiddlecamp ‘This is not safe.’ Nurses hold vigil in SLO to protest shortage of coronavirus equipment https://t.co/UA9Ash2nKy Twitter7:59 a.m. Katrina vandenHeuvel@KatrinaNation Criminal, Inhumane— Despite Calls for Global Ceasefire, Trump Threatens War With Iran Amid COVID-19 - https://t.co/erVXy1k452 via @commondreams Twitter 2020-04-01 5:39 p.m.
'When We Are Infected No One Is Safe': Nurses Nationwide Protest Over Lack of Coronavirus Protective Equipment
"For the wealthiest hospital corporation in the United States to show such disregard for the health and safety of its caregivers, is disgraceful and unconscionable."
Nurses and supporters participate in a vigil at UCLA Ronald Reagan Medical Center, during a shift change for nurses, amid the global coronavirus pandemic on March 30, 2020 in Los Angeles, California. (Photo: Mario Tama/Getty Images)
Nurses at 15 hospitals across the country are set to stage protests both Wednesday and Thursday over what they say is a dangerous lack of protections for healthcare workers and demanding their employers provide respirators, gowns, gloves, and other protective equipment to help them safely fight the coronavirus pandemic.
"When we are infected, we become a real danger of infecting everyone else around us, patients, hospital staff, and a risk to our own families."
—Kim Smith, registered nurse
National Nurses United (NNU) helped organize the protests at hospitals run by HCA Healthcare, the country's largest and wealthiest for-profit hospital operator, in seven states. The union represents 10,000 nurses at HCA hospitals, which the union says has left its nurses even less prepared for the pandemic than healthcare providers at most other facilities in the nation.
The union posted a video on social media of nurses detailing their harrowing experiences from the past several weeks as the outbreak has spread to every state in the U.S., killing more than 3,900 people so far.
Listen to––and protect––nurses. All our lives are on the line.
"PPE, or personal protective equipment, is virtually non-existent at my hospital," one nurse in Oakland, California, said.
"I had a patient who was having respiratory issues and was not able to get a respiratory treatment because the respiratory therapist did not have the proper mask," said another who works in Auburn, California.
"Listen to—and protect—nurses. All our lives are on the line."
—Bonnie Castillo, NNU
Despite making $23 billion in profits in the last decade, NNU said in a statement, HCA Healthcare nurses in states including California, Florida, and Texas have fewer N95 respirators and other equipment to keep them from contracting the new coronavirus, officially known as COVID-19, than healthcare providers at other hospitals.
Just 7% of nurses at HCA Healthcare facilities say they have enough PPE to protect staff and patients if there is a surge in coronavirus patients in their hospital, compared with 19% of nurses in general.
Only 35% of nurses in the HCA network report having access to N95 respirators, compared with 52% of nurses nationwide.
"For the wealthiest hospital corporation in the United States to show such disregard for the health and safety of its caregivers, is disgraceful and unconscionable," said Jean Ross, president of NNU.
"Nurses at various HCA hospitals are reporting that they have had to work without proper protective equipment," Ross added. "Nurses say they are not informed when they are exposed to an infected patient. They are told to unsafely reuse masks and at one hospital they are even being told not to wear masks because it 'scared the patients.'"
One hospital in Florida delayed informing nurses that they had potentially been exposed to the coronavirus, while nurses at Corpus Christi Medical Center in Corpus Christi, Texas say they were told to report to work while waiting for the results of COVID-19 testing, potentially exposing others.
Calling nurses "canaries in the coal mine" in an op-ed published Wednesday at Common Dreams, registered nurse Amy Silverman raised similar concerns, denouncing the lack of transparency at hospitals across the country regarding the exposure of healthcare providers:
You deserve to know the truth: healthcare workers are falling ill by the thousands, some are dying, an unknown number are in critical condition, and there are no tests. Hospitals aren't testing their workers unless they have obvious symptoms, but we all know that sources of infection aren't limited to those of us who seek care in emergency rooms. Hospitals should be testing all of their workers in order to understand how to control infection within their facility—and the White House regularly broadcasts support of this strategy by relaying the message that "everyone who needs a test will get a test" yet the opposite is happening: we are spreading the virus throughout our healthcare systems, within our families and communities.
HCA Healthcare nurses stressed that allowing them to fall ill due to a lack of protective equipment will put many others in danger.
"When we are infected no one is safe," said Kim Smith, an intensive care nurse in Corpus Christi. "When we are infected, we become a real danger of infecting everyone else around us, patients, hospital staff, and a risk to our own families."
Nurses in USA protest lack of supplies to fight coronavirus•Apr 3, 2020 Nurses and hospital workers dealing with Covid-19 patients in the United States staged protest and shared posts on social media, crying about their lack of supplies like surgical masks and personal protective equipment (PPE) in the fight against the deadly virus.
HCA nurse protests slam hospital preparation for COVID-19
Kelly Gooch -
Registered nurses in seven states protested this week at 15 HCA Healthcare hospitals over what they say is a lack of COVID-19 preparedness, according to the union that represents them.
National Nurses United, which claims more than 150,000 members nationwide, said it wants Nashville, Tenn.-based HCA to provide healthcare workers with optimal personal protective equipment such as N95 respirators or powered air-purifying respirators and other head-to-toe coverings.
"Nurses at various HCA hospitals are reporting that they have had to work without proper protective equipment," Jean Ross, RN, president of National Nurses Unite said in a news release.
"Nurses say they are not informed when they are exposed to an infected patient," she said. "They are told to unsafely reuse masks, and at one hospital, they are even being told not to wear masks because it scared the patients."
Registered nurses protested April 1 at facilities in California, Florida, Missouri, Nevada, Texas. Protesting also occurred April 2 at additional Texas and Florida facilities.
Separately, registered nurses at HCA's Mission Hospital in Asheville, N.C., delivered a petition to hospital officials April 2 expressing their concerns, according to NNU.
HCA, a for-profit hospital operator, pointed to its efforts to equip healthcare workers to provide safe, effective care, and accused the union of "trying to use this crisis to advance its own interest — organizing more members."
"The pandemic has strained the worldwide supply of personal protective equipment, including masks, face shields and gowns, a challenge that is not unique to HCA Healthcare or any other health system in the United States," a statement from HCA said.
"While we are doing everything in our power to secure additional supplies, and we are following CDC protocols for using and conserving PPE, the worldwide shortage is a reality that we are addressing with realistic, workable solutions," HCA added.
HCA said these steps include enacting universal masking for employees; appointing personal protective equipment stewards in hospitals; and creating strategically located personal protective equipment distribution centers on hospital campuses. The hospital operator said it also has staffing contingency plans to ensure hospitals are prepared for an influx in patients; is ensuring pay for healthcare workers during the pandemic; and is offering scrub-laundering for workers who care for COVID-19 patients.
Healthcare lost 43,000 jobs in March, with job losses primarily in ambulatory healthcare services, according to the latest jobs report from the U.S. Bureau of Labor Statistics.
The job losses — which occurred the same month the World Health Organization declared the COVID-19 outbreak a pandemic — included offices of physicians (-12,000), dentists (-17,000) and other healthcare practitioners (-7,000). At the same time, hospitals added only 200 jobs last month, compared to the 7,800 positions they added to the U.S. economy in February.
U.S. Secretary of Labor Eugene Scalia issued a statement on the March jobs report, saying it reflects the initial effect on U.S. jobs of the public health measures being taken to fight against COVID-19.
"It should be noted the report’s surveys only reference the week and pay periods that include March 12; we know that our report next month will show more extensive job losses, based on the high number of state unemployment claims reported yesterday and the week before," said Mr. Scalia.
Overall, healthcare employment had been growing. In the 12 months prior to March, industry employment had grown by 374,000, according to the bureau.
This story was updated at 9:50 a.m. CDT April 3. ‘When we are infected no one is safe’: Nurses nationwide protest over lack of coronavirus protective equipment April 1, 2020 By Common Dreams
“For the wealthiest hospital corporation in the United States to show such disregard for the health and safety of its caregivers, is disgraceful and unconscionable.”
Nurses at 15 hospitals across the country are set to stage protests both Wednesday and Thursday over what they say is a dangerous lack of protections for healthcare workers and demanding their employers provide respirators, gowns, gloves, and other protective equipment to help them safely fight the coronavirus pandemic.
When we are infected, we become a real danger of infecting everyone else around us, patients, hospital staff, and a risk to our own families.” —Kim Smith, registered nurse
National Nurses United (NNU) helped organize the protests at hospitals run by HCA Healthcare, the country’s largest and wealthiest for-profit hospital operator, in seven states. The union represents 10,000 nurses at HCA hospitals, which the union says has left its nurses even less prepared for the pandemic than healthcare providers at most other facilities in the nation.
The union posted a video on social media of nurses detailing their harrowing experiences from the past several weeks as the outbreak has spread to every state in the U.S., killing more than 3,900 people so far.
“PPE, or personal protective equipment, is virtually non-existent at my hospital,” one nurse in Oakland, California, said.
“I had a patient who was having respiratory issues and was not able to get a respiratory treatment because the respiratory therapist did not have the proper mask,” said another who works in Auburn, California.
“Listen to—and protect—nurses. All our lives are on the line.” —Bonnie Castillo, NNU
Despite making $23 billion in profits in the last decade, NNU said in a statement, HCA Healthcare nurses in states including California, Florida, and Texas have fewer N95 respirators and other equipment to keep them from contracting the new coronavirus, officially known as COVID-19, than healthcare providers at other hospitals.
Just 7% of nurses at HCA Healthcare facilities say they have enough PPE to protect staff and patients if there is a surge in coronavirus patients in their hospital, compared with 19% of nurses in general.
Only 35% of nurses in the HCA network report having access to N95 respirators, compared with 52% of nurses nationwide.
“For the wealthiest hospital corporation in the United States to show such disregard for the health and safety of its caregivers, is disgraceful and unconscionable,” said Jean Ross, president of NNU.
“Nurses at various HCA hospitals are reporting that they have had to work without proper protective equipment,” Ross added. “Nurses say they are not informed when they are exposed to an infected patient. They are told to unsafely reuse masks and at one hospital they are even being told not to wear masks because it ‘scared the patients.'”
One hospital in Florida delayed informing nurses that they had potentially been exposed to the coronavirus, while nurses at Corpus Christi Medical Center in Corpus Christi, Texas say they were told to report to work while waiting for the results of COVID-19 testing, potentially exposing others.
Calling nurses “canaries in the coal mine” in an op-ed published Wednesday at Common Dreams, registered nurse Amy Silverman raised similar concerns, denouncing the lack of transparency at hospitals across the country regarding the exposure of healthcare providers:
You deserve to know the truth: healthcare workers are falling ill by the thousands, some are dying, an unknown number are in critical condition, and there are no tests. Hospitals aren’t testing their workers unless they have obvious symptoms, but we all know that sources of infection aren’t limited to those of us who seek care in emergency rooms. Hospitals should be testing all of their workers in order to understand how to control infection within their facility—and the White House regularly broadcasts support of this strategy by relaying the message that “everyone who needs a test will get a test” yet the opposite is happening: we are spreading the virus throughout our healthcare systems, within our families and communities.
HCA Healthcare nurses stressed that allowing them to fall ill due to a lack of protective equipment will put many others in danger.
“When we are infected no one is safe,” said Kim Smith, an intensive care nurse in Corpus Christi. “When we are infected, we become a real danger of infecting everyone else around us, patients, hospital staff, and a risk to our own families.”
