Republica Press

Your Business & Political News Source

REPUBLICA PRESS
Your Business & Political News Source

Nursing and Nurses

India’s Doctors and Medical Workers Face Danger and Trauma

by

NEW DELHI — The shifts are long, the wards full, the demand so urgent that medical students and interns have been coaxed into filling in. Hundreds of workers have died. Family members at home have fallen ill.

India’s doctors and other medical responders find themselves short-handed and underfunded as they battle the world’s worst coronavirus outbreak. Beyond the physical danger they also face, they have been forced by the devastating size of the outbreak and the government’s mismanagement of the crisis into cruel routines of helplessness, making decisions day after day that could determine whether a patient lives or dies.

As beds fill up, they have to choose who among the throngs outside the hospital gates to allow inside for treatment. As the oxygen runs out, they have to choose who gets precious supplies. The emotional toll is mounting.

to the World Bank, India’s health care spending, public and out of pocket, totals about 3.5 percent of its gross domestic product, less than half of the global average.

They also face intimidation and violence, with videos circulating of angry family members thrashing medical staff in hospital halls covered in blood, or local strongmen bullying and scolding them.

when the hospital ran out of oxygen for 80 minutes early in May. Dr. Himthani had treated Covid patients for 14 months before he and his wife were infected.

As the oxygen ran out, Dr. Shiv Charan Lal Gupta, the director of the hospital and a friend of Dr. Himthani for three decades, ran up and down the hallways sending messages to government officials, media outlets and anybody who might help.

In their masks and gowns, the hospital staff gathered with teary eyes and folded arms at the main gate to pay their final respects as Dr. Himthani’s body was wheeled out. Then they went back to work.

44.5 trained health workers per 10,000.

The distribution is unequally concentrated in urban centers. About 40 percent of health care providers work in rural areas, where more than 70 percent of India’s population lives. Bihar, one of India’s poorest states, has only 0.24 beds per 1,000 people, less than one-tenth of the world average.

“When I close my eyes, I feel someone needs my help,” said Lachhami Kumari, a nurse at a government hospital in the Rohtas district of Bihar, one of India’s poorest states. Her 80-bed facility has been overwhelmed by critical Covid patients. “When I manage to fall asleep, I see people all around, begging for help. That has kept me going.”

At another government hospital in Patna, Bihar’s capital city, Dr. Lokesh Tiwari said almost half of the doctors and paramedic staff have lost family members.

on Twitter. “He asked her vitals, thanked me and hung up.”

View Source

Nurses’ Union Condemns C.D.C.’s New Mask Advice

by

The nation’s largest union of registered nurses condemned the Centers for Disease Control and Prevention on Saturday for lifting mask recommendations for vaccinated people and called on the agency to “do the right thing” and revise its guidance.

Bonnie Castillo, a registered nurse and executive director of the union, National Nurses United, said the most recent guidance, which was issued on Thursday and rolled back mask recommendations and other precautions for those who are fully vaccinated, “is not based on science.” Ms. Castillo said the new guidance would jeopardize the health of frontline workers and the general public and would disproportionately harm people of color.

“This is a huge blow to our efforts at confronting this virus and the pandemic,” said Ms. Castillo, whose union represents 170,000 nurses nationwide. Although vaccination is vitally important to stopping the virus’s spread, she noted that millions of Americans still had not been vaccinated.

“The mask is another lifesaving layer of protection for workers,” she said.

The union also criticized the C.D.C. for other actions, including its decision to stop monitoring breakthrough infections among vaccinated individuals and to investigate such cases only if they result in a hospitalization or death. The agency announced that, as of May 1, it would no longer track or investigate all infections among vaccinated people so that it could “maximize the quality of the data collected on cases of greatest clinical and public health importance.”

The nurses said that meant the C.D.C. would not gather the data necessary to understand whether vaccines prevent mild and asymptomatic infections, how long vaccine protection lasts and what role variants play in breakthrough infections.

The union also called on the agency, which recently recognized that the virus could be transmitted through aerosolized particles, to update its guidance about ventilation and respiratory protection accordingly. The union also called on the Occupational Safety and Health Administration to immediately issue emergency temporary standards on infectious diseases to protect people in the workplace.

The C.D.C. did not immediately respond to the criticisms. Introducing the new recommendations on Thursday, Dr. Rochelle P. Walensky, the C.D.C. director, cited two recent scientific findings as significant factors: Few vaccinated people become infected with the virus, and transmission seems rarer still; and the vaccines appear to be effective against all known variants of the coronavirus.

The union noted that more than 35,000 new cases of coronavirus were being reported each day and that more than 600 people were dying each day. “Now is not the time to relax protective measures, and we are outraged that the C.D.C. has done just that while we are still in the midst of the deadliest pandemic in a century,” Ms. Castillo said.

View Source

Italy Pushes Back as Health Care Workers Shun Covid Vaccines

by

ROME — Giulio Macciò tested negative for the coronavirus and spent weeks receiving treatment for emphysema in a sealed-off hospital under the care of doctors and lung specialists — and a nurse who had refused to be vaccinated. On March 11, he unexpectedly died. A post-mortem swab found that he had contracted the virus, as had 14 other patients and the unvaccinated nurse who spent her shifts in his midst.

“It makes no sense that a person whose job is to heal the sick gives them Covid and kills them,” said Mr. Macciò’s son, Massimiliano Macciò, who filed a complaint against the San Martino hospital in the northern Italian city of Genoa. He believes that the nurse, one of an estimated 400 who have refused vaccination against Covid-19 at the hospital, infected his father, who died unvaccinated at 79.

As vaccination rollouts build momentum, businesses everywhere are grappling with whether they can require the inoculation of their employees, raising thorny ethical, constitutional and privacy issues around Europe and the United States. But that quandary becomes all the more urgent when the person is your health care worker.

In Italy, the original Western front in the war against Covid, a rash of outbreaks in hospitals where medical workers have chosen not to be inoculated has raised fears that their stance is endangering public health. It has also prompted a forceful response from an Italian government that is struggling to get vaccinations on track.

pronouncement by Italy’s data protection authority that the vaccination status of health workers should be unknown. “But this right exists until it does not limit another person’s right,” Mr. Petralia said.

made some vaccinations compulsory for children, including for measles, and barred the unvaccinated from attending school — a decision backed by Italy’s constitutional court because it also safeguarded public health. In the northern city of Belluno, a court ruled in mid-March that a nursing home that employed several health care workers who chose not to get vaccinated could force them to take paid leave.

Mr. Macciò, whose father died in Genoa, said it made no sense that the people entrusted to care for his father were allowed to potentially harm him. He said he had complained to the doctors, who told him their hands were tied because the nurses were protected by privacy rules.

But amid Italy’s frustration, and the new decree, something appears to be changing. Mr. Macciò said the police had asked for his help in identifying the nurses he saw when going to pick up his father’s belongings.

“I hope some good comes of it,” he said of his father’s death. “These people should change their job.”

Emma Bubola contributed reporting.

View Source

California Sues Nursing Home Chain, Saying It Manipulated Ratings System

by

The result, prosecutors said, was that Brookdale “has been awarded higher star ratings than it deserved.” They added, “The chain’s manipulation has allowed Brookdale to attract prospective patients and their families to its facilities by misleading them about its quality of care.”

Prosecutors also accused Brookdale of illegally evicting or transferring residents so that the chain could “fill its beds with residents who will bring in more money.” In one instance highlighted in the suit, prosecutors said Brookdale discharged a 78-year-old resident who suffered from heart and kidney disease without removing his catheter.

The lawsuit seeks civil penalties and an injunction to prevent future unlawful conduct. Under California law, civil penalties are up to $2,500 per violation. In this case, where the violations are committed against seniors or people with disabilities, the law provides for an additional penalty of up to $2,500 per violation.

A Brookdale spokeswoman didn’t immediately respond to a request for comment.

The Times previously reported that a Brookdale facility in Lexington, Ky., told Medicare in 2017 that every resident got an average of 75 minutes of care each day. In reality, nurses at the Brookdale Richmond Place facility spent an average of less than 30 minutes a day with patients. Brookdale received five stars for staffing. Absent the inflated numbers, it probably would have received only one or two stars.

A former Brookdale nursing assistant said in a deposition last year that her supervisors had told her to falsify residents’ medical records to make it look as if they received more care than they did.

Heather Hunter, a spokeswoman for Brookdale, told The Times, “We have detailed policies in place to ensure compliance with C.M.S. reporting rules, and we are not aware of any instance where inaccurate or false information was submitted by any of our communities outside of the confines of the C.M.S. rules.”

President Biden nominated Mr. Becerra, whose office brought the case against Brookdale, for secretary of health and human services, which oversees C.M.S. The Senate has not yet voted on the nomination.

Robert Gebeloff contributed reporting.

View Source

10 Years After Fukushima Disaster, This Nurse May Be the Region’s Best Hope

by

Rina Tsugawa recalls a charmed childhood amid rice paddies in northern Japan, hopping on bicycles with her sister and roaming the streets of their village, where monkeys sometimes descended from the mountains and neighbors offered the girls sweets as they popped into their homes.

The sisters were the only children in their hamlet in Fukushima Prefecture, living with their mother and grandparents in the house where their grandfather was born. On that terrible day a decade ago when Fukushima was struck by a catastrophic earthquake and tsunami, setting off a triple meltdown at a nuclear power plant, a 12-year-old Ms. Tsugawa was at school 90 miles inland. As the powerful shaking jolted her sixth-grade classroom, she and her classmates hid under their desks, crying in fear.

In the years since, many of her peers have left for jobs in Tokyo and other cities, an outflow common to rural Japan but accelerated by the disaster in Fukushima. Ms. Tsugawa has different plans. After graduating this month from nursing school, she ultimately wants to return to her hometown to care for the aging residents who helped raise her.

“They gave us so much when we were little,” said Ms. Tsugawa, now 22. “I want to help these elderly people stay healthy longer.”

several towns near the nuclear plant remain uninhabitable.

many graying and shrinking communities, where jobs are sparse, the lifestyle is inconvenient and birthrates are low. The town’s population, which peaked at close to 20,000 in 1950, has fallen to 6,000. Aging residents are close to half of the population, and health care workers are in short supply.

Katsuei Hirasawa, the country’s 10th minister for reconstruction since the disaster, said in a news briefing. “We must communicate that there are no safety-related issues in produce from Fukushima.”

Timothy Mousseau, a biologist at the University of South Carolina who has studied how radioactive contamination has affected animals and plants in Chernobyl and Fukushima.

As the disaster unfolded, Ms. Tsugawa did not learn just how devastating it was until her grandparents turned on the television later that afternoon. Like a horror movie on an endless loop, they watched scenes from the tsunami as it devoured the coastline. The next day, they learned of an explosion at the nuclear plant. A wall of water had knocked out the reactors’ cooling systems.

Although the residents of Nishiaizu never evacuated, Ms. Tsugawa began to read news items and social media posts insinuating that Fukushima was tainted. “There were these rumors that everyone in Fukushima was dangerous,” she recalled. “And that if you got close to them, you might get radiation sickness from them.”

When her mother, Yuki Tsugawa, took a business trip outside the prefecture about a year after the nuclear accident, someone scrawled the word “baka” — “stupid” — on the side of the car she had been driving. Ms. Tsugawa, 47, said she wondered if her Fukushima license plate was the reason.

Her elder daughter said she had no qualms about the safety of her hometown, where she hopes someday to raise her own family. “Just because there are some areas that are not safe,” she said, “doesn’t mean that all of Fukushima is unsafe.”

With her decision to become a geriatric nurse, Ms. Tsugawa is giving the prefecture exactly what it needs.

The demand for nursing care across Japan is so great that before the pandemic, the country began to relax its longtime insularity and allow more workers to be hired from other countries. In Fukushima, there is already a shortage of doctors and nurses. Kiyoshi Hanazumi, chief of the prefecture’s social welfare division, said that based on current trends, it will meet only about three-quarters of its needs for health care workers for older residents by 2025.

Ms. Tsugawa said she had wanted to become a nurse ever since she was 3 years old. Her grandfather had been hospitalized with lung cancer, and she observed the kindness of the medical staff who treated him.

Her interest in geriatric nursing developed over time. While their mother worked as a welfare coordinator in Nishiaizu, Ms. Tsugawa and her younger sister, Mana, 19, would accompany their grandmother, Haruko Tsugawa, 74, to visit neighbors.

“Everyone treated them as honorary grandchildren,” Mrs. Tsugawa said.

A year after the 2011 disaster, Yoshihiro Yabe, 42, also wanted to reclaim this kind of community. Mr. Yabe, a landscape architect, decided to return to Nishiaizu, where he was born, and start a family.

At one time, Mr. Yabe had planned to escape. But now he wants to reverse the migration that is all too common from his hometown.

When the earthquake and tsunami struck, Mr. Yabe was training in Canada and hoping to find a job in the United States.

“I was watching media in Japan and all over the world, and I felt that Fukushima was labeled as a contaminated prefecture,” he said. “So who would come here to create new businesses or want to start agriculture or raise their babies?”

Mr. Yabe said he felt he had to return, and he moved into his ancestral home — it has been in the family for 19 generations — and renovated some old storage warehouses for miso and soy sauce, converting them into a small inn.

He took over a local arts center and established an artists’ residency. Over the last eight years, he said, he has recruited 60 people to live in Nishiaizu, some from Tokyo and others from different parts of Fukushima Prefecture.

The town is far from resuscitated. Near Mr. Yabe’s home, half of the houses are abandoned. Aside from his 8- and 3-year-old daughters, he said, “I am the youngest guy” in the neighborhood.

Ms. Tsugawa, who starts a residency at the hospital connected to Fukushima Medical University in April, is also likely to be the youngest person in Sugiyama — population 21 — which is the enclave of Nishiaizu in which she grew up.

Even her mother had not originally intended to raise Ms. Tsugawa and her sister in Nishiaizu. Yuki Tsugawa attended technical college in Koriyama, more than 50 miles away, married and gave birth to Rina and Mana. Only after divorcing did Yuki move back in with her parents in the 100-year-old wood and slate-roofed home where she had been raised.

“If I stayed married, I probably would have stayed out” of Nishiaizu like most of her childhood classmates, Yuki Tsugawa said. “I often think ‘wow, nobody ever came back,’” she said.

Rina Tsugawa, who said she wanted to specialize in caring for patients with dementia, knows her town may struggle to survive.

“Of course, I don’t want my little village to disappear,” she said. “But even if we do things to try to get new people to come, that isn’t really happening. It’s difficult to make progress.”

View Source

Terms and Conditions - Privacy Policy