Wisconsin Nurse - September 2020

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Page 10 The Wisconsin Nurse September 2020 Nurse Disrupted - A Nurse Led Start-up for Pandemic Response Bre Loughlin, MS, RN “Hey Google - how many days has it been since March 23rd?” ‘Today, 123 days.” Nurse Disrupted is a company I co-founded in response to COVID-19. We are a nurse led Wisconsin-based company that combines technology, the science of nursing, and compassion to solve healthcare problems. Since forming on April 8th we have completed nearly 3,000 video screenings for COVID-19 for Madison’s homeless population and have connected nursing students from three different programs with practicum hours. I’d like to tell you our story for three reasons: • To showcase the power of nursing in this fight against COVID19. • To show how WNA was vital to the work we do. • To ask you to join us. Background March 23rd, 2020 It got down to 29 degrees in Madison, Wis. that night. As a nurse executive at Epic, our local healthcare software company, I had taken a week for spring break with my daughter. Since we couldn’t travel we decided to pitch in to our community, and we found posts from the Executive Director of Porchlight, a local homeless shelter, on social media. We had grabbed cash cards, but what they needed help with was COVID-19 screening. Within 48 hours I had two ipads and a MiFi donated from Epic and four nurses willing to volunteer to complete COVID-19 screenings on shelter guests through Zoom video. The Department of Health recommends the best way to fight COVID-19 is to stay home, if you have one. But over half million Americas don’t. 1 People have a lot of thoughts about why folks don’t have a home, but I’d like to give you some facts: About 25% of our homeless are employed. They just don’t make enough money. 2 Roughly 11% of our homeless served in the military for our country. 3 People experiencing chronic homelessness typically have complex and long-term health conditions 4 Something homelessness and COVID-19 have in common is that it doesn’t affect the U.S. population evenly. There is a racial and socio-economic divide here that as nurses we must see and help educate the public on. I think the most important thing right now to understand is that some of us won’t get to the other side of the curve until we all do. We’ve gone through such a time of divisiveness and seeing people as other or not seeing them at all. But this incredible nursing revolution started on March 23rd using the simplest technology and nursing fundamentals such as evidence-based practice, observation, and education. The power of nursing: Some science you should know: • If you use a touchless thermometer you have a 50/50 chance of detecting someone with an active COVID-19 infection. 5 • If you use a temporal thermometer correctly (which is rare), you are still only measuring skin temperature. • 69% of the US population have poor computer literacy and 26% can’t use a computer at all. Although there are more than 300K health apps on the market, COVID-19 chat bots and self screeners won’t work for most people 6 • Mass production of a vaccine has uncertain timeline and outcomes 7 We are not helpless - the solutions are just harder than what we want them to be. It is not an app, a bot, or an injection that will suddenly flip a switch. But as nurses, we are trained to do what it takes in making distance in this battle. Today we have expanded to The Salvation Army women’s shelter and have 70 registered nurse volunteers. We have had to update our clinical decision support tool five times to reflect the evolving evidence base and sweep the literature daily. Today, businesses and schools are asking if we can help them too. The number one thing anyone can do right now is stay home. For those places where this is not possible, we have a way to make spaces safer. We have more shelters as well as companies and academic organizations asking if we can bring screening to these spaces. We can. The Value of WNA: The Wisconsin Nurses Association has three main pillars. Professional development, Protecting your interests, and Staying connected. All of these have impacted the work we do at Nurse Disrupted. WNA has guided and supported us from the start. The night of March 23rd the Wisconsin Nurses Association had a COVID-19 Response meeting that brought together the Public Policy, TriCouncil, and Workforce Advocacy members. I had been talking throughout the day to co-founder of Nurse Disrupted, and chair of WNAs Public Policy Council, Tracy Zvenyach, PHD, APRN-NP. Tracy raised, and continues now to lead the complex regulatory waters of our company. We had to definitively understand if nurses were protected while conducting screening as virtual volunteers. When we brought the concept to the WNA meeting the association never questioned if we had what it took to conduct screening virtually. They came together to support us in how to build the program. WNA’s Executive Director, Gina Dennik-Champion connected us with legal council and eventually, national press to help recruit volunteers. WNA TriCouncil member Kim Udlis, PhD and Associate Dean and Chief Nurse Administrator at the Marian School of Nursing had the idea of creating practicum opportunities for Marian Nursing students at risk for not graduating. She had the program approved and students volunteering within the first month. August 5th WNA has given us the opportunity to present a webinar Nurse Innovation in Reducing COVID-19 among the Homeless Population, and is giving us a voice here in Wisconsin Nurses Connect. That brings us to the third reason I want to tell you our story… Join us Every night we provide COVID-19 screening for homeless shelters. Additional shelters, businesses and schools are asking if we can help them too, and we can together. Please consider joining Nurse Disrupted. We provide the training, tools, and support to connect you with the opportunity to volunteer, and in the near future to work from your home. You can find us at www.nursedisrupted.com and often at a (virtual) WNA event. Thank you for all you do, Bre Loughlin, MS, RN Chair, Workforce Advocacy Council CEO, Nurse Disrupted LLC 1 “State of Homelessness: 2020 Edition - National Alliance to ....” https:// endhomelessness.org/homelessness-in-america/homelessness-statistics/ state-of-homelessness-2 020/. Accessed 27 Jul. 2020. 2 “Working Homeless Population Grows in Cities Across the U.S..” 7 Feb. 2018, https:// parade.com/643064/beckyhughes/working-homeless-population-grows-incities-across-the-u-s/. Accessed 27 Jul. 2020. 3 “Background & Statistics - National Coalition for Homeless ....” http://nchv.org/index. php/news/media/background_and_statistics/. Accessed 27 Jul. 2020. 4 “Background & Statistics - National Coalition for Homeless ....” http://nchv.org/index. php/news/media/background_and_statistics/. Accessed 27 Jul. 2020. 5 “COVID-19 (Coronavirus) Resource Center - ECRI.” https://www.ecri.org/ coronavirus-covid-19-outbreak-preparedness-center. Accessed 27 Jul. 2020. 6 “This Chart Shows How Computer Literate Most People Are.” 7 Dec. 2016, https:// lifehacker.com/this-chart-shows-how-computer-literate-most-peopleare-1789761598. Accessed 27 Jul. 2020. 7 “Fauci warns that COVID-19 vaccine protection may be ‘finite ....” 7 Jul. 2020, https:// www.marketwatch.com/story/fauci-warns-that-covid-19-vaccine-protectionmay-be-finite-2020-07-07. Accessed 27 Jul. 2020. Contribution to WINPAC 2020 is an important election year, and during the 2021-2023 Legislative Biennium, WNA will be working on the following: Passage of the APRN Modernization Act, Funding for Increasing Nurse Faculty, Supporting the Important Role of Nurses in the Workplace, and Improving our Public Health Infrastructure. WINPAC is the political action arm of the Wisconsin Nurses Association that raises and distributes funds to state legislative candidates. WNA cannot achieve its legislative priorities without financially supporting legislative candidates that recognize the importance of health, safety, and the practice of nursing. WNA needs your support to help achieve its legislative priorities. Please contribute to WINPAC today so we can advance nursing now and influence tomorrow. Contribute Here: https://www.cognitoforms.com/WisconsinNursesAssociation/ WINursesPoliticalActionCommitteeContributionWINPAC
September 2020 The Wisconsin Nurse Page 11 Trust and the Professions Dr. Mary Ellen Wurzbach When we enter into a relationship with our patients in a variety of settings we form a tacit contract. We agree to protect their physical, psychological and social well-being. Physically we agree not to harm our patients. When we perform treatments or prescribe medications we agree that we understand the burden and benefits of what we are suggesting or doing to our patients. We agree to be responsible and accountable for the outcome. The same is true of psychological and social interventions including everything from mental health treatment to working with insurance coverage or in an administrative capacity in a health care institution. Some of us are direct care providers; some are faculty, researchers or administrators. All of us have tacit contracts with our students, participants, policy holders or patients. We usually think of individuals as having responsibilities and accountability in health care. We think of ourselves as individual nurses, not necessarily team members or agents of an organization. We have individual liability insurance plus possibly an institutional policy. We believe we are accountable for our actions and that currently we practice under our own licenses. Thus, as individuals, we have formed a bond with our patients, policy holders, students, research participants or subordinates. All of these beliefs about responsibility and accountability are writ large in the health care organization – the clinic, hospital, insurance company or government agency. Without this commitment to accountability and responsibility accompanying the authority to make choices and decisions in health care, trust - the silent contract - suffers. Trust is essential. Nurses and pharmacists are seen as the most trustworthy of the professions by the public. Even the word profession means that one belongs to a group that can provide a valued service to society and be a self-monitor of its own behavior. By definition a profession agrees to accountability to society and the control of its own practice. Years ago Amitai Etzioni called nursing, social work and teaching semi-professions. Through the years we have become a full fledged profession as well as an academic discipline. Without trust think of what the health care system would be. Why would a patient, student, subordinate, research participant or policy holder follow the directives of a person with authority in a technical sense but no moral authority, no accountability or responsibility? What are accountability, responsibility and moral authority? They have various characteristics, including legitimate concern and caring, the knowledge to perform certain health care functions and prudence. This concern and caring, knowledge and, above all, prudence support moral authority conveyed by society to the professional. Teaching, research and administration are more disciplinary functions but they too entail trust and professionalism in the practitioner. What seems to be happening today in health care is the abdication of this moral authority based on trust: practitioners not knowing, for example, the side effects of a medication or not offering, if known, informed consent; record keeping that seems to be paramount, but not protecting these records; teaching that does not instill a true feel for the patient’s experience; research that abrogates the rights of the participants and administrative lack of due diligence. The health care system is growing and more organizations are becoming members of a giant complex of functions. Unless we actively demonstrate concern and caring, knowledge and prudence, all of which support out moral authority conveyed by society, our societal function will descend into chaos. Without these attributes of a committed human being why would our clients, whether patients, students, participants, or subordinates, trust us? Most professionals feel concern and caring and believe themselves to be knowledgeable. But with the burgeoning data base it is difficult to remain current with all knowledge no matter how concerned and caring. This raises the issue of prudence and not expecting our clients to assume risks we would not assume ourselves. Many of us would be horrified if we knew the results of well-meaning but misguided health care interventions. Prudence may alleviate some of these iatrogenic outcomes. Prudence entails planning. It entails, more than anything, anticipating the possible outcomes of a treatment, medication, advice, teaching or simply technology. Anticipation means thoughtful consideration of what might be detrimental to our clients if a particular course of action is instituted. It means taking precautions to prevent an unanticipated treatment, drug reaction or technological problem. It means considering consequences before they occur and working diligently to prevent side effects of our actions. Trust is the tacit (silent) contract we enter into with our clients. The entire health care enterprise is based on this trust. Unless the professions meet this societal obligation to be caring and concerned, knowledgeable and prudent why would society trust us anymore than our individual clients do? At some point the moral authority society has invested in us may be revoked and much of our unflagging effort to be seen as trustworthy will be diminished. There are actions that can be taken which include anticipating possible outcomes, following up on interventions, being responsible for the result and offering informed consent so that clients can assist us in monitoring the side effects of interventions. Assiduously acquiring new knowledge and remaining current with therapeutic norms is critical - talking with our clients and offering advice and appropriate education and reciprocity. Authentic caring and concern, constant knowledge acquisition and prudent anticipation of consequences all will amplify and support our client’s trust in us and in health care. Trust is the bond we have with our clients. It is also the bond that holds health care together. We must not squander it. Iowa County Registered Nurse/LPN Full Time Night Shift (set schedule) $3,000 RN/$1,500 LPN Sign-on Bonus CNA Full Time/Part Time PM and Nights We’re Hiring! NEW! Night Shift Differential of $3.00 per hour! EOE Apply online at www.iowacounty.org or by calling (608) 935-0374
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Wisconsin Nurse - September 2020

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