Recent press items can’t agree on nurses’ role in Covid care
As 2020 ends, coverage of nursing in Covid care still depends on who is involved. A recent NBC News piece offered a good quick look at the travel nurses who are trying to cope with the current U.S. surge. In a BBC Newshour report, an NYU physician forcefully affirmed the key role skilled nurses play, especially in ICUs. Yet a long New York Times article on a shortage of “specialists” to run ventilators excluded nurses. And one governor had to defend his health commissioner, an RN, from an MSNBC anchor’s suggestion that an “upgrade” to a physician was needed.
December 7, 2020 – Recent news items about the role nurses play in Covid care are all over the map. One recent bright spot was a November 20 NBC Nightly News report by Gabe Gutierrez, “Hospitals Face Staffing Shortages as Coronavirus Cases Soar Nationwide.” The piece highlighted the “army of traveling nurses” who have rushed in to care for Covid patients. It featured good quotes from two nurses, who stressed their physical and emotional exhaustion, as well as the frustration of dealing with Covid deniers. A pulmonologist rightly emphasized that creating more hospital facilities is meaningless “if we don’t have the people to take care of the patients.” The report concluded that “for this latest wave, the most dire shortage nationwide is not always beds, ventilators, or protective gear—it’s people.” The piece might have briefly explained the difference that nurses make in patient outcomes.
Another good message about the role of nurses appeared in a December 3 Covid report on the BBC World Service’s Newshour program. That piece consulted New York University population health physician Leora Horowitz. When the reporter seemed a little surprised to have heard that nurses were most at risk for Covid, Horowitz correctly explained that in fact nurses provide most of the skilled care hospital patients get, especially in the ICU, and that physicians only appear occasionally.
At the other end of the spectrum was an egregious November 22 New York Times article by Andrew Jacobs, “Now the U.S. Has a Lot of Ventilators, But Too Few Specialists to Operate Them.” Its main concern was a shortage of “respiratory therapists, pulmonologists and critical care doctors who have the training to operate the machines and provide round-the-clock care for patients who cannot breathe on their own”—of course, that is exactly what ICU nurses do. But the lengthy piece was full of information about how “doctors,” alone, have figured out how to provide better respiratory care for Covid patients. For expert comment, the report consulted eight named physicians and zero nurses. Even the photo captions excluded nurses through language that obscured their role, like the one that showed several staff “proning a patient.” Of course the Times can run Covid articles focusing on physicians, just as NBC’s piece focused on nurses. The problem is offering detailed descriptions of critical care in which nurses actually take the lead, yet seeming to go out of your way to avoid noting the role they play, suggesting that physicians do it and consulting only physician experts.
More broadly, nurses are woefully under-represented in press coverage of the public health response to the pandemic, and the same is true of actual Covid decision-making bodies. There are exceptions, but they are not always well-received in the media. Today, MSNBC anchor Stephanie Ruhle asked New Jersey Governor Phil Murphy whether he needed to “upgrade” his team (at the 11:59 mark) because the state’s health commissioner was “an RN” rather than “an infectious disease doctor.” Murphy’s answer: No, Commissioner Judy Persichilli is “terrific,” and anyway “her number two is a medical doctor.”
We thank those who provide a realistic account of Covid care.
If you’d like to write to the various players above their Twitter addresses are:
Gabe Gutierrez @gabegutierrez
Leora Horowitz @leorahorwitzmd
Andrew Jacobs @AndrewJacobsNYT
Stephanie Ruhle @SRuhle
NJ Governor Phil Murphy @GovMurphy
Thanks for keeping the Ruhle issue alive. Yesterday, she ask for responses on her Twitter related to if workers were going back to their jobs in 2021. I wrote her and ask if she was ok with the RN state health commissioner returning to her job. Of course, she did not answer.
I could work a 12 hour ICU shift and never lay eyes on a physician OR respiratory therapist the entire time. You might see attendings on morning rounds. Much of the time it was nurses teaching the newer medical/surgical residents. Years ago I flew in a Life Flight program where residents rotated with us. The Chief at the time made it clear the Flight Nurse was in charge. Many times I intubated a patient when the resident couldn’t. People don’t understand it’s the nurses there 24/7 and the ones so in tune with the patient they pick up the slightest change a physician rushing through might never catch.
On my comment above, patient care takes a team of people. They all know their roles, and the better that team functions together and the more respect they have for each other, the better the care received by the patient.