THE OJNA JOURNAL Issue 6 | Summer 2020 Coronavirus Dispatches from COVID-19 The Great the Frontlines Risk Factors Infl uenza Th e OJNA Journal - Page 1 TABLE OF Editor's Note OJNA LEADERSHIP CONTENTS: Dear Members, Mission: As a critical care nurse and nurse practitioner for over a decade, I thought I knew what nursing was about. Though Th e mission of Th e OJNA Journal is to there is always more to learn, I was comfortable with my • Provide timely news and research updates role, my knowledge, and my skills. The last four months have thrown me for a loop. I have never in my career wit- • Relay evidence-based research nessed so much death and dying. I have never felt so help- • Share OJNA news and updates less in my inability to save patients. I’m hurting for the loneliness of my patients and the terrible distance and Editor-in-Chief: fears of their families. I don’t like the feeling of flying blind, of having no evidence upon which to base my Chaya Milikowsky, MSN, AG-ACNP-BC practice. Managing Editor: CORONAVIRUS That is my personal COVID experience. Yet I know that Sarah Bracha Cohen, MS, RN DISPATCHES FROM THE each nurse is experiencing their own COVID reality. Different patient populations, practice settings, admin- FRONTLINES Editorial Board: istration, colleagues, amounts of protective gear, family page 4 support, pain tolerance, and individual coping mecha- Tobi Ash, MBA, BSN, RN PROLONGED MASK USE AMONG nisms; all these factors coincide to give each of us a dif- Toby Bressler, PhD, RN, OCN ferent life-altering COVID existence. Together, we have HEALTHCARE PROFESSIONALS Tzippy Newman, BSN, RN experienced the gamut of human emotion. We have felt DURING COVID-19 page 10 Yocheved Weinreb, RN, OCN helpless and hopeless. We have felt betrayed and aban- TO PAUSE AND HONOR OUR doned. Afraid and exhausted. Frustrated and angry. Heartbroken. Depressed. Empty. But we also feel hope- Board of Directors: PATIENTS AND ONE ANOTHER ful. And courageous. Proud. Supported by incredible Shevi Rosner, MSN, RN-C, President page 11 colleagues. Heartened by acts of kindness. Driven to do Toby Bressler, PhD, RN, OCN, Vice President PISKEI HALACHA RELEVANT TO more, and overcome when our patients do well. Mara McCrossin, MSN, NP, Treasurer COVID-19 OF RABBI HERSHEL Until COVID-19 erupted with a vengeance, your journal Chaya Milikowsky, MSN, AG-ACNP-BC, Secretary SCHACHTER, RIETS page 12 team had been working on a summer journal focusing on mental health and psychiatric nursing. As COVID-19 be- All advertising is subject to the approval of OJNA. came the predominant issue on everyone’s minds, we changed our focus and decided to publish this special fea- OJNA Mission Statement: page 2 OJNA EDITORIAL MESSAGE ture journal instead. Though there is a paucity of clinical Th e Orthodox Jewish Nurses Association was page 3 ISSUE AT A GLANCE data and evidence at this point, there is a preponderance founded in 2008 by Rivka Pomerantz, BSN, RN, page 4 FEATURE ARTICLE of stories. Nurses’ voices and stories that scream to be IBCLC. It seeks to provide a forum to discuss profes- heard. And so, in a departure from prior journals, we page 12 HALACHA CORNER have replaced our feature article—typically an explora- sional issues related to Orthodox Jewish nurses and tion of a clinical topic—with a series of essays that OJNA arrange social and educational events. We strive to page 13 RESEARCH RECAP nurses wrote for a Jewish Press column, “Dispatches from meet the needs of our members, promote profes- page 15 APRN CORNER the Frontline.” The data will come. The clinical knowl- sionalism and career advancement, and be a voice page 15 STUDENT CORNER edge will come. But as we wait for those answers, as we for Orthodox Jewish nurses across the world. personally generate data that will one day become the page 16 MEMBER MILESTONES very evidence and trials through which we will attempt to Contact us at [email protected] page 17 NURSES TO KNOW pin COVID down, we share our lived experiences to the Follow us! world at large and within our small internal community. page 18 OJNA UPDATE Sharing our stories here acknowledges that we are living @jewish_nurses page 19 NURSES OF OJNA this experience together, and together we can find com- fort and hope. Orthodox Jewish Nurses Association (OJNA) RECOMMEND With prayers for a better tomorrow, @JewishNurses Chaya Milikowsky, MSN, AG/ACNP-BC www.jewishnurses.org Editor-in-Chief, The OJNA Journal Th e OJNA Journal - Page 2 THIS ISSUE AT A GLANCE: Wearing masks for a prolonged THESE ARE THE SMALL WAYS THAT amount of time causes a host of WE PAUSE AND HONOR OUR physiologic and psychologic burdens. PATIENTS AND ONE ANOTHER page 10 page 11 Like a chipped and For patients, knowing their risk factors can help them repaired glass, I am make better decisions technically all here. But page 13 run your fi ngertip along While the desire to maintain morale is understandable, it the glue line. You can is most imperative that the population be able to still feel the crack trust those in charge. page 19 page 4 Rapid scribbles STAY HOME SO I CAN GO I never took an oath and pantomime HOME. SO WE ALL CAN to run into a have become the GO HOME TO OUR FAMI- burning building communication naked. page 8 methods of choice. LIES AND NOT HAVE TO page 6 CHOOSE OUR PATIENTS I keep asking myself, where are the OVER OUR FAMILIES Their eyes. I should patients with strokes ANYMORE" have paid more or brain bleeds? page 5 attention to page 8 their eyes. WE ARE ASKING SKILLED STAFF TO GO page 7 ABOVE AND BEYOND THE CALL OF DUTY. page 7 Th e OJNA Journal - Page 3 Dispatches from the Frontline Over the past few months, the Jewish Press has gave of themselves to showcased a series of personal essays by OJNA others. To all those of nurses. Titled “Dispatches from the Frontline,” this you who have stories series has given the Jewish Press readership a yet untold, we hear glimpse into the lives and struggles of frum nurses your unsaid words taking care of COVID patients. Thank you to all and we know of your of these nurses for sharing their new world and bravery and sacrifi ces. making a kiddush Hashem in the process. More And please, continue important is the appreciation for all the lives they to share your voices. saved, the suffering they ameliorated, the families The world needs to they reassured, and the hours, sweat, and tears they hear them. By Yaakov Shereshevsky, RN A month ago, I laughed about coro- So much pain. Endless. It is horror we sure are not going to let some- from dropping navirus—or as Facebook memes for healthcare workers now. Lean one leave that way. too critically. A central venous called it, the “WuFlu.” It was a world back in your seat, mouth agape, pressure port on one of those ports Th is is a 34 bed ICU, one of several away, and it was never going to af- eyes wide horror. Th e suff ering is hooked up to a monitor to see the in this building. When I left yester- fect us here in the US of A. Today, unrelenting. fi lling pressure of the heart. Anoth- day, there were 34 patients. When I I had actual, physical palpitations er one or two IVs in their arms for We do what we can, but it is not came back, 34. But not the same 34. when I parked my car at work. I am some other IV meds. Maybe an an- enough. Not nearly enough. Our Th ree patients passed while I was scared to go in. I am a nurse. I have tibiotic, maybe an anticoagulant to medicine is excellent. Our skills are gone, each bed now fi lled with an- worked in healthcare in some form prevent a blood clot. A line in their sharp. And it means nothing. If Co- other patient, just as sick as the last. or another for the last 14 years, and rona were a movie villain, it would radial artery for continuous inva- there has always been risk. But it Each patient had a name. I remem- be laughing right now. Our people sive blood pressure measurement. has always been calculated. Has al- ber two of their names right away, are dying. And so much pain. Fami- A tube coming out of the nose at- ways been small. Now, I can bring it and struggle to recall the third. I lies, desperate for information, call- tached to wall suction to prevent home and HURT MY CHILDREN. can’t, and feel guilty. Too many peo- ing the hospitals. Hospitals doing gastric fi lling of particles they aren’t Oh, I’m careful. I strip in the door- ple here, too much to do. One of the their best to give them some news capable of digesting right now. An way where my wife leaves the laun- names I remember was my friend’s with the little time we have. And not endotracheal tube out of the mouth dry bag. I Lysol my shoes and my father. I am slowly breaking. enough supplies. And med short- connected to a ventilator to breath watch. I wash my hands at work ages, because being on a ventila- I am not an emotional person by for them. Th e ventilator itself, a so oft en my knuckles hurt. I wear tor requires sedation, and comfort nature.