March-June 2020 | Volume 101, Number 2
PANDEMIC COVERAGE
BY: PAUL N. OLIVIER, FACHE
Hospitals are community assets, and legislators are public servants. Both have a shared commitment to serve the health of the community, which creates a crucial synergy in a public health crisis. The pandemic of COVID-19 pulled hospital operators and local, state and federal legislators together against a common crisis, and each group brought unique strengths to the challenge. Hospital government relations professionals solidified their working relationships with legislators in ways that yielded maximum collaboration during this time of threat to the health of the communities they jointly serve.
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BY: MARY ANN STEINER
Just before long-term care facilities closed to visitors for the long season of COVID-19, our 92-year-old mom was discharged from a rehab facility to my home to continue her recovery from a terrible fall. We were just learning the vocabulary of COVID, watching the first wave of the pandemic come at us.
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BY: JUSTIN HINKER
It will come as no shock to professionals in long-term care, but among the most important lessons our team learned in recent weeks is the uniquely fluid nature of time. At Avera Prince of Peace Retirement Community in Sioux Falls, South Dakota, we have 114 skilled nursing facility beds, 60 assisted living beds and 74 independent living beds. Our residents are why we do the work we do.
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BY: BRIAN SMITH, MS, MA, MDiv
During the past few months we have heard the word "unprecedented" used to describe the coronavirus pandemic. Others have referred to this time as "disruptive" and "chaotic" as the health care world we have known has been turned upside down. No one believes that we will ever go back to the way things were. Everyone seems to be asking, "What will our new reality be?"
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BY: FR. GERALD A. ARBUCKLE, SM, PhD
Loneliness is the feeling of being disconnected, excluded and disengaged from others, an agonizing feeling of emptiness or desolation, a feeling that no one cares. At the same time there is the yearning to belong, a restlessness to make a satisfying relationship, to feel valued. Prior to the coronavirus pandemic, loneliness had been identified as the next global health epidemic of the 21
st century. But, in early 2020, the COVID-19 pandemic generated forces that have intensified widespread loneliness beyond what was even imagined in the 2019 projection.
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BY: JASON T. EBERL, PhD and G. KEVIN DONOVAN, MD, MA
The COVID-19 pandemic has prompted an unprecedented need for health care institutions to develop and implement triage policies for allocating scarce resources if they experience a surge of patients needing life-sustaining treatment for severe acute respiratory distress. In the absence of definitive guidance from the Church's Magisterium concerning specific requirements of such policies, there is space for moral disagreement concerning triage criteria and allowable practices.
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BY: FRED ROTTNEK, MD, MAHCM
As I child, I was drawn to the rituals of Lent and the Easter season. It started with ashes on our foreheads, and Fridays meant Stations of the Cross. There was something about the physicality of doing the Stations — facing directions we normally didn't face in church; rhythmic kneeling, standing, listening and responding; and hearing heartbreaking stories of every type of cruelty. Holy Week opened with palms and pageantry, then foot washing, processions to kiss the cross, stripping of the altar, lights lowered and then brightened. And then Easter morning exploded with joyful hymns, alleluias, and the sights and smells of Easter lilies..
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BY: KATE JACKSON-MEYER, PhD
As the coronavirus pandemic rages on, it is becoming increasingly evident that many on the frontlines are, understandably, distressed. Distressed by the high volumes of patients and the lack of personal protective equipment (PPE). Anxious about not having enough ventilators as they face unprecedented resource allocation decisions. Grieving from watching patients die alone. Health care workers, first responders and chaplains may experience moral distress due to the COVID-19 crisis, and this can affect them psychologically, morally and spiritually. It is incumbent on Catholic hospitals and long-term care facilities to care for their personnel, with particular focus on the frontliners who are experiencing more of this kind of harm.
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BY: DENNIS P. GONZALES, PhD
Hello friends. After years of eagerly awaiting each issue as a mission leader in the field, I am excited to be writing my first article in Health Progress as a CHA employee. Although I have come to know many of you in the health systems over time, allow me to introduce myself formally. My name is Dennis Gonzales, and I am privileged to serve as CHA's new senior director for mission innovation and integration.
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BY: DAVID SHEETS
If there is anyone who can appreciate the value of Catholic sisters in nursing and the crucial role they play in health care and patient advocacy, it's Pope Francis: One of them saved his life when he was a young man.
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BY: BICH HA PHAM, JD, and DAVID ZUCKERMAN, MPP
COVID-19 is bringing a new level of attention to the deadly effect of health inequities in our country, particularly the disparate impact on people of color, immigrants, low-wage service workers and those without access to health care.
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BY: LAURA McKINNIS, MSN, NP-C
I've worked in emergency medicine for 20 years and have come to believe the foundation of emergency medicine is problem solving: We see weird stuff and we figure out how to handle it. We first started seeing cases of COVID-19 in late February. That seems like a lifetime ago. The department was drowning in its normal, heavy volume, and then we lost use of COVID isolation rooms that needed extensive cleaning. As the fears of the coming pandemic grew, so did patient volume. It felt like we were always managing the problem a week too late. As soon as we adjusted, made space and found solutions, the testing protocol would change or the patient volume would shift or new concerns over availability of personal protective equipment (PPE) caused us to proceed in ways that never before would have been tolerated. But we keep adjusting.
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BY: SUSAN HUBER
"Are we there yet? … How many more miles? … When are we going to be there? … But it's taking too long!"
Not yet … A few more … In a little while … Be patient. It will be great when we get there!""
As adults, many of us have been on both sides of this classic vacation conversation. We learn at a young age that patience is hard – and usually painful. The need for patience is also part of implementing global mission initiatives.
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BY: DAVID LEWELLEN
In the first week of the coronavirus epidemic in the Bay Area, Sr. Donna Moses, OP, a chaplain, was asked to visit a dying patient who was symptomatic for COVID-19. At the nurses' recommendation, she put on an N95 mask, a gown, a face shield and two sets of gloves.
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BY: DANIEL J. DALY, PhD
Medical facilities in the United States must ration health care in response to the COVID-19 crisis. There is an acute scarcity of medical resources. Facilities lack both the materials (ICU beds, ventilators, testing kits, personal protective equipment) and the personnel (doctors, nurses, respiratory therapists) required to treat patients suffering from COVID-19. In response to the impending scarcity of resources, some fear that rationing could disadvantage patients with physical and mental disabilities for mechanical ventilation. Some ethicists have suggested that age be a factor in determining which patients are disadvantaged for scarce resources. The scarcity of resources during this pandemic requires ethicists to determine just principles for the rationing of life-sustaining treatment. Should age, life-years expected, or the quality of a patient's life be considered when deciding who receives a ventilator and who does not?
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BY: BRIAN M. KANE, PhD
The present COVID-19 crisis has been with us for months. The threat seemed to be inching along until a switch was thrown, the danger multiplied and panic set in. That transition from security to fear seems to have changed everything, especially people's behaviors.
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Elden Cox, RN, unit supervisor, Trauma-Neuro Critical Care at Our Lady of the Lake Regional Medical Center in Baton Rouge, Louisiana shares a nurse’s personal perspective on Ministry and COVID-19
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BY: BETSY TAYLOR
At a time when the global coronavirus pandemic has just about everyone feeling some level of anxiety or sadness, St. Vincent Charity Medical Center in Cleveland, like hospitals elsewhere in the nation, rapidly reworked its provision of care to patients with serious behavioral health concerns. St. Vincent has a long history of providing a lifeline for patients with mental illness, addiction or both.
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BY: LISA SMITH, MPA
As a vital ministry of the church, Catholic health care has long been called to bring healing and hope—to provide care for patients and communities as well as to advocate for the changes needed in our society to protect human dignity and promotethe common good. We believe every person is created in the image of God, that each life is sacred and possesses inalienable worth, and that access to health care is essential to protecting the inherent dignity of every individual.
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BY: FR. CHARLES BOUCHARD, OP, STD
All of us would like to see the ministry of Catholic health care as prophetic and oriented to the common good. That should be easy, except for two things. First, the common good is widely misunderstood, and second, prophets have an image problem.
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BY: RACHEL C. TANNER, MJur
Across the United States, rural communities are facing enormous pressure to survive.Younger generations are leaving to find economic opportunity elsewhere, employers are shutting down, the remaining population is aging, and health care providers and facilities are stretched nearly to the breaking point. In fact, more than 160 rural hospitals have closed since 2005, and 21% of all rural hospitals are at high risk of closure due to financial instability.
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BY: LILIA CERVANTES, MD, and NANCY BERLINGER, PhD
Health policy that serves the common good in America's unequal society should aim to mitigate health-related disadvantages. Low income, minority race/ethnicity, and lack of insurance are examples of social (non-medical) determinants of health associ-ated with barriers to health care access and/or poorer health outcomes. Health equity starts by confronting inequality, then using tools of research and policymaking to reduce built-in – structural disadvantages a patient or population cannot fix.
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BY: DAVID SHEETS
With the 2020 presidential campaign well underway, economic inequality continues to gain strength as one of the top issues in the election. Six in 10 U.S. adults believe the level of inequality is too high, according to the Pew Research Center.
Of those, most say the solution requires a wholesale change to the economic system.
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BY: BENJAMIN F. MILLER, PsyD
The data is going in the wrong direction. While life expectancy has been on the rise since the 1960s, its sharp decline over the last three years is a sign that something is fundamentally broken in the United States. It's 2020, and we are losing more lives to preventable causes than ever before. Deaths due to drugs, alcohol and suicide are at an all-time high, and our country is hurting in ways that are multifaceted — attributable to overlapping issues and circumstances. For some, it may be access to affordable health care. For others, it may have more to do with social and economic factors. Loneliness, worry, isolation and issues of belonging are key drivers of despair, and we must be bold in our vision and courageous in our decision making if we are serious about making a difference in our country's health.
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BY: ALISHA COTTRELL, SEAN D. GEHLE and LINDA ROOT, RN, MAHCM
Catholic health care is called to assure and promote the common good and Catholic social tradition, thought and practice. We answer the Gospel call to affirm that each person's life is a treasure and everyone should have the opportunity to flourish. Access to quality health care is a right and is necessary for everyone to achieve that vision.
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BY: SR. DORIS GOTTEMOELLER, RSM, PhD
Nothing is as intuitively simple to grasp and as complex to implement as the concept of the common good. According to the U.S. Catholic bishops, the common good comprises "the social conditions that allow people as individuals and groups to reach their full human potential and to realize their human dignity." It would be hard to make an argument that the common good is not something to be universally valued and sought.
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FEATURE
BY: FR. GERALD A. ARBUCKLE, SM, PhD
Today so many people are overwhelmed with grief, a consequence of the global revelations of appalling sexual abuse scandals and cover-ups. Church hierarchies, priests and religious feel demoralized by what has happened. Lay people feel betrayed, ashamed, disillusioned and angry, their trust in their leaders destroyed.
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100th ANNIVERSARY
BY: BRIAN SMITH, MS, MA, MDiv
"Whether it be the sweeping eagle in his flight, or the open apple-blossom, the toiling work-horse, the blithe swan, the branching oak, the winding stream at its base, the drifting clouds, over all the coursing sun, form ever follows function, and this is the law. Where function does not change, form does not change. The granite rocks, the ever-brooding hills, remain for ages; the lightning lives, comes into shape, and dies, in a twinkling. It is the pervading law of all things organic and inorganic, of all things physical and metaphysical, of all things human and all things superhuman, of all true manifestations of the head, of the heart, of the soul, that the life is recognizable in its expression, that form ever follows function. This is the law.".
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