A resurgent interest in public health and a sharper focus on the mental health of those delivering care are among the lasting transformations resulting from a worldwide crisis

King, Jill B., 98

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DigitalCommons@Linfield

Linfield Magazine Volume 17 Number 1 Summer 2021 Article 8 April 2023 Changed by the pandemic Jill B. King 98 Linfield University Follow this and additional works at: https://digitalcommons.linfield.edu/linfield_magazine Recommended Citation King, Jill B. 98 (2023) "Changed by the pandemic," Linfield Magazine: Vol. 17: No. 1, Article 8. Available at: https://digitalcommons.linfield.edu/linfield_magazine/vol17/iss1/8 This article is brought to you for free via open access, courtesy of DigitalCommons@Linfield. For more information, please contact digitalcommons@linfield.edu. Summer 2021     |     Linfield Magazine - 19Summer 2021     |     Linfield Magazine - 18Changed bythe pandemicA resurgent interest in public health and a sharper focus on the mental health of those delivering care are among the lasting transformations resulting from  a worldwide crisis.By Jill B. King ’98Mindy Close ’08 is one of Oregon’s nearly 104,000 nurses impacted by the COVID-19 pandemic.“Nurses are proximate to trauma. We are having to take  on a lot of that trauma – holding a patient’s hand, holding phones while loved ones say goodbye. It’s impossible  for this not to fall back on you.”Summer 2021     |     Linfield Magazine - 21Summer 2021     |     Linfield Magazine - 20 She received her associate degree in August 2019, yet her work as a public health nurse requires a bachelor’s degree, and she quickly realized the benefits of pursuing it. “I have always had a heart for getting to people before they are sick and having a proactive approach, rather than a reactive one,” she said. “The most difficult thing for me during the associate program and clinicals was that it felt like the patient education was too late.” With a focus on public health, Linfield’s RN to BSN program has been the perfect fit for Fairhurst. “I found it intriguing that the BSN program focused on community health in great detail, whereas the associate pro-gram hardly mentioned it,” she said. As the largest segment in the U.S. healthcare workforce, nurses play a key role in public health. The National Academy of Medicine describes nurses as “trusted bridge-builders  who collaborate with people, communities and organizations to promote good health and wellbeing no matter one’s  background.” It’s a role that nursing programs like Linfield’s emphasize.  “Nurses connect to people at their most vulnerable moments. They are the human interface between the data, science and patients,” said Kim Dupree Jones, dean of the Linfield-Good Samaritan School of Nursing. “While data informs decisions, relationships drive decisions. So, when a nurse builds a relationship and invests in the health of one patient, they are also impacting and improving the health of that patient’s community.” The pandemic has made fundamental public health measures a topic of regular conversations, including hand-washing, social distancing, face coverings and vaccinations. It has also spotlighted the need for improved access, equity and emergency preparedness at local and federal levels – some-thing that will keep public health, and the critical need for public-health nurses, in the headlines for years to come.Addressing the effects of  mental health  As Close’s example illustrates, the emotional toll the pan-demic has taken on healthcare workers is profound. Levels of anxiety, depression and loneliness are similar to those seen in patients fighting COVID-19 in isolation.  The nonprofit group Mental Health America (MHA) recent-ly surveyed more than 1,000 healthcare workers, and 93% re-ported high stress while 83% indicated emotional exhaustion. More than half of the nurses surveyed, in particular, reported a lack of emotional support. “Nurses are driven, caring and want to do everything they can for their patients, and therefore, have an underlying tendency to set high expectations of themselves,” said Sarah Fleischauer, a counselor in Linfield’s School of Nursing. “A profession that allows a pretty low margin for error paired with a self-created pressure to be almost superhuman, it primes nurses for trauma and anxiety – which is the perfect storm for emotional distress.”“Nurses connect to people at their most vulnerable moments. They are the human interface between the data, science  and patients.”he demand on nurses like Mindy Close ’08 has never been greater. Close, a registered nurse and team leader at Salem Health, has spent the past 18 months working long hours in stressful conditions, while filling her free time as a student in Linfield’s Master of Science in Nursing (MSN) program. She vividly remembers being stripped of her regular routines in early 2020 as the hospital focused on treating COVID-19 patients, just as she was starting graduate school.  Salem Health, the largest hospital in Oregon’s capital city, was hit hard early on taking COVID-19 patients from areas as much as 250 miles away. Her previous patients in the wound ostomy department were deferring care, elective procedures were canceled and many departments like hers did not have the patient load to justify their previous staffing. Some nurses were cross-trained in new specializations and others were forced to use vacation time or leave the profession altogether. The irony was not lost on Close: at a time when  public health was more critical than ever, nurses and  doctors in some specializations were seemingly being  shunted to the sidelines.   On top of uncertainty about their jobs was the worry that time spent in hospitals might make them a risk to others in their families. Close and her husband eventually decided to send their kids to live with grandparents to minimize their risk of exposure. “Within a week, I found myself longing for a hug from my kids,” Close said. “We weren’t able to celebrate Easter or Mother’s Day as we normally would together. It began to feel like there was no light at the end of the tunnel. It became the loneliest time.”  At one point during those dark days, Close ended up checking on and advocating for a friend in the ICU.  “You understand it as a nurse from a clinical perspective,” she said of the care. But, she said, watching her friend suffer alone, with no family allowed to visit, “the fight becomes per-sonal in your heart.” It was to be a fight in vain. Her friend’s death, one of the nearly 3,000 Oregonians and four million people worldwide who lost their lives to COVID-19, pushed Close nearly to her breaking point.  “This virus is killing people, and we don’t know  who’s next,” she remembers thinking. She was lonely,  exhausted, grieving and unsure what the next moment  or day might bring. The importance of public health Even as frontline healthcare workers like Close continue to battle the disease, the pandemic has had lasting effects on the healthcare system and nursing education programs that will be felt for decades. The increased focus on public health has coincided with a noticeable growth in interest in public health schools. Al-though public health education enrollment has grown for the past two decades, the Association of Schools and Programs of Public Health reported a 40% increase in applications to public health programs from March 2020 to March 2021. Becky Fairhurst ’21 started her Bachelor of Science in Nursing (BSN) at Linfield online in February 2020. She cur-rently co-leads the COVID-19 investigative team in south-ern Oregon’s Coos County. At the height of the pandemic, Fairhurst was working more than 60 hours a week, balanc-ing life in a blended household with two young children and volunteering in vaccine clinics on days off. – Kim Dupree Jones, dean of the Linfield-Good Samaritan School of Nursing– Kaitlynn Durham ’21, student in Linfield’s ABSN program and president of the Public Health ClubSummer 2021     |     Linfield Magazine - 22 The history of the Good  Samaritan School of Nursing was rich and impressive long before Linfield entered the pic-ture. The oldest nursing school in the West was founded in 1890 and its growth was initially shaped by Emily Loveridge, its leader until 1905. Loveridge was the first – but far from the last – dedicated, hardworking, exacting, patient and compassion-ate caretaker of the school, from which more than 4,000 nurses graduated in 95 years. For many of those years, Good Samaritan was like most nursing schools of the time: a diploma program dedicated to the hands-on, practical education of professional nurses. Faculty consisted mainly of professional nurses and staff who worked alongside nursing students as they trained. The school became known for producing strong, caring, in-de-mand nursing graduates. In the 1960s and ’70s, nursing education underwent a fundamental shift, with a new emphasis on prerequisite courses in the sciences and humanities before practical training, which itself was becoming more advanced and spe-cialized. Most successful nursing programs became affiliated with established universities to handle the new demands.   In Oregon, Good Samaritan was the last standalone three-year diploma nursing program of its kind in 1975 and faced an uncertain future. The administrators of the hospi-tal and school sought to carry on the legacy by finding the right four-year college as a partner. Linfield, seeking a presence in Portland and an expan-sion of its curriculum, emerged as a possible match. Just as A legacy of nursing educationPictured above: Emily L. Loveridge at age 23 in New York City. At the time this photograph was taken, Loveridge was studying nursing at Bellevue Training School for Nurses (in New York City), from which she graduated in 1889.Summer 2021     |     Linfield Magazine - 23 For Close, it wasn’t long into 2020 that the emotional toll of the pandemic hit her and her team.    “It’s like running a marathon without adequate training or an end in sight,” she said. “As nurses, our give-a-damn became broken.” Mental health has an effect on physical health. In the MHA survey, respondents reported trouble with sleep (70%), physical exhaustion (68%), changes in appetite (57%) and physical symptoms like headache or stomachache (56%). This physical, emotional and mental burnout places an increased importance on nurses to advocate for greater self-care and for organizations and schools to integrate training on nurses’ health and wellbeing into their programs. “Nurses are proximate to trauma,” said Kaitlynn Durham ’21, a student in Linfield’s accelerated Bachelor of Science in Nursing program and president of the Public Health Club.  “We are having to take on a lot of that trauma – holding a patient’s hand, holding phones while loved ones say goodbye. It’s impossible for this not to fall back on you.” Close’s hospital introduced mental health days, made Peloton bikes available, created access to the Headspace meditation app and trained managers to check in with their frontline staff more often, encouraging breaks and fresh air whenever possible. At Linfield’s School of Nursing, two staff counselors offer individual, group and family sessions for free. Through sessions and quarterly workshops, the counselors work with students on coping skills and building plans to support their mental and physical wellbeing. With the help of Durham’s leadership, the Public Health Club promotes intentionality and thoughtfulness about mental health. “It’s important to remember that we are more than this,” Durham said. “I am more than a nursing student. I am more than just some experience in the pandemic. I am all of that PLUS.”  At this point in the pandemic, Close is reflective on her own journey.  “There has been a lot of growth, not just in myself, but in the nurses and frontline staff I work with every day,” she said. “We are all changed by what we have witnessed, worked through and felt.” Special thanks to Kathryn Schach ’72 and Cindy Evans, a longtime Good Samaritan Hospital employee, for their assis-tance with this article. And, as always, “Inspired Pragmatism” by Marvin Henberg and Barbara Kitt Seidman is a wonderful resource for learning more about Linfield’s history.each school sought something in the other, each had concerns about what a partnership might mean. Adding a professional baccalaureate nursing program could alter Linfield’s liberal arts core and finding the necessary faculty might be a daunting task. Also, adding the curricular demands of Linfield’s program might take away from the clinical, hands-on learning that was Good Samaritan’s key characteristic. After an extensive process of exploration and negotiation, the schools came to an agreement in 1982. The first class of Linfield-Good Samaritan School of Nursing students came in 1983, and the final class that had entered Good Samaritan prior to the agreement graduated in 1985.  From the start, Linfield and new nursing dean Pam Harris sought to make Good Samaritan alumni feel like part of the family. Dean Harris embraced Good Samaritan’s history and sought to bring together alumni of the diploma program and the new baccalaureate curriculum. The School of Nursing thrived and quickly became one of Linfield’s core programs, building the early foundation for the recent expansion to a dynamic campus and its many possibilities. Linfield and Legacy Health, Good Samaritan’s successor, may no longer have a formal partnership, but Good Samaritan’s legacy – especially its emphasis on excellence in care – has carried on and remains at the heart of Linfield’s nursing tradition.– Rich Schmidt, director of archives and resource sharing

Changed by the pandemic

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