PORTLAND, Ore. - Nurses provide a range of care, and not all of it is delivered in person. The Providence RN Medical Advice Line is a phone number Providence members in Oregon and Washington can call any time, day or night.
But staff shortages due to the COVID-19 pandemic have meant nurses can't help patients in a timely manner.
Calls to the advice line vary in urgency and can include folks who have recently had surgery and parents who need guidance when their child is sick in the middle of the night.
Dawn Bryan, a nurse and a member of Oregon Nurses Association who works on the advice line, said reassuring people is a big part of the job, but that can be hard when it takes days to get back to someone.
"It's really significantly impacting people who have real questions and needs from the nurse advice line," said Bryan. "They're going to urgent cares and the ER because they don't know what to do, because it takes a day and a half or longer for us to get back to them."
A spokesperson for Providence said it's experiencing major staffing shortages just like other health systems across the country.
Heidi Sweeney, a nurse and an Oregon Nurses Association member who also works on the advice line, said they have seen more than double the normal amount of calls because of COVID-19 and understaffing.
She said many nurses are feeling burnt out and that she and her union have presented solutions to Providence.
"The first step is to utilize the staff we already have," said Sweeney. "Utilizing the staff we already have through incentives would be an amazing way to encourage people to step up, take some extra hours and also just acknowledge the value that they have."
Sweeney said Providence hasn't yet accepted any of their proposals. The health system says it's working to acquire and retain staff by intensifying its recruiting efforts and with cash incentives and bonuses for caregivers.
Sweeney said unfortunately, the importance of their work often is overlooked.
"We are not somewhere that the powers that be can see what we do," said Sweeney. "And the workload that we have is not visible. And so, we are not receiving value for what we do at all."
Disclosure: Oregon Nurses Association (AFT Local 5905) contributes to our fund for reporting on Budget Policy & Priorities, Health Issues, Livable Wages/Working Families. If you would like to help support news in the public interest,
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People who are part of the Deferred Action for Childhood Arrivals program, known as DACA, will be dropped from their CoveredCA health plans at the end of August.
The move comes after the Trump administration changed a Biden-era definition of "lawfully present" to revoke health care eligibility for thousands of immigrants.
Christine Smith, policy and legislative advocate for the nonprofit Health Access California, said people only have a few weeks to get medical appointments in before their coverage ends.
"If you're enrolled in Covered California and you're a DACA recipient, the Trump administration just ended your coverage," Smith emphasized. "People should use as much of your health care as you can before the August 31st deadline."
The Centers for Medicare and Medicaid Services defended the move, saying it will save taxpayers money. CoveredCA estimated the change affects about 2,400 DACA recipients in the state who make too much to qualify for Medi-Cal and have jobs not providing health insurance. They can still buy private insurance but it is much more expensive. People who prepaid for their coverage can seek a refund.
Smith predicted it will be a blow not just to those who lose coverage but to the state's health care system as a whole.
"The lines in the ERs are going to be longer because people are not going to be able to get affordable preventive care," Smith projected. "They're just going to get sicker and then end up in the ERs. People will overall incur more medical debt. Hospitals will have more uncompensated care."
The change is nationwide. As of mid-July, about 538,000 people in the DACA program across the U.S. are ineligible to enroll in any state-based insurance marketplace and are unable to access premium subsidies or cost-sharing assistance.
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Artificial intelligence is appearing more prominently in many aspects of life and research suggests older populations are curious, yet remain wary of using the technology in their everyday lives.
According to Stats Indiana, there are more than 1.5 million Hoosiers aged 65 and older, or 18% of the state's population. Experts said it is likely the demographic will use AI in some form in the next few years, either by choice or necessity.
Dr. Shaun Grannis, vice president of data and analytics for the Regenstrief Institute on Aging, said AI offers real benefits.
"It can reduce loneliness through conversation, provide reminders for medications and appointments," Grannis outlined. "It can support cognitive stimulation via games, storytelling, news updates."
The technology can also offer a low-pressure way to access information on public services, he added, which is valuable for those with mobility issues or those who feel intimidated by technology.
Grannis cautioned any tool which can be used for good can also lead to problems. He noted AI can create a false sense of companionship and mask social isolation. Overdependence is a legitimate concern, he argued, if the technology becomes a "crutch" for all forms of interaction.
"All cognitive activities or decision-making, it can actually lead to and create a negative feedback loop, lead to a decline in engagement and even basic self-management skills," Grannis explained. "This is risky."
Grannis believes one solution is designing AI systems to complement, not replace, human interaction. He stressed it can be done though building broader support ecosystems including family, friends, caregivers and community services. Grannis emphasized it would encourage real-world activity, prompting the user to go for a walk, call a grandchild or attend a local senior event.
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If you have an extra five minutes, you can save a life because you can learn cardiopulmonary resuscitation at no cost from a new mobile, hands-only CPR kiosk.
The new kiosk is in the lobby of Saint John's Health Center in Santa Monica. The machine's touch screen gives a brief overview of hands-only CPR and you can practice right there, on a mannequin.
Dr. Rigved Tadwalkar, cardiologist at St. John's, said it is an easy way for people to get more comfortable giving chest compressions in an emergency.
"It's a lot like a video game but of course, a lot more important than a video game," Tadwalkar pointed out. "It gives real-time feedback about the depth and rate of compressions, proper hand placement, which are all factors that influence the effectiveness of CPR."
The American Heart Association operates the St. John's mobile kiosk and a stationary model at L-A-X with support from the hospital. Santiago Canyon College in Orange County also has a mobile hands-only C-P-R kiosk now through September, sponsored by Edwards Lifesciences.
Steven Munatones, an Orange County business owner, said he survived what's known as a "widowmaker" heart attack which led to cardiac arrest nine years ago, thanks to his 17-year-old son, who gave him immediate CPR with instructions from a 911 operator.
"You don't have to put your mouth to anybody's mouth," Munatones explained. "You just put your hand on their chest and pump. He saved me, and others can do the same, anywhere. So, it's absolutely a lifesaving, heroic act that anybody can do."
Statistics show 350,000 Americans suffer from cardiac arrest outside a hospital each year and about 90% die, in part because they do not receive CPR. About 70% of those cardiac arrests happen at home, so people often depend on family or friends to give CPR before an ambulance arrives.
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