BISMARCK, N.D. -- North Dakota health care professionals say they're happy to see new statewide measures aimed at stopping the dramatic COVID-19 surge. But an advocacy group for nurses remains concerned a prior decision will impact the safety of workers and patients.

Over the weekend, Gov. Doug Burgum announced a statewide mask mandate and business restrictions. A number of groups have long called for such moves as the coronavirus tightens its grip on North Dakota.

Tessa Johnson, president of the North Dakota Nurses Association, said they hope the public complies with these protocols to ease the burden on hospital staff. She said many nurses are being thrown into troubling situations.

"They're just exhausted and they're unprepared," Johnson said. "And so, the majority of nurses I think will stick it out because it's just kind of what we do, we don't want to bail on our patients. But also, it's really difficult to be put into a situation where you feel unsafe and you feel your patient's may be unsafe because you can't give the care that they need."

She said ICU staff are trained to provide specialized care, and nurses being hurried to fill gaps creates risk.

Meanwhile, the group still is opposed to a state announcement that because hospitals are at full capacity, nurses who have a coronavirus diagnosis but are asymptomatic are allowed to stay on duty in COVID units. Gov. Burgum said he made the decision at the urging of health care administrators. Such a move is allowed under guidelines from the Centers for Disease Control and Prevention.

Johnson acknowledged as hospital staff become stretched thin, there's only so much that can be done to respond. But she said that decision creates another level of concern and trepidation for nurses.

In the meantime, the association hopes residents take the new mandates and the virus more seriously.

"Think of all the actions you're taking -- to wear masks, to socially distance, to stay in your own household for the holidays so we can enjoy holidays with our family next year,"Johnson said. "Because if we don't take those precautions right now, there's not gonna be anybody left in the workforce."

In addition to staff members getting sick, Johnson said some nurses might opt to leave the profession once the crisis subsides. Nurses have expressed concern that being rushed into providing care they're not trained to provide could threaten their license.

As of Monday, the state health department said less than 10% of staffed hospital beds in North Dakota were available for patients.



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New Mexico saw record enrollment numbers for the Affordable Care Act this year and is now setting its sights on lowering out-of-pocket costs - those not reimbursed by insurance. More than 56,000 New Mexicans are enrolled in a medical health insurance plan on the state exchange - an increase of 12,000 people overall.

Colin Baillio, deputy superintendent with the state's Office of Insurance, said the state has boosted its outreach and made efforts to improve the overall consumer experience.

"We saw a 40% year-over-year increase, and New Mexico saw the biggest percentage increase during the open-enrollment period among all of the state-based marketplaces," he explained

Part of the enrollment increase is due to what's called the "unwinding" - a federal directive that required all states to redetermine Medicaid eligibility following a three-year pause on checks during the COVID pandemic. He said by using expanded tools made available by the federal and state government, 8% of New Mexico's population is now uninsured - down from 23% in 2010.

Following approval by lawmakers in the 2024 legislative session, the New Mexico governor signed seven health care-related bills into law - one of which requires annual reporting of prescription drug pricing. Baililo said the Affordable Care Act built the foundation that has allowed the state to pursue additional affordability initiatives.

"I'm really glad to see that there's so much interest in the next step of health reform, really leaning into these out-of-pocket cost issues and making it easier for people to afford to stay covered and see their doctors," he continued.

Two years ago, the state also passed a one-of-a-kind law that did away with behavioral health co-pays for people in certain insurance plans.

New York's medical aid-in-dying bill is gaining further support. The Medical Society of the State of New York is supporting the bill. New York's bill allows terminally ill people with only six months to live to use this option, with safeguards requiring two physicians' approval.

The bill's Assembly sponsor Amy Paulin, D-Westchester, said despite the growing support, other hurdles lie ahead.

"Now we have what I believe, if it came to the floor, a majority. There's still a hesitation on the part of leadership. You know, we need members to assure leadership that they no longer have reservations," she said.

Other newly resolved concerns center on making sure insurance companies and doctors who don't support this aren't held liable. She's optimistic the bill will pass after nine years in the Legislature. New York would be the 11th state along with Washington, D.C. to have medical aid in dying legislation.

Corinne Carey, senior New York campaign director with Compassion and Choices finds the pandemic drew a vivid picture of a person's end-of-life experience. There were images of people dying on ventilators, apart from loved ones, and unable to communicate. She said people began thinking about a "good death."

"And, what is a good death is being surrounded by loved ones, having some measure of control, experiencing the touch of your loved ones, and being the one in the driver's seat," she explained.

Now people have different options for end-of-life care, each of which presents various challenges. Polls show medical aid in dying has garnered considerable support since being introduced in 2015. A 2022 Compassion and Choices poll finds 57% of nurses support medical aid in dying professionally, although fewer support it personally.

The California State Assembly is considering a bill to require schools to have a cardiac arrest response plan. Assembly Bill 2887 would make sure schools update their safety plans to include CPR training and an automatic external defibrillator or AED onsite.

Dr. Stephen Sanko, a professor of clinical emergency medicine at USC, and a founding member of the Cardiac Arrest Survivor Alliance, is a volunteer expert for the American Heart Association. He said having a plan in place is critical.

"The American Heart Association is promoting that schools have a cardiac arrest response plan. A written protocol for what to do in order to decrease the likelihood that if somebody collapses, that they die," he said.

Two years ago, 15-year-old Cash Hennessy collapsed on the football field due to a previously unknown heart defect. Two off-duty medics in the stands gave him CPR. The school brought out its AED - but it was useless, because the batteries were dead.

Hennessy said the experience was traumatic.

"I feel blessed that I had people there for me, that could give me C-P-R. But I think about if those people weren't there and that was another kid, who knows what would have happened? Because there wouldn't have been an AED to save them," he explained.

An AED walks people through the steps to deliver a life-saving shock to a person's heart until an ambulance arrives. Studies show that 70% of kids who suffer sudden cardiac arrest at school recover if an AED is deployed correctly - whereas the survival rate for kids and adults not in the hospital is less than 12%.