Summary/Paraphrase Assignment
Part A: Read and summarize the following article (excerpt).
America Is Running Out of Nurses
Travelling nurses have been moving from one hot spot to another. What happens when the hot spots keep multiplying?
https://www.newyorker.com/science/medical-dispatch/america-is-running-out-of-nurses
Just how big is the coronavirus’s winter wave? It can be hard to get your mind around it. One way to try is to note that, right now, more than a hundred thousand Americans are in the hospital with covid-19—which is roughly as many people as can fit into the country’s biggest stadiums for the Super Bowl, and nearly twice as many as were hospitalized during the pandemic’s worst days in April and July. Another is to note that, around the U.S., hospitals are running out of nurses and doctors. At least half of all states are now facing staff shortages, and more than a third of hospitals in states as varied as Arkansas, Missouri, New Mexico, and Wisconsin are simply running out of staff. Ordinarily, an I.C.U. nurse might care for, at most, two critically ill patients at a time. Now, some are caring for as many as eight patients simultaneously. Recently, North Dakota’s governor issued an order allowing asymptomatic but coronavirus-positive health-care workers to continue seeing patients. (People without symptoms can still be infectious.) In most of California, I.C.U. usage now exceeds eighty-five per cent—the threshold above which new stay-at-home restrictions kick in. Since the beginning of the pandemic, the nation’s hospitals have developed protocols and purchased ventilators, and the mortality rate has fallen. But now the spread of the virus is so extreme that a shortfall of clinicians is becoming an insurmountable barrier in the fight against covid-19.
Alexi Nazem is the co-founder and C.E.O. of Nomad Health, a medical-staffing company based in New York City. Nomad fills physician and nursing needs across the U.S.; it sends nurses, in particular, to hospitals big and small, urban and rural, from coast to coast. Nazem has marked the evolution of the pandemic by the scale of the job orders he’s received, which have shifted, more or less, with the seasons. “It’s been a remarkable roller coaster,” he told me recently. In the spring, it was a “five-alarm fire.” There were unprecedented needs in New York and other early epicenters, but hospitals around the country felt compelled to staff up, too. “No one had ever experienced anything like it,” he said. “Hospitals looked around and saw that the covid light switch could flip overnight. They thought the same thing would happen to them. There was an explosion of job orders from all over.” For the most part, though, covid-19 patients didn’t materialize; many hospitals, having postponed elective procedures and non-urgent visits, sat empty and ended up cancelling their staffing requests. “It was complete whiplash,” Nazem said. “They said, ‘Actually, we don’t need all these extra people. We can’t even afford to pay our regular staff.’ ”
In the summer, when the coronavirus surged across the Sun Belt—in Florida, Texas, Arizona—Nazem’s company sent clinicians to affected states. But hospitals elsewhere didn’t feel the need to bolster covid-19 staffing. “Hospitals were more experienced by then,” Nazem said. “They weren’t over-ordering.” The composition of new job requests also shifted. Many hospitals were staffing not for coronavirus wards but to help in operating rooms and procedural suites that had postponed cases and were now running overtime to work through huge backlogs of colonoscopies and knee replacements. “These specialties were the worst hit in the spring,” Nazem said. “They were among the hottest in the summer.”
Now the need for clinicians has erupted again. “It’s been insane,” Nazem said. “Orders are coming from everywhere. There are no hot spots. It’s crazier than we’ve ever seen.” In the past, Nomad Health has provided hospitals with nurses who will work specifically on covid-19. “It’s now impossible to distinguish by job,” Nazem said. “Hospitals are saying, ‘Just come. Who knows what we’ll need you for.’ ” Given the current wave’s persistence, hospitals are renewing contracts for travelling nurses at unprecedented rates, effectively taking them out of circulation. “The number of extension requests tripled from summer to fall,” Nazem said. “The market is getting tighter and tighter. Hospitals are saying, ‘Let me hold on to whatever I can.’ ” In the past, they were picky about whom they would hire. “They used to say, ‘We need the perfect person,’ ” Nazem told me. “Now they say, ‘If you find someone, anyone, send them over.’ ” (Nomad Health thoroughly reviews credentials for each clinician; Nazem was at pains to say that quality has not been compromised.)
In normal times, there are some fifty thousand travelling nurses in the United States. Most are full-time gig workers who move from job to job, usually staying in one place for thirteen weeks. (That length is a holdover from old maternity-leave policies for nurses; the staffing industry evolved, in part, to fill such gaps.) According to Nazem, travelling nurses generally fit two profiles. One group consists of early-career nurses who want to acquire a range of clinical experiences—academic, urban, rural—and to travel the country. Another includes nurses at the end of their careers: “They say, ‘Hey, the kids are out of the house. I’d like to make some extra money. Wouldn’t it be fun to go to Alaska for the summer?’ ” The pandemic has diversified the pool. Severe staff shortages have brought more nurses into the travelling workforce. Many clinicians, especially those with critical-care training, feel an obligation to help. But, because demand has far outpaced supply, pay for travelling nurses has also skyrocketed. “Traditional nurses look around and say, ‘Hey, that travelling nurse is making double what I am,’ ” Nazem said. Before the pandemic, hospitals might have offered a travelling nurse seventy-five dollars an hour; now, in many places, that rate has tripled. “High pay draws more supply into the market,” Nazem said. “But at some point you reach a limit. Even if you were willing to pay a thousand dollars an hour, there just aren’t enough nurses. All you’re doing then is shuffling people around. You’re robbing Peter to pay Paul. We’re dangerously close to that.”
Part B: Read and paraphrase the following article (excerpt).
Breaking the silence: are we getting better at talking about death?
By Edmund Dewaal, May 21, 2018, in The Guardian
https://www.theguardian.com/books/2018/may/21/breaking-the-silence-are-we-getting-better-at-talking-about-death
As the media brings us constant news of strangers’ deaths, grief memoirs fill our shelves and dramatic meditations are performed to big crowds, we have reached a new understanding of mortality
It has become clear that we are living through an extraordinary moment where we are much possessed by death. Death is the most private and personal of our acts, our own solitariness is total at the moment of departure. But the ways in which we talk about death, the registers of our expressions of grief or our silences about the process of dying are part of a complex public space.
Some are explorations of the rituals of mourning, how an amplification of loss in the company of others – the connection to others’ grief – can allow a voicing of what you might not be able to voice yourself.
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