James Yoo

On September 28, 2022, Hurricane Ian devastated southern Florida, killing at least 119 people, disrupting power to more than four million customers, and causing tens of billions of dollars in damage.

Ranking high among the victims of the storm were Florida’s nurses. And at the forefront helping them to recover is Nurse Tara Kosmas and her group, Debriefing the Front Lines. Debriefing the Front Lines is a nonprofit devoted to helping the emotional health of healthcareworkers. Emma at Incredible Health spoke with her on an Instagram Live chat.

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Responding to Disaster

While Debriefing the Front Line’s main focus is on healing the unique and complex occupational trauma that affects nurses collectively, the organization also recognizes the need for post-traumatic response recovery following disasters.

Hurricane Ian left Florida’s nurses — already struggling with physical, emotional, and spiritual symptoms of cumulative caretaking trauma — with a lack of food, water, or shelter, Kosmas said.

“There are nurses, healthcare workers, people of all kinds who have lost their homes,” she said. “Their homes are destroyed. They honestly have nothing but the clothes on their back. They don’t have a toothbrush or toothpaste. They don’t have tampons. They don’t have toilet paper. All the things that you need to be human. And they lack these things while they’re also going into work, expected to care for other people.”

Kosmas and her husband responded immediately after Ian struck. They rented a U-Haul truck, loaded it with $3,000 worth of supplies, and drove south from Baltimore. Since then, the group has conducted a needs assessment that resulted in the group collecting over $10,000 in donations, with hopes of raising $25,000 by the end of the year. 

They have delivered basic essentials to hospital units where nurses have been hit the hardest, including toilet paper, paper towels, food, soap, toothpaste, and hot meals. Kosmas explained that the group’s current focus is on night shift nurses because they found that there were more resources available to day shift staff. They have also set up an Amazon wish list that has helped them get the specific supplies that they need.

Debriefing the Front Lines has also sought to provide psychological first aid to nurses and other healthcare workers. They have begun offering informal text sessions and debriefings on a limited basis. Kosmas is also working with other nonprofits to coordinate three mental health sanctuaries that they hope will go live within the next two weeks. “As the needs move from basic physiologic we are looking at moving towards psychological and mental health,” she said. “This is going to be a long, long haul.”

How Can You Help? How Can You Find Help?

Kosmas suggested her organization’s website and Instagram bio where you can find links to their services and hurricane relief response. You can also make a financial contribution at their hurricane relief donation page. 

Who is Debriefing the Front Lines?

Debriefing the Front Lines was founded to respond to nurses’ need for a psychologically safe space outside of the workplace where they could express their emotions without fear of judgment or repercussion. It was started 15 days after the global COVID-19 pandemic was declared.

In the three years since it began, the organization has gone on to provide nurses with a variety of psychological support services including structured debriefing, board-certified nurse coaching, emotional wellness offerings, and nervous system regulation tools.

Sources

• Hurricane Ian’s Path of Destruction. National Environmental Satellite Data and Information Service. nesdis.noaa.gov. Accessed October 18, 2022.

President Joe Biden announced a three-part plan to provide student debt loan relief. This will affect nurses at every level of education and experience. 

The President’s three-part plan cuts monthly payments in half for low-income borrowers,  provides repayment credit for certain types of work experience, works to reduce the cost of college in the future, and provides targeted debt relief for low-to-middle income borrowers.

As part of a three-part plan being administered in cooperation with the U.S. Department of Education, nurses whose individual income is less than $125,000 (or whose household income is less than $250,000) will be eligible for up to $20,000 in debt cancellation. 

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Targeted student debt relief will help nurses earning less than $125,000

Here is what you need to know about whether you are eligible for the debt cancellation program:

• You must have one of the following loans: 
  • Direct subsidized and unsubsidized federal student loans
  • Parent Plus Loans
  • Direct Stafford Loans
  • Grad Loans
• Your annual income must be below $125,000 (individual) or $250,000 (married or head of household).
• If you received a Pell Grant in college and meet the above-listed income threshold you will be eligible for up to $20,000 in debt cancellation.
• If you did not receive a Pell Grant in college and meet the above-listed income threshold you will be eligible for up to $10,000 in debt cancellation.
• Borrowers who are dependent students will be eligible for relief based on their parents’ income rather than on their own.
• If you qualify for the relief listed above, your debt cancellation is limited to no more than the amount of your outstanding debt. For instance, if you qualify for $20,000 in debt cancellation and you have $13,000 remaining to be paid, you will receive $13,000 in debt relief.

What nurses need to do to claim student debt relief

Student debt cancellation represents a significant relief for countless nurses. Whether you are currently in school or have been carrying student debt for decades, here is what you need to know in order to obtain student debt relief under the Biden plan.

• The Department of Education has set up a subscription page for notification of when the application process begins. You can sign up here to receive these notifications. Simply enter your email address and check off the top box that reads “Federal Student Loan Borrower Updates.”
• If you are one of the 8 million borrowers for whom the U.S. Department of Education has income information, you will receive relief automatically.
• If the U.S. Department of Education does not have your income information (or you are not sure whether they do or not), an application will become available within the next few weeks. If you have signed up for notifications for Federal Student Loan Borrower Updates you will receive an email letting you know when the application is available.
• While you are waiting for the application to become available, the pause on federal student loan payments will remain in effect until December 31^st, 2022. The application will be available prior to the pause expiring.

Not all nurses will qualify for the federal student loan debt forgiveness program

Though it is anticipated that President Biden’s action will help millions, it will not address debt on loans that do not qualify. Fortunately, there are other student loan forgiveness programs available for nurses. These include:

• The Nurse Corps Loan Repayment Program pays up to 85% of unpaid nursing education for up to three years of work in under-resourced communities.
• The Public Service Loan Forgiveness Program offers loan forgiveness to nurses who have worked full time and who have made 120 non-consecutive payments for working 30+ hours for a government or nonprofit agency.
• The Federal Perkins loan cancellation and discharge program is available to nurses who had previously taken out federal Perkins loans and who work full time.
• Military nursing student loan forgiveness is available for nurses who have served in the Army, Navy, and Air Force.
• State nursing student loan forgiveness programs are available in most states for nurses who work in critical needs areas.

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Next steps

If you are a nurse carrying a student loan that is eligible for federal student loan forgiveness and your individual income is under $125,000, sign up immediately to be notified by the U.S. Department of Education when more information becomes available. You will not need to prove that you qualify for the loan, as the education department has all of the information on the type of loan that you are carrying.

If you are uncertain as to whether the Department of Education has your current income information, fill out the application once it is available. When the debt forgiveness program begins, your new balance and payments will be automatically calculated for you. This is expected to take place at the beginning of 2023.

The American Academy of Nurses is dedicated to transforming health systems. Its 2,800 Fellows and their governing board of directors have a mission that includes enhancing the quality of health and nursing care, reducing health disparities and inequalities, shaping healthy behaviors and environments, and strengthening the nursing and health delivery system. Each year the Academy identifies a small group of members who have made remarkable, multiple contributions to society at large and the nursing profession in particular, designating them as Living Legends and celebrating them at the organization’s annual Health Policy Conference taking place October 27^th through 29^th of 2022.

The Academy has announced that it has chosen six nurse leaders to receive the 2022 Living Legend honor.  A release revealing the recipients of the Academy’s highest designation notes that “[t]hrough their tenacity and vision for how the nursing profession can lead system change, they have made an indelible impact on policy and public health.”

The six recipients are:

• Jane Barnsteiner, PhD, RN, FAAN 

(Photo from AAN)

Professor Emerita at the University of Pennsylvania School of Nursing and Editor of Translational Research and Quality Improvement for the American Journal of Nursing (AJN), she is a highly respected leader and early innovator in the development and implementation of programs that improve quality, safety, and evidence-based practice. Her signature efforts have focused on ensuring that practice is evidence based, that academics relevant to real-world practice through improved cohesion between service and educational institutions. Prior to her current position she served as Director of Nursing for Translational Research at the Hospital of the University of Pennsylvania and as Director of Nursing Practice and Research at The Children’s Hospital of Philadelphia.

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• William L. Holzemer, PhD, RN, FAAN

(Photo from AAN)

Distinguished Professor and Dean Emeritus of the School of Nursing at Rutgers, The State University of New Jersey, he also serves as the Editor-in-Chief of the Japan Journal of Nursing Science and is Professor Emeritus at the University of California San Francisco School of Nursing and Distinguished Honorary Professor at St. Luke’s University, Tokyo. His work, which has been recognized by the World Health Organization and the U.S. Department of State, has transformed the care that patients with HIV/AIDS have received as well as the research aimed at improving the quality of life of patients and their families. He is internationally recognized for striving to eliminate stigma and address the health disparities that HIV/AIDS creates, as well as for addressing the challenges of medication adherence and symptom management.

• Jeanette Ives Erickson, DNP, RN, FAAN

(Photo from AAN)

Currently serving as interim CEO and President of Nantucket Cottage Hospital, Chief Nurse Emerita at Massachusetts General Hospital (MGH), an Instructor at Harvard Medical School, and Chair of the Board of Trustees and a Professor at MGH Institute of Health Professions, Dr. Ives Erickson is noted for her leadership in improving health outcomes, her patient advocacy, and her mentoring of nursing professionals. Her achievements include having developed nurse training programs and other innovations that have been implemented nationally and internationally to improve the care environment and the establishment of a field hospital at the Boston Convention Center during the early days of the global COVID-19 pandemic. These actions, as well as her dedication to research and education, are examples of her dedication to advancing public health and improving outcomes.

• Norma Martinez Rogers, PhD, RN, FAAN

(Photo from AAN)

Professor Emeritus at the University of Texas Health Science Center San Antonio (UTHSC San Antonio) School of Nursing and past- and current President of the National Association of Hispanic Nurses, she is the founder of multiple high-impact organizations, including Martinez Street Women’s Center and the International Association of Latino Nurse Faculty. The former provides support and educational services to women and female adolescents, while the latter hosts the Cultural Inclusion Institute. She was UTHSC San Antonio’s first and only full tenured Latina Professor, and while there she created a peer-to-peer mentoring program for nursing students called Juntos Podemos (Together We Can.)

• Joyce Newman Giger, EdD, APRN-BC, FAAN

(Photo from AAN)

Professor at Florida International University College of Nursing and previously President of the American University of Health Sciences; Professor and Lulu Wolf Endowed Chair, University of California, Los Angeles (UCLA); Professor of Graduate Studies, University of Alabama at Birmingham; Dean, School of Nursing, Columbus State University; and Founding Dean, Bethel College, Dr. Newman Giger is a trailblazer in improving outcomes for patients of color and of raising awareness of the unique health factors that they face. Her appointment as a tenured professor oat UCLA’s School of Nursing marked the first time in the institution’s history that an African American nurse had held such a position. Her efforts and the many publications she’s written have transformed nursing standards in the delivery of culturally-appropriate patient care and her research has effected real change in eliminating racism, investigating social determinants of health, and promoting equity in care.

• Franklin A. Shaffer, EdD, RN, FAAN, FFNMRCSI

(Photo from AAN)

Recently appointed to serve on the Board of the Conference of NGOs in Consultative Relationship with the United Nations (CoNGO), Dr. Shaffer is also President and Chief Executive Officer of CGFNS International Inc. (formerly known as the Commission on Graduates of Foreign Nursing Schools. His six-decade-long career has blended clinical practice and education, research and consultation, administration, regulation, credentialing, standards and quality, and global collaboration.  His efforts have made a significant difference in how nurses practicing in a wide range of settings are perceived and in the quality of their education, and he has dedicated significant resources to supporting nursing institutions, to challenging norms, and to improving outcomes.

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These remarkable nursing professionals exemplify the best of what the nursing profession can be, making invaluable and lasting contributions to society, to patient, health, to research, and to nursing education.

Responding to a critical shortage within their health care workforce, the governors of Connecticut and New York have announced initiatives designed to attract new students and expand the ability to prepare them for service.

Each of the two states has taken a slightly different approach. The state of New York is prioritizing economic needs. Its Nurses for Our Future program hopes to expand the state’s number of nurses by offering full tuition to scholarship winners enrolled in both Associate Degree in Nursing and Bachelor of Science in Nursing programs. Connecticut’s CT Health Horizons”program will address the shortage of both nurses and behavioral health providers through a combination of tuition assistance, recruitment and retention of faculty, and innovative job placement partnerships.

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Two initiatives with the same end goal

Both Connecticut and New York are facing significant shortages in healthcare workers. New York currently has more than 9,300 openings for registered nurses in the state, while a 2020 report by Connecticut’s Governor’s Workforce Council reported that 52% of the state’s registered nurses are over the age of 50 and that there would be a need for 3,000 new RNs per year, while Connecticut’s schools only have the capacity to graduate 1,900 per year. Each state has taken its own approach to the dilemma.

In New York, Governor Kathy Hochul recently announced the winners of the Nurses for Our Future Scholarship Program. The program was introduced in December of 2021, inviting people to apply for 1,000 scholarships for the State University of New York and the City University of New York. These scholarships will  cover four full-time semesters of tuition for flexible part-time or full-time students to become nurses.The 1,000 winners were New York State licensed nurses with Associate’s degrees, New York State residents seeking ADN degrees, and out-of-state licensed nurses who will relocate and practice in New York State to earn a BSN. To win the scholarship, participants completed an online entry.

In Connecticut, Governor Ned Lamont announced a three-year program that will similarly address the state’s critical healthcare workforce shortage. CT Health Horizons will take a three-pronged approach. It will 1) provide tuition assistance to attract low-income and minority students to accelerated nursing and social work programs, 2) recruit new faculty and incentivize the retention of existing faculty in order to train and educate a greater number of nurses, and 3) create pathways between nursing schools and employers to promote greater hiring of graduates. The Connecticut program represents a partnership between Connecticut State Colleges and Universities (CSCU), the Office of Workforce Strategy (OWS), multiple state agencies, the University of Connecticut (UConn), the Connecticut Conference of Independent Colleges (CCIC), and the Connecticut Hospital Association. It is being funded through  the federal American Rescue Plan Act.

Lawmakers, workforce advocates, and healthcare administrators express optimism for programs

The need for more skilled nurses is critical to meeting current and future needs, and the governors of both states expressed enthusiasm for the new programs. In announcing the 1,000 scholarship winners, Governor Hochul said, “This scholarship will go a long way in strengthening the workforce with individuals who are ready to begin their education and training.” Her optimism was echoed by Assembly member Deborah J. Glick, who said, “I’m excited for this first cohort of Nurses for Our Future scholars to receive an exceptional and tuition-free education at our SUNY and CUNY schools, and I wish them every success as they prepare to care for New Yorkers in the future.”

The President of the New York State Nurses Association, President Nancy Hagans, RN, BSN, CCRN, made it plain that investing in attracting and training nurses would have a direct impact on the quality of care, saying, “The Nurses for Our Future Scholarship program will help attract and train more nurses to help New York’s health care facilities staff more safely. Investing in the nursing workforce now is one part of the solution to deliver quality care for all New Yorkers into the future.”

Because Connecticut faces the challenge of a shortfall in the capacity to educate more nurses, a significant portion of the state’s investment will be concentrated on increasing the educational supply. Governor Lamont explained, “By making this investment, we are taking a critical step toward expanding the number of nursing seats at our public and private institutions of higher education.” The Connecticut program aims to provide financial assistance to 1,200 incoming nursing and social work students, and particularly to those entering AND, Accelerated BSN, and MSW programs. At the same time, by retaining and adding more faculty, it is hoped that Connecticut schools will be able to accept 1,000 more students each year. 

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