Part A: Read and summarize the followingarticle (excerpt).

AmericaIs Running Out of Nurses

Travelling nurses have been moving from one hotspot to another. What happens when the hot spots keep multiplying?

By Dhruv Khullar

https://www.newyorker.com/science/medical-dispatch/america-is-running-out-of-nurses

 

Just how big is the coronavirusswinter wave? It can be hard to get your mind around it. One way to try is tonote that, right now, more than a hundred thousand Americans are in thehospital with covid-19whichis roughly as many people as can fit into the countrys biggest stadiums forthe Super Bowl, and nearly twice as many as were hospitalized during thepandemics worst days in April and July. Another is to note that, around theU.S., hospitals are running out of nurses and doctors. At least half of all statesare now facing staff shortages, and more than a third of hospitalsin states as varied as Arkansas, Missouri, New Mexico, and Wisconsin are simplyrunning out of staff. Ordinarily, an I.C.U. nurse might care for, at most, twocritically ill patients at a time. Now, some are caring for as many as eightpatients simultaneously. Recently, North Dakotas governor issued an orderallowing asymptomatic but coronavirus-positive health-care workers to continueseeing patients. (People without symptoms can still be infectious.) In most ofCalifornia, I.C.U. usage now exceeds eighty-five per centthe threshold abovewhich new stay-at-home restrictions kick in. Since the beginning of thepandemic, the nations hospitals have developed protocols and purchasedventilators, and the mortality rate has fallen. But now the spread of the virusis so extreme that a shortfall of clinicians is becoming an insurmountablebarrier in the fight against covid-19.

Alexi Nazem isthe co-founder and C.E.O. of Nomad Health, a medical-staffing company based inNew York City. Nomad fills physician and nursing needs across the U.S.; itsends nurses, in particular, to hospitals big and small, urban and rural, fromcoast to coast. Nazem has marked the evolution of the pandemic by the scale ofthe job orders hes received, which have shifted, more or less, with theseasons. Its been a remarkable roller coaster, he told me recently. In thespring, it was a five-alarm fire. There were unprecedented needs in New Yorkand other early epicenters, but hospitals around the country felt compelled tostaff up, too. No one had ever experienced anything like it, he said.Hospitals looked around and saw that the covid light switch could flipovernight. They thought the same thing would happen to them. There was anexplosion of job orders from all over. For the most part, though, covid-19 patientsdidnt materialize; many hospitals, having postponed elective procedures andnon-urgent visits, sat empty and ended up cancelling their staffing requests.It was complete whiplash, Nazem said. They said, Actually, we dont needall these extra people. We cant even afford to pay our regular staff.

In the summer,when the coronavirus surged across the Sun Beltin Florida, Texas,ArizonaNazems company sent clinicians to affected states. But hospitalselsewhere didnt feel the need to bolster covid-19 staffing. Hospitals weremore experienced by then, Nazem said. They werent over-ordering. Thecomposition of new job requests also shifted. Many hospitals were staffing notfor coronavirus wards but to help in operating rooms and procedural suites thathad postponed cases and were now running overtime to work through huge backlogsof colonoscopies and knee replacements. These specialties were the worst hitin the spring, Nazem said. They were among the hottest in the summer.

Now the needfor clinicians has erupted again. Its been insane, Nazem said. Orders arecoming from everywhere. There are no hot spots. Its crazier than weve everseen. In the past, Nomad Health has provided hospitals with nurses who willwork specifically on covid-19. Its now impossible to distinguish by job,Nazem said. Hospitals are saying, Just come. Who knows what well need youfor. Given the current waves persistence, hospitals are renewing contractsfor travelling nurses at unprecedented rates, effectively taking them out ofcirculation. 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 whomthey would hire. They used to say, We need the perfect person, Nazem toldme. Now they say, If you find someone, anyone, send them over. (NomadHealth thoroughly reviews credentials for each clinician; Nazem was at pains tosay that quality has not been compromised.)

In normaltimes, 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 oneplace for thirteen weeks. (That length is a holdover from old maternity-leavepolicies for nurses; the staffing industry evolved, in part, to fill suchgaps.) According to Nazem, travelling nurses generally fit two profiles. Onegroup consists of early-career nurses who want to acquire a range of clinicalexperiencesacademic, urban, ruraland to travel the country. Another includesnurses at the end of their careers: They say, Hey, the kids are out of thehouse. Id like to make some extra money. Wouldnt it be fun to go to Alaskafor the summer? The pandemic has diversified the pool. Severe staffshortages have brought more nurses into the travelling workforce. Manyclinicians, especially those with critical-care training, feel an obligation tohelp. But, because demand has far outpaced supply, pay for travelling nurseshas also skyrocketed. Traditional nurses look around and say, Hey, thattravelling nurse is making double what I am, Nazem said. Before thepandemic, hospitals might have offered a travelling nurse seventy-five dollarsan hour; now, in many places, that rate has tripled. High pay draws moresupply into the market, Nazem said. But at some point you reach a limit. Evenif you were willing to pay a thousand dollars an hour, there just arent enoughnurses. All youre doing then is shuffling people around. Youre robbing Peterto pay Paul. Were dangerously close to that.

 

Part B: Read and paraphrase thefollowing article (excerpt).  

 

Breaking the silence: are we getting better at talking about death?

ByEdmund 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 mediabrings us constant news of strangers deaths, grief memoirs fill our shelvesand dramatic meditations are performed to big crowds, we have reached a newunderstanding of mortality

 

It has becomeclear that we are living through an extraordinary moment where we are muchpossessed by death. Death is the most private and personal of our acts, our ownsolitariness is total at the moment of departure. But the ways in which we talkabout death, the registers of our expressions of grief or our silences aboutthe process of dying are part of a complex public space.

 

Some areexplorations of the rituals of mourning, how an amplification of loss in thecompany of others the connection to others grief can allow a voicing ofwhat you might not be able to voice yourself.