1. Kennedy, Maureen Shawn MA, RN, FAAN


This presidential election may be the most important of modern times.


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Our October cover is the third political cartoon we've published by two-time Pulitzer Prize-winning cartoonist David Horsey. As with prior covers, we try to focus on the health care issues at stake when depicting candidates or their parties. This year, we wanted to focus on nurses and the power we have if all 4 million of us vote. Thus, our cover shows a battle-worn nurse exiting the voting booth wearing personal protective equipment (PPE), since for many nurses, the availability of PPE was and remains a key issue during the COVID-19 pandemic. How this administration has dealt with the pandemic may be the deciding factor in whether the current president is reelected.

Figure. Maureen Shaw... - Click to enlarge in new windowFigure. Maureen Shawn Kennedy

The numbers show a dismal accounting of the failure of the richest country in the world to protect its populace. According to the Johns Hopkins Coronavirus Resource Center, as of September 4, the U.S. data on positive cases and fatalities is the worst in the world: over 6 million cases and more than 186,000 deaths. And while many countries are returning to some semblance of normalcy, the United States continues to see cases rise in many states.


As I see it, the U.S. failure to manage the pandemic is because leaders declined to implement a national plan (a 69-page report completed in 2016 in anticipation of a pandemic was available). Instead, we saw disease experts sidelined because they painted a harrowing picture of what reality would look like if we didn't enact measures to stop transmission-and we're living that reality now. Presenting scientific facts has been labeled as fearmongering and politically motivated because the facts go against the illusion put forth by the current administration that everything is under control.


States have been left to forage for resources on their own, resulting in bidding wars among them and with the federal government over supplies. There are still reports of PPE shortages in many areas, especially in rural hospitals and long-term care facilities.


We have witnessed the current president reject science in favor of unfounded theories discussed on talk shows. His announcement that he saw no need to follow proven public health measures recommended by his own administration and his continued downplaying of the danger of this still-evolving virus has led thousands of his supporters-including elected officials-to follow his lead, resulting in widespread virus transmission and thousands of deaths. After six months, we still do not have a national plan.


We also do not have an alternative to the Affordable Care Act, yet this administration continues to try to dismantle it and leave millions uninsured, and that includes those who have recently lost their employer-sponsored plans because of pandemic-related job losses.


As a nurse, I believe in science as a guide for our actions-from stopping a pandemic to dealing with a changing climate to controlling polluting industries. As a human being with morals, empathy, and compassion, I believe there are lines no person, certainly no government leader, should cross. That would include mocking someone with a disability, forcibly separating children from their parents, bragging about assaulting women, showing support for racists, creating barriers to care for women and vulnerable groups, wishing sex traffickers and convicted felons well, and not coming to the defense of U.S. soldiers targeted by a foreign government.


The Code of Ethics for Nurses with Interpretative Statements includes provisions about practicing "with compassion and respect for the inherent dignity, worth" of every person (provision 1); about protecting human rights and reducing health disparities (provision 8); and that the profession's organizations "must articulate nursing values" and "integrate principles of social justice into nursing and health policy" (provision 9). As a nurse, I believe we should adhere to our code of ethics.


As many nurses know, the American Nurses Association (ANA) has adopted a policy of not endorsing a presidential candidate. This might be a prudent decision to avoid appearing partisan when both candidates offer different, but reasonable, policies. But this election-more than any other-presents a clear determination of which candidate is aligned with the positions and, perhaps more importantly, the values that the ANA holds. By the time you read this, perhaps the ANA will have rethought this policy-I hope so.