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Heroes, or just doing our job? The impact of COVID-19 on registered nurses in a border city

Heroes, or just doing our job? The impact of COVID-19 on registered nurses in a border city

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Some nurses who live in Windsor, Ont. work at hospitals in Detroit, just across the Ambassador Bridge. (Shutterstock)

The Year of the Nurse brought increased attention to the “heroes of health care”: nurses working on the front lines of COVID-19. However, despite public displays of thanks, it’s becoming clear that many nurses are not getting the support they need to feel safe on the job and to maintain their own health and well-being.

As researchers in psychology and nursing at the University of Windsor, we sought an in-depth understanding of how nurses in a border city felt about working during the pandemic.

Evidence from SARS in 2003 indicated that nurses may experience significant, long-term mental health effects from working during the pandemic. Early research from China and Italy found that nurses working during the surge of COVID-19 cases in those countries reported high rates of depression, anxiety and sleep disturbances.

Commuting in a border city

As a border city, Windsor, Ont., is home to nurses who reside and work locally, but also a significant number who commute daily to hospitals in Detroit, Mich. Early in the pandemic, Detroit emerged as a “hot spot” partly due to significant racial inequalities and health disparities in the city’s population.

Detroit hospitals depend on their Canadian nurse employees. In 2016, 20 per cent of the nurses working at Henry Ford Hospital were Canadian, and a total of 1,600 Windsor residents reported working in health-care settings in Detroit. The continued ability of these hospitals to operate during and after the pandemic depends on the retention of Canadian personnel.

A Canadian flag and an American flag in the foreground with a suspension bridge over a river behind them.
Canadian and American flags fly near the Ambassador Bridge at the Canada-United States border crossing in Windsor, Ont., on March 21, 2020. THE CANADIAN PRESS/Rob Gurdebeke

In May and June 2020, our team interviewed 32 female and five male nurses living in Windsor and working in health-care settings in Windsor (20 nurses) or Detroit (17 nurses). They worked on intensive care units, COVID-specific units, labour and delivery units, in emergency departments and field hospitals, with experience in nursing ranging from 1.5 to 36 years.

Concerns about family and mental health

Nurses consistently reported increased mental health concerns, difficulties coping and substantial dissatisfaction with the level of support provided by their hospitals.

The support that nurses felt from their organization and managers varied from workplace to workplace and unit to unit. A few felt well supported, but many reported they were not valued, citing organizations that furloughed them, stopped employer contributions to retirement funds or did not provide adequate PPE. One participant noted:

“I didn’t sign up for not having myself protected, you know, I think I deserve as a nurse to at least have that.”

Despite increasing levels of depression and anxiety, there was a strong sense that referrals to employee assistance plans (EAPs) were not sufficient. Overall, we found that nurses were surprisingly resistant to the idea of formal mental health supports. They felt more comfortable seeking support from their coworkers or “work family” than non-nurse family/friends or organizational supports. Many expressed fears that seeking help from hospital administration would be perceived as a sign of weakness. One participant stated:

“Heaven forbid, you say mental health or stress … because then they’ll take you from your unit, and say, put you at the front door as a greeter.”

Nurses also expressed concerns about their own health and the health of family members. They described difficulties balancing quality patient care with “cluster care,” which limited their time in patient rooms, and the emotional toll of “death over Facetime” as one participant called it: holding electronic tablets as dying patients said their goodbyes to family.

They experienced difficulties navigating rapidly changing hospital policies (sometimes during a single shift), discrepancies between governmental and hospital recommendations, do not resuscitate orders that were either avoided or forced, and inadequate access to PPE.

Many reported sleep issues, nightmares, fatigue, increased irritability, increased alcohol consumption, unhealthy eating habits and use of sleep aids and cannabis. Many self-isolated from their families and missed out on the day-to-day moments and key developmental milestones of their children. One participant recounted:

“I missed my kid’s entire crawling stage.”

Many nurses spoke of inequity and moral injury. They expressed frustration about doctors and men with facial hair receiving better PPE, temporary employees (that is, travel nurses) getting better pay and/or hours, being reassigned to multiple units and doing non-nursing tasks like cleaning COVID-19 positive rooms. Nurses felt better prepared to be reassigned if they volunteered, but not if it was forced (and some were).

Some nurses were encouraged to purchase their own PPE to use at work, for example, face shields from Amazon or even dollar store raincoats. Almost everyone we interviewed expressed concern about second and third waves and whether the hospitals would be prepared.

Heroes … but stigmatized

Nurses expressed appreciation regarding the community responses (for example, clapping, food donations, skipping lines at businesses) but also felt a lot of stigma as potential “disease carriers.” One participant shared:

“[The public] keep saying: ‘Oh, nurses are heroes. Doctors are heroes. They’re doing so much for us.’ You’re out in scrubs and they’re like, ‘They’re contaminated, get them away, they’re infectious.’”

There were some differences in responses between nurses employed in Detroit and those working in Windsor. Overall, nurses working on the Michigan side of the border reported greater patient mortality, PPE shortages, community stigma and dissatisfaction with hospital administration. However, these findings are complicated by the much more rapid onset and greater intensity of the COVID-19 pandemic in Detroit compared to Windsor, and therefore can’t be interpreted with confidence.

Most nurses said that they were not planning on leaving nursing, but several are considering changing units or looking to a career change if the pandemic continues for many months or even years. Nurses also highlighted issues that the public may not be aware of: a moratorium on organ donation, decreased quality of care or risk of family-patient online meetings getting hacked.

Rapid intervention and availability of supports are needed to quickly address symptoms of mental health issues and reduce loss in the nursing workforce that has been observed after previous outbreaks, such as SARS, which could exacerbate a pre-pandemic shortage of nurses in Canada.

Nursing is a profession with a reputation for trustworthiness and dedication to quality care. As a community, we need solutions that go beyond a pat on the back and “hero” label, and instead address unsafe working conditions and offer practical effective support.

Jody Ralph receives funding from WE-SPARK Health Institute and the University of Windsor.

Dana Ménard receives funding from WE-SPARK Health Institute and the University of Windsor.

Kendall Soucie receives funding from WE-SPARK Health Institute and the University of Windsor.

Laurie A. Freeman receives funding from WE-SPARK Health Institute and the University of Windsor

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Germany Is Running Out Of Money And Debt Levels Are Exploding, Finance Minister Warns

Germany Is Running Out Of Money And Debt Levels Are Exploding, Finance Minister Warns

By John Cody of Remix News

German Finance Minister…

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Germany Is Running Out Of Money And Debt Levels Are Exploding, Finance Minister Warns

By John Cody of Remix News

German Finance Minister Christian Lindner is warning his own government that state finances are quickly growing out of hand, and the government needs to change course and implement austerity measures. However, the dispute over spending is only expected to escalate, with budget shortfalls causing open clashes among the three-way left-liberal coalition running the country.

With negotiations kicking off for the 2025 budget, much is at stake. However, the picture has been complicated after the country’s top court ruled that the government could not shift €60 billion in money earmarked for the coronavirus crisis to other areas of the budget, with the court noting that the move was unconstitutional.

Since then, the government has been in crisis mode, and sought to cut the budget in a number of areas, including against the country’s farmers. Those cuts already sparked mass protests, showcasing how delicate the situation remains for the government.

German Finance Minister Christian Lindner attends the cabinet meeting of the German government at the chancellery in Berlin, Germany. (AP Photo/Markus Schreiber)

Lindner, whose party has taken a beating in the polls, is desperate to create some distance from his coalition partners and save his party from electoral disaster. The finance minster says the financial picture facing Germany is dire, and that the budget shortfall will only grow in the coming years if measures are not taken to rein in spending.

“In an unfavorable scenario, the increasing financing deficits lead to an increase in debt in relation to economic output to around 345 percent in the long term,” reads the Sustainability Report released by his office. “In a favorable scenario, the rate will rise to around 140 percent of gross domestic product by 2070.”

Under EU law, Germany has limited its debt levels to 60 percent of economic output, which requires dramatic savings. A huge factor is Germany’s rapidly aging population, with a debt explosion on the horizon as more and more citizens head into retirement while tax revenues shrink and the social welfare system grows — in part due to the country’s exploding immigrant population.

Lindner’s partners, the Greens and Social Democrats (SPD), are loath to cut spending further, as this will harm their electoral chances. In fact, Labor Minister Hubertus Heil is pushing for a new pension package that will add billions to the country’s debt, which remarkably, Lindner also supports.

Continue reading at rmx.news

Tyler Durden Mon, 03/18/2024 - 05:00

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You can strike gold and silver investment opportunities at Costco

Costco (NDAQ:COST), known for its wide array of products, also offers a distinct opportunity for investors: gold and silver.
The post You can strike gold…

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Costco known for its wide array of products ranging from groceries to electronics and sporting goods, also offers a distinct opportunity for investors: precious metals Costco began selling 1-ounce 24-karat gold bars, in the United States in October 2023 and sold more than US$100 million by November Investors are looking for inflation-proof opportunities and as Stockhouse’s recent Thematic Insights report details, the gold supply has remained essentially flat over time, so it is never diluted Costco Wholesale Corp. stock last traded at US$725.63 on the NASDAQ and C$34.01 per share on the NEO Exchange

With gold prices hovering around all-time highs, one of the top warehouse retailers and Canada’s favourite grocer has brought the precious metal to its consumers.

Costco (NDAQ:COST), known for its wide array of products ranging from groceries to electronics and sporting goods, also offers a distinct opportunity for investors: precious metals. While the retail giant might not be the first place that comes to mind when thinking about gold and silver investments, Costco’s offerings in Canada have caught the attention of savvy investors looking to diversify their portfolios.

Let’s delve into what Costco Canada has to offer in terms of gold and silver investments and explore the potential benefits and considerations.

Gold and silver bullion at Costco

Costco began selling 1-ounce 24-karat gold bars, in the United States in October 2023 priced around US$2,000 and sold more than US$100 million by November.

Observing Costco shoppers can provide interesting economic and cultural indicators. Just like the early days of COVID-19 in 2020 when consumers emptied pallets of toilet paper, the supplies of gold and silver at Costco might reveal how confident the public is in Canadian currency and the economy.

Costco Canada stocks a selection of gold and silver bullion available online at Costco.ca, providing investors with the opportunity to add physical precious metals to their investment portfolios. Gold and silver bullion are typically offered in the form of bars or coins, each carrying intrinsic value based on the metal content.

(Source: Costco.ca) Benefits of investing in gold and silver Portfolio diversification: Gold and silver have historically served as a hedge against inflation and economic uncertainty. By adding precious metals to their portfolios, investors can diversify risk and potentially protect their wealth during times of market volatility. Tangible assets: Unlike stocks or bonds, which exist only as digital entries or paper certificates, gold and silver bullion offer investors tangible assets they can hold in their hands. This physical presence can provide a sense of security and stability, especially during turbulent economic times. Liquidity: Gold and silver are globally recognized as valuable commodities, making them liquid assets. Investors can easily buy and sell gold and silver bullion in various markets around the world, providing flexibility and accessibility. Store of value: Throughout history, gold and silver have maintained their value over the long term. While fiat currencies may depreciate because of factors such as inflation, political instability or economic crises, precious metals have proven to retain their purchasing power over time. Considerations when investing in precious metals Price volatility: Like any investment, the prices of gold and silver can fluctuate based on supply and demand dynamics, geopolitical events, and macroeconomic factors. Investors should be prepared for price volatility and hold a long-term perspective. Storage and security: Owning physical precious metals requires adequate storage and security measures to protect against theft or damage. Investors might opt for secure vault storage services or invest in home safes to safeguard their bullion. Transaction costs: When buying and selling gold and silver bullion, investors might incur transaction costs such as premiums, commissions or storage fees. It’s essential to factor these expenses into investment decisions to accurately assess potential returns. Costco also marks up its precious metals at a few hundred dollars above its market value, but you will likely find it slightly cheaper than what the big Canadian banks offer, if their stock isn’t sold out. Market timing: Timing the market is notoriously difficult, and attempting to predict short-term price movements in gold and silver can be challenging. Instead, focus on the long-term fundamentals and consider dollar-cost averaging as a strategy to mitigate market timing risk. Why buy gold and silver at Costco?

Already up more than 5 per cent since the beginning of the year, the value of gold is expected to continue to climb this year. Earlier this month it hit record highs above $2,181/oz. as speculation rises around the prospects of June interest rate cuts.

… but is it a good investment?

In an interview with CBC Radio’s The Current, Will Huggins, an associate professor of finance and economics at McMaster University’s DeGroote School of Business called this a good marketing strategy by Costco, but believed that buying gold from Costco doesn’t offer any advantage compared with the big Canadian banks.

“It’s not like a herd of cattle or some land or a corporate entity that we can keep bringing new people into,” he said. “It’s just a yellow rock.”

(Source: Costco Wholesale Corp.) Final thoughts on buying gold and silver

Costco Canada’s offering of gold and silver bullion presents an intriguing opportunity for investors seeking to diversify their portfolios with tangible assets.

Investors are looking for inflation-proof opportunities and as Stockhouse’s recent Thematic Insights report details, the gold supply has remained essentially flat over time, so it is never diluted and is essentially immune to inflation.

Whether you’re a seasoned investor looking to bolster your portfolio’s resilience or a newcomer exploring alternative investment avenues, the availability of gold and silver bullion at Costco Canada may offer a convenient and accessible option to incorporate precious metals into your investment strategy.

While investing in precious metals carries certain benefits and considerations, it is important for investors to conduct due diligence, assess their risk tolerance, and consult with financial professionals before making investment decisions. As with any investment, prudent decision-making and a long-term perspective are key to navigating the complexities of the financial markets.

Costco Wholesale Corp. (NDAQ:COST) stock last traded at US$725.63 on the NASDAQ and C$34.01 per share on the NEO Exchange.

Join the discussion: Find out what everybody’s saying about this stock on the Costco Wholesale Corp. Bullboard, and check out the rest of Stockhouse’s stock forums and message boards.

The material provided in this article is for information only and should not be treated as investment advice. For full disclaimer information, please click here.

The post You can strike gold and silver investment opportunities at Costco appeared first on The Market Online Canada.

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Home buyers must now navigate higher mortgage rates and prices

Rates under 4% came and went during the Covid pandemic, but home prices soared. Here’s what buyers and sellers face as the housing season ramps up.

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Springtime is spreading across the country. You can see it as daffodil, camellia, tulip and other blossoms start to emerge. 

You can also see it in the increasing number of for sale signs popping up in front of homes, along with the painting, gardening and general sprucing up as buyers get ready to sell. 

Which leads to two questions: 

  • How is the real estate market this spring? 
  • Where are mortgage rates? 

What buyers and sellers face

The housing market is bedeviled with supply shortages, high prices and slow sales.

Mortgage rates are still high and may limit what a buyer can offer and a seller can expect.  

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And there's a factor not expected that may affect the sales process. Fixed commission rates on home sales are going away in July.

Reports this week and in a week will make the situation clearer for buyers and sellers. 

The reports are:

  • Housing starts from the U.S. Commerce Department due Tuesday. The consensus estimate is for a seasonally adjusted rate of about 1.4 million homes. These would include apartments, both rentals and condominiums. 
  • Existing home sales, due Thursday from the National Association of Realtors. The consensus estimate is for a seasonally adjusted sales rate of about 4 million homes. In 2023, some 4.1 million homes were sold, the worst sales rate since 1995. 
  • New-home sales and prices, due Monday from the Commerce Department. Analysts are expecting a sales rate of 661,000 homes (including condos), up 1.5% from a year ago.

Here is what buyers and sellers need to know about the situation. 

Mortgage rates will stay above 5% 

That's what most analysts believe. Right now, the rate on a 30-year mortgage is between 6.7% and 7%. 

Rates peaked at 8% in October after the Federal Reserve signaled it was done raising interest rates.

The Freddie Mac Primary Mortgage Market Survey of March 14 was at 6.74%. 

Freddie Mac buys mortgages from lenders and sells securities to investors. The effect is to replenish lenders' cash levels to make more loans. 

A hotter-than-expected Producer Price Index released that day has pushed quotes to 7% or higher, according to data from Mortgage News Daily, which tracks mortgage markets.

Home buyers must navigate higher mortgage rates and prices this spring.

TheStreet

On a median-priced home (price: $380,000) and a 20% down payment, that means a principal and interest rate payment of $2,022. The payment  does not include taxes and insurance.

Last fall when the 30-year rate hit 8%, the payment would have been $2,230. 

In 2021, the average rate was 2.96%, which translated into a payment of $1,275. 

Short of a depression, that's a rate that won't happen in most of our lifetimes. 

Most economists believe current rates will fall to around 6.3% by the end of the year, maybe lower, depending on how many times the Federal Reserve cuts rates this year. 

If 6%, the payment on our median-priced home is $1,823.

But under 5%, absent a nasty recession, fuhgettaboutit.

Supply will be tight, keeping prices up

Two factors are affecting the supply of homes for sale in just about every market.

First: Homeowners who had been able to land a mortgage at 2.96% are very reluctant to sell because they would then have to find a home they could afford with, probably, a higher-cost mortgage.

More economic news:

Second, the combination of high prices and high mortgage rates are freezing out thousands of potential buyers, especially those looking for homes in lower price ranges.

Indeed, The Wall Street Journal noted that online brokerage Redfin said only about 20% of homes for sale in February were affordable for the typical household.

And here mortgage rates can play one last nasty trick. If rates fall, that means a buyer can afford to pay more. Sellers and their real-estate agents know this too, and may ask for a higher price. 

Covid's last laugh: An inflation surge

Mortgage rates jumped to 8% or higher because since 2022 the Federal Reserve has been fighting to knock inflation down to 2% a year. Raising interest rates was the ammunition to battle rising prices.

In June 2022, the consumer price index was 9.1% higher than a year earlier. 

The causes of the worst inflation since the 1970s were: 

  • Covid-19 pandemic, which caused the global economy to shut down in 2020. When Covid ebbed and people got back to living their lives, getting global supply chains back to normal operation proved difficult. 
  • Oil prices jumped to record levels because of the recovery from the pandemic recovery and Russia's invasion of Ukraine.

What the changes in commissions means

The long-standing practice of paying real-estate agents will be retired this summer, after the National Association of Realtors settled a long and bitter legal fight.

No longer will the seller necessarily pay 6% of the sale price to split between buyer and seller agents.

Both sellers and buyers will have to negotiate separately the services agents have charged for 100 years or more. These include pre-screening properties, writing sales contracts, and the like. The change will continue a trend of adding costs and complications to the process of buying or selling a home.

Already, interest rates are a complication. In addition, homeowners insurance has become very pricey, especially in communities vulnerable to hurricanes, tornadoes, and forest fires. Florida homeowners have seen premiums jump more than 102% in the last three years. A policy now costs three times more than the national average.

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