The Dual Epidemics of 2020: Nursing Leaders' Reflections in the Context of Whole Person/Whole Systems.

The Greater Boston Nursing Collective, a consortium composed of university nursing deans and chief nursing officers within academic medical centers and specialty hospitals in Boston, Massachusetts, was formed in 2014. Since the group's inception, our mission has been to create and reinforce whole-person/whole-system healing environments to improve the health of all communities. Through our collaboration in navigating the dual epidemics of COVID-19 and structural racism within our respective organizations, and across the United States and the world, we share experiences and lessons learned. Our common mission is clearer than ever: to create safe and joyful work environments, to protect the dignity of those we are privileged to serve, and to generate policies to advance health equity to rectify societal forces that have shaped this dual epidemic. We are humbled by the many who persist despite limited rest and respite, and whose stories, innovations, and leadership we are honored to witness and share. They have defined our generation, just as nurses in earlier crises have done: leading through service to others as our purpose and privilege.

Multidisciplinary care of the obese patient with chronic critical illness after surgery.

The surgical patient with prolonged critical illness usually has a higher severity of illness on ICU admission, and is destined for greater morbidity, debilitation, and poorer hospital and long-term survival. Care of those with obesity is particularly difficult. Only with meticulous attention to detail and refined, dedicated, multidisciplinary processes of care, preferably assisted by protocolization, can these patients sustain any hope of recovery to acceptable functionality.