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Clinical TopicsImmune/Lymphatic SystemInfection preventionMy Nurse InfluencersPediatric & Maternal Pulse with Dr. Donna Hallas

Living and learning immersed in chaos

Author(s): Donna Hallas PhD, PPCNP-BC, CPNP, PMHS, FAANP

Four months ago, we could not have imagined how quickly our lives and healthcare practices would change as all individuals, families and communities including businesses, schools and universities worldwide paused as we became immersed in an unprecedented pandemic – COVID-19. We remain in a pandemic. And yet, some do not believe that we are in a pandemic and proclaim their rights to not wear a mask believing that they will not be affected by the virus. Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases, at the Center for Disease Control and Prevention (CDC), has warned Americans about the risks of further spread of COVID-19 and now advocates for all to wear masks as well as continue to practice social distancing (CNN, 6-18-2020).

For parents of children and adolescents, we should support best practices including: demonstrating how children over 2-years-old can safely wear a mask, wearing eye protection in public to avoid touching eyes, following social distance guidelines in public, and good handwashing. Encourage parents to support their children academically and help them engage in healthy eating and physical activity. Help parents realize the value of engaging in play with their children.

There are concerns for further COVID-19 surges as states re-open earlier than suggested by the CDC guidelines or by individual state data. In addition, there are concerns for further spread among those individuals who are gathering in large groups protesting systemic racism, social injustices, police brutality, and lack of access to healthcare. Two questions arise as a starting point: 1.) What can 4-million nurses in the U.S., who practice at all levels within the nursing profession, do to help all whom we encounter better understand COVID-19 practice preventive measures? 2.) How can each of us support transformational, meaningful changes in our society to remove systemic racism?

How do we transition from chaos to harmony?

Chaos theory was developed from an understanding of mathematical and natural systems. “Nursing knowledge is composed of many systems, such as physiological systems, health care systems and human systems. … Chaos theory explains how seemingly random events have a pattern of association” (Lett, 2018).

Where do we begin to transition from chaos to harmony? What patterns of association will lead to harmony? Begin as role models in your own home, communities, places of employment, and your own practices. Advocate for following CDC guidelines and in particular, wearing masks in public. Practice social distancing. Gently but accurately correct misconceptions about COVID-19 best practices (as we currently know them) and keep up to date with the day to day changes in recommendations as new scientific evidence for practice emerges almost daily. Be a change agent – lead change – small meaningful changes in one community, (remember communities are also groups on social media), may be a model for changes in many other communities. Communicate outcomes of positive meaningful change. Nurses are educated to be leaders. Activate your leadership potential.

Find patterns that lead to harmony. Help parents understand that children are born without bias. Talk about ways to support the growth and development of children in homes that prepare children to become a member of a society that supports harmony and denounces systemic racism. Develop a list of resources for parents and age-appropriate ones for children. Take your leadership skills to local school boards to make meaningful changes in our educational system.

To heal our country from systemic racism, we must critically analyze ways to make meaningful and lasting changes in our current chaotic world to achieve one in which we live in peace and harmony. It may be simplistic, but meaningful change in systemic racism may most likely begin with education from conception and continue throughout university educational institutions and our lifetimes.


Fauci, A. (6-18-2020). CNN. Retrieved from https://www.cnn.com/2020/06/18/politics/anthony-fauci-coronavirus-anti-science-bias/index.html

Lett, M. A case for chaos theory in nursing. Australian journal of advanced nursing, 18, (3), 14-19. Retrieved from https://www.ajan.com.au/archive/Vol18/Vol18.3-2.pdf

Donna Hallas PhD, PPCNP-BC, CPNP, PMHS, FAANP, FAAN is a certified as a pediatric nurse practitioner and pediatric primary care mental health specialist. She is a Clinical Professor and Director of the PNP program at New York University Rory Meyers College of Nursing. She has presented nationally and internationally on numerous research and clinical topics with the overall goal of improving health care outcomes for infants, children, adolescents and young adults. 

Her first book, Behavioral pediatric healthcare: A growth and developmental approach to intercepting abnormal behaviors, earned the prestigious American Journal of Nursing 2018 Book of the Year Award earning first place for Psychiatric and Mental Health Nursing and third place for Child Health.

Dr. Hallas is a digital editor for Contemporary Pediatrics and writes a monthly commentary which focuses on applying information in one or more journal articles to pediatric clinical practice. Here is a link to the PNP corner www.contemporarypediatrics.com/pnp-corner.

Dr. Hallas’ most recent research focuses on vaccine hesitancy. She and colleagues designed a web-based intervention study using the concepts of informed decision making and the influence of social media. The study was conducted using two populations: pregnant women  and mothers of newborns and young infants to determine the effectiveness of population-specific web-based interventions to reduce the incidence of vaccine hesitancy (Hallas, Altman, & Fletcher, 2018). The study was statistically significant for prenatal women and approached statistical significance for mothers of newborns and young infants. 

Please click on this link for a brief discussion by Dr. Hallas on vaccine hesitancy and the most recent measles outbreak: https://www.nyu.edu/about/news-publications/news/2019/october/one-question–why-do-some-parents-hesitate-to-vaccinate-their-ch.html.

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