In a span of just one week, there have already been two mass shootings that have gained national attention. The killings in Georgia and Colorado are the latest in what seems like a never-ending stream of stories about innocent people getting killed senselessly and violently. Now, in what has become a national routine, political lines are already being drawn. And they are being drawn on the same old line: gun control.
It is hard to not take a breath of exasperation whenever we see the same cycle play out repeatedly in the aftermath of a mass shooting. It starts when the seemingly dormant, yet perpetually antagonistic factions of gun policy resurface in mass media and re-ignite their unending war against each other. As the public’s attention on gun violence once again reaches a critical mass, public officials then proceed one by one to take up gun policy as their new priority. Depending on their persuasion, some leaders may say that there are not enough guns to protect the innocent, while others may say that gun ownership is out of control. The debate intensifies and captivates the nation for weeks or months on end until finally, it reaches a crescendo that ends in nothing but the same, inevitable stalemate that has become the hallmark of almost every mass shooting. The problem never gets solved, national discourse moves on to other news, while innocent people never get the justice they truly deserve.
It does not have to be this way. We, as a society, need to re-evaluate how we approach mass shootings. Gun policy is certainly an issue worth looking into, but it is not THE main issue in these cases. Perhaps we need to start looking at something else. Talking about guns just because guns factored into a news story addresses only the symptom of a major problem, but do not address the true causes of mass shootings.
Public discourse is important. But what is equally important is the content of such discourse. Mass shootings are not and should not be mainly about gun control. Instead, mass shootings must be seen as opportunities to discuss ways on how to address the country’s mental health crisis. Rather than worsening the fault lines of national political dialogue, our leaders can instead find more common ground in improving our nation’s mental health infrastructure. Clearly, these mass shootings are psychotic acts of violence. Guns are the tools that these people use to cause destruction, but it is the mind controlling these guns that we must really be focusing on.
In the medical field, a typical psychiatric assessment involves asking people if they are thinking of harming themselves or others. An affirmative response triggers a cascade of interventions that most likely will lead to a ‘5150’ or an involuntary hold until a person is no longer deemed a danger to self or others. The desire to harm others is so serious that health professionals are trained to carry out a set standard of procedures to protect people from imminent danger. In these situations, there is no debate. There is no time to waste. The person deemed to be a danger is promptly treated and given the attention they deserve. In doing this, the medical community sees thoughts of self-harm or harm to others as an acute crisis, just like any ailment or disease that warrant a visit to the hospital.
If society can give mental health issues the same sense of urgency and level of seriousness that it gets from the medical community, we may be able to find meaningful solutions and prevent these atrocious mass shootings in the future. Our leaders can work together towards allocating more resources towards identifying and assisting at-risk individuals and groups. For instance, hiring more school counselors and other types of mentors who are trained in psychiatric disorders may be able to curtail the possibility of school shootings if early intervention is provided for students that are showing signs of antisocial behavior. Companies and organizations can also be incentivized to provide robust training programs that promote understanding and tolerance of cultural differences. And instead of relying completely on police to deter criminal behavior, communities can invest some resources towards social workers who are trained to diffuse aggressive behavior peacefully and potentially help would-be deviants towards a better path in life.
Mental health issues are not just a medical issue. They are a vital social issue that warrant our utmost attention. Mental health issues permeate the fabric of our collective soul as a nation whether we recognize it or not. The problem is, if we continue to ignore them, they can and will fester like an untreated, open wound.
Nurses in the United States have a unique privilege in being the healthcare providers for one of the most diverse populations in the world. Our country is home to millions of people coming from various racial groups, religious affiliations, and sexual orientation. Promoting the well-being of these individuals require more than just a uniform set of standards. They require a dynamic nursing practice that emphasizes not just sensitivity, but more importantly, responsiveness to cultural differences.
Being educated and sensitive to differences among individuals is a crucial trait for any nurse. However, it is not enough to simply be aware of the nuances between one person and another. Nurses must take a step further and adapt their practice to these differences. Nurses are taught from their earliest days in nursing school to individualize their plan of care. This principle applies not just to how they tailor their approach to the physiological aspects of a patient’s condition, but other factors that affect their patients’ entire being, including their cultural background and preferences. Doing so creates a healthcare system that not only pays respect to the uniqueness of American society, but also helps foster a culture in which diversity becomes an inseparable part of our national identity. In other words, a culturally responsive healthcare system treats diversity as more than just novelty, but as something that our society simply cannot do without.
There are countless ways by which nurses can become advocates for a more culturally responsive healthcare system. Some actions can be done on a larger scale, while some can be done within the confines of one’s practice setting. Here are a few ideas:
1. Ask and listen.
Nurses have been educated to some degree on the differences between various cultural groups. This knowledge is indispensable, but certainly not comprehensive. There is simply no way to ascertain each patient’s cultural preferences without talking to individual patients. Some practice settings may allow more time to get to know patients and even their families, while other settings are fast paced. Nevertheless, assessing for cultural preferences should be codified into every nurse’s assessment in the same way that routine examination of the entire body is considered part of standard practice. Taking the time to ask and to listen to patients’ cultural preferences creates a positive experience for patients and their families at a time when they are vulnerable.
2. Be cognizant of workplace practices that are not culturally responsive.
In a typical work setting, it is not uncommon to have certain entrenched practices or policies that have become so prevalent no one seems to question or even notice them anymore. They are not necessarily wrong, but it may be worth revisiting how these actions may be affecting a unit, agency, or health care setting’s ability to respond to the culturally diverse needs of their population. Making the effort to look at one’s workplace from a fresh perspective may bring to light opportunities for improvement.
3. Get involved with committees or associations.
Larger healthcare institutions, like hospitals, have committees in which nurses can participate and help shape policies in their workplace. Smaller facilities may have a less formal structure but may have protocols in place for nurses to take on advocacy roles. On a broader scale, there are also various nursing organizations, such as the American Nurses Association, that provide avenues for nurses to make their voices heard in local, state, and federal governments. Regardless of how nurses choose to speak up, nurses can make a significant impact simply by choosing to be the voice for cultural responsiveness.
4. Run for office.
Nurses have been consistently named as one of the most trusted professions in the United States. At a time when political polarization and cynicism is so rampant, Americans may be willing to find common ground with leaders that have a track record of integrity and reliability. Nurses fit that bill and can most definitely leverage the public trust to create a more robust healthcare system that celebrates and protects the rights of various cultural groups on a much wider scale. Running for office may be an overwhelming endeavor, but it is certainly something nurses can do.
American society will continue to evolve in ways that will create a more diverse population. This is an inevitable fact, and many industries will need to adapt now. However, the healthcare sector is special in that it does not deal with commodities, but lives. Lives that are vulnerable. Lives that are unique and have specialized sets of needs. Nurses have always served as an integral part of the healthcare workforce, and they can and must continue to do so by taking the lead in create a more culturally responsive healthcare system.
Community-based hospice nursing is one of the many areas in which nurses can practice the art of caring towards others. It is somewhat of a non-traditional specialty, given that it takes place outside the walls of hospitals and facilities, but it is definitely rewarding. But becoming a successful community-based hospice nurse has its own challenges. It requires a certain set of skills for those who choose to pursue it.
1. The ability to work with little supervision.
Working in the community means spending most, if not the entire day, working alone. This means that nurses need to be able to hold themselves accountable in getting things done in a timely manner. There are no managers to watch what they are doing, but they are still expected to accomplish what they need to do for the day.
2. The ability to cope with solitude.
Humans are built to be social beings, and that applies to work settings. Workplaces can function as social settings, which can provide the interaction people need on a day-to-day basis. As a community-based hospice nurse, social interaction may be very limited, and those who wish to try it must learn other ways to meet this basic human need to connect with others. There are many ways to do this, including participating in meetings and gatherings at the office, connecting with other community-based nurses through various associations, and maintaining communication with colleagues who work in other places. Working alone does not need be a cause for social isolation.
3. Being a diligent communicator.
Community-based hospice nurses may spend most of their time alone, but much of what they do is actually in coordination with a team. Hospice nurses are part of an interdisciplinary team that includes, licensed practical/vocational nurses, home health aides, social workers, chaplains, among others. In order to be effective, community-based hospice nurses must be able to communicate with these other disciplines when necessary to ensure proper delivery of care to patients and families.
4. Being culturally sensitive.
Cultural sensitivity is an important aspect of nursing practice and this applies to hospice nursing in the community. Hospice nurses must be keen to ask and know about any religious, cultural, or social practices that patients and families may have towards the end of life. Doing this helps ensure that patients die with the dignity they deserve.
5. Being emotionally strong.
Nurses, in general, deal with people at their most difficult times. This is especially true for hospice nurses. Visiting patients in their homes requires great emotional resiliency. Hospice nurses may find themselves dealing with patients who are in distress or are living their last days or hours. In some cases, hospice nurses may be the only person besides family members present when a patient dies at home. Nurses must not only come to terms with their feelings about mortality, but also being able to provide comfort to families who have just lost a dear loved one.
Being a community-based hospice nurse is fulfilling in many ways, and those who possess the right skills may find this to be viable long-term career.
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