Black Lives Matter. These three words have been used countless times in protests and in the media. As a result of the protests, more people are talking about racism and how it affects people who are BIPOC (Black, Indigenous, and People of Color).
Many nurses have experienced it. We interviewed three Black nurses to listen to their experiences with racism, learn how to begin conversations about it, and how allies can help.
Shantay Carter, BSN, RN, founder of Women of Integrity and best-selling author of Destined for Greatness, and nurse of more than 20 years, encountered racism back in nursing school. She recalls that some instructors would “try to wean students of color out of the program.” “I had instructors accuse me of cheating on tests or tell me that I would never become a nurse,” says Carter. Early in her career, she says, “I had patients say that they didn’t want a colored nurse taking care of them…I have had patients call me the N-word or threaten to hit me….I also experienced medical providers speaking down to me because they assumed that I am dumb.” Carter also got asked, “Are you the nurse?”
Bianca Austin, RN, BSN, CCRN, has been a nurse for 19 years. She works at an inner-city Level I Trauma Center as an intensive care nurse and is also a Major in the Army Nurse Corps, U.S. Army Reserves. Austin recalls an instance in which she and three other nurses, all dressed alike in navy scrubs, were waiting for their assigned rooms. The pod leader made the assignments based on having three nurses on duty. She had to be told that Austin was a nurse, even though she was dressed like the other nurses and wore a badge with her credentials.
Glenda Hargrove, BSN, RN, owner of Pill Apparel, has been a nurse for 11 years. She says that once a patient didn’t want her as their nurse because she is Black. Another instance occurred when she was the only Black nurse working on a unit and also the only nurse who was never invited to after-work staff outings. “At first, I tried to brush it off—until even the new nurses were invited, and I was not,” she says.
We asked all three nurses to weigh in on their experiences with racism and how to start the conversation.
If nurses experience racism, what would you suggest they do? How should they react?
Carter: “In situations where the patient is being really disrespectful, I have asked another nurse to care for that patient. As a nurse, I don’t have to be subjected to or tolerate someone’s ignorance. I also make sure to know the policy when it comes to escalating a situation to management. Knowing my rights as a nurse and employee of the institution that I work in is very important. If you encounter racism, I strongly recommend that you make your manager aware and HR if necessary. Racism and any other forms of discrimination should not be tolerated at any institution.”
Austin: “Use it as a teaching moment. Always be gracious.”
Hargrove: “There is really no easy way to answer this question. Racism has different types—it can be overt or covert. As the nurse, we have to always remain professional because like Michelle Obama said, ‘When they go low, we go higher.’ In some medical spaces, there is no one else who looks like you or even believes racism is occurring. As nurses, we are taught to advocate for our patients, but when experiencing racism, you have to essentially advocate for yourself and your right to practice in a racist-free clinical setting.”
How can nurses start the conversation about racism—and this may be different with patients, coworkers, and facility management? What steps should they take to make sure that if racism occurs, it doesn’t continue.
Carter: “As nurses, we have the power to create change. In order to have a discussion about racism, the hospital, community, and country has to be willing to talk about implicit bias, and system oppression. Joining an employee resource group or (BERG) is a great way, to encourage employees and leadership to come together to address the issues that are affecting their employees and finding solutions to make the workplace a better, more diverse, and safer environment for all. There also have to be policies in place to address those issues and have training on Diversity & Inclusion as well as on Implicit Bias. The culture and tone have to be set by the hospital leadership. Racism is something that can’t be tolerated or accepted.”
Austin: “The steps to take to make sure that racism is stopped is to not let an opportunity pass by to educate someone. Kindly let the person know the offense and explain why you were offended. They would tell us if we said something to offend them.”
Hargrove: “Nurses must start the conversation about racism by acknowledging the African-American nursing pioneers. Every nursing student learns about Florence Nightingale, but the majority have no idea who Mary Mahoney is. She was the first African-American Nurse to work professionally in the United States in 1879. When I started the brand, Pill Apparel, the mission has been to educate and acknowledge Mary Mahoney and her historic contribution to our profession.
“If racism occurs the only way to make sure it doesn’t continue is to NOT ignore it. Don’t let racism be the ‘elephant in the room’ but acknowledge it in order to learn from it and prevent it in the future.”
How can the community at large be an ally or offer support to BIPOC nurses in these situations?
Carter: “The community at large can be our allies by calling people out on their racist behavior towards others and standing with them in solidarity. BIPOC nurses would appreciate their friends and colleagues to stand up for them. We have to come together as one in the face of adversity. Just because you are not a BIPOC nurse, doesn’t mean you can’t fight against what’s morally and ethically wrong.”
Austin: “The facility I work for makes annual statements that they encourage diversity. It is a major player in the community with many business alliances. I would like to see more recruitment of BIPOC nurses, starting in high school. I believe the University and the hospital could improve enrollment and employment of BIPOC nurses if they start at that level, and the community could offer resources such as money, opportunities for shadowing, and help with preparation for nursing school.”
Hargrove: “We all know the difference between right and wrong. Martin Luther King Jr. said it best, ‘The ultimate measure of a man is not where he stands in moments of comfort and convenience, but where he stands at times of challenge and controversy.’”
The UConn School of Nursing is pleased to announce it has received a nationally competitive grant award from the U.S. Health Resources and Services Administration for a groundbreaking program. The innovative “PATH to PCNP” Clinical-Academic Partnership aims to increase diversity among primary care providers in medically underserved communities in Connecticut.
The nearly $3 million grant will provide scholarship support to 24 undergraduate students with disadvantaged backgrounds each year for five years. Six students from each academic year – freshman, sophomore, junior, and senior – will receive scholarships starting in the 2020-21 academic year.
“The mission of the School of Nursing is to educate nursing scholars, clinicians, and leaders, with the goal of advancing the health of individuals, communities, and systems,” says School of Nursing Dean Deborah Chyun. “The funding provided through this innovative program for underrepresented students will enhance their ability to focus on their education and graduate with minimal debt, in the hopes that they will go on to serve the areas of our state that are most in need.”
The group of faculty members leading this initiative at the School of Nursing includes: Ivy Alexander, Ph.D., APRN, ANP-BC, FAANP, FAAN; Natalie Shook, Ph.D.; Marianne Snyder, Ph.D., MSN, RN; and Thomas Van Hoof, MD, EdD, FACP.
Despite efforts to recruit registered nurses with disadvantaged backgrounds to the School of Nursing’s primary care nurse practitioner (PCNP) master’s program, numbers of such students remain low, according to Alexander. In order to increase diversity among PCNPs, the School must first increase successful completion of the bachelor’s program among disadvantaged students, and without overwhelming debt.
The objective of “PATH to PCNP” (Provide Academic Transformational Help for disadvantaged nursing students to become Primary Care Nurse Practitioners) is to help such students graduate on time through a “fast track” undergraduate program. The partnership will: increase educational support for students with disadvantaged backgrounds; foster a sense of belonging and ability for positive self-care to reduce stress, anxiety and depression; and infuse primary care curriculum and experiences in medically underserved communities.
“Students participating in the ‘PATH to PCNP’ Program will have primary care experiences during their undergraduate nursing education and graduate ready to begin graduate school to become primary care nurse practitioners,” the faculty team says.
“PATH to PCNP” is a partnership between the UConn School of Nursing and Community Health Center Inc. Senior-level students in the program will complete a capstone clinical rotation at CHCI, gaining experience providing primary nursing care to patients with complex health issues in medically underserved communities. CHCI’s Chief Nursing Officer Mary Blankson, DNP, APRN, FNP-C, will lead the initiative at CHCI, which is one of the largest federally qualified health centers in the country.
The first quarter of 2020 has revealed, to many, the depth of the racial problem in American society. First, COVID-19, which has disproportionately impacted communities of color, revealed the inequities in the American health care and economic system. Then, the killings of three African Americans, Ahmaud Arbery, Breonna Taylor, and George Floyd, by white men, including police officers in two of the cases, restarted a conversation on racial violence and police brutality in America. All of this has led to a national discussion on the health of the American republic.
To provide some illumination on this important topic, we interviewed Dr. Stacie Craft DeFreitas, who has a PhD in Clinical Psychology from Duke University. Her interest in race, ethnicity, and academic achievement was sparked in high school when she participated in Kaleidoscope, a math and science enrichment program for African American students housed on the campus of Wake Forest University. Her work, African American Psychology, is a highly relevant work that covers many of the issues raised by the recent events in America. She is currently an Associate Professor of Psychology and the Assistant Chair of the Social Sciences department at the University of Houston-Downtown.
DeFreitas, what is your reading of the origins and purpose of the current Black Lives Matter movement and how do you place it in the historical context of black civic action in the United States?
The current Black Lives Matter movement stems from the murder of Trayvon Martin in 2012 when women of color began using the hashtag to bring awareness to such acts against people of color. Nearly 10 years later, the movement is still striving to protect black and brown people from such state sanctioned murder. Black Lives Matter is one of the larger current movements pushing the United States towards the ideals that are penned in the Declaration of Independence and Constitution. BLM is forging a place in history as an agent for change.
What motivated you to write the book African American Psychology and how is it relevant for understanding race in America today?
It seemed to me that there were not enough messages about the strengths of African Americans out there in the world. There was so much negative media and I wanted to realistically counter that. I wanted to tell more of the story of the African American community by focusing on the historical elements that have led to the current psychological state of African Americans as well as look at how the strengths can be used to help the community prosper. There are so many people that really need to read this book so that they can begin to get a better understanding of African Americans in this country. Many people assume that they know about Black people because of the media that they ingest, TV, movies, news, and music. Many people do not know that they often get a stereotypical view of African Americans and only see the lives of a small subset. African Americans are heterogeneous. There is so much diversity within this group that is often ignored. This book also helps to bring some of that out. It will help readers to understand that African Americans are strong and resilient people who have survived so much and often come out of the other side better off. But it will also help readers to understand that they are battling so much and that we should marvel in all of the progress that has been made despite the plethora of barriers. Perhaps readers will love and admire the African American community as I do once they have a better understanding of their lives, or at the very least reevaluate their own biases and stereotypes.
What was the most surprising thing you learned, as an African American woman and psychologist, about the psychology of African Americans during your research for the book?
This may not be surprising to others, but I learned more about all of the ways that the United States has worked to keep African Americans from prospering. I knew about some of it, but got a much better understanding of the events in Rosewood, lynchings, the Tulsa bombings, redlining, and other ways that citizens and businesses worked to keep African Americans from prospering. There was so much, I chose not to include much of it in the text as I assumed someone would say that I was being anti-American and would therefore discount the book. It amazes me that we sweep these things under the rug and imagine that since slavery, or at least since the Civil Rights Movement, the U.S. has only tried to support African Americans. That is clearly not true and continues to be untrue today. Doing nothing is often the same as doing harm.
Can you discuss the nature of structural racism in the U.S. and some of the ways it impacts the mental and physical health of African Americans?
Structural racism is weaved into the fabric of the United States. It is inherent in its capitalist ideologies, laws, history, and culture. Racism impacts the mental and physical health of African Americans in so many ways. One very important way is through racism’s impact on where and how people live. African Americans are much more likely to live in impoverished neighborhoods as a result of the history of racism in this country and the current laws that do not protect or support them fully. Unfortunately, I cannot go into all of the racist practices that work to push Black people into segregated and often lower income neighborhoods, but there are many, and they continue to be practiced today. One example is crime free housing ordinances which allow landlords to evict or deny housing for any person who is suspected of a crime which effectively works to deny housing to people of color as a result of heightened, unjustified police surveillance among people of color, especially Black men. The neighborhood that one lives in impacts the schools that they attend, the quality of the restaurants that they are near, whether they live in a food desert, the recreational space available to them, and other factors that all impact mental and physical health.
Further, racism has created a system of mistrust between Black patients and their often non-Black health care providers. Black patients often do not trust these health care providers to really have their best interest at heart as result of a history of mistreatment. Because of this mistrust, they often avoid going to the doctor for as long as they can and they are less comfortable sharing all of their symptoms when they finally do go to the doctor. Doctors in turn do not trust their Black patients to carry out their prescribed orders and they often discount their experiences. This cycle leads to lower quality care for Black patients.
You talk about the need to embrace a more holistic view of mental health in the Black community that goes beyond the presence or absence of mental disorders. Can you discuss this point further?
It is really important that all people start considering a more holistic view of health in general. We create these false divisions between different aspects of health, but what makes us think that we need to separate our mind from our body? We have so much evidence that they are very connected and that what happens in our minds impacts our bodies and what happens in our bodies impacts our minds. For that reason, all people, Black people especially because of the number of stressors that they face, should really focus on taking care of the whole self, mentally, physically, and spiritually. Ideally, we would have more health care centers that take this integrated approach. One piece of evidence for this interconnection is the fact that Black people have relatively good mental health overall when we consider their typical life stressors, but often have poorer physical health. It could be that in an effort to preserve their mental health, Black people are harming their bodies. This goes beyond things like a tendency towards eating unhealthy comfort foods when a person is stressed. It appears that for many Black people, negative factors such as stress may not result in mental health problems like depression, but instead would result in physical manifestations such as high blood pressure. With a more holistic view of health, doctors could examine whether there are mental health factors (such as stress from experiences of discrimination) that are leading to physical problems (poor cardiovascular health). That type of treatment approach could help us to reduce health disparities. Further, I am a huge proponent of mental health treatment. I believe that people should get yearly mental health check-ups just like they get physical exams, but the African American community has a lot of stigma surrounding mental health. An integrated approach would help remove this stigma if your mental health check-up is just a part of your regular health care practice.
What are some things about the African American community that members of the health care profession should be aware of in order to provide the best mental and physical health service to members of the community?
The most important thing for health care providers to do is to check their own biases and assumptions. Health care providers must do some soul searching. What do you really think about people of color? Do you expect that they will not follow the doctor’s orders, so why give them anyway? Do you make assumptions about how they live and what they understand without proper assessment? Do you truly listen to their concerns? Do you make an effort to build rapport with all patients equally so that they feel safe and cared for? Further, medical facilities need to start really looking at their practices and making sure that treatment of all patients is equitable. For example, hospitals should keep track of things such as how often patients are given pain medication based on ethnicity. There is an assumption that African Americans can handle more pain and therefore they are denied this medicine. Also, African Americans experiences can often be discounted by medical professions. One example of this is the high rate of deaths by African American women during childbirth. These deaths are often preventable and occur because health care providers may discount the complaints and concerns of African American women. I experienced this first hand and it resulted in the one of the scariest moments of my life. If the only time that health care providers interact with people of color is at work, this is a recipe for poor rapport and low quality care.
Can you discuss the nature of symbolic racism and the role it plays in the current racial dynamic in the U.S.?
Symbolic racism is a subtle form of racism in which people believe that racism is not real and that people of color have not progressed more in life due to their own deficiencies. This is one of the most damaging forms of racism because it is widespread and people can feel good about themselves for having an “American work ethic,” believing they have achieved their goals completely due to their own hard work. What they do not consider is the fact that often, they have had many people and situations help them along the way that people of color have not had. European Americans are more likely than African Americans to have parents that went to college, have parents that own a home and can pass that home down to them, get inheritances from other family members, have teachers that look like them and have similar cultural values, live in a neighborhood that is middle class with access to healthy food and medical care, and see positive images of people who they can identify with in the media. All of these factors are aspects of structural racism and impact health, financial, and educational outcomes. So those who harbor symbolic racism beliefs discount all these factors and the many more that impact the lives of African Americans. These are the same people who ask “well what did he do” when an unarmed Black man is shot by the police because they cannot fathom that the murder could be a result of a system of racism and no fault of the murdered Black man. Such ideas are inherent in those who assume that the Black Lives Matter movement suggests that other people don’t matter. Unfortunately, we have to state that Black lives matter even when WE know that all lives matter; it is just that the United States does not seem to know. For that reason, they need to be reminded, Black lives matter.
Can you discuss color-blind racism and how it impacts the psychology of African Americans?
Color-blind racism is when a person says that they don’t see color so they cannot possibly be racist. This is problematic first of all because it is not true. Perhaps a person may not have biases against other people due to their race or ethnicity, but unless you have some type of disability, you will determine (or attempt to determine) an individual’s race or ethnicity when interacting with them. This is part of being human. We categorize people into ethnicity, gender, age, etc. when we first see them. It is a quick way to get information about who a person is and how you should interact with them. What we must pay attention to is the fact that we often do treat people of different ethnic groups differently, even when we think that we do not. This is the major problem. One important way that color blind racism may sneak into the world of health care providers is through mentorship. When you think of who you have mentored or been mentored by, how often has a good mentoring relationship been with someone of a different ethnic background? Usually it is not. This is because we assume that we are color blind, but biases and expectations often cause us to connect with those who we believe are like us. People may reach out to support others who they can identify with, but if one is being color blind, they can pretend that ethnicity has nothing to do with it, when often, it does. They can say, “well she reminds me so much of myself when I started” and deny the fact that they had biases about the Black nurse and therefore did not reach out to support her. Color-blind racism is also problematic because by trying to discount ethnicity, people are ignoring important aspects of who a person is and often this will result in a poor interaction. This can be particularly problematic for a health care worker who is unwilling to ask the questions that they need to in order to better understand a coworker or patient and is instead just acting on their assumptions.
In your book, you discuss some of the gender based ways that Black men and women react to the experience of racism in the U.S. Can you describe some of these responses?
My text discusses John Henryism—when referring to Black males—and Sojourner Syndrome—for African American women—as coping mechanisms for overcoming the barriers that racism creates to their success. Both ideologies suggest that Black people must work harder to achieve what European Americans are able to achieve in this country as a result of racism. Though these coping mechanisms may result in financial, career, or educational success, they often take a toll on the individual’s physical health through negative impacts on the cardiovascular system. The individual is often under constant stress as they try to overcompensate for the racial barriers that are placed in their way. Another interesting idea that has been put forth about Black women is the Strong Black Woman ideology which suggests that Black women often feel that they must be independent, resilient, and self-sufficient to the point that they often do not ask for help when needed and are ashamed to demonstrate weakness. They have often taken on the more of the burden of supporting their families than Black men because Black men face so many more racial barriers than they do. The Strong Black Woman ideology often is linked with poorer mental health as these women do not seek out support when they are struggling.
What is one area of ongoing research into the psychology of African Americans that you feel excited about and why?
I am excited about any research that works towards improving the outcomes of African Americans across the board. Right now, I am doing work examining mental health stigma, which is negative beliefs about individuals who have a mental health disorder or about treatment of mental health disorders. Mental health stigma is relatively high in the African American community. I am very interested in research that focuses on the best ways to reduce this stigma because it has such a profound impact on treatment. If there is less stigma, more African Americans would be willing to seek mental health treatment. Then the next step for research would be making sure that there is effective and available treatment.
It’s a great time to be a nurse. Especially with the COVID-19 pandemic and as the global population continues to swell, improving public health is paramount. Health care professionals, especially nurses, are essential to helping people establish and maintain healthy lives. Thus, nursing professionals are in high demand. Job growth within the industry is expected at least through 2028, reports the Bureau of Labor Statistics (BLS), at a rate that’s much higher than average.
At its core, nursing is a fulfilling job where you can truly make a difference. But the perks of a nursing career don’t end with humanitarianism. Nursing opportunities essentially span the globe, giving you free rein to comfortably live wherever you want, from dynamic cities to suburban enclaves or rural communities where the pace of life is slower.
So where will you live? It’s in your best interest to find somewhere that you enjoy, and where you can envision building a life over the long-term. In fact, your health may count on it.
Cultivating Happiness at Home and on the Job
Every place we have ever lived has left some kind of an impression on us. Many of those places spark joy and fuel happy memories, aptly illustrating the connection between mood, emotions and place. As a healthcare professional, you may be aware of the ways in which where you live affects your happiness. And where your personal happiness is concerned, it all comes down to well-being: According to NPR, well-being is associated with “longer life expectancy and better health outcomes.” The place we call home has the power to diminish or boost our well-being
Most of us have heard the old cliché, “home is where the heart is.” Or how about “there’s no place like home?” Your hometown and its traditions are the building blocks of your personal identity, influencing everything from your choice of sports team to favorite recreational activities. What’s more, cultivating a sense of place helps us build our identity as we grow older, and make decisions that impact our career.
No matter how much you love the place you call home, however, changes in your work or life situations can lead to a geographical change as well. Sometimes, we outgrow a place, a company, or a once-beloved position and want to start afresh. And figuring out where shouldn’t be done lightly. Start by asking yourself what you want in a city while also looking for employment opportunities that reflect your values. Conducting research into the top states and cities for career growth, including Seattle and Austin, may help you narrow down your choices.
And with a nursing degree, you can broaden your search well beyond jobs in the U.S. Across the world, 6 million more nurses are needed to help fill demand and meet global health targets. The nursing shortage is more prevalent in low- and middle-income countries, the World Economic Forum reports.
Taking the International Leap
Nursing provides plenty of opportunities for adventurous spirits to satiate their wanderlust, in the U.S. and beyond. For many, the international nursing experience is life-changing, broadening your worldview as you build essential skills. Further, nurses with a job history that spans continents may have a leg up when it’s time for a career change.
Employers in the health care industry appreciate a diverse background in their candidates, as well as the ability to quickly adapt to changing environments. Alongside the U.S. and its territories, some of the best countries for nursing include Italy, Canada, and Luxembourg.
International nursing is a great choice for those who are passionate about the humanitarian side of health care. Some international workers may care for refugees or marginalized populations, for example, such as those aboard Africa Mercy, a hospital ship. It’s important to note that international nursing jobs aren’t always paid positions, but volunteer experience in the health care trenches can be an invaluable tool in furthering your education and career.
Reflecting on Your Career Choices
Just as there are different types of nurses, there exists a seemingly endless array of places in which you can practice your craft. Your chosen career field is a guide towards the place that you can call home — For instance, Nurse Practitioners (NPs) may end up working with marginalized populations in a primary care provider (PCP) capacity. Registered Nurses (RNs), on the other hand, primarily work in hospital settings, so city life may be in the cards.
Your nursing career provides boundless gifts. For starters, you can truly make a difference in the world, helping improve quality of life at both the individual and community levels. But nurses also enjoy the freedom to choose where to live, and that gift shouldn’t be taken lightly.
Whether you’re kicking off your nursing career or entering a new field of nursing, it may be the perfect time to upgrade your location as well. You may find that a change of scenery does wonders for your personal well-being, allowing you to thrive like never before.
Summer is here and the living is supposed to be easy. But for nurses, especially in 2020, the summertime looks like it’s going to be pretty busy. Are you looking for an energy boost?
Even as cases of the coronavirus taper off in some of the spring hotspots, it’s increasing at a rapid rate in other areas across the country. As a nurse, you know caring for yourself right now is essential, even as you find your time and energy depleted.
One way to boost your energy, your immunity, and your outlook is by eating food that offers both top nutrition and comfort food but is easy to prepare. As a bonus, any leftovers become an easy lunch to bring to work.
Here are a few tips for focusing on food to give you energy.
- Choose Seasonal Foods
Summer makes it easy to get a lot of nutrition because so many fruits and vegetables are in season. Whether it’s in a supermarket, a big box store, or a farmers’ market, ripe produce is often available when you are doing other errands. Choose peaches and melons that are sweet, packed with energy-boosting water, and offer plenty of vitamins. Dark green lettuces are tender, easy to wash, and full of folate.
- Get Your Protein
Protein prevents hunger pains between meals, fuels your long days, and keeps your body running. Lots of people choose to cut down on protein when they are trying to lose weight (or some weight-loss plans rely on protein overloads). Keeping a steady supply of protein from your food choices varies nutrition totals and keeps you from fading fast during a long shift. Choose from meats and seafood, beans, tofu, cheeses, and other dairy items like yogurt.
- Try Something New
You don’t have to be in the mood to whip up new recipes to try something new. Many supermarkets offer prepared foods that you can try with a small size or just commit to trying a new food. Or see if your family or a friend would want to go in on ingredients and try to come up with a dish that take less than five ingredients and three steps.
- Convenience Works
When you’re tired and facing down the dinner hour, a prebagged, washed salad and a cooked rotisserie chicken makes a great dinner with plenty of leftover possibilities. Premade soups, slices of veggie pizza, and frozen meatballs also add variety and ease to your meal selections. Thaw bagged, cooked frozen shrimp and cook a box of pasta—top both with a jarred cream sauce and some cherry tomatoes and you have a nutritious and filling meal. Watch out for extra salt and fat in some premade meals, but choosing something easy is what summer eating is all about.
Be mindful of what you’re eating and see if you notice any changes in your energy levels or even in the way you look at food. Summer is a good time to lighten up cooking effort, but you don’t want to skimp on getting healthy food. Make it enjoyable and easy to prepare and recoup a little peace during these stressful times.
Today is World Sickle Cell Day—a day designed to spread awareness and understanding of sickle cell disease–an often painful inherited blood disorder.
The Sickle Cell Disease Association of America (SCDAA) is marking the 10th year of this recognition. There is no cure for sickle cell disease right now, although some patients have had success with various treatments including hydroxyurea treatment and bone marrow treatment.
According to SCDAA, complications from sickle cell disease (SCD) happen when a normal blood flow is reduced or prevented from flowing normally throughout the body. With SCD, some normally round red blood cells become crescent shaped (sickle shaped) and because of that change, can no longer flow through small blood vessels. These misshapen cells can actually cause a blockage, thereby reducing a normal blood flow that tissues need to stay healthy and to keep the body functioning properly. A common result is that reduced blood flow damages tissues and can lead to debilitating pain.
Blood cells with sickle cells don’t live as long in the body (about 16 days vs. 120 days for normal cells according to the SCDAA), so that rapid turnover can lead to the myriad complications that come with a sickle cell diagnosis including anemia and jaundice. Because SCD affects nearly every organ in the body, systemic complications can involve major systems including the lungs and kidneys. And the damage can also leave the body less able to fight off and control infections.
Current treatments are often a reaction to the complications, although some, like a preventative antibiotic and vaccinations in children, can help prevent complications from beginning. Patients may find various combinations of blood transfusions, pain management, antibiotics, breathing treatments, proper vaccinations, and other medications.
As with other chronic conditions, people with SCD have to take extra care with their own health. Because people are born with sickle cell disease, the disorder is a lifelong condition and can be especially challenging for children to cope with. Generally, a hematologist will manage the condition and any treatments. According to the Centers for Disease Control and Prevention, staying well-hydrated is especially important as is good nutrition and rest. Anyone with sickle cell disease can stay active to help overall health, but just be especially aware of fatigue and fluctuations in body temperature—moderation is the best approach.
According to the CDC, sickle cell disease affects about 100,000 people in the United States with a greater diagnosis rate in minority populations. Sickle cell disease happens in approximately 1 out of every 365 Black or African-American births and 1 out of every 16,300 Hispanic-American births.
More common is being diagnosed as a carrier of the sickle cell trait (SCT) which is not sickle cell disease. A carrier of SCT has one copy of the defective gene that can cause sickle cell disease (you need two copies to have the disease).
For those with SCD, finding a provider who is familiar with the disease and with cutting-edge treatment is important. Research information, through organizations such as the Foundation for Sickle Cell Disease Research is essential. But the emotional struggle of coping with a complex, chronic, and invisible disease that can have such disruption in someone’s life is big. Getting the emotional and social support of a caring community is going to make a difference in developing coping skills and getting through rough times.
If you know someone who is impacted by sickle cell disease in any way, today makes it easier to spread the word, provide education, and let them know they aren’t alone.
I woke up this morning thinking about how some organizations who employ nurses, universities, and schools in general are making statements about diversity and inclusion. Some are including George Floyd’s name in these statements. I also thought about how there are many schools who are not making open statements about their heartfelt sentiments to the community, students, or faculty regarding the recent events. Within these organizations many nurses and faculty members are also working as frontline staff during the COVID-19 pandemic. In addition, to the current COVID 19 pandemic, African Americans have continued to have mental anguish existing due to continued racial inequalities existing and these truths being ignored by others.
Earlier this month, the American Nurses Association sent out an open statement about the social and racial injustices still existing and acknowledging how this goes against our dedication to nursing practice. I applaud this acknowledgement as it shows advancement of improving racial inequalities in an open forum.
Today, I am calling out organizations who employ nurses, schools of nursing, and universities worldwide to make a statement about racial inequalities existing and how they will address them in their organizations. It is not enough to say “I do not see color or it’s getting better”. In the recent months this has proven not to be the case. Those statements are not an accurate depiction of the truth as this dismisses those who are racially profiled against and judged based on the color of their skin.
Nursing assistants (NA) have been essential members on healthcare teams throughout the COVID-19 crisis. And while the pandemic continues to spread around the world, National Nursing Assistants Day on June 18 is timed to thank nursing assistants for the care they provide.
For 43 years, the National Network of Career Nursing Assistants has sponsored an entire week to celebrate those who choose this career. This year, that week runs from June 18 to 25 and is being marked as “Celebrate in Place” as many events have moved away from in-person formats.
According to Genevieve Gipson, RN, Med, RNC, and director of the National Network of Career Nursing Assistants, the theme for the week is kindness. NAs are encouraged to focus on a different aspect of kindness throughout the week and focus on events and projects that can continue to have an impact over the course of the year.
The National Association of Health Care Assistants seeks to elevate and promote the professional NA career . Working on teams and with other healthcare providers delivers more consistent and better patient care and nursing assistants are part of the team.
Nursing assistants and certified nursing assistants perform the routine patient care that often allows opportunities to talk with patients and learn more about them. Whether a patient is in a long-term care facility and sees a nursing assistant almost daily or in a short-term hospital stay and only has brief interactions, NAs and CNAs can make an enormous impact on the patient’s general care. By getting to know a patient and listening to them, nursing assistants can pick up on subtle physical or emotional changes or on preferences that could help fine tune such necessities as a preferred meal plan or understand family relationships.
NAs work under the supervision of registered professional nurses and perform duties that can range from basic patient care including bathing, feeding, toileting, grooming, dressing, and answering patient calls for help. They are generally responsible for things that help keep patients comfortable such as changing linens or checking bandages.
NAs can increase their training and competency with certification. Each state determines its own certification requirements, so plan to look into this additional step in whichever state you plan to practice. The extra certification can take a couple of months to complete, but offers additional skills that will be used every day.
The impact of NA-provided patient care can’t be understated. Because of their close interaction, they often help patients who are lonely and can comfort those who may need companionship. During the COVID-19 crisis, many facilities restricted visitors and so healthcare teams were the only people many patients could see for months. Having a friendly person to talk with calms nerves, staves off loneliness, and provides a much-needed human connection.
Celebrate National Nursing Assistants Day and National Nursing Assistants Week and be proud of the much appreciated care you provide.
June is recognized as Alzheimer’s and Brain Awareness month and during this month nurses act as excellent resources for their patients.
Whether your primary patient population is young or old, education about taking care of this essential organ is important. And while Alzheimer’s disease causes the biggest impact on those 65 and older, early onset Alzheimer’s devastates families as well.
Alzheimer’s and dementia, although not the same, are related. Both conditions affect the brain because they are related to damage of the brain’s cells, but neither is actually a normal result of growing older.
Although Alzheimer’s has no cure, many experts believe that protecting brain health can help delay it or possibly avoid it. There’s no magic, however, as so many varied factors can weigh into whether or not someone develops particular brain diseases.
Because there are still so many unanswered questions, anything that can help brain health is worthwhile for people who have concerns about these conditions. Many times, anything that protects health in general, especially heart health, is good for the brain. Talking to patients about the importance of taking care of themselves in general, from food choices to protecting against preventable head injury, can lead into conversations and education about how to do that in everyday activities.
According to the Alzheimer’s Association, 60 to 80 percent of dementia cases are caused by Alzheimer’s disease, a specific brain disease. Dementia, on the other hand, is characterized by general symptoms of decline in thinking, including the memory issues that many people begin to worry about as they age, but it doesn’t always mean someone has Alzheimer’s.
What can impact someone’s chances of developing Alzheimer’s? Advancing age is a risk factor as more cases of dementia, including Alzheimer’s, show up in older people. But a family history can indicate a genetic risk for developing the disease. People who are Black or Latinx also have greater risk of Alzheimer’s disease, so education about heart health and controlling high blood pressure, high cholesterol, and getting heart-pumping activity can go a long way to helping keep hearts and brains healthy.
Although no one can cure Alzheimer’s yet, research is ongoing into medications and treatments that offer much hope for a cure. In the meantime, if patients ask what they can do, there’s plenty you can tell them. They can get involved in advocacy on the local, state, and national level. That could mean advocating for residents of a long-term care facility in their hometown or getting involved on a national scale to pass legislation that impacts the research and the people affected by Alzheimer’s and brain health in general. There are many clinical trials run through the Alzheimer’s Association, the Mayo Clinic, and the National Institute on Aging, among others that need people who might offer clues into the disease, whether they have a brain disease or not.
Patients can also learn what they can do to help their own brain health. Small things like ensuring rugs are not trip hazards, clearing walkways of snow and ice, wearing a seatbelt always, and being aware of sports with high concussion risk such as football or soccer can help prevent the injury that can lead to cell damage.
During June, have conversations with your patients to help get them started on a path that boosts their brain health.
In the last two months, the world has begun to recognize and acknowledge what anyone in the health care field has always known: that nurses are society’s real superheroes. And yet for all the praise and adulation being heaped on our health care providers, for thousands of nurses, it all feels like lip service.
The fact that nurses are risking their lives every day in the fight against coronavirus isn’t news. But what few people know is that nurses aren’t just being asked to sacrifice their physical and mental health in the face of the pandemic. They’re also being asked or required to sacrifice financially as well.
This article discusses the profound economic impact of the COVID-19 pandemic on nurses, especially nurses of color. It also provides strategies for minority nurses to protect themselves financially as well as physically during the pandemic and beyond.
Nurses worldwide and particularly in the US are being asked to risk their lives and health to care for infected patients without even the most basic of protective equipment. At the same time, they’re facing job cuts on a level second only to those of the restaurant industry.
And even as nurses not called to the frontlines are facing furloughs and job losses, minority nurses find themselves contending with skyrocketing rates of infection in their own communities. This means minority nurses who may have been exposed on the job or at home now face the prospect of illness and the massive expenses of treatment on a reduced income and possibly without health insurance.
A Heightened Risk
It’s not only the loss of income and insurance that nurses are facing today. The coronavirus pandemic has also fundamentally changed the way health care is delivered, and that has increased both the physical and the financial risks that nurses must face.
For example, as the virus began to spread and lockdowns became more prolific across the country, health care providers turned increasingly to telehealth to care for their patients. This was a great benefit in ensuring continuity of care while protecting against the spread of the virus. Telehealth, however, is an entirely new beast for many nurses, and that’s exposing them to greater liability than they might ever have faced in the clinic. As effective as telehealth technologies may be, they can’t duplicate the conditions of a face-to-face patient exam. There are things that can be missed when you can’t touch the patient, see how she walks into the room, or listen to her breathing.
The question isn’t whether mistakes will be made or symptoms unrecognized. The question is how many of those mistakes will be judged to be malpractice and who will be held financially as well as legally responsible. This is a particular concern for nurses caring for patients with substance abuse disorder. The national lockdown has pretty much necessitated that patients in recovery transition to telehealth.
And yet substance abuse disorder is notoriously susceptible to relapse and the signs of relapse often incredibly difficult to detect, especially through remote care. Should a patient overdose while under the auspices of telehealth care, it is not unimaginable that a treating nurse could be held financially responsible
No matter how deep a toll the pandemic has taken on your physical, emotional, and financial well-being, there is a tomorrow to come. If you have been furloughed because of the pandemic or if you simply cannot tolerate the conditions you have been asked to endure, you might find that a career change is your best option.
That doesn’t mean that you have to leave the field of nursing entirely. If it’s still your heart, then you might take the hard lessons learned during the outbreak and use them for good. You might find your purpose in a new career spent solving the problems that threatened to break you.
For instance, you might decide to pursue a Master’s degree in Health Policy and spend the rest of your working life developing programs to protect those on the frontlines and the patients they care for. You could build a career ensuring that tragedies like those nurses are encountering every day of the pandemic never happen again.
You might decide, however, that you need an entirely new start and venture into an entirely new industry. You might reinvent yourself. If that’s the case, then you need to be strategic and start thinking like a recruiter. Now, more than ever, hiring managers are using behavioral interviewing to find the ideal candidate. Understanding what that is and how it works can give you a decided advantage, especially when breaking into a new industry. At its core, behavioral interviewing gives you the opportunity to demonstrate exactly why you are the ideal person for the job. You simply have to “read” what the interviewer is looking for in the questions she asks.
Nurses are finally being recognized as the superheroes they are, but they are far from getting the treatment they deserve. Instead, they are facing massive job losses, potentially lethal working conditions, and significant financial liabilities. Because of this, some nurses are choosing to leave the field altogether, while others are looking to transform it from within.