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SafetyNurse1968 ADN, BSN, MSN, PhD

Oncology, Home Health, Patient Safety

If I were in charge of the universe, there would be staffing ratio laws and unions in every state and you'd get written up for NOT taking your breaks.

Content by SafetyNurse1968

  1. I reached out to Mary, an old college acquaintance, to ask if she would talk to me about her experiences as a black nurse. I was concerned that asking her to talk about her history might be triggering or an imposition and I wanted to honor her willingness to share with me, so I asked if I could make a donation in her honor. She asked that I make a donation to the Alzheimer's Association in honor of her mother, who suffers from Alzheimer’s. I didn’t realize that June is Alzheimer’s and Brain Awareness Month. The more people know about Alzheimer's, the more action is inspired. In addition, I made a donation to The Bail Project™ National Revolving Bail Fund – “a critical tool to prevent incarceration and combat racial and economic disparities in the bail system.” Black RNs According to Minority Nurse, 9.9% of RNs are black or African American (non-Hispanic); 8.3% are Asian; 4.8% are Hispanic or Latino; 1.3% categorize themselves as two or more races; 0.4% are American Indian or Alaskan Native. There are 279,600 black RNs and 162,800 LPNs. Black or African American (non-Hispanic) nurses were more prevalent among the nurse population in the South Atlantic (9.5%), West South Central (8.8%), and East South Central (7.7%) areas than anywhere else. 14.6% of black or African-American nurses have related master’s or doctoral degrees, compared to 13.4% of white nurses.1 The profession of nursing shares a long and prestigious history of African-American nurses. Despite centuries of oppression and prejudice, Harriet Tubman, Mary Eliza Mahoney and Lillian Holland Harvey overcame adversity and fought to improve not only the lives of those around them, but the profession of nursing as a whole.2 Talking with Mary Safety Nurse (SN): “What experiences have you had in your career as a nurse in which the color of your skin played a role?” Mary: “Historically as a nurse working on the med surg unit, having older, white patients who assumed that if I was walking in the door with a white person, they would assume I was not the nurse, or that I was something less.” She went on to say, “It made me feel shocked and a little angered. I was quick to correct that. It didn’t make me sad, just shock and anger.” Growing Up with Different Races Mary grew up in a small town in the Southwestern U.S. She started out at an all-black school, but then from the third through eighth grade she went to an all-white, private school. Then she ended up graduating from a mixed-race high school. Mary: “I’ve been in every type of situation.” SN: “Where were you most comfortable?” When Mary shared, “I felt safer from being bullied in the all-white school.” I was surprised. I would have thought the opposite would have been true, but she went on to explain, “As a black person with other black people I felt more comfortable at the all-black school, but being the black girl in a black neighborhood, my dad had a better job, he made more money, I was catholic, I had longer hair, guys liked to hang around with me, I was bullied by those of the same color. They were jealous.” I understood better. She did say that she dated a white boy for a while. “I couldn’t go to his home because his mom was racist. I was hurt by it. It left me wondering why?” Mary attended a technical school to obtain an ADN and was an RN for five years before getting her BSN. She then went on to get an MSN in nursing leadership and management, and then she went on to obtain a post master’s nurse practitioner license. Now she’s in school for her doctorate. I joked that she and I have that much in common. We both love school! SN “Why did you shift from the hospital to academia?” Mary: “My thoughts when I worked in the hospital were to move up the chain of command, but no matter what I tried, charge nurse, CNE – it didn’t happen. I was on every committee, everyone thought I was the charge nurse, but I wasn’t.” SN: “Do you think race played a role?” Mary: “I don’t think it was race. I think it might be because I’m very honest. Sometimes that can be perceived as ‘the angry black woman’ I’ve always gotten in trouble for being honest.” “Its’ hard for black people to know if someone doesn’t' like us because of personality or race? When we don’t get a job, either you weren’t qualified, or the person didn’t like you, but we have to add on the extra one of race.” I was relieved when Mary told me she had never had any negative experiences with the police. She has two children, a teenaged daughter, and a son in his twenties and she said to her knowledge, neither of them has ever had a negative interaction with the police either. SN: “What about at your university? Have you experienced racism there?” Mary: “Going to some outside meetings, being on general education committees, it’s just a different atmosphere – being the only black person in those faculty meetings. Usually what you say isn’t as important as what your white counterparts say.” SN: “How about in the nursing program?” Mary: “Within our department – I feel very comfortable. Our dean is black, and our associate dean is black. Race is not an issue in our department. There was some shock when a black woman became the Dean. I don’t recall anyone being excited and I thought there should have been more excitement around that.” SN: “What about students? Do you feel there are any racial issues for your students?” Mary: “The old dean, I heard she treated the black students differently, but I don’t know the specifics. Now, it isn’t a problem. There may be some hidden problems. Being the most diverse division in our university, I’m comfortable and pleased with what we have.” SN: “How have things been for you since George Floyd was murdered; since the protests began? Are you okay?” Mary: “I can count on one hand how many people who have been sensitive on social media, who have reached out to me. I’m hurt by the person that I hang with the most hasn’t reached out to check on me. Initially what pops in my head is just to have her tell me, ‘I’m here, I’m listening, I understand.’” SN: “How have you felt since the protests started?” Mary: “It’s something that needs to be done. I’m happy with some of the changes that people are trying to make. There is still just so much more that needs to be done. There’s a lot more dialogue that needs to happen with certain people.” SN: “What do you think would make a difference at your school?” Mary: “I think it would be neat to have a diversity round table about the issues to talk about what’s going on, something like where different races get to talk about their perspectives respectfully. As a nursing instructor, I sent an email to my students that with what is going on, to be safe and remember you are in school for a profession that cares and takes care of all people. Remain professional” SN: “Anything else you can think of?” Mary: “What baffles me the most – I have a white friend who claims to be a Christian, she says she goes to church three times a week. She says she’s not racist, but she doesn’t want her daughter dating a black person. That’s hypocrisy, it contradicts what she’s saying. Admit what you are. The flat-out hatred and discrimination – I don’t understand it. How do you live like that?” Racism in Nursing? I had difficulty finding peer-reviewed research about racism in nursing. I know it exists, so I’ll keep looking and write up an article specifically on this topic. Until then ... I’d like to hear from you ... Have you experienced racism as a nurse? If so, did it come from patients, coworkers or management? Thank you in advance for being willing to share.
  2. SafetyNurse1968

    You Don’t Know How to Argue

    Open Your Mind Have you been on social media lately? Maybe you posted something you thought was pretty benign like, “My daughter is really struggling with depression. I think we should consider having some in-person sessions of school this fall.” After a few thumbs up and heart emojis from close friends, your co-worker posted about an increase in deaths from COVID-19 after Korea reopened their schools and said, “This is a stupid idea.” Their best friend replied with an article about a child who just died from COVID saying, “You never consider things like this”. Your aunt broke out the ALL CAPS to say, “TEACHER’S LIVES MATTER” and your cousin’s mother-in-law said, “you’re heartless, you don’t care who dies.” The final straw was your dad who chimed in, “This is all Trump’s fault.” You ended up lying awake in bed all night fuming, thinking you should just delete your facebook account. I’ve been trying to post well-reasoned information on social media only to be met with what my grandmother would have called, “downright meanness.” I try very hard not to get defensive, and I usually succeed, but it’s got me thinking about how much energy we expend fighting, when we could perhaps be learning something from a well-reasoned discussion. In this article, I’m going to challenge you to open your mind. I’ve got some examples and ideas and I hope you’ll keep them in mind the next time you respond to an article. Who Taught You How to Argue? I’ll bet it was your parents, and I’ll bet most of them weren’t very good at it. My parents argued. A LOT. When they were unhappy, they yelled at each other. My mother would yell at my dad for being lazy and then slam her bedroom door. We’d hear her crying in there and feel just terrible. Maybe there was a well-reasoned argument for why my dad should perhaps get a job…but I never witnessed it. I’m also learning that what they were doing wasn’t “arguing” – they were “fighting” and typically this is the only example most of us have for how to deal with differences in opinion. When I think about effective argument, I think about lawyers and the techniques I see on television and in the movies. They typically use well-reasoned arguments to make a case, though for dramatic effect, you often seem them yelling and getting emotional. I wonder if they do that in real-life? Is it effective to get emotional and raise your voice? Does cutting down your opponent, name calling and “ornery-ness” win an argument? From personal experience, when someone yells at me and calls me stupid, I tend to shut down and walk away. It makes me want to “delete my facebook account.” And everything that goes with it. Classroom Training In the dim recesses of my memory, I know I learned the elements of a good argument in school, but I can’t recall if it was high school or college and I don’t remember many details. Several phrases have been popping up in my brain as I strain to recall useful details. “Straw man argument; appeal to emotion; ad hominem” Do any of these phrases sound familiar? You might have been exposed to argumentation in debate club, or maybe you took an argumentative writing course. I think I learned about it in philosophy 101 in college, but I’m not 100% sure. Luckily for us, there’s the internet – always available to refresh our memory if we know where to look. What is a Logical Fallacy? It’s a fancy name for an error in reasoning. There’s a long list of logical fallacies and they include “Straw man and ad hominem” (I’m pretty excited that I remembered something from my college days!) I won’t go into detail on all of them, but let’s unpack a few of the most common. Insulting comments Ad hominem means “against the man” and is the exact terminology you want when describing a personal attack or shouting match. When you get called “stupid” on social media, logical argumentation has been replaced with attack-language unrelated to the truth of the matter. You are rejecting another person’s view on the basis of personal characteristics, background, physical appearance or other features irrelevant to the argument at issue. It’s not just an insult, it’s an insult used as if it were an argument or evidence in support of a conclusion. You might know it as “mudslinging” in politics. I’m thinking of how some folks have been making fun of our president for slurring his speech. You can Google lists of insults against politicians - I won’t list any here so as not to detract from my argument that we can learn to argue effectively. Ad hominem signals to me that instead of arguing we are now fighting. In the above example, it’s when the original poster was called “heartless” or when their idea was called “stupid.” But I didn’t say that! In the strawman argument, someone attacks a position the opponent doesn’t really hold. It’s an easy way to make your position look stronger than it is. Often this type of argument is accidental because the offender doesn’t realize they are oversimplifying a narrow, cautious claim as if it were broad and foolhardy. In the original post about going back to school, the original poster (OP) wanted to look at the idea of re-opening. The “straw man” is that the OP suggested schools should reopen “no matter who dies.” Some of the others… Appeals to ignorance – claiming that because something hasn’t been disproven then it must be true. Example: “There’s no evidence that kids can spread the virus, so it’s okay to reopen schools.” False dilemma/False dichotomy – either-or fallacy limits the options to two when there are in fact more options to choose from. Example: “We can either reopen schools and kill people or keep them closed and save lives.” Slippery slope fallacy – moves from a seemingly benign premise or starting point and works through a number of small steps to an improbable extreme. It suggests that unlikely or ridiculous outcomes are likely when there’s not enough evidence to think so. Example: “If you reopen schools, millions of teachers and caretakers will die.” Circular argument – when a person repeats what they already said and doesn’t arrive at a new conclusion. If A is true because B is true, B is true because A is true. For example, “My daughter is depressed, and reopening schools will help, so we should reopen schools.” Hasty Generalization – a general statement without sufficient evidence to support it. The statement, “You never consider things like this.” is an example– using always or never is a generalization. A simple way to avoid this is to add qualifiers like “sometimes”, “maybe”, “often” or “it seems to be the case that…” Red herring fallacy – a distraction from the argument with something that seems to be relevant but isn’t really on-topic. It’s common when someone doesn’t like the current topic and wants to detour into something else instead. Derailing the topic of possibly re-opening schools with a comment about President Trump is a good example of this strategy. How to Argue Effectively Be prepared Know when to argue and when to walk away Think about how you’re saying what you want to say Listen. Repeat. Know your audience – what kind of argument might they find convincing? Watch out for logical fallacies Maintain relationships – when in doubt ask the person to explain their thinking Admit weakness – acknowledge when you are wrong I’m looking forward to your comments about arguing vs. fighting. Maybe you’ll share some examples I’ve missed, point out some of my errors or share frustrations or successes. As always, thank you for reading! References The Proper Way to Argue: The purposes and pitfalls of arguing - Psychology Today Logical Fallacies - Purdue University
  3. SafetyNurse1968

    Do Black Nurses Have a Different Experience?

    You sound like you are in a lot of pain and really hurting. I hope we can find a way to communicate.
  4. SafetyNurse1968

    Do Black Nurses Have a Different Experience?

    I am asking you to answer the original question of the post which was "Do Black nurses have a different experience?" If you are discussing that topic, then I welcome your post. I'd like for you to do it in a civil and reasonable way. Help me understand where you are coming from. Your words seem full of anger. Are you angry? I'd be happy to talk to you off post in a private message. Would you be willing to state your opinion without being unkind?
  5. If you think you know the correct diagnosis for this Case Study (CSI)... DO NOT POST ANSWER HERE. Instead, post your answer in the ADMIN HELP DESK.; We don't want to spoil it for others who are late in joining us. In a few days, after I post the diagnosis, the Admins will announce the names of those members who correctly identified the problem. We hope to turn this into a friendly competition with more Case Studies to come. You CAN post questions and post comments below. BUT... Do NOT post your diagnosis guess below. Chief Complaint Fever of 101o F, fatigue and lethargy, stiff neck and jaw, chills and sweating with fever, muscle aches and pains with fever. “I feel like I have the flu. I’m worried I might have Covid-19.” History of Present Illness Lakeith awoke on Saturday morning feeling exhausted. As the morning progressed, he began to have aches and pains. He took an oral temperature that was 101o F. His first thought was that he had contracted Covid-19. He is a home health physical therapist who specializes in geriatric physical therapy. He sees four to five patients each day. Several of his patients have tested positive for Covid-19. When working with any of his patients, Lakeith wears an N-95 mask and gloves and practices strict hand hygiene. Before calling his primary care provider, Lakeith went online and took the Mayo Clinic Covid-19 Self-Assessment Tool to see if his symptoms fit with those for Covid-19. Here are the questions with his response Have you been within 6 feet of a person with a lab-confirmed case of COVID-19 for at least 5 minutes, or had direct contact with their mucus or saliva, in the past 14 days? YES Does the person with COVID-19 live with you? NO In the last 48 hours, have you had any of the following NEW symptoms? Check all that apply. Response Symptom Yes Fever of 100 F (37.8 C) or above Yes Fever symptoms like alternating chills and sweating No Cough No Trouble breathing, shortness of breath or severe wheezing Yes Chills or repeated shaking with chills Yes Muscle aches No Sore throat No Loss of smell or taste, or a change in taste No Nausea, vomiting or diarrhea Yes Headache No None of the above Do you have any of the following possible emergency symptoms? Check all that apply. Response Emergency Symptom No Struggling to breathe or fighting for breath even while inactive or when resting No Feeling about to collapse every time you stand or sit up (floppiness or a lack of response in a child under age 2) No None of the above Is the person with a fever younger than 3 months old? NO Have you traveled in the past 14 days to regions affected by COVID-19? NO Do you live in a care facility? NO Do you work in healthcare? YES After taking the test, he called his primary care office and the triage nurse directed him to come in for a Covid-19 test. General appearance The patient arrived at clinic for a Covid-19 test wearing a mask, shoulders drooping, eyes heavy-lidded. Speech is slow and measured. While the nurse prepped for the test, she noticed the patient repeatedly attempting to scratch his back. Past Medical History Uncomplicated appendicitis at age 12 Family History Father, age 56, and mother, age 52 both have HTN and hypercholesterolemia. Thirty-three-year-old sister with obesity and type 2 diabetes. Social History Occasional marijuana use, drinks alcohol 1-2 times weekly. Non-smoker. Lives alone. Patient has a girlfriend of three years. He has been socially isolating since March 15th due to his high-risk job. Medications Takes Tylenol or ibuprofen for aches and pains. Daily Allegra for seasonal allergies. Allergies NKA This case study is different from others in that I am letting you know from the start that Lakeith has Lyme disease, Covid-19 or both. What information do you need to determine his diagnosis? He’s had a nasal swab for Covid-19, but the results won’t be available for another three days. What else would you check before he leaves the primary care clinic? REMEMBER: DON’T post the ANSWER HERE! Ask questions and I’ll give you more information. References Merck Manual Professional Edition: Lyme Disease
  6. SafetyNurse1968

    Differential Case Study: Lyme Disease or Covid-19?

    My personal Tick specimen TC-15013 tested negative for the presence of Lyme disease, ehrlichiosis and Rocky Mountain spotted fever.
  7. SafetyNurse1968

    Differential Case Study: Lyme Disease or Covid-19?

    NG swab negative!
  8. SafetyNurse1968

    Differential Case Study: Lyme Disease or Covid-19?

    My nares/nostril swab just came back negative, still waiting for the NG results. Of course I’m almost at the end of my quarantine now. And feeling fantastic except for a nagging headache. I’m still checking my temperature and pulse ox every day just to be sure.
  9. SafetyNurse1968

    Differential Case Study: Lyme Disease or Covid-19?

    I have to say as sick as I am right now, these little comments really bring me a lot of support and joy thank you. Spiked an axillary at 103.5 and barfed -if I spike again I’m headed to the ER. Will keep you posted! Suddenly feeling much better now that my fever is coming down. So many positives- O2 sat high, no shob and Tylenol works- just not long enough. Maybe 3rd dose of doxy will do it!
  10. SafetyNurse1968

    Differential Case Study: Lyme Disease or Covid-19?

    Thank you! I really needed that- good convo is a good outcome. IKR! Not back yet- will post as soon as it comes in! Thanks for your support.
  11. SafetyNurse1968

    Differential Case Study: Lyme Disease or Covid-19?

    Please scroll up -I did reveal the answer and it is Lyme disease!
  12. SafetyNurse1968

    Differential Case Study: Lyme Disease or Covid-19?

    https://www.health.com/condition/infectious-diseases/coronavirus/lyme-disease-coronavirus?amp=true Just took second dose of doxy- fever is 101.9 this morning
  13. SafetyNurse1968

    Do Black Nurses Have a Different Experience?

    A great article describing how racism is a pandemic - I agree.
  14. SafetyNurse1968

    Racism and Covid-19: The Unmasking of Two Pandemics

    Thank you for bringing this important issue to light. We must continue to advocate for better health outcomes for people of color. I have been carrying around a quote I found on a Black Lives Matter website: "We are not all in the same boat, but we are all in the same storm." Some of us are in yachts, some of us are in dingies, some of us are holding onto the edge of a packing crate that is going under. Also, wanted to share an article I wrote on this topic: I will post a link to your article in mine as well.
  15. SafetyNurse1968

    Do Black Nurses Have a Different Experience?

    Thank you for sharing your story. No need to mute or ignore - I appreciate anyone who reads my articles - it helps me hone my abilities to debate and pushes me to find evidence and resources for my opinions. I spent an hour online with a librarian today and have a long list of research articles about racism and Black nurses in America. I'll be writing it up soon. Thanks for your support.
  16. SafetyNurse1968

    Differential Case Study: Lyme Disease or Covid-19?

    Sorry I didn't post the final results sooner, but I seem to have some kind of infection...folks, it’s getting weird over here. Over the weekend I developed the exact same symptoms I described in Lakeith (fever, aches and pains, chills, headache). I had a tick bite 2 weeks ago, though no bulls eye rash. I just got tested for Covid-19 this morning at an urgent care clinic, and I’m waiting to hear back from my primary care provider (apparently, they don’t call you back the same day anymore!) I’ll keep you posted on my case, but in the meantime: Lakeith’s Lab values: ALT 150 (normal is 7-55 U/L) AST 105 (normal is 8-48 U/L) Bilirubin 3.5 (normal 0.1 to 1.2 mg/dL) All other blood work was normal Elevated liver enzymes are common in both Covid-19 and Lyme disease, so this isn’t a good differential. A study I read showed 76.3% of 417 patients had abnormal LFTs and 21.5% had liver injury with Covid-19 (April 13, 2020, https://www.journal-of-hepatology.eu/article/S0168-8278(20)30218-X/fulltext). They had ALT, AST, total bilirubin and gamma-glutamyl transferase levels elevated to more than 3× the upper limit. Patients with abnormal liver tests of hepatocellular type or mixed type at admission had higher odds of progressing to severe disease For practical and efficient screening of large populations for a viral infection like Covid-19, reports from China recommend including white blood cells (WBC) and C-reactive protein (CRP) in laboratory examinations for early monitoring of infection (Lu, L. Interpretation of 7th edition of COVID-19 diagnostic and treatment guidelines. Lifotronic webinar: Diagnosis Guidelines for COVID-19, March 19, 2020 https://onlinelibrary.wiley.com/doi/10.1002/ajh.25774) Their analysis revealed that on admission (so this would be for patients much sicker than Lakeith), most patients had a normal CBC (normal Hb, WBC and platelet count) and lactate dehydrogenase (LDH). And, no patient presented with moderate or severe thrombocytopenia that is frequently observed in other viral illnesses such as dengue fever. However, reports from China are showing high levels of lymphopenia (Absolute Lymphocyte Count < 1 × 109/L). Those requiring ICU care had a lower ALC and higher LDH. Lymphopenia (ALC) and lactate dehydrogenase (LDH) have both been significantly elevated in hospitalized COVID-19 patients in a small study of 96 confirmed COVID-19 cases in Singapore. Lyme Disease In the U.S., Lyme disease is caused by Borrelia burgdorferi and Borrelia mayonii. The most common tick-borne illness, Lyme disease is transmitted by the bite of an infected deer tick. Lakeith’s nurse practitioner ordered an ELISA test for Lyme, though an ELISA test might not be positive during the early stage of Lyme disease. The rash is distinctive enough to make the diagnosis without further testing in people who live in areas infested with ticks that transmit Lyme disease (New York State is a hot spot for Lyme disease). In addition, the ELISA test can sometimes provide false-positive results, so it’s not the sole basis for diagnosis. Lakeith’s ELISA and subsequent Western blot both came back positive. Signs and Symptoms of Lyme A small, red bump, similar to the bump of a mosquito bite, may appear at the site of a tick bite or tick removal, but this may occur with or without Lyme disease. Erythema migrans (bullseye rash) is one of the hallmarks of Lyme disease, although not everyone with Lyme disease develops the rash. Other symptoms include Fever, chills, fatigue, body aches, headache, neck stiffness and swollen lymph nodes. If untreated, new signs and symptoms of Lyme infection might appear in the following weeks to months (https://www.CDC.gov/lyme/signs_symptoms/index.html). These include bouts of severe joint pain and swelling, especially likely to affect the knees, but the pain can shift from one joint to another. Weeks, months or even years after infection, meningitis can cause Bell's palsy, numbness or weakness in limbs, impaired muscle movement and problems with mentation and memory, so it is important to diagnose Lyme early. Delayed diagnosis increases the risk of Post Treatment Lyme Disease Syndrome (https://www.cureus.com/articles/24863-lyme-disease-with-erythema-migrans-and-seventh-nerve-palsy-in-an-african-american-man) and other long-term complications from Lyme disease. Antibiotics are used to treat Lyme disease. In general, recovery will be quicker and more complete the sooner treatment begins. Many signs and symptoms of Lyme disease are often found in other conditions, so diagnosis can be difficult. Covid-19 False Negatives Researchers at Johns Hopkins have found that the chance of a false negative result -- when a virus is not detected in a person who actually is, or recently has been, infected -- is greater than 1 in 5 and, at times, far higher. The researchers caution that the predictive value of these tests may not always yield accurate results, and timing of the test seems to matter greatly in the accuracy. https://www.sciencedaily.com/releases/2020/05/200526173832.htm. Lakeith requested a second Covid-19 test, which was also negative. He is currently taking a two-week course of oral Doxycycline. Health disparities and Lyme A recent study finds that African Americans who contract Lyme disease are 10% more likely than Caucasians to exhibit symptoms such as neurological or heart problems, and they are 30% more likely to suffer from arthritis as a result of the disease. Whites were nearly six times more likely than African Americans to have detected a bull’s-eye rash, according to the study, which may be due to darker skin color that hides the bull’s-eye rash. Because skin tone may hide this key indicator, African Americans may remain untreated longer and therefore suffer more complications from Lyme disease. This highlights the need for increased health care education on Lyme disease in African-American communities. https://minoritynurse.com/darker-skin-tones-slow-detection-of-lyme-disease/ Health disparities and Covid-19 Twenty-two percent of U.S. counties that are disproportionately black account for 52 percent of the nation’s COVID-19 cases and 58 percent of COVID-19 deaths (https://directorsblog.nih.gov/2020/05/14/covid-19-brings-health-disparities-research-to-the-forefront/) In another study, 33% of hospitalized patients were black, compared to 18% in the community, and 8% were Hispanic, compared to 14% in the community. These data suggest an overrepresentation of blacks among hospitalized patients. Death rates among black/African American persons (92.3 deaths per 100,000 population) and Hispanic/Latino persons (74.3) that were substantially higher than that of white (45.2) or Asian (34.5) persons. (https://www.CDC.gov/coronavirus/2019-ncov/need-extra-precautions/racial-ethnic-minorities.html) Racial disparities are a major issue with Covid-19. Evidence has emerged that doctors are less likely to refer African Americans for testing for covid-19 when they exhibit symptoms (https://www.washingtonpost.com/outlook/2020/05/18/most-medical-professionals-arent-racist-but-our-medical-system-is/). U.S. Senator Elizabeth Warren (D-MA) and Representative Ayanna Pressley (D-MA) have called for more thorough collection of racial data, faulting the government for “currently failing to collect and publicly report on the racial and ethnic demographic information of patients tested for and affected by Covid-19.” (https://www.nejm.org/doi/full/10.1056/NEJMp2012910) Thanks for commenting and liking - I so appreciate it. I'm going to take some acetaminophen and go back to sleep. Ugh. I thought it would make for an interesting and informative discussion. Thanks for reading and commenting.
  17. SafetyNurse1968

    Do Black Nurses Have a Different Experience?

    Please let that be true. I hope we can keep the momentum going. I joined a group of Black women fighting for positive change several years ago. My goal was to sit and listen and learn. My biggest takeaway is that as a white woman, I can never understand how uncomfortable it is to be Black. I try to remind myself of that every day.
  18. SafetyNurse1968

    MNA and Nurses Respond to the Killing of George Floyd by Police

    Regarding the statistics you've presented, what do you believe are some of the reasons that blacks commit more crimes than whites, besides socioeconomic reasons?
  19. SafetyNurse1968

    Do Black Nurses Have a Different Experience?

    @Ella26, thank you for sharing your stories. I am grateful that you took the time to educate me on the injustices you have experienced. It saddens me that even anger is taken away from Black women. I'm here to listen and learn.
  20. SafetyNurse1968

    Do Black Nurses Have a Different Experience?

    Thank you for sharing. I'm sorry you've experienced this. I am fighting for an America in which racism doesn't exist. We are a long way off...
  21. SafetyNurse1968

    Do Black Nurses Have a Different Experience?

    I disagree with you that black disparities are no more important than LatinX, Asian, Gay, Male and Caucasian. I believe that black people in this country are suffering. They are the only group I can think of that is facing a history of slavery in this country. What Black Americans have suffered at the hands of white people in this country is an injustice. We must stand up for our Black brothers and sisters and work every day to dismantle the systemic racism that plagues our country. As an example, I would ask you to look at what happened during the Tulsa race massacre in 1921 - it is just one example of how institutionalized racism has resulted in the torture and death of black citizens. What baffles me is what white people are so afraid of. I look forward to a United States that is run by Black, LatinX, Asian and Gay folks - I'm hoping we might see universal health care and fewer health disparities. https://www.tulsahistory.org/exhibit/1921-tulsa-race-massacre/ Thank you for sharing your experience. I am sorry this happened to you.
  22. SafetyNurse1968

    Do Black Nurses Have a Different Experience?

    @mangopeach, I am so sorry this happened to you. It is beyond frustrating that you had to find out this way that you were not being paid the right salary. I think what frustrates me even more is that administration so often shies away from saying, "I'm sorry, we made a mistake." At least they admitted they were wrong and rectified it, though that by no means makes what they did okay.
  23. SafetyNurse1968

    Do Black Nurses Have a Different Experience?

    Thank you for sharing your experience. This kind of behavior from an instructor can have such a dehumanizing and traumatic impact on students. I am sorry this happened to you. The instructors who did this were wrong in their actions. Dr. Madenya I salute you! Thank you for sharing your experience, strength and hope. I admire your perseverance in the face of such struggle.
  24. SafetyNurse1968

    Do Black Nurses Have a Different Experience?

    Thank you for sharing your experience with me. I am so sorry these things have happened to you. I can certainly understand why you decided to leave. I can't imagine how hard it would be to be judged for the color of my skin.
  25. The next time you’re at work, look around. How many of your fellow nurses are men? I teach nursing and in a class of forty students, I have only three students who identify as men. None of the forty faculty members at my school of nursing are male. Back in the 1960s, only 2 percent of nurses were male, but now the number has risen to 13 percent.1 Why is nursing so female-centric? HISTORYWe were taught in nursing school that the first nurses were male caregivers in Ancient Rome, tending the sick and dying during the Crusades. Male nurses were also found in the Civil War in both the Union and Confederate armies. The shift to an all-female workforce didn’t begin until the Army Nurse Corps (ANC), established in 1901, banned men from serving as nurses. It wasn’t until 1955 that they commissioned the first male officer.2 MEDIAYou may have seen a movie called Meet the Parents, in which Ben Stiller plays Greg Focker, a male nurse who perpetuates stereotypes that women are nurses and men are doctors. If you look at Grey’s Anatomy, Scrubs and ER, the stereotypes continue. We might see a female doctor, but never a male nurse. In a survey of male nurses, 70 percent stated that gender stereotypes are the main barrier to entering the field of nursing.1 Male nurse respondents indicated they were influenced by the misperception that the profession of nursing is not “appropriate” for men. CHALLENGING MASCULINITYIn an article in American Nurse Today, David Foley shares some of his experiences as a male nurse. “The pressure to create a masculine identity within a historically female profession proves overwhelming and they [male nurses] flee for the operating room, emergency department or intensive care unit.” Male nursing students may face questions from family and friends about choosing nursing and may face challenges to their masculinity because women are traditionally seen as nurturers, while men are in more dominant leadership roles. Foley shared a story about a student who was actively discouraged from going into a less technical discipline in nursing with comments like, “You’ll never be accepted,” “Why would you want to make your life so hard,” and “What’s wrong with critical care? You’ll make more money.”3 Edward Bennett, named 2018 Student Nurse of the Year by the National Black Nurses Association, said, “I’ve definitely gotten pushback for being a black male nurse. Other people look at me like, ‘why would you want to be a nurse when you can be doctor?” Bennett continues to advocate for changing misconceptions by reminding prospective male nurses that, “You work with your hands, you think critically and you advocate for your patients every day.”4 Male nurses face a particularly steep challenge in obstetrics and OB-GYN. Even if they overcome stereotypes about who should pursue this field of nursing, often they cannot obtain access to patients. As an instructor I have seen it happen many times – a woman giving birth or having a pelvic exam doesn’t want a male nursing student to observe or care for her.3 In a survey of 462 undergraduate nursing students in Canada, male students demonstrated significantly lower scores on the efficacy subscale, suggesting that some men experience feelings of marginalization and discrimination.5 SOLUTIONSAccording to the IOM report, The Future of Nursing: Leading Health, Advancing Change, we must find a solution. Men provide unique perspectives and skills that are crucial to the profession and to society as a whole. We need to place a greater emphasis on recruiting men into the field. We know that patients are more receptive to healthcare providers of similar cultural and ethnic backgrounds.1 Male patients may feel more comfortable discussing certain conditions, especially those related to sexual and reproductive health, with other men, than with women. The World Health Organization identifies the “men’s health gap” – men visit the doctor less frequently and are less likely to ask questions or bring up concerns during appointments. “Having a male nurse could help open them up” says Bryan Smith, president of the American Association for Men in Nursing.6 The nursing shortage is another reason to recruit men. The president of the American Assembly for Men in Nursing, William T. Lecher, states that “The shortage of the future will likely not be solved unless men are part of the equation.”1 Elias Provencio-Vasquez, a Robert Wood Johnson Foundation Executive Nurse Fellow, shares that when he was met with resistance from some female patients in the maternity ward early in his career as a student at the University of Texas, in El Paso, “We overcame that by presenting ourselves as students, and our faculty members were very professional and very supportive."1 Bennett recommends creating pipeline programs for male students at predominantly African American high schools to diversify the profession in multiple ways.4 THE AAMNTo encourage more men to join the profession, the AAMN conducts outreach, challenging local chapters to reach as many male middle and high school students as possible through classroom visits, career fairs and more. The AAMN also offers an award to the best schools for men in nursing to recognize programs that have made efforts in recruiting and retaining male students. Award winners include Nebraska Methodist, Duke, Goldfarb, New York University, Rush, Rutgers, Vanderbilt and West Coast University. In addition, the AAMN enlists members to guest lecture at nursing schools. Only 6 percent of faculty are men. Having a lecture from a male nurse can have a powerful impact on male students who are feeling isolated and alone. “Just seeing a male being successful in nursing, even though it seems like something so small, can really trigger a sense of belonging.” says Smith.4 Nurse educators and preceptors must acknowledge that gender bias exists. We need to refrain from gender-biased language and teaching practices that may discourage male nurses from embracing a career in any of the specialties of nursing. WHAT DO YOU THINK?I’d love to hear from male nurses out there – what has your experience been? Did you find support when you needed it? Do you have ideas for how we can recruit more men into nursing and remove some of the misconceptions that are preventing a diverse workforce? Read Gender Bias in Health Care to learn more about gender bias in health care. REFERENCES Male nurses break through barriers to diversity professionMen in Nursing: History, Stereotypes, and the Gender Pay Gap How to Avoid Gender Bias in Nursing Education Bohanon M. (2019, January 8). Men in nursing: A crucial profession continues to lack gender diversity. Sedgwick, M. G. & Kellett, P. (2015). Exploring masculinity and marginalization of male undergraduate nursing students’ experience of belonging during clinical experiences. Journal of Nursing Education, 54(3):121-129.American Association for Men in Nursing.
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