About peggychinn

feminist, nurse activist, writer, editor of ANS Advances in Nursing Science, quilter, grandmother nurturing the future of the amazing children in my life.

One thing you can do – now


#NursesResist

All the talk about repealing the U.S. Affordable Care Act (ACA) is scary stuff for those of us who are concerned about those who would be harmed immeasurably if this were to happen.  Of course this is a U.S.-specific problem, but all countries face ongoing threats that weaken healthcare systems worldwide (for example, the U.K. “Brexit” initiative is a significant threat for their National Health Service). Here in the U.S. we are at least a bit encouraged by the signs that repealing our fledgling ACA may not be easy – that the voices of the people letting MoCs s (members of Congress) know that this is not a good idea – may be getting through.  However, as Rachel Maddow has been advising us for weeks now – watch what they DO, not what the say. In fact one of the most damaging things we can do is to repeat over and over what they say, which only reinforces their message.

So fortunately, we have folks stepping up to help us watch what they do, and giving us leads about what we can do about it.  When, just a few days ago, Tom Price, avid opponent of the ACA, became Secretary of Health and Human Services, put up a proposal to make it harder and more expensive to get coverage under the ACA, and also supporting DJT’s speakupexecutive order that gives insurers freedom to deny and limit benefits for those who already have it – most of the public had no way to know that this was happening.  The brand new DCReport.org, established by David Cay Johnston, is filling this void.  Read the report on the new ACA proposal here – Administration Moves To Block Access To Health Insurance.  Here is the action box that accompanies this report:

Citizens have until March 7 to weigh in on the new rule. Use the rule-making code CMS-9929-P in any correspondence.

Write: Centers for Medicare & Medicaid Services / Department of Health & Human Services / Attention: CMS-9929-P / P.O. Box 8016 / Baltimore, MD 21244-8016. The phone number is 410-786-7195.

You can also comment online. This link will take you to the text of the proposed rule. There is a comment button on the right.

Of course this is not a dramatic, showy kind of action, and it certainly will not remove the threat that our country is facing. But if nobody speaks up now, then this administration will be further emboldened to continue down a damaging path.  We can at least put them on alert by sending strong and clear messages that they do not have a mandate to continue.

We will continue to alert all NurseManifesters of actions we can take related to health and healthcare – but to stay alert for any issues that concerns you, follow DCReport.org, and other trusted news sources that help guide your own actions.

#ProtectTheTruth
#HealthForAll
#FreePress
#MakeJournalismGreatAgain

Postcard campaign – #Idesoftrump, #TheResistance


Nurses Declaration of Solidarity and Resistance

There is an organic, world-wide movement afoot to participate in a massive show of resistance to the new U.S. President – write a simple postcard with your message of resistance and mail it on March 15th. This is an opportunity for those of us who are nurses to join in sending messages affirming our support for world-wide health and opposing all that threatens health of the earth, and all that inhabit the earth. Check out the source I refer to below (The Daily Kos) below for details! Here is the basic information about what to do to participate:

Prepare for March 15th, 2017, a day hereafter to be known as #TheIdesOfTrump. Postcards are important here! Regular mail must go through content inspections that slow them down, whereas postcards don’t have such postal obstacles.
Write one postcard. Write a dozen! Take a picture and post it on social media tagged with #TheIdesOfTrump ! Spread the word! Everyone on Earth should let Donnie know how he’s doing. They can’t build a wall high enough to stop the mail.
Then, on March 15th, mail your messages to:
President (for now) Donald J. Trump
The White House
1600 Pennsylvania Avenue NW
Washington, DC 20500
from The Daily Kos, February 7, 2017

Guidelines for Resistance


It has been one week since we posted the Nurses Declaration of Solidarity and Resistance, and today we registered 833 signatories, and still counting!  But what matters is that nurses are not only signing this Declaration, but we are acting in our communities all over the world to put the values of this Declaration into action. We have heard from many nurses directly who have said “I have never taken this kind of action before, but now I am doing it.”

Of course not all nurses share the commitment that we have put forward, and we respect any challenge or difference of opinion.  The fact remains that there are hundreds of nurses who, like growing numbers of our colleagues and neighbors, continue to be alarmed by the actions of the new administration.  The book “Don’t Think of an Elephant” by George Lakoff has helped me to understand the perspectives that different people have concerning what is happening in our nation and the world. Recently a friend heard Professor Lakoff speak of central guidelines for resistance – ways to avoid inadvertently helping the new administration, ways to resist, and ways to promote the values that stand on the side of health and justice.  These guidelines can be applied not only to public action, but to our own language and thinking about the situation we are in:

1. Don’t use the name of the new President, and do not repeat his tweets.
2. Remember this is a regime and he’s not acting alone;
3. Do not argue with those who support him–it doesn’t work;
4. Focus on his policies, not his orange-ness and mental state;
5. Keep your message positive; they want the country to be angry and fearful because this is the soil from which their darkest policies will grow.
6. No more helpless/hopeless talk
7. Support artists and the arts
8. Be careful not to spread fake news. Check it.
9. Take care of yourselves; and
10. Resist!

If you have not found your way yet to a place and time to take specific political action.in your community, go to the Indivisible Guide website – and start by searching for groups in or near your zip code.  Read the guide, talk with your friends, explore existing groups or form one of your own.

When you get involved in a group, let everyone know that you are a nurse, and that you are speaking up based on the values that nurses hold dear! Together we can make a difference! And let us know here!  Add your comment to our blog any time to share what you are doing, because your action inspires all of us to act in our own ways and times!

Nurses Declaration of Solidarity and Resistance


The 2017 U.S. Executive Branch is taking steps that will have an effect on the health and well-being of all who reside within the borders of the United States, and of all people worldwide.  At this moment in history, we call upon nurses to stand together, act to resist that which harms health and well-being, protect those who are harmed, and build coalitions that move toward the ideals we seek.  We stand on a long legacy of political activism by nurses that arises from our moral imperative to actively promote public policy to assure social/health equity. Our actions are grounded in the premise that health and well-being depends on healthy environments and  just communities. We pledge to join with others to engage in determined action to protect health and justice for all, regardless of age, social/economic circumstance, religion, skin color, race, sexual orientation or gender identity.

1. We believe that health and well-being of mind, body and spirit is a fundamental human right.

As nurses, we are committed to provide care for all people – care that promotes and supports high level wellness, prevention and treatment of injury and disease, and restoration of health when it is compromised.  

2. We believe the integrity of our environment is integral to human health and well-being.

We oppose all actions that contribute to damage and erosion of the earth’s ecosystem and the physical structures which we inhabit. We will promote, protect, and support actions toward healthy and sustainable structural and natural environments for all the earth’s inhabitants.   

3. We believe that all people deserve access to affordable quality care.

As nurses, we are committed to caring for all patients and families, regardless of economic status, sexual orientation/gender Identities, current immigration status, age, ability to pay, or spiritual/religious beliefs/practices (or lack thereof).

4. We oppose all forms of oppression and discrimination.

We commit to protect and care for those whose safety and well-being is threatened based on gender, race, ethnicity, nationality, sexual identity, physical ability, economic status, or any other attribute seen as “difference.”  We will take public stands opposing any attempt to weaken public policies and programs designed to protect health and well-being of those who are disadvantaged. We will fight for policies and programs that assure equality and justice.

5. We oppose intimidation and violence in our homes and communities.

We will act to protect any who are victims of intimidation and violence, particularly those who are vulnerable because of skin color, race, sexual orientation, gender identity or religion.  As nurses, we nurture peaceful resolution of conflict and support those who step up to intervene peacefully in situations of threat and danger.

6. We believe that the health of women must be protected.

We will act to assure that all women receive the full range of care that assures their right to control their own reproductive choices as well as all women’s healthcare services needed to maintain their own health and the health of their families.

7. We trust scientific knowledge that supports a wholistic approach to nursing care

We examine all sources of evidence to inform the choices we make in caring for those we serve. We can assure the public that we practice from a firm foundation of sound and reliable scientific evidence. We will take all steps needed to inform the public of the science that supports our practices.

We invite all nurses, and our colleagues who support our values, to join us in declaring these  values and actions by signing this declaration. You can add your signature to this document here.  We invite you to use this declaration as you wish, and revise to suit your own purposes.  Let us know of your actions, follow #nursesresist, and join our Facebook group.

Contributing authors:

Carey S. Clark, PhD, RN, AHN-BC
Peggy Chinn, RN, PhD, FAAN
Elizabeth Berrey, PhD, RN
Lisa Sundean, RN, MS, PhD Candidate
Adeline Falk-Rafael, PhD, FAAN
Leslie Nicoll, PhD, PhD, MBA, RN, FAAN
Sue Hagedorn, RN, PhD, FAAN

Thank you to the Cambridge Health Alliance for inspiration!

If you would like to co-sign your name to this declaration, please provide your information using this formThe list of co-signatories will be updated as frequently as possible.

SEE THE DECLARATION AND LIST OF SIGNATORIES HERE

Full Practice Authority for APRNs in the U.S. Veteran’s Administration


On December 14, 2016 the U.S. Department of Veteran’s Affairs issued a final ruling authorizing full practice authority of Certified Nurse Practitioners (CNP), Clinical Nurse Specialists (CNS), or Certified Nurse-Midwifes (CNM) in the VA system.  This final ruling does aprn-scales_lgnot include Certified Registered Nurse Anesthetists (CRNA), but is inviting commentary on “on whether there are access issues or other unconsidered circumstances that might warrant their inclusion in a future rulemaking.”  This is a huge victory – one that serves the interests of the patients who receive care through the V.A.  As stated in the ruling:

This rulemaking increases veterans’ access to VA health care by expanding the pool of qualified health care professionals who are authorized to provide primary health care and other related health care services to the full extent of their education, training, and certification, without the clinical supervision of physicians, and it permits VA to use its health care resources more effectively and in a manner that is consistent with the role of APRNs in the non-VA health care sector, while maintaining the patient-centered, safe, high-quality health care that veterans receive from VA. (https://www.federalregister.gov/documents/2016/12/14/2016-29950/advanced-practice-registered-nurses)

Various physician groups, including the American Medical Association, have registered strong opposition to this ruling, which in part is responsible for the exclusion of CRNAs (see Forbes report here).  Part of the objection from some physicians is the claim that full practice authority for APRNs (i.e. APRNs can practice without physician supervision within the scope of APRN practice) is that physician-nurse collaboration is undermined. Those of us who follow the politics of this relationship recognize the absurdity of this claim, but nonetheless, this very current situation reminds us that we still have a long road ahead in establishing nursing’s sovereignty over our own practice.  For more about the long-standing physician opposition to initiatives such as this, see the excellent 2012 report on the ‘Truth About Nursing

If you are inclined to comment on the exclusion of CRNAs from this ruling, you must do so by January 13, 2017. Here are details about how to comment:

Written comments may be submitted: Through http://www.Regulations.gov; by mail or hand-delivery to Director, Regulations Management (02REG), Department of Veterans Affairs, 810 Vermont Avenue NW., Room 1068, Washington, DC 20420; by fax to (202) 273-9026. Comments should indicate that they are submitted in response to “RIN 2900-AP44-Advanced Practice Registered Nurses.” Copies of comments received will be available for public inspection in the Office of Regulation Policy and Management, Room 1068, between the hours of 8 a.m. and 4:30 p.m., Monday through Friday (except holidays). Call (202) 461-4902 for an appointment. (This is not a toll-free number.) In addition, during the comment period, comments may be viewed online through the Federal Docket Management System (FDMS) at http://www.Regulations.gov.