#DetentionIsDeadly  #FreeThemAll #D4CCQuiltProject


Guest contributor: Jane Hopkins Walsh

Background

 Social justice movements have historically incorporated arts based visual components to amplify their messages by using images and visual art to literally making the invisible more visible. Examples of this include Judy Chicago’s Dinner Party  and the AIDS quilt

As an arts based medium, quilts are powerful semiotic vehicles for protest and memory, and actual representations of comfort and care. Throughout history, suffragettes, abolitionists, enslaved people, Vietnam war protesters, and HIV/AIDS and 911 survivors have used fiber art and the quilt medium to come together in communal spaces for the purpose of grieving, memorializing and honoring others, and for communicating political opinions about important issues of the day.

This week, health care providers from the group called Doctors for Camp Closure, (D4CC) are coordinating a nationwide 24-hour protest vigils outside detention centers to draw attention to the serious risks of infection from CoVid-19 in detention centers and prisons nationwide. In solidarity and collaboration with community groups around the nation, D4CC are incorporating many arts based events including poetry reading, music, story telling, reflective journaling, and the creation of a virtual and actual protest quilt called the #D4CCQuiltProject.

 Using the social media platform Instagram and the use of the project hashtags, the virtual  #D4CCQuiltProject project will “sew” together images from the nationwide protest, banner messages, and other images or words drawing attention to the risks of CoVId-19 infection for detained and incarcerated people. The #D4CCQuiltProject can also spotlight less obvious historical and structural issues of the Capitalocene that are driving refugees to immigrate around the globe including persistent white settler colonialism, neoliberalism, militarization, persistent extraction of living and non living resources around the world by the Global North, and climate related extremes- all factors driving im/migration globally and to the US, and contributing to conditions of extreme poverty, violence, and food and water insecurity throughout the world. Structural violence issues 

MIssion Statement:  The #DetentionIsDeadly  #FreeThemAll Quilt Project messages are intersectional social justice messages and may include these ideas among others :

  • Show healthcare worker support for the Free Them All movement to release people detained by ICE during COVID pandemic, draw media attention to the dangers of incarceration, and increase public support for decarceration
  • Prisons and detention centers are filled with impoverished Black and Indigenous People of Color, and Undocumented People, and they are increasingly the largest sites of COVID-19 infection
  • Social distancing in detention or prison to reduce the risk of COVID-19 is impossible.
  • As health care providers we oppose detention.
  • Many prisons and detention centers in the US are capitalist oppressive for-profit systems that filled with people who have been disadvantaged across generations by the very systems that now hold them prisoner.
  • Migration to the US is driven by intersectional issues for which we as US citizens are complicit including US colonialism, climate injustice, capitalist extractive industries, globalization and neoliberalism (think sugar, palm oil, hydroelectric power, coffee, lumber, beef, global agriculture to name a few).
  • Native American and Indigenous land rights issues in the US are erased within discussions of immigration. (One example among others is: May 2020 The Wampanoag Tribe in in Massachusetts are struggling to retain land rights).
  • LQBTQI issues get erased in the discussion of immigration and detention.

Project Vision   

  • A virtual quilt that “sews” together square virtual images that align with the purpose of the action. and/or 
  •  An actual quilt that has names, images etc on fabric and that can be actually sewn together and/or 
  • An intersectional art project that is open to the greater art community. 

Project Guide: How to Participate 

DIRECTIONS  

There are TWO WAYS TO PARTICIPATE IN THE QUILT PROJECT

VIrtual Quilt 

  • Take a square photo of any message or image that aligns with issues of social justice, examples above, open to interpretation; the only restriction is the photo/image must pass minimum standards for social media, ie) non vulgar non obscene etc
  • Can be poetry, single words or phrases, a photo of a flower, headline in news, anything, names of deceased persons to honor who have been impacted by structural violence, See some image examples below. 
  • You may superimpose a message on a photo you already have. You may superimpose the project hashtags, or a message on a picture of your Protest Banner.
  • A Square image is needed to “fit them together “
  • Upload to Instagram with 3 primary hashtags #DetentionIsDeadly  #FreeThemAll#D4CCQuiltProject
  • Secondary hashtags are fine too but you have to use these 3 so we can “find” the “images” on Instagram you can also Tag @doctorsforcampclosure 
  • Ultimately, the images can be placed on colored squares see below and “sewn” virtually into a virtual quilt. This will happen in the near future after we have a number of images.
  • The quilt will be shared on social media to amplify the messages

Actual Quilt

  • During the vigil, before or up to two- four weeks after vigil,  people can mail me 12 by 12 inch squares of actual fabric with messages hand written or sewn , and I will sew them together and make them onto a physical quilt. 
  • Any fabric is acceptable but dimensions should be 12 inches by 12 inches
  • This is a way to get the public, friends, kids,  and family members involved in this cause.
  • People can include the creation of a physical square as a way of reflecting during the 24 hour vigil. Think child art, spontaneous, no pressure to have any “art” or sewing skills. Just has to be about 12 by 12 fabric based no rules on type of fabric.
  • People can invite local community groups to participate in the creation of squares.
  • PM Jane Hopkins Walsh for address where to send fabric.
  •  Fabric must reach me by +- June 15th 2020. 
  • The actual quilt could be part of a larger traveling protest quilt that gets added on to in other future protests. 
  • Ultimately the actual and the virtual quilt could be part of larger intersections with the art community to amplify and intersect our messages. For example we could have sew-ins in protest in NYC or other places, intersecting with other protests, or the quilt could travel to other cities and immigrant groups to include diverse social movements and groups all over. This is fluid and open to discussion as it unfolds.

EXAMPLES OF IMAGES BELOW- PLEASE IF YOU SHARE THESE IMAGES  GIVE CREDIT  AS LISTED BELOW.

Credit these 4 tags for this image above please
@voxpopuliprintcollective @shimartnetwork #voxpopuliprintcollective
#shimartnetwork

Credit for this image: from Twitter user@denimfemme Lou Murrey

Credit for the quilt images are
Instagram @janewalsh357 #BorderQuiltProject

Credit for the two quilt images above are
Instagram @janewalsh357 #BorderQuiltProject

Credit for this image
@voxpopuliprintcollective @shimartnetwork #voxpopuliprintcollective
#shimartnetwork

 

About Jane Hopkins Walsh

Protest Opinions in this document are My own
Pronouns She / Her
Jane Hopkins Walsh MSN, PNPC
Pediatric Nurse Practitioner
Primary Care at Longwood
Boston Children’s Hospital
300 Longwood Ave
Boston, MA  02466
jane.hopkins-walsh@childrens.harvard.edu

Volunteer and Board Member
Cape CARES
Central American Relief Efforts
www.capecares.org

PhD Candidate and Research Fellow
Boston College
William F. Connell School of Nursing
Enrolled: Center for Human Rights and International Justice
Lynch School of Education
Jonas-Blaustein Scholar Cohort 2018-2020
walshjm@bc.edu

 

 

Nurses’ Concerns with COVID19: Update April 1, 2020


Ongoing Issues: By now, most of us know the obvious: nurses and other healthcare professionals do not have the PPE that they need to practice safely. Nurses are testing positive for COVID19. The Defense Production Act has not been activated to produce more PPE and ventilators, and nurses and other providers are even fired for speaking out about it or organizing ways to access more PPE (Doctors and Nurses Fired for Speaking Out ).

Nurses’ Skill Level: Nurses are worried about being asked to do work they aren’t prepared to do. A former student of mine, who has been in more of an administrative role, is extremely concerned with being asked to go back into a hands-on medical surgical or even ICU in a supportive role. Practicing beyond one’s skill level or expertise is just one area of concern that is likely to grow as more nurses become ill, or refuse to work, or are otherwise unable to work. 

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Volunteer calls: From California to NYC to Maine, nurses are being asked to submit their names to volunteer to work. Most of these nurses will be paid, and it is an effort to organize our resources.

Nurses on the Front Line: The stories I am hearing from nurses are war-time hell-like, maybe even worse then you have heard of if you don’t have direct contact with nurses on the front line.

An example is a story a friend of mine posted from his friend in NYC: in the ER, there may be 7-10 COVID+ vented patients waiting for ICU placement. Some patients are lying on the floor in the ER because there are no beds. People are being taken to rooms on the floors and passing away before they even get seen by a nurse on that floor. Medications like propofol, ketamine, versed, and fentanyl are being run without pumps because there are no more pumps. Supplies are running out. Med Surg nurses are being forced to run drips and vents that they have not been trained on.

Pay Issues: In Utah, nurses and doctors are being asked to take pay cuts, and there is concern that this will create a great deficit of providers in this state when professionals go elsewhere to work (Utah’s largest medical provider announces pay cuts). Meanwhile, note this lovely NYC serene skyline shot, with pay that must recognize the obvious inherent hazard pay for these positions.

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(nurses recruitment add, contact information removed)

Populations and Outcomes:

Much preventative and maintenance care for those with chronic and even acute illnesses is now taking a back seat. A positive note is that telemedicine and telehealth are being used much more widely, and this may have a favorable effect on how we care for populations in the future.

Dr. Chinn forwarded a first-hand account to me of a nurse who is working in Brooklyn. She is concerned about how this illness is impacting Latinx populations, as they are often members of “essential worker” populations, and they also live in large households. This nurse states that these patients are at higher risk for death, and often experience death with less dignity. She also sees all staff getting sick, from direct care providers to janitors, and patient care technicians.

Anecdotally, in one social media group, I heard the nurses estimating that survival rate once a patient is ventilated is only around 14-20%. This is devastating to be surrounded around so much futile care and facilitating so much end of life care without perhaps the time and space it requires to do this well. (Edited: national statistics show a recovery rate of about 50% post ventilator initiation).

Heartbreak:  I am hearing heartbreaking stories of nurses sending off their children to grandparents or ex-spouses, so they won’t be exposed in the household should the nurse become sick themselves or accidentally contaminate the household. Nurses who can’t hug or hold their loved ones are aching inside every day. Nurses dying. Nurses looking around at their colleagues and they might wonder, who will be the next to not be at work, which one of us might end up in the ICU? Nurses may know that much of the care they are providing is futile or palliative, which creates moral distress. I am very concerned when I hear of nurses working multiple shifts, with one nurse posting that she had worked 13 shifts in a row, another posting about minimal sleep, and losing 10 pounds already. They don’t have time to eat and when they go shopping, the stores are lacking in supplies. There is no question in my mind that nurses are being put at greater risk not only due to exposure, but also due to physical, mental, emotional, and spiritual stressors.

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Post-Traumatic Stress: We could say nurses are stressed, or maybe we should just be truthful and say that nurses are being traumatized. I have great fears of nurses leaving the profession after this, and I also have great fears about the health of the population in general. I am fearful for those on the front lines without access to proper PPE. This sort of chaos we are experiencing may lead to positive change eventually, but for now, it’s extremely uncomfortable, painful, confusing, infuriating, and even disorienting.

We need to take good care of ourselves and take good care of one another.

I am reaching out with loving-kindness to all nurses:

May all nurses be safe

May all nurses be at ease

May all nurses be loved

May all nurses know personal healing

Namaste

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Nurses’ Concerns COVID19: Update March 29, 2020


There is so much going on that it’s really hard to summarize all of the issues. I welcome dialog and discussion of your concerns and what you are seeing and hearing about.

Nurses’ Shifting Thinking About Duty To Provide Services

I am seeing a shift in thinking with more nurses being willing to leave their jobs as they are not adequately protected: working without adequate PPE creates harm to self, others, and community.  An emergency room doctor was fired for speaking out about his hospital’s response (US NEWS report). So these actions are not without their cost.

We are also seeing more and more healthcare workers testing positive for COVID19. What stands out to me is the over 160  healthcare workers in Boston have tested positive for COVID19 in these early days. (Boston Hospital Workers test positive) and 12 nurses in Chicago have tested positive for COVID19 Chicago nurses test positive for COVID19.

Nurses who are staying in the direct care workforce are often very frightened: they are staying because if they quit, they won’t’ get unemployment, they are fearful that they won’t find another job because they left their current job abruptly, they are the sole or majority breadwinners in their families, and they are afraid of losing their healthcare benefits. Some nurses may still feel the deep roots of historically being linked to self-sacrificing, or with links to nursing’s history of religious or military duty (I do anecdotally feel like I am seeing less of this as the pandemic crisis grows).

New Grad Nurses as a Resource: Dr. Chinn pointed out to me that one area that is not getting enough attention is the idea of new grad nurses being allowed to or recruited into practice early, perhaps even before sitting for NCLEX or even finishing their final exams. An example: A CNO in a large New Jersey medical facility is begging a Nursing Program Director to send her senior nursing students to the clinical site, the NLN is okay with this, but how can she, in good conscience, allow her students to be there without proper PPE? Her students who work as techs at this facility also convey the dire conditions in the facility. Also, her faculty, like most nursing faculty, is older (in this case, age 59 on average) with underlying health conditions, which creates a greater risk for them as well.

My ethical perspective answer to this is that unless adequate supervision and proper PPE can be assured, the students should not be allowed into theses settings, as they will ensure harm to self and others, and we must abide by our ethical responsibility to practice beneficence and nonmaleficence. In my own setting as a director of an RN-BSN nursing program, we decided to remove all of our students from all clinical settings, even though we had students who wanted to stay in these community settings, the risks do not outweigh the benefits.

I also think of the challenges of being a new grad nurse: there is so much to learn and process and in a crisis situation will this even be possible? Will we ultimately end up losing a large number of these new grad nurses to post-traumatic stress and illness? This seems to me to really be lacking an ethic of care toward a very vulnerable population, our new grad nurses.

Is Nursing Political?

I was reminded this week that nursing is of course political. I found an interesting posting about how very political Florence Nightingale was. Cynthia Sim Walter (March 22, 2020, facebook) stated that during the Crimean War, Florence was first known as the Lady with a Hammer; she fought for her nurses to have what they needed to provide proper care, and she beat down military storerooms with a hammer.  I loved this quote: “Military leaders loathed her and feared her. She drank brandy with the soldiers, did statistics for fun, and had no respect for the politics of men,” (I did not fact check this).

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Florence took physical action when nobody else would and her actions were a political act of rebellion to save lives in dire times.

Let’s Reuse Our Masks? Here’s some data 

This is heartbreaking when our leading facilities are looking for ways to somehow sterilize single-use masks. Here is something floating around on social media, put out by Stanford.

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The full report can be read here. It sums up two important things, that autoclave may be effective (the mask will not have the same integrity, particularly over time; please see stats above). Also with the plastic face shields over other masks, we have no efficacy data around their effectiveness (Stanford Report). 

We still need PPE to be well stocked so we can be more assured that we are well protected. We still need to be demanding that.

New Resources and Webinars:

To share more current information, the American Journal of Nursing has joined with Johns Hopkins and others to share ideas around keeping nurses safe. Here’s the link with all the info. https://nurses.wikiwisdomforum.com/

The Schwartz Center for Compassionate Healthcare is offering a webinar on Tuesday, April 7, 1-2 pm EDT, entitled: Leading with Compassion: Supporting Healthcare Workers in Crisis. Register Schwartz Compassion Center Webinar

Be well.

 

 

Nurses’ Concerns COVID 19: Update March 26, 2020


Yesterday, I received an email from Governor Cuomo asking about my availability to be part of the surge, where they are training and employing nurses to be on the front line of care during this pandemic. I am assuming I received it as I am newly licensed in NY state for my job.

Today, I learned from a nurse colleague of this story of an assistant nurse manager dying of COVID19. He had been treating COVID19 patients, was hospitalized March 17, and passed away Tuesday. Kious Jordan Kelly, RN, may he rest in peace, was only 48 years old. It was reported that he had asthma.

Unfortunately, he worked at one of the hospitals, Mount Sinai West Hospital, where nurses were reportedly short on PPE and using trash bags for PPE.

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The nurses were also posting that they were out of masks and they were reusing disposable ones, along with reusing face guards that are simply wiped and reused. Some nurses are stating that the hospital should be held responsible for Nurse Kelly’s death, as they failed to provide him with proper PPE. Despite the pictorial evidence, Mt Sinai denies that the staff doesn’t have proper PPE.

I am seeing a bit of a shift in social media, where nurses are starting to resign or refuse to work due to lack of PPE. Nurses, in general, appear to be more accepting of the idea that some nurses have decided that it’s not worth the personal risk. I think we have to consider that the amount of stress and anxiety this pandemic has caused can also decrease immunity and stress resilience. We need to take care of each other.

Meanwhile, many states are calling for new grad RNs who may not even be licensed yet to be trained and allowed to work in these settings. We all know that ER and ICU type nursing skills that COVID19 patients require are not created overnight: it takes many nurses years of learning and growing toward expertise to be truly effective in these settings. This brings to mind questionable standards of care; as the population in need grows, we will lack the ability to provide skilled care that is needed. Some hospitals are trying to do rapid ICU classes, in literally 2-3 days, attempting to train nurses with some experience to become ICU prepared. I don’t know if that is really effective or possible, and I also don’t have other solutions to offer. I’d love to hear your thoughts on this.

Lastly, I leave you with this great link to the New England Journal where Dr’s Ranney, Griffith, and Jha discuss much of what I have also written about around the Defense Production Act. We need the President to actually enact so ventilators and PPE can be manufactured and distributed here. https://www.nejm.org/doi/full/10.1056/NEJMp2006141

Please, take action: contact your congressional members and the white house and demand that action be taken. https://www.usa.gov/elected-officials

Nurses’ Concerns COVID19: Update March 24, 2020


I heard from a friend of mine who is a nurse; her sister is a nurse who is now off from work because she became very ill with COVID19 after just a few days of working.

I’ve seen nurses in social media posts fashioning PPE from garbage bags and using plain cloth gowns.

I’ve been told nurses are now putting cloth masks over N95 masks (no evidence that this helps and it may actually harm). There is talk on social media of nurses washing or autoclaving or UV sterilizing N95s, although all of these actions likely degrade the masks or render them useless.

The World Health Organization’s guidelines clearly state to not use cloth masks and to not reuse single-use masks. You can download the guidelines here. https://www.who.int/publications-detail/advice-on-the-use-of-masks-in-the-community-during-home-care-and-in-healthcare-settings-in-the-context-of-the-novel-coronavirus-(2019-ncov)-outbreak?fbclid=IwAR2NRGtIs9AIIeI2HWiA5ZnOu4DoQL3GBOr40AvEJxul3Gms8RnQPb_ORCg

Through the social media grapevine, I heard that a health system in California has notified unionized nurses that they can be fired for choosing to wear their own N95s masks in the workplace.  The systems standards of care and use of PPE around COVID19 positive and presumptive positive appears to have degraded due to lack of PPE and CDC claims. I could not verify this, but below is the circulation of the information.

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Lastly, I received notice today that the American Academy of Nursing joined the ANA, AHA, and AMA calling upon the president to enact the Defense Production Act’s authorities in order to ensure that all healthcare providers have PPE and the needed medical equipment to care for people.

You can take similar action; all of the links to contact your legislative representatives and the President are in yesterday’s update posting.

Wishing you wellness and peace.