Nurses’ Concerns with COVID19 Update: March 21, 2020

March 21, 2020 / Carey S. Clark, PhD, RN, AHN-BC, RYT, FAAN / 15 Comments

This will be a quick update to implore nurses to not use cloth masks and not call for the creation of more cloth masks. The evidence shows that they are ineffective, do not create a barrier for transmission, and may in some ways increase transmission.

We all learned in nursing school that once the mask becomes damp it’s not effective. Cloth masks will become damp within minutes and we have no evidence around if adding in a filter or other materials sandwiched between layers of cloth will help. Add to this that one then has a wet, potentially contaminated cloth mask that should likely be disposed of, but at the very least needs laundering, and it becomes clear that cloth masks are not the answer. They may indeed be harmful.

In my humble opinion: The CDC stating that bandanas, scarfs and cloth masks could be helpful when they are actually potentially harmful is reprehensible.

Please review the BMJ Open article entitled:

A cluster randomised trial of cloth masks compared with medical masks in healthcare workers.

https://bmjopen.bmj.com/content/5/4/e006577?fbclid=IwAR2bng1KIAtVW3PjBns3usq_3tOmQG2wvYxWiSxJXdITf4uqvIuB-tMcHy4

While the ANA has called out the CDC on their call for non-evidence based protocols and statements and addressed the white house, nurses are going to have to act locally.

At the very least please contact your representatives and demand access to proper PPE, increases in manufacturing, the federal government taking more responsibility for ensuring our safety.

How can we organize ourselves around advocating for proper PPE?

An Open Letter on the vital importance of empathy in STEM

August 24, 2018 / Peggy L Chinn / Leave a comment

Nursing Activism Think Tank participant Rachel Walker just shared this information about a letter-writing campaign that many who follow this blog might want to see! Here is her message:

UMASS professors Dr. Sarah Perry, Dr. Sandra Petersen and I have recently penned an open letter on the vital importance of empathy in STEM. Our letter is addressed to the task force currently writing the next 5-year Federal Strategic Plan for STEM education.

You can read our letter here

And if you wish, add your signature as well:

(And please note, this letter is an exercise in academic freedom. We are proposing our views, not an official position of the University.)

Reflections on Nurses Declaration of Solidarity and Resistance

November 4, 2017 / Peggy L Chinn / 1 Comment

It has been nine months since we posted the Nurses Declaration of Solidarity and Resistance, calling for nurses to join together in expressing the values on which we will act in the face of potential US government policies and actions harming health and well-being of people and the environment. We now have over 2,000 co-signers – a modest but important expression of concern and determination to act to protect and promote health. We have heard from many NurseManifest readers with comments, some raising concerns and issues with bits and pieces of our Declaration, but many giving “voice” to their own renewed dedication to exercise the rights of citizenship on behalf of these values.

Now, nine months later, it is clear that we had a sound basis for sounding the alarm regarding the new administration’s intentions. At the same time, the underlying belief in the power of people to resist is also well-founded. The efforts to dismantle and undermine the US Affordable Care Act have not abated, and some of these efforts are beyond our reach, but the remarkable resistance expressed by people across the nation has been loud and clear, and largely effective. Indeed, there is no thoughtful person who claims that the ACA is as it should be, but the steps that it provided toward more equitable care for all have embedded in the heart and mind of our nation that we can do better than we have in the past, and that it is worth striving toward an even better way.

Yes there are many reasons to still despair. Serious, deeply embedded social and political problems like the challenges of healthcare, protection of the environment, and protections against economic insecurity seem intractable. But as we support one another in raising our voices and lending our energies to work toward the ideals we seek, we will continue to see a way forward to do what we believe is right and good.

So today, I call upon all who read this blog, to reflect on the values that are embedded in the Declaration, and in the Nursing Manifesto, and renew your focus on values that guide your intentions and that energize your actions! Share with us here things that have inspired you over the past few months, and that have made it possible to act on the values you hold dear!

Drug Wars, Drug Addiction, and Social Justice Issues

July 10, 2017December 22, 2017 / Carey S. Clark, PhD, RN, AHN-BC, RYT, FAAN / 3 Comments

I have been reading Johann Hari’s Chasing the scream: The first and last days of the war on drugs.

This book provides a very detailed account of how we came to be an anti-drug \ and pro-prohibition nation that lead the way toward making criminals out of people who struggle with use of substances and millionaires out of people/ cartels who sell drugs on the black market to drink ayahuasca in the Andes. I have found the book in some aspects hard to read because the political manipulation of our global population and the injustices that have arisen from this global movement. I get angry about what has happened as I read and I have to step away for awhile.

Some key points from this text for nurses to consider:

The dominant medical establishment (in particularly the AMA) was initially very against “drug” prohibition, but key vocal players were forced into silence by the government.
Overall, 90% of people use substances we call “illicit drugs” without having addiction issues, yet we continue to think that people need to be cautious with drug use. For instance, many (not all) soldiers used heroin in Vietnam to get through the hellish experiences, yet many (not all) had no issues with heroin addiction when they returned stateside.
There is a clear connection between lack of social support, childhood abuse, and adverse childhood experiences (ACEs: see the CDc website for more info on this) with addiction. We need to be compassionate toward those who are suffering, because these childhood experiences literally changed how their brains function, making them very vulnerable toward addiction. Adverse childhood events impact young people across the socio-economic spectrum, and many people who came from “good families” have also experienced a lot of childhood trauma.
When it comes to death and illness, our two leading “drug use issues” are likely nicotine and alcohol, both legal, and both toxic and deadly. Yet, we simply put warning labels on these drugs and let folks self-determine their fate. Why are these drugs okay, but others are not? Because they are socially acceptable? Because they are “cheap”?

When we think of the opiate crisis, one of the biggest issues of course is people not having safe and affordable access to opiate medications: when people are cut off from safe supplies (ie, their pain prescriptions which the medical establishment has endorsed and prescribed, with potentially some of the cost covered by their medical insurance ), they may turn toward heroin and other “street” opiate medications. These drugs are expensive, sometimes hard to find, and in many ways they force or perhaps support people to live a life of crime in order to maintain their habits, if people have gone that far they must get help. And people overdose because they have no idea what is in the products they are obtaining.

Maybe, we have created an addiction monster in our society.

However, Portugal has found a way out of the addiction monster’s clutches. In 2001, with a growing heroin addiction problem, Portugal decriminalized all drugs and began to consider addiction to be a public and personal health issue. Drug addiction was viewed for what it is: a chronic, debilitating illness. People caught with a 10 day supply of any drug are referred to a sociologist who helps to determine their treatment options. And what Portugal has realized is that not only is this a more humane approach, it is also far less expensive to provide adequate medical care and treatment to addicts versus incarcerating them. Portugal has experienced a 75% drop in addicted persons from the 1990’s, and their addiction rates are 5 times lower than the rest of the EU. Meanwhile, drug related HIV infections have dropped by 95%, and the stigma around addiction has lessened dramatically.

http://www.npr.org/sections/parallels/2017/04/18/524380027/in-portugal-drug-use-is-treated-as-a-medical-issue-not-a-crime

As nurses, we are concerned about social justice issues and public health issues. I would posit that nurses and politically active nursing organizations should be taking action around the opiate crisis in several ways:

Calling for safe injection sites and distribution of clean needles (or needle exchange centers) and free condoms.
Looking at prevention and early identification of at risk persons (both ending early childhood trauma through supporting parents at risk for enacting trauma and assessing for early childhood trauma both across the lifespan and across all populations to determine risks for addiction).
Supporting harm reduction techniques.
Supporting a view of addiction as a public health issue, and a chronic disease issue.
Considering a call toward decriminalization of drugs and ending incarceration for addicts (the Portugal Model).
Acting compassionately toward all addicts (even the “drug seeking” ones).
For emergencies, call medicaltransport.co.

If you are interested in this topic, I do recommend reading Chasing the scream. This text provides great historical insight into how we came to where we are at with the global “war on drugs” and the escalating issue of for-profit prisons.

We have become the nation with the greatest number of incarcerated individuals (not %, but sheer number!): though we only have 5% of the world’s population, we incarcerate 25% of the world’s total prison population (this link looks at the complexity of these numbers and supports the idea of the truth that in the land of the free, we incarcerate a much higher percentage of people due to lack of alternative ways to provide help https://www.washingtonpost.com/news/fact-checker/wp/2015/07/07/yes-u-s-locks-people-up-at-a-higher-rate-than-any-other-country/?utm_term=.1ca70c3620af).

Columbia University’s CASA group has released multiple reports that link drug addiction issues to crime, incarceration, and repeat offenses. Sadly, while 65% of our prison population qualify for addiction treatment, only 11% actually receive treatment. Meanwhile, the majority of violent crimes are committed by those suffering from addiction. https://www.centeronaddiction.org/newsroom/press-releases/2010-behind-bars-II

Poverty, race, and income inequality also play a role in both addiction and incarceration, and as nurses, we are ethically obligated to advocate for change in healthcare and system wide policies that impact vulnerable populations. Raising awareness is a first step, but perhaps nursing organizations need to also start taking stances and lobbying for more humane treatment of those who struggle with addiction.