Latino and African American people are disproportionately impacted by Alzheimer’s. In fact, by 2030 African Americans and Latinos will make up 40 percent of Alzheimer’s patients in the United States. To combat this, these communities need equal access to healthcare and more information about brain health from people they trust – and nurses are among the most trusted voices in communities across the country.
Dr. Dyanne Rodriguez, RN, has earned her MPH from the University of Alaska Anchorage and DNP from the University of Massachusetts Amherst. Her work as a public health nurse leader includes a focus on education, Canadian and U.S healthcare systems, health promotion and outreach. Dr. Rodriguez has committed her focus in public health through collaborating with communities and healthcare team members. She currently works in urban/rural acute care centers, is a faculty lecturer and an active community member.
My heart has been heavy the last few days. Every time I open my social media pages, I am reminded of the tragedy that occurred in Dallas on October 22, 2022. Two healthcare workers, a nurse and a social worker, were senselessly killed while only trying to provide care. A few days before this incident, a psychiatric nurse practitioner was stabbed to death by her patient. These incidents are mere drops in the bucket when it comes to violence against nurses.
In 2019, the American Journal for Managed Care published an article titled “Violence Against Healthcare Workers: A Rising Epidemic” by Wallace Stephens. The article discusses how workplace violence against healthcare workers has risen as reported by emergency department physicians. The article further points out that while 70% of staff reported acts of violence, only 3% pressed charges. Furthermore, the article points out that healthcare has become like factory work. Staffing challenges, sicker patients, and less resources have stretched healthcare’s limits. Expectations of family and patients are high, leaving healthcare workers unable to meet their demands. Being able to “manage” the workload simply isn’t enough.
A Press Ganey analysis showed that, on average, 2 nurses are attacked every hour in the United States. Attackers included patients, family member, coworkers, visitors and intruders (Putka, 2022). It is important to note, that not all workplace violence is physical. Verbal assaults occur more frequently than physical assaults and come most often from patients, followed by their family members and/or visitors (Kim et al., 2021).
I have been a nurse for over 20 years. In those years, I cannot recall a single year that went by without some form of assault. While mostly verbal, I have also experienced physical assault. In the course of providing care, I have been cursed at more times that I can even think. I have been told I am stupid. I have been slapped, kicked, pinched. I have been grabbed to the point of having bruises on my arms. All for the sake of patient care. While my positive nursing experiences far outweigh these negative ones, I found myself questioning if those were the reasons I left bedside nursing. Had it become too much for me?
I see the posts on social media. The RN badge with the black line through it. The show of support, solidarity. But I also know that this is temporary. We will forget. We will move on to the next thing. In honesty, what have we accomplished? Our profile showed how much we “cared”, for a day, maybe a week. What have we accomplished?
Nurses are one of the largest professions in the United States. There is the old saying “power in numbers”. We have the numbers. Why do we not have the power?
After the shooting that killed 2 healthcare workers in Dallas, American Nurses Association president Ernest Gant released this statement: “We mourn for the individuals who horrifically lost their lives, and we extend heartfelt condolences and deepest sympathies to the families and loved ones of the victims. Time is up. Violence against nurses is unacceptable. This must end now.”
Violence against healthcare workers must end. It is dangerous not only to those providing care, patients are suffering. We are suffering. We have the numbers. Now is the time to use those numbers. To gather and speak up against these violent acts. It is time to do more than change our social media profile picture for a day or two.
How can you make a difference? Talk to your legislators. Go to their offices. Write them letters. VOTE!. Time is up. It is now time to take action and become involved. It is time to use our power of numbers to make a difference for ourselves and future nurses.
Kim, S., Mayer, C., & Jones, C. B. (2021). Relationships between nurses’ experiences of workplace violence, emotional exhaustion and patient safety. Journal of Research in Nursing, 26(1-2), 35–46. https://doi.org/10.1177/1744987120960200
Serena is a nurse education specialist with a passion for nurse advocacy. Serena is currently pursuing a PhD in Nursing Science at Texas Woman’s University. She earned her MSN-Nursing Education from the University of Houston in 2019. Serena is actively involved with Texas Nurses Association, including Nurse Day at The Capitol. We have the power, we just need to use it.
Contributors: Jeneile Luebke, Jacqueline Callari-Robinson, Elizabeth Rice; Ashley Ruiz, Kaylen Moore
As nurse scholars, allies and advocates, our hearts are broken as we collectively share the horror of yet another woman lost to gender-based violence and express empathy for the family and friends of Gabby Petito. There are no words to describe the loss of a brilliant loving woman, and all too often, this is our reality and the emotional distress we experience in our work as healers. As practicing forensic nurses, scholars, and advocates we see and anticipate this trauma far too often, and it is our working reality. As antiracist and social justice activists, we are committed to sharing stories that all lives lost should be met with the same outrage and immediate response, quick compassion, justice. As Indigenous women and allies, we are using our collective voices to highlight the systemic racism, oppression, and injustice that exists in response to survivors of gender-based violence among Indigenous women by police and mainstream media.
Anyone can be a victim of sexual abuse or intimate partner violence, but some communities are at greater risk after a sexual assault, and the response to their victimization is not heard or felt with the same compassion. Indigenous women are disproportionately impacted by gender-based violence including intimate partner violence and sexual assault (McKinley; Luebke, 2021). The US National Intimate Partner and Sexual Violence Survey (NISVS) revealed that 84.7 percent of Indigenous women experienced gender-based violence during their lifetime, and 56.1 percent of Indigenous women and 25.5 percent of men have experienced sexual assault in their lifetime (Rosay, 2016). Indigenous women in the United States also have some of the highest rates of homicide perpetrated against them compared to other racially defined groups; homicide is the third-leading cause of death among Indigenous girls ages 1-19 and the sixth-leading cause of death for Indigenous women ages 20-44 (CDC, 2020).
The unjust crisis of gender-based violence against Indigenous women began with the earliest colonial contact. Violence against Indigenous women became a means of colonial conquest by European settlers through the social construction of Indigenous women as subhuman, exotic, and sexually promiscuous, leading to the idea that Indigenous women were (and still are) deserving of sexual violation (Casselman, 2016; Deer, 2015; Luebke, 2021). Sadly, this violence continues into the present time. For example, Native American women and children make up to 40% or more of sex trafficking victims in some states, even though they represent only 1-2% of the general population (Native Hope, 2021).
Indigenous women also experience systemic injustice and prejudice through erasure and invisibility, fueled by a lack of media coverage when they have gone missing or murdered. Racialized and stereotypes are still pervasive in contemporary representations of Indigenous women in all aspects of society. When media reports occur about Indigenous women who are missing or murdered, the reports often sensationalize and normalize the violence in tribal communities. Playing on centuries of historical and intergenerational violence, the media coverage of our MMIW is often infused with undertones of stereotypes and assumptions of our communities with references to drugs, alcohol, sex work, and victim-blaming, and shaming after experiences with gender-based violence (Native Hope, 2021).
Conversely, when an affluent, white woman goes missing, it often comprises nationwide manhunts, alerts, an outpouring of prayers and support from the public, and round-the-clock news coverage. Currently, the world has recently witnessed the disappearance and recovery of the body of Gabby Petito. The police and FBI response was swift and immediate after Gabby’s family reported her missing on September 11, ten days after her 23-year-old boyfriend, Brian Laundrie, returned home from a months-long cross-country trip in the van without her. After her reported disappearance, a media obsession and sensation began with frequent updates in national and international news outlets. A google search on September 22, 2021, yielded 2,910,000,000 hits for “Gabby Petito.” Sommers (2016) discusses this very issue of race and gender disparities in the media by highlighting the “white missing white woman syndrome”. Time and time again, we see round the clock news coverage when a white affluent woman goes missing, while Indigenous and other women of color are not seen as deserving of such valuable media coverage. It is critical to note that widespread media coverage of a missing woman can make the difference between life or death. Widespread media coverage often aids in the timely discovery of a missing woman, subsequently saving her life, as well as perpetrator being caught or not.
In contrast, the disappearance of young Indigenous women such as Katelyn Kelly, an enrolled member of the Menominee Nation in Wisconsin, received minimal media coverage limited to local media sources. Katlyn was missing for nine months before her remains were finally recovered, and her family could grieve their loss, in comparison to the eight days that it took authorities to locate the body of Gabby Petito (Bezucha, 2021). It was because of grassroots efforts from the Native community who performed endless searches, held vigils and gatherings to raise awareness about her disappearance. Katelyn and her family did not receive a national response, teams of forensic experts, and endless outpouring of support from around the country, even though they were deserving of it. In solidarity and collaboration with the Native community, we as recipients of a US Department of Justice FAST Grant, Tracking Our Truth, funded a billboard in hopes of gaining attention to finding this beautiful young soul while she was still missing.
Many missing and murdered Indigenous women today remain unnamed and their disappearances unheard of or unknown. It is unknown how many Indigenous women, men, and children are currently missing or have been murdered in the US. Collecting and tracking accurate data has yet to be prioritized by our local, state, and federal authorities. There are thousands of reports of missing Indigenous women and girls every year, and few of them make it to the Department of Justice missing person database (NAMUS). For example, in 2016, there were 5,712 reports of missing Indigenous women and girls nationally, and only 116 of those were logged into the NAMUS database (Urban Indian Health Institute, 2018). In Wyoming, the state that Gabby Petito went missing from, there are at least 710 Indigenous people, mostly women and girls, reported missing between 2011 and 2020 (Wyoming MMIW Task Force, 2021). A google search for “MMIW,” also on September 22, 2021, yields 679,000 hits. The lack of media coverage of our MMIW relatives sends a clear message to women that they are not “worthy victims” deserving of media attention and valuable law enforcement resources, leading to further systemic oppression and violence against our people.
Highlighting the pervasiveness of racial disparities and inequities that exist surrounding the phenomenon of missing and murdered Indigenous women has implications for practicing nurses and allies. As with any survivor, it is crucial to recognize that the complex layers of current and historical trauma and resultant health disparities when working with Indigenous communities. Given the colonial history of intergenerational and historical trauma experienced by Indigenous women, the first step that for nurses delivering services to address gender-based violence is to have a clear understanding of the traumatic effects of colonization and the impacts of violence, as well as developing confidence in the types of culturally safe and trauma informed care that will be effective (National Indigenous Women’s Resource Center, 2021). Trauma informed care and practice embraces a recovery focused, strengths-based approach, with an understanding and response to the neurobiological impacts of trauma. Trauma informed care emphasizes the psychological, physical, and emotional safety of survivors while consistently providing opportunities for the personal control and empowerment of survivors (National Indigenous Women’s Resource Center, 2021; Klingspohn, 2018). This ensures that we as nurses actively resist the perpetuation of trauma and oppression of our patients, while simultaneously building trust with survivors and their communities.
As recipients of the United States, FAST Grant, Tracking Our Truth, we value the opportunity given to us by our community partners Lac Courte Oreilles Tribe (LCO), Gerald Ignace Indian Health Care Center (GIHC). We commit to advocating for all individuals and working side-by-side to create access to Advocacy driven Medical Forensic programming that is survivor-led and Native community-centered. Through this grant, we have learned to listen attentively and value the insights shared with us. All programing and outreach are contingent on consensus, as is this blog and all information and actions related to this project. We commit to showing humility, leading from behind, ensuring that our activities are antiracist, and listening for feedback. In a previous Nursology blog we omitted one of our valuable partners and were accountable for our actions with a commitment never to repeat the act of exclusion. As we continue to work on this project, we will amplify the voices of the community, listen with respect, and continue to nurture this sacred opportunity to build and value relationships to offer access to advocacy-driven medical forensic care. Last week former District Attorney of Ashland County and Wisconsin Representative Sean Duffy was complicit in perpetuating racist stereotypes and oppression on National television. He was quoted saying, “They burned villages, raped women, seized children, and took land,” referring to the American Indian communities in Wisconsin. He also stated that “the conditions from Native Americans have everything to do with government dependency, cycles of poverty and alcoholism, and family breakdowns”, with zero evidence or factual basis for his claims (Native News Online, 2021). Upon hearing this news, we immediately acted, sharing this news and video with our National FAST Grant partners and the Social Justice Committee of the International Association of Forensic Nurses. We commit to advocating for American Indian Communities, using our privilege as nurses.
Bezucha, D. (24 September 2021). A Special Feature in Wisconsin’s 2020 Domestic Abuse Homicide Report Points to Need for More Accurate MMIW Data. Wisconsin Public Radio. Retrieved from: https://www.wpr.org/were-forgotten-new-report-draws-long- overdue-attention-missing-and-murdered-indigenous-women-girls.
Casselman, A. L. (2016). Injustice in Indian country: Jurisdiction, American law, and sexual violence against native women. New York: Peter Lang.
Deer, S. (2015). The beginning and end of rape: Confronting sexual violence in native America. Minneapolis: University of Minnesota Press.
Luebke, J., Hawkins, M; Lucchesi, A., Weitzel, J., Deal, E., Ruiz, A., Dressel, A. & Mkandawire-Valhmu, L (2021). The Utility of Using a Postcolonial and Indigenous Feminist Framework in Research and Practice about Intimate Partner Violence against American Indian Women. Journal of Transcultural Nursing. 32(6) 639-646. https://doi.org/10.1177/1043659621992602
McKinley, C. E., & Knipp, H. (2021). “You Can Get Away with Anything Here… No Justice at All”- Sexual Violence Against U.S. Indigenous Females and Its Consequences. Gender Issues, (0123456789). https://doi.org/10.1007/s12147-021-09291-6
Jeneile Luebke PhD, RN is an Anna Julia Cooper post-doctoral fellow at University of Wisconsin-Madison, School of Nursing. She received her LPN/ADN degrees in Bemidji, MN, and her BS and MS in Nursing from UW-Madison, and her PhD in Nursing at UW-Milwaukee. Jeneile is an Anna Julia Cooper Post-Doctoral Nurse Research Fellow at the University of Wisconsin-Madison, School of Nursing. She’s Anishinaabe/ Métis (enrolled member of Bad River Band of Lake Superior Chippewa). Her area of research and expertise include gender-based violence in the lives of Indigenous women, community health and utilization and application of postcolonial and Indigenous feminist frameworks. She is a key part of a team of multi-site researchers who are involved in several community engaged research and service grants that aim to better understand the lived experiences of gender-based violence, as well as advocating for survivor-led, trauma informed, and culturally safe interventions and options for survivors of gender-based violence. Her other current work focuses on the impacts of gender-based violence on the health and wellbeing of Indigenous women and girls, particularly focusing upon the relationship between land violence and gender-based violence
Elizabeth Rice is an enrolled member of Lac Courte Oreilles Band of Lake Superior Chippewa and Director of the Lac Courte Oreilles Emergency Women’s Shelter.
Jacqueline Callari Robinson, BSN, RN, SANE-A/P, DF-IAFNis presently the Research Assistant for Tracking Our Truth, Department of Justice, FAST Grant, and a Ph.D. Student at The University of Wisconsin Milwaukee. Jacqueline’s clinical practice is a tele safe nurse for the United Concierge in Troy, New York, taking call to evaluate sexual assault patients. In 2020, Jacqueline edited the SANE A/P Preparation Manuscript, published by Springer Publishing Company. Her expertise is assessing and providing sexual abuse medical forensic care and training providers and systems to offer patient-centered compassionate care. Her present duties include oversight of the Advocacy Driven Medical Forensic Care to AI communities throughout Wisconsin, training nurses, program development, providing technical assistance, and Medical/Forensic program sustainability. Jacqueline also serves as Co-Chair of the IAFN Social Justice Committee, creates statewide protocols and procedures to develop survivor social systems response to sexual assault victims. In 2011 she was awarded the Distinguished Fellow award from The International Association of Forensic Nurses. Jacqueline also provides case consultation and technical assistance; and develops training materials, resources, and publications.
Ashley Ruiz, BSN, RN is a doctoral nursing student and clinical instructor at the University of Wisconsin—Milwaukee. She is also a Sexual Assault Nurse Examiner (SANE) at Aurora Sinai in Milwaukee, Wisconsin, through which she has contributed to enhancing excellence in nursing care by addressing the healthcare needs of women who have experienced violence. She began her nursing trajectory (CNA and ADN) at Madison College in Madison, Wisconsin, after which she practiced at a local magnet hospital. She received her BS in Nursing from the University of Wisconsin—Milwaukee in 2015, while continuing a commitment to nursing practice through gaining experience within community health, long-term care, leadership, and in acute care settings. Through her experience in practice, Ashley began to identify gaps where healthcare providers failed to address the needs of patients who had experienced violence. Based on this experience, Ashley began to pursue a doctoral degree through the University of Wisconsin—Milwaukee. Her current work focuses on advancing feminist theory in nursing science for the purposes of providing a theoretical foundation for addressing the problem of violence against women, particularly for ethnically diverse populations.
Kaylen Moore, BSN, CCRN, SANE-A, SANE-P. Kaylen Moore is currently a PhD nursing student at the University of Wisconsin-Milwaukee. She earned her BSN from Marquette University in 2003. Kaylen began her career at Froedtert Hospital, a Level I trauma academic medical center, where she has held many leadership positions in Shared Governance and continues to be involved in nursing research. She has been a Forensic Nurse Examiner with Advocate Aurora Healthcare since 2013. She has contributed to forensic nursing practice and the trauma-informed care of sexual assault patients through her authorship of the chapters Medical Forensic Photography in the Sexual Assault Patient and Medical Forensic Documentation in the book IAFN Sexual Assault Nurse Examiner Certification: A Review for the SANE-A® and SANE-P® Exams. Her research interest includes gender-based violence among ethnic minority women with a current focus on Black women survivors of intimate partner violence.
Registration is available for our September “Overdue” discussions! Each discussion requires advance registration on Zoom – when you register you will receive the information to connect to the Zoom meeting! Go to the Ongoing Overdue Reckoning on Racism in Nursing page for more information and to register!
Here is a short video that explains “anti-racism” – our project is perfectly aligned with this explanation! Message: this is a journey, not a destination!
For this week’s reflection on our “Overdue Reckoning on Racism in Nursing,” watch this conversation between Jemele Hill (staff writer at The Atlantic) and Ibram X. Kendi about his book “How to Be an Antiracist.” This conversation was recorded at the 2019 Aspen Ideas Festival, and touches on so many fundamental ideas that are at the heart of what we are doing in our “overdue reckoning.” At the close of this conversation, Dr. Kendi speaks to the importance of caring for ourselves as we engage in anti-racism activism!