The Aftermath of George Floyd’s Death: How 8 Minutes + 46 Seconds Affected the Health of a Community


by Guest Contributor Kathleen M. Clark, DNP, RN
Edited by Kaija Freborg, DNP, BSN 

Racism is a public health issue and has been the root cause of health disparities for Black, Indigenous, and Persons of Color (BIPOC) in our country for over 400 years.  The recent killing of George Floyd has brought this emergent issue to the forefront of our nation’s attention as we bear witness to a man struggling to breath against a knee of a police officer.  An incident that took 8 minutes and 46 seconds, which may be the same amount of time it takes for you to read this blog, sent people around the world into a rage demanding justice.  In the words of James Baldwin, “Not everything that is faced can be changed, but nothing can be changed until it is faced.”1(p0)  And in my view, facing George Floyd’s death will change the world– we have a responsibility to make sure that it does.

Katie Clark

The reflections I offer in this blog are rooted in the epicenter of the unrest, the city of Minneapolis, amidst the worst pandemic in modern day history.  As a nurse, representing a profession repeatedly cited as the most trusted profession, my worldview is influenced by the patients I serve, those experiencing homelessness in Minneapolis.  In this setting, as I direct the Augsburg Central Health Commons, a nurse-led drop-in center serving those unhoused or marginally housed, I have witnessed the implications of health issues for these individuals.  One of those individuals was George Floyd.  While I knew him in a limited capacity, his membership in the community has amplified the emotions and passions felt by others to take action in response to his death.  Poverty and police brutality, both longstanding issues in the black community of Minneapolis steeped in institutional and structural racism, ultimately led to George Floyd’s murder; his arrest was allegedly over a counterfeit $20 dollar bill.  Stories like this are but one of the many stories I have collected as a nurse engaging in civic agency. I teach in the graduate nursing programs at Augsburg University, which focus on transcultural nursing and social justice praxis. Here are some of my reflections and experiences.

 During the height of our state’s peak of COVID-19, the video capturing George Floyd’s wrongful death spread through social media sites.  The anger at yet another killing of a black man by the hands of systemic racism in our policing systems could no longer be silenced as Minnesota has been the home of first Jamar Clark, followed by Philando Castile, and now George Floyd. Peaceful protesting resulted in nights of looting and rioting where buildings were burned, stores were raided, and the Minneapolis 3rd Police Precinct was taken over by demonstrators.  After each night of protests, the early morning hours revealed not only the visible social carnage but also the anger, fear, despair and loss felt throughout the community. 

One of those mornings I was providing care at the Health Commons, counseling people who had known George and mourned the destruction of their community.  Despite all of this loss, they still felt compelled to support the riots because otherwise there would be no systematic change without it.  Following the Health Commons, I was to bring food to the encampments that afternoon through local volunteer efforts to address the lack of food and water that existed for those living on the streets due to the restrictions of COVID-19.  I was assigned to distribute food to the largest encampment in the Minneapolis area, referred to as the Sabo Encampment.  Accessing the encampment itself was deemed difficult as the typical path to access it was located in the parking lot where a Cub Foods grocery store and Target had been set on fire the night before.  After discovering a way to the area, I found myself in the middle of what I fail yet to understand.  The police were dismantling the tents of the residence in the name of public safety.  According to these officers, the residents of the encampment were the root cause of the rioting, and the encampment served as a public health concern due to the drug use and human feces discovered onsite.  Thus, amongst the back-drop of charred rubble and buildings still in flames, surrounded by a group of activists from Native Against Heroine and Cop Watch groups, I made my way into the encampment to bring the food and water. Realizing how many people were now displaced by a pandemic and now race riots, with no place to go,  I left that moment in a flood of emotions, tears pouring down my face. How could I possibly leave these people in this moment, knowing that they did not cause this unrest, had no place to stay, and were likely to endure more violence?  I felt paralyzed.

As the days of unrest and destruction continued, those who were displaced bore the burden of violence from tear gas used and rubber bullets fired.  That following Saturday night the National Guard entered the streets of Minneapolis on the Governor’s order to address the civil unrest.  News stations across the nation captured tensions rising between demonstrators and the National Guard.  Word spread that those causing much of the unrest were not local residents, but instead they were flooding in from other states, seeking to escalate the situation to a civil war.  Those residing in those neighborhoods found themselves at a loss, not sure of where to turn to ensure personal safety, as vans of white supremacists dropped off people in alleys, explosives were placed in people’s yards, and the National Guard was firing rounds of paint pellets at people on their own porches.

Many residents shared stories of forming neighborhood watch groups during the unrest in response to 911 calls for help were no longer an option, as the system was overwhelmed.  Lee George stated, “Last Saturday we were told by City Councilwoman Alondra Cano during a gathering in Powderhorn Park, that if something happens tonight, if your buildings are burning, if you have armed men in your neighborhood, you are on your own.”  People organized a 24 hour watch system, prepared buckets of water, and connected hoses to spigots (for possible fires or if the water supply became compromised), packed a bag for an emergent exit if needed, and identified those who had certain skills such as medical training.  Not only was the community mobilizing to protect one another, they found themselves caring for peaceful protesters caught in the crossfire or displaced after curfew.  These actions demonstrated acts of solidarity in the community, as neighbors demanded justice for George Floyd.

A group of volunteers, who had been organizing efforts to address the health and safety issues in communities of homeless people during the pandemic, found themselves needing to mobilize in new ways due to the civic unrest. Inspired by the organization theory of mutual aid, they formed a human shield as best possible; volunteers, service workers, and nurses fought to secure safety for the unsheltered.  After negotiating with a nearby hotel, the unsheltered were welcomed to stay at what was temporarily named the Sanctuary Hotel.  The plan was that these individuals would be allowed to stay until the night time violence ended.  That next morning (Sunday), I was able to help provide care to those staying in the hotel and in a nearby encampment.  Most people were exhausted from the endless chaos and trauma they found themselves in.  A few individuals suffered from eye irritants, wounds from rubber bullets, or falls while attempting to flee.  Not one person told me they were actually part of the protesting, but instead they were caught in the crossfire because that is where they had currently called home.  The owners of the hotel decided to allow the unsheltered guests stay longer, while a nearby foundation offered funds to cover the cost of the hotel.  The members of the volunteer group, where there is no one leader named, spread the word that additional volunteers would be needed to maintain the hotel for the guests.  Thus, endless volunteers helped to coordinate on site collecting donations, distributing food, cleaning rooms, washing clothes, providing medical attention, and operating the front desk.  I have never witnessed a group acting in solidarity, without hierarchies or self-interests dictating the next moves.  People came from outside communities to provide assistance and formed trusting relationships in real-time.  While the hotel had to end the stay for the residence 10 days later, being part of this experience with this group re-invigorated my hope as a nurse in the way we can co-create community in the future.

            While still enduring this pandemic, Minneapolis communities continue to organize in unity as well as protest for justice in the wake of George Floyd’s death. While I have endless stories to offer from my nursing practice, these ones surfaced as vital in demonstrating the capacity to act, to create solutions in community that are potentially life-saving.  Nurses have power and this privilege can be used to support and create change in communities where we are called to care.  I have been transformed by the destruction, fear, and pain that has been embodied in structural racism in Minneapolis for more than 100 years, but I’ve also been transformed by the kindness, goodwill, and brave actions of people – many of them nurses – demanding justice for George Floyd.

Photos of Unrest

1Li C. Kinfolk. Confronting History: James Baldwin. 2017.  https://kinfolk.com/confronting-history-james-baldwin/#:~:text=But%20nothing%20can%20be%20changed,wrote%20the%20late%20James%20Baldwin.

About Katie Clark

pronouns she/her:

Kathleen ‘Katie’ Clark is an Assistant Professor of Nursing at Augsburg University and is the Director of the Health Commons. She has taught at Augsburg University since 2009 where her primary responsibilities are in the graduate program in courses focused on transcultural nursing, social justice, and civic agency. She also practiced for over eight years in an in-patient hospital in both oncology-hematology and medical intensive care. She has a Masters of Arts in Nursing degree focused on transcultural care and a Doctor of Nursing Practice in transcultural leadership, both from Augsburg University.   Katie has been involved in the homeless community of Minneapolis for over 15 years and has traveled to over twenty countries.  She lives with her husband and three children in Stillwater, Minnesota.

Katie and family
About Kaija Freborg

Kaija Freborg is the Director of the BSN program at Augsburg University and has been teaching as an assistant professor in the undergraduate and the graduate nursing programs since 2011. Her focus in teaching includes transcultural nursing practice as well as addressing social and racial justice issues in healthcare. She obtained a Doctor of Nursing Practice degree in Transcultural Nursing Leadership in 2011 at Augsburg before teaching at her alma mater. Currently her scholarly interest in whiteness studies has her engaging in anti-racist activism work both in nursing education and locally; her aspirations include disrupting and dismantling white supremacy within white nursing education spaces.  Previously Kaija had worked at Children’s Hospitals and Clinics in Minneapolis, in both pediatrics and neonatal care, for over 15 years.

Nurses’ Concerns with COVID19: Update May 2, 2020


I find that nothing is more powerful than hearing the stories of our nurses during this pandemic crisis. This website has some of these powerful stories from nurses around the globe, sharing their experiences of caring for COVID19 patients: Nursespeak.com

PPE: Nurses continue to lack Personal Protective Equipment: A recent survey showed that 75% of staff in home-care settings are lacking in PPE. Home Care Survey. 86% of healthcare systems are also concerned with having adequate PPE available: PPE shortages

Political unrest emerges even as nurses remain on the front lines of providing care for patients during the pandemic. Nurses rose to the occasion to stand their ground in the face of protestors. Nurses Urge Protestors to Stay Homeimage.png

National Nurses United organized a nation-wide May-Day protest about lack of PPE: https://www.cbsnews.com/news/may-day-protest-nurses-ppe/

image.png Nurses also took  action by protesting outside of the Whitehouse on April 21 and reading aloud the names of nurses who died from contracting COVID19 in the workplace: Nurses Whitehouse Protest

And nurses are still speaking up, even if it puts their jobs at risk: Hospitals fire and suspend staff for speaking out

 

Nurses deaths: The virus continues to take its toll on nurses and other professionals. Issues around post-trauma recovery are now coming to light. Healthcare workers may be feeling hopeless or helpless or suffering clear PTSD symptoms. Sadly we have lost some professionals to suicide: NYPost tragic deaths.

If you need help please reach out. National Suicide Prevention Lifeline: 1-800-273-8255

A Missouri nurse, Celia Yap Banago, who raised concern about lack of PPE died of COVID19. Nurse Banago had worked as a nurse for 40 years and was literally days away from retirement.Nurse Banago

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New York State Nurses Association houses a memoriam page to nurses lost to COVID 19. NYSNA memoriam page The retired executive director of the National Student Nurses Association is counted in the losses: Rest in Peace Robert V. Piemonte, EdD, RN, FAAN. image.png

To all of the nurses taking action, thank you for stepping up.

Nurses’ Concerns with COVID19: Update April 17, 2020


The COVID19 pandemic continues to be quite an issue in New York, with over 14,000 deaths reported. I found this link to the New York Times to be helpful in assessing where we are with official numbers of reported testing and deaths (NYTimes CVOID19), though in many states we know that testing remains very limited and accuracy of tests is still only at about 67-70%.

PPE: Nurses are still without proper PPE. While the federal government claims to have distributed millions of masks and gowns, frontline workers are still faced with shortages and putting themselves at risk. Now we are seeing surges in the cost of PPE, with costs going up over 1000%, according to a report published last week by the Society for Healthcare Organization Procurement Professionals. Competitive bidding for these supplies both internationally and within our own county has compounded the issue, and if we had federal government oversight and processes in place, it is likely these issues could be addressed in ways that would help to prevent price inflation ( CNN review of the inflation of PPE cost).

This video that appeared on CBS’s 60 minutes made it clear that nuses like New York nurse Kelley Cabrera are beginning to speak out. Nurse Cabrera works at Jacobi medical center in the Bronx. She makes the point that when nurses are required to reuse N95masks for up to 5 days, they are literally being provided with medical waste to be used as PPE. Nurse Kelley Cabrera 60 minute’s interview

Nurses Stories: Meanwhile, I have heard the stories of nurses continuing to work without proper PPE and we reultantly have high numbers of nurses testing positive in areas like Ohio.

Nurses have started to reject the idea that they be considered to be angels or heroes. They didn’t become nurses to die, and they don’t want to be martyrs. While the 7 pm clapping and cheering ritual in New York City seems to have built a community spirit, some nurses experience this differently. One New York City nurse wrote: ” I ask that you do not pity me, that you do not call me a hero. I do not wish to be made into a martyr….Clap for me and other healthcare workers at seven o’clock if it makes this pandemic feel more bearable. I concede, your cheers help us trudge on. Just know that cheers and hollering don’t change the outcome. This is my fervent plea – that we change what we can after all this is over”.

Fallen Nurses: The loss of nurses becomes hard to track as the numbers increase. NYSNA has set up a memoriam page: Fallen Nurses Memoriam

A 28-year-old pregnant nurse in the UK passed away on 4/12, RIP nurse Mary Agyeiwaa Agyapong. Her father passed away two weeks before she died. Mary’s baby daughter was delivered via cesarean section before Mary died.

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Many other nurses and hospital staff in the UK have also died (daily mail review of nurse and staff COVID19 deaths).

Two nurses in Palmetto, Florida have also died from work related exposure to COVID19. Nurse Danielle Dicensio leaves behind a 4 year old son and hubsand. Nurse Earl Bailey also worked at the same hospital, Plametto General Hospital, and he passed away from CVOID19 a few weeks ago. Both nurses complained about not having access to proper PPE, which the hospital denies (two nurses die of COVID19 ). 

A colleague of Nurse Cabrera’s (mentioned above), Freda Orcan,  who worked at Jacobihospital in the Bronx passed away March 28.

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ANA’s response to COVID19:

The Ameican Nurses Association has issued a statement that nurses should be reporting when then experience retaliation around their raising concerns regarding their personal safety in the workplace, as these are OSHA violations (OSHA and retaliation issues). While hundreds of complaints have been filed, it’s difficult to determine specifically how OSHA is responding to reports made. There is a plethora of information on their website regarding COVID19 issues (https://www.osha.gov/SLTC/covid-19/),

The ANA has created a page of resouces for nurses (ANA COVID19 page). There have developed a corona virus response fund for nurses. There is also a section about ethical guidelines for nurses that may help some in their decision making process and calls forward the bigger ethical issues that nurses are facing, and  links that show all of the steps that ANA is taking in advocating for nurses.

The latest ANA/ AHA/AMA letter witten calls for the government to address the issue of minorities and the disparities they experience with receiving adequate care for their COVID19 issues. (ANA letter to the Secretary, US Department of Health and Human Services). The letter in part reads:

“As organizations that are deeply committed to equity in health status and health care, we have long recognized differences in the incidence and prevalence of certain chronic conditions, such as diabetes, asthma, and hypertension — conditions that are now known to exacerbate symptoms of COVID-19. We also recognize that other factors, including but not limited to socioeconomic status, bias and mistrust of America’s health care system, may be resulting in higher rates of infection in communities of color. Lack of access to timely testing and treatment will inevitably lead to worse outcomes for these patients.

As America’s hospitals and health systems, physicians and nurses continue to battle COVID-19, we need the federal government to identify areas where disparities exist and help us immediately address these gaps.”

While ANA has been interacting at the national level, my perception from the nurses directly working with patients on the frontlines is that they feel under-represented and that ANA is not providing them with the voice they need. One time letters to federal authorities seem to make little measurable immediate impact. around what matters for nurses being able to practice safely. They also feel that many of the practicing nurses don’t belong to ANA exactly for this reason: that there is somehow a gap between the reality of nursing practice and the work and publications of the ANA. The crisis is far from over.

May all nurses and all beings know some peace and ease.

Nurses’ Concerns with COVID19: Update April 7, 2020


At this point, things are so disheartening for so many people. The range of nurses’ stories is so wide and varied, from OR nurses being essentially laid off due to no elective surgeries happening, to nurses being offered a lot of money to come to New York City to work.

New York State has taken the unprecedented step of merging all of its 200 hospitals into one system (New York State hospital system consolidation ). 

There’s a lot of death. One nurse told a story of how she had 10 patients in one shift and 7  of them died. In some hospitals, there is a different kind of rapid response team called, specifically for CVOID19 patients, and they are being called sometimes just minutes apart on different units throughout the hospital.

Also, nurses are working with their colleagues who end up being patients in their same units; one nurse told of their nursing supervisor being hospitalized in their own ICU, and they conjectured the supervisor most likely would pass away there.

There’s a lot of understaffing and over-working, including on the medical-surgical units. Part of this is because nurses themselves are becoming ill and unable to come to work.

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Some nurses are actually more frightened to work in the medical-surgical units because they have a lack of PPE, and all patients are presumed to be COVID19 negative. Of course, when tests come back days later, the nurses discover that they worked with these COVID19 positive patients without proper PPE. There are also many issues around HIPPA and staff not being able to find out the COVID19 status of the patients they worked with previously.

Another nurse relayed this story: he works twelve-hour shifts on a medical-surgical floor, and their usual patient load now runs from 12-15 patients, the only real charting they really do is vital signs and meds. This is possible because NYC has suspended a lot of normal operations when it comes to providing care as per the governor’s laws:

“A massive section of regulations on the “minimum standards” governing hospitals — dealing with everything from patients’ rights to the maintaining of records — has been suspended ‘to the extent necessary to maintain the public health with respect to treatment or containment of individuals with or suspected to have COVID-19’.” (read about all of the laws suspended) .

This nurse cries after every shift, and he stated his tears are so different from before, in part due to his utter exhaustion. His family and friends want him to quit, they are worried about his health, but he stated he can’t quit now, they need him too much.

Nurses are asking about ramifications of quitting their jobs; some claim that they have been threatened that they will be reported to their board of nursing for disciplinary action (this is not the reportable offense of walking out and abandoning patients, rather for resigning their position). While these threats are likely idle, some nurses are still fearful of losing their licenses.

One nurse states that she works in a COVID19 only ICU unit. She says it’s mostly completely staffed by RNs: they have no NPs, PAs, Residents, Techs, or Housekeepers. Nurses and ICU Attending and Intensivists care for the patients. Med Surg nurses act as techs and assist the ICU nurses.

Recruiting: There is still a lot of recruiting going to bring nurses to NYC. One new graduate nurse (recently licensed, with no work experience) posted on social media about being offered to be “trained” to work in the ICU in NYC. All of her travel and lodging would be covered. She would be required to work 21 days, 12-hour shifts, with no days off.  The majority of the experienced nurses tried to set her straight about why this was a really bad idea, but we have no idea if she proceeded or not.

It’s not just NYC: We now have a 54-year-old nurse in Michigan who died, Lisa Ewald.

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Unfortunately, nurse Ewald may have had some issues with initially being tested by her workplace, Herny Ford Health System in Detroit, Michigan. She was likely exposed on March 24, received her positive test on March 30, and passed away on April 3. She died alone in her home. (Lisa Ewald’s story).

Rest in Peace Nurse Ewald.

Meanwhile, more than 700 Henry Ford employees have tested positive for COVID19; 500 of the positive tests are nurses. (Henry Ford COVID19)

The field of nursing will be forever changed by this.

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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