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Tuesday, November 21, 2017

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The following guest post is by Patricia Wagner Dodson, a fiction writer and research nurse at Massey Cancer Center, Virginia Commonwealth University, Richmond, VA. She recently attended Telling Stories, Discovering Voice: A Writing Weekend for Nurses, led by Jim Stubenrauch and Joy Jacobson and co-sponsored by the CHMP and Hunter–Bellevue School of Nursing. Pat blogs at StoryStreams: fiction as comfort.

"Storyteller Under Sunny Skies," a clay sculpture in the permanent collection of The Children’s Museum of Indianapolis

Storyteller Under Sunny Skies, Rose Pecos-Sun Rhodes, Jemez Pueblo, NM

I’m a nurse, I might say.

But I don’t say it. I qualify it. I spin it. I elaborate on it. I never just say it.

I’ve often wondered why.

I used to think it might be because it sounds so ordinary. I imagine that the person I am speaking to might conjure up an image of a woman in white going from room to room, dispensing medications, holding the hands of the dying, recording the responses to treatment, changing IV fluids. I did that for six months when I graduated from nursing school. I was exhausted and miserable, and it nearly sent me back to my old job, the job I had before I became a nurse.

Jim Stubenrauch is a CHMP senior fellow.

Photo by Amy Dixon

What I’m feeling right now in my body is a sense of comfort and familiarity, even though there are a few aches and pains. I’m an old blue work shirt hung across the back of a chair, and that’s fine for now. The breathing exercise we just did gives me a feeling of warmth and pleasure that flows down my arms and
legs. . . .

That’s what I was writing on a Friday morning two weeks ago, to a prompt from CHMP poet-in-residence Joy Jacobson, at the start of “Telling Stories, Discovering Voice: A Writing Weekend for Nurses,” a three-day writing intensive cosponsored by the CHMP and the Hunter–Bellevue School of Nursing. Joy and I led the workshop—the first of many, we hope—and joined in the writing exercises. I’m still processing what turned out to be an incredibly rich experience.

We had a small but surprisingly diverse group of nurses, nine in all (a good size: large enough to make for lively discussion, small enough to preserve intimacy). Some were beginning writers; others, more experienced. We spent the weekend writing, reading, and sharing stories.

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Free health clinic for uninsured of Wise, VA, by Remote Area Medical. Source: Vanessa Potter Photos, http://tinyurl.com/cahf3l3

This week’s New England Journal of Medicine includes a study of the impact of expanding Medicaid coverage to more poor, uninsured adults under the age of 65 years. Comparing states that expanded their Medicaid coverage with surrounding states that did not, the Harvard School of Public Health researchers–Benjamin D. Sommers, M.D., Ph.D., Katherine Baicker, Ph.D., and Arnold M. Epstein, M.D.–reported that expansion of Medicaid eligibility is associated with reduced mortality,  a 25% increase in Medicaid coverage, 15% lower rates of uninsurance, a 21% reduction in cost-related delays in care, and a 3% increase in self-reported excellent or very good health.”

Senior Fellow, Nancy Cabelus, DNP, MSN, RN, is an international forensic nurse consultant currently working with Physicians for Human Rights on a program addressing sexual violence in conflict zones in central and east Africa.

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Nancy Cabelus

In recent weeks I visited impoverished areas in Kenya to specifically meet with women and talk with them about sexual violence.  In Kibera slum, the largest and most renowned slum on the African continent, I spoke one morning with 16 women.  The women I met with are HIV positive and receive antiretroviral (ARV) treatment.  I asked the women to whom they would turn if they or someone close to them were raped. All said that they would seek care from a doctor but most were not aware of places they could go where medical treatment was free. Only two reported that they would seek help from the police. Police are perceived as rude, accusatory, and often ask for bribes from women seeking help.  Two women stated they would speak to the tribal chief in the slum and eleven others said they would tell a trusted friend. None would tell a family member and would prefer to suffer in silence rather than deal with the stigma and family outcast attached to rape.

Daliah Heller, PhD, MPH, joins the Center for Health Media and Policy (CHMP) at Hunter College this year as a Visiting Scholar.

I’m beginning to think Health Homes are one of the best-kept secrets in the Patient Protection and Affordable Care Act (ACA). I’ve spoken with a lot of health care providers lately, and few seem to know about this provision, and that it is not the same as a Medical Home, though could be part of one.

Health Homes are case management-type entities established by the state health authority to
serve Medicaid-eligible people with chronic health conditions. ACA includes substance use
disorders among the eligible conditions, alongside mental health conditions, asthma, diabetes,
heart disease, and being overweight. And for the record, the term ‘substance use disorder’ refers
to a spectrum of excessive or harmful alcohol or drug use.

On July 17th I attended the Title V Summer Institute Media Training Workshop held at the Hudson County Community College Culinary Arts/Conference Center in Jersey City, presented by Barbara Glickstein and Dr. Kenya Beard. This program was a series of workshops aimed at improving diversity in nursing and in classrooms, retaining students from Hispanic and Latino communities, and helping to mentor them in study skills, test taking, and leadership. Only 1.7% of nurses in America are Hispanic or Latino, and the purpose of the Title V grant is to increase this percentage so that it may be proportional to the percentage of Hispanic and Latino patients in hospitals. The purpose of this specific workshop, called Nurse Messenger Media Training, was to teach foundational media skills, so that attendees would leave knowing how to address the media in a way that clearly expresses why diversity in nursing is essential, as well as how to share several key points during a short interview, and also how to capture the targeted audience. The workshop, a series of interactive, engaging, and educational activities, was definitely successful, as attendees left saying how much more confident they felt now and how they were camera-ready. Attendees had the opportunity first to learn about why addressing the media effectively is crucial in achieving their goals, and then to practice addressing the media- first in mock television interviews and then in mock press releases- after articulating the key points they wanted to express as well as the audience they wanted to reach. Although participants in the program were wary at first of being put on the spot and having to watch themselves on TV after having their mock interviews, they soon realized how fun and empowering having a media presence can be, and everyone left seeming ready to head to the newsroom for a real televised interview.