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Saturday, June 7, 2025

Block 2

Jim Stubenrauch is a CHMP senior fellow and a co-founder of the program in Narrative Writing for Health Care Professionals. Follow him on Twitter: @jimstuben.


At a press conference on Wednesday afternoon, five days after the mass murder in the Sandy Hook Elementary School in Newtown, CT, President Obama announced the formation of a task force on gun control to be headed by Vice President Biden—and then for the next 22 minutes of a half-hour Q & A, he took questions from a roomful of White House correspondents—the crème de la crème of the Washington press corps—about the so-called fiscal cliff. (Here’s a video and here’s the official transcript.)

At the precise instant that the POTUS stood up before the world and spent some precious political capital in declaring that, at long last, some serious effort would be made to end decades of paralysis on gun control and that substantive changes might soon help prevent acts like Adam Lanza’s slaughter of defenseless schoolchildren and teachers, the AP’s chief White House correspondent, Ben Feller, and the Wall Street Journal’s Carol Lee, among others, took the opportunity to turn away from discussion of this critical issue and return to the topic that had so preoccupied the news media before last week’s mass murder. The questions that followed amounted to an obsessively detailed but redundant parsing of the stalled budget negotiations. Half of that conversation is already old news.

I understand that this kind of thing happens all the time at presidential pressers, but in this particular instance I found the business-as-usual approach to the business of Washington insufferable and inappropriate. What this says to me—and I’m not the only one criticizing the press for this—is that the professionals in the room didn’t necessarily see the president’s statement as anything out of the ordinary; to them it was nothing more than the expected response to yet another routine tragedy that, in the long run, won’t make any difference in how guns are manufactured and sold, used and misused, or how—all too often in our country—innocent people die. The gun violence task force and the prospect of bipartisan support for gun control legislation are apparently of less moment than the same old same old about tax hikes and entitlement cuts. (And let’s leave aside the question of whether it’s accurate to say that we’re experiencing a “fiscal crisis” or whether what we’re hearing is anything more than the cynical maneuvering of antigovernment ideologues on behalf of the richest of the rich.)

Perhaps I found this incident particularly galling because of the way television and radio had been for the previous five days not only reporting on the shootings but dramatizing the nation’s collective response to the event.

This post is by CHMP senior fellows Jim Stubenrauch and Joy Jacobson, co-founders of the program in Narrative Writing for Health Care Professionals. Follow them on Twitter: @jimstuben and @joyjaco. Woman Reading

When talking about the work we do here at the CHMP, bringing workshops and classes in writing reflective narratives to nurses and nursing students, we occasionally get puzzled looks. Why teach writing to nurses?

A recent essay in the Narrative Matters section of the journal Health Affairs exemplifies the power of nurses’ narratives and the way personal stories can illuminate larger policy issues.

In “A Nurse Learns Firsthand That You May Fend for Yourself After a Hospital Stay,” Beth Ann Swan tells of a dire medical ordeal: while in Chicago on a business trip, her husband was hospitalized after a brain stem stroke. “In an instant,” Swan writes,

we were thrown into the unreal world of medical “care coordination” and “transition management.” There would be no easy way for us to get Eric from a hospital there to a hospital here and then to home. And along the way there would be gaps in the care Eric received—gaps so large they were more like chasms. We just didn’t know it yet.

It fell to Swan, dean and professor at the Jefferson School of Nursing at Thomas Jefferson University in Philadelphia, to coordinate all aspects of her husband’s recovery, including his transfer from Chicago to a rehab facility in Philadelphia. Even with all of her nursing knowledge and medical contacts, Swan found the following year of coordinating Eric’s outpatient care nearly all-consuming.

In addition to telling this compelling personal story, Swan goes on to advocate one of the strategies for health care reform supported by the Affordable Care Act. Often overlooked in political debates and mainstream media coverage, the ACA’s transitional care initiatives offer real hope of improving health care by bridging the many gaps in our fragmented health care system.

Nurses play a crucial role in transitional care. Swan writes that her husband’s hospital nurses answered questions at any time but that after Eric’s discharge—when they needed as much help as they did during his hospitalization—the nurses were nowhere to be found:

As a patient’s wife, I would have welcomed having an RN as a point of contact. As a nursing school dean, I know the evidence demonstrating that registered nurses are critical to the operational and financial success of health care delivery systems. . . . I also know that nurses have the expertise to bridge care transitions and are critical to coordinating care across all settings.

Swan shows how a well-told story can bring home, with urgent poignancy, a complex topic like transitional care and explain why it should be part of the ACA. (For more on the ACA’s support of new transitional care models, see CHMP co-director Diana Mason’s recent HealthCetera blog post.)

Fitzhugh Mullan, a physician who founded the Narrative Matters column in Health Affairs, said in an interview published in the Permanente Journal that he defined the policy narrative as “an essay form that falls between the editorial and the short story or memoir.” He goes on to say,

Theresa Brown, RN, is an oncology nurse and one of the very few nationally prominent nurse-writers in the areas of nursing and health care. She is a member of the Center for Health, Media and Policy’s National Advisory Council.

Flickr/Abrilon

It all started with a tweet. I’m a somewhat reluctant user of social media, but I’m giving it more of a go lately, and my tweet in question was this: “#nihmim12 Day 2 and no mention of nurses EVER. RNs do the bulk of patient education in the hospital, but we don’t even merit a nod?” The hashtag “nihmim12” denotes the Medicine in the Media workshop sponsored by the National Institutes of Health and held this October in Potomac, MD. Having just completed the course, I can highly recommend it, but the issue of nurses’ absence in the curriculum requires a closer look.

My twitter post got the attention of Lisa Schwartz and Steve Woloshin, the engaged and thoughtful MDs who organize the course curriculum and do the bulk of the teaching. They were genuinely interested in my perception that nurses’ work needs to be represented in the course in order to render the actual working of health care accurately. I promised them I would look through the course PowerPoint slides with an analytical eye and get back to them with more specific comments about including nurses, and I plan on doing that.

However, I also told them that my indignant tweet came in response to an attempt earlier in the day to talk with one of the conference organizers about including nurses in the course. I won’t go into particulars, because maybe this person was just at the end of a long day and had heard one complaint too many, but I was told that the physicians who were teaching the course could not be expected to “comment on the nurses’ experience.”

It’s been a week since Hurricane Sandy it the eastern U.S. The big news today was not about President Obama’s re-election. It was the forecast for another nor’easter.

Many in the New York metro area are still struggling in the aftermath of this giant storm. Thousands still lack power. They’re cold, tired, and frustrated. Large trees still lie across many streets, forcing detours. Hundreds and hundreds lost homes and cars, and sadly some even lost their lives.

It’s not only the physical upheaval that tri-staters must cope with. It’s also the mental health effects of this unnerving act of Mother Nature. I asked my friend Alison Pratt, PhD, a private practice psychologist in Floral Park, NY about the anxiety that accompanies natural disasters like Sandy. She focused on what most of us are now experiencing. Those living through extreme scenarios in places like Breezy Point or Staten Island have a different level of trauma to contend with, but Dr. Pratt reminded me that even the more “mundane” events like long lines for gasoline or downed phone lines are still very stressful.

For example, many who lost power are feeling a lot of resentment, anger and helplessness, she told me. “You start  with a can-do attitude when everyone is in it together. But then you begin feeling left out, or victimized by the power companies, when other neighborhoods come back on line and yours doesn’t.”