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Social Justice November 17, 2007

Posted by mariemanthey in Academia, Nursing Salons.
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The aftermath to the Summit of Sages has been fascinating. I have been in two major discussions with nurses about social justice with almost explosive results.The first was at the Zeta Chapter of Sigma Theta Tau and the second was a week later at a Salon in my home.

At the Zeta Chapter about 50 attendees heard three nurse leaders from here in the Twin Cities speak about the issue of Social Justice from the perspective of their workplace. The first person is a CNO of a specialty hospital that provides coordinated care for children with severe developmental disabilities. She spoke of finding there were NO similar services available to their patients as they become adults. The whole segment of adults with developmental disabilities from childhood have no specialty in or out patient service providers.

The second speaker is from a local liberal arts college with a major nursing program who spoke about a college-wide initiative to eliminate abusive or violent communications among students and faculty members.

And the third CNO of a local community hospital spoke of her previous experience in the Canadian system where no one goes bankrupt or loses their home because of illness and no one dies because they can’t afford health care. She also spoke of the young adults who arrive in their ER due to a sports injury with no insurance because they are no longer on their parents plan and not yet established themselves.

After these three speakers, the audience entered into a free-flowing passionate discussion about the fact that as nurses we see the effects of this crazy “non-system” of health care … and yet we seldom speak about what we know. There was a strong consensus about the need for nurses to speak up about what we know and about how we think the system should change.

The second discussion was at a Salon a week later and again, the stories about what we know were overwhelming. A quick summary:

  • ER Nurse Manager told of 3 patients in 2 weeks who died upon arrival at the ER door, having waited too long because they didn’t have insurance. Upon arrival at the place of help, they simply gave up the struggle. She also told of a man arriving in a friend’s car with a bleeding leg. She looked at it while he was still in the car and realized it was shooting arterial blood. He waited some time for his friend because he couldn’t afford an ambulance.
  • A Medical ICU nurse told of excessive end-of-life activities that have astronomical costs for elderly patients with no hope of recovery.
  • Another nurse told of the multiple-birth cases where 5 and 6 babies are born, most of whom cannot survive but whose care is always extremely costly.

The point that was made over and over again is that as nurses we are at the point of care and see the effects of the current health care crises on the lives of our citizens. the discussion ended with a commitment to find ways to speak our  “truth-to-power.”

The Latest Salon Report November 2, 2007

Posted by mariemanthey in Academia, Nursing Salons, Values.
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Last night we had our monthly salon at my home. About half the group was new and the other half had been here before. This time only one student nurse came and one fairly new graduate working as a staff nurse and 3 attendees were not nurses, one teaches at health related topics at a local college, one is a retired physician I have known for a long time and the other was a visitor from Iceland who wanted to see how a salon worked. Most of the rest were middle-aged staff nurses and nurse managers from various hospitals around the Twin Cities.

Although many topics were raised during the initial check-in, we ended up focusing on a wide-ranging discussion related to staffing/resource issues, social justice and inequities in the health care system so often part of the every day life of a nurse.

A manager at a local ER told about three patients who died on the floor of the ER vestibule, collapsing as soon as they arrived, having stayed away from care until the last possible moment because they have no insurance.  She also told of a man who cut his leg and waited for a friend to drive him to the ER as he couldn’t afford an ambulance. This man had an arterial bleed and had lost enormous amounts of blood before he arrived. In this ER visits are increasing astronomically while care hours/visit are continuously reduced to increase margins.

A NICU nurse talked about the cost of caring for multiple birth babies (5 or 6) the result of infertility treatments who stay in NICU’s for months. Often staffing throughout their life is 1:1 or 2 nurses/baby. The last group six births resulted eventually in one baby actually living. A nurse manager of a medical ICU talked about the hundreds of thousands of dollars spent during the last few weeks or months of care for catastrophically failing people in their nineties.

The student is now in her public health rotation and wonders why the savings created by keeping people healthy isn’t part of the economic equation.

This may sound like an overall pessimistic evening, but it was far from it. I can’t really explain what happens at a Salon, but we seem to be able to connect with our positive values and experience strength just from knowing each others’ experiences and values.

I am definitely sensing from this discussion and others that have been occurring recently that the “Voice of Nursing” is in the process of become loud enough to be heard. I’m not sure just how this will happen, but I sense a real strengthening of our commitment to make the world a better place coupled with an awareness that we are strong and can be stronger.

I am encouraging all of us to initiate conversations about social justice in all of our professional meetings. Specialty organizations looking for great programs for their meetings could do what the Zeta chapter of Sigma Theta Tau did here last week when three nurse leaders presented brief comments about social justice issues in their workplace. The discussion that ensued was energizing and confidence-building. This concept of social justice has a rippling effect that continues to strengthen with each new discussion.