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Posts tagged ‘Hunter College’

Calling All Nurse Writers

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 on the Center’s Advisory Council and this is her first post as a HealthCetera guest blogger.

Being the “nurse who writes” means I work under a misconception. Although a number of physicians regularly opine on the work they do in books, articles in The New Yorker, and my own home base The New York Times, I’ve never heard the MD-writer combination described as odd or bewildering. However, being an RN-writer is seen as unusual, and my admittedly unusual academic background—I have a PhD in English from the University of Chicago —- contributes to the view that I’m an intellectual oddity among my nursing peers.

But I am not alone in combining nursing and writing. Many nurses will be familiar with Echo Heron’s nursing memoirs and Carol Gino’s The Nurse’s Story. Tilda Shalof, a Canadian ICU nurse, and Patsy Harman, a certified nurse midwife, are both nursing and writing right now, and Harmon’s new novel, The Midwife of Hope River was just released. Saving Lives: Why the Media’s Portrayal of Nursing Puts Us All at Risk, a polemic by Sandy Sommers, RN, MSN, MPH powerfully argues that media stereotypes of nurses dangerously undermine nursing’s professional legitimacy.

These nurses, and I, all write for the same reasons that physicians do: educating the public about how health care works, outlining ways to make health care better, exploring how hard it is to work in a job that often deals with death, or showing what nurses’ clinical work actually involves.

By writing about nursing (or medicine) we learn about the nature of our roles as caregivers and we communicate the importance of that role to readers. In a recent column entitled “Money or Your Life” I wrote for The New York Times, I argued in favor of the Affordable Care Act by telling the story of a patient who wished for a death panel because he had no health insurance and worried that the care he needed to save his life would bankrupt his family. His choice would have been for the government to kill him rather than for his family to become destitute financing his care. Read more

Nursing Students as Writers

Notebook collection by Dvortygirl
Notebook collection, a photo by Dvortygirl on Flickr.

A new writing course for Hunter–Bellevue School of Nursing graduate students got off to a great start this past Thursday evening. CHMP poet-in-residence Joy Jacobson and I will teach the class for the next four and half weeks of Summer Session II. Our immediate goal is to help the students sharpen their skills in writing—scholarly writing, blogging, and narrative writing—and in on-the-job communication. But we also hope to motivate students to invest more energy in their writing by developing a daily writing practice focused on their clinical and personal experience. We’ll supplement this work by close reading of literary and scholarly texts that deal with the experiences of illness and caregiving.

The combination of reflective writing and close reading is an adaptation of the pedagogical approach used in the emerging field of narrative medicine. The mission statement of Columbia University’s Program in Narrative Medicine provides a good introduction to the aims of this discipline:

Narrative Medicine fortifies clinical practice with the narrative competence to recognize, absorb, metabolize, interpret, and be moved by the stories of illness. Through narrative training, the Program in Narrative Medicine helps doctors, nurses, social workers, and therapists to improve the effectiveness of care by developing the capacity for attention, reflection, representation, and affiliation with patients and colleagues. . . .

(I wrote a previous blog post about a presentation given by the founder of the Columbia program and one of the pioneers in this field, Rita Charon, MD, PhD. An extensive bibliography with links to several publications by Charon and others can be found here.)

We adapted our guidelines for developing a daily writing practice from Writing as a Way of Healing: How Telling Our Stories Transforms Our Lives, a fascinating book by Louise DeSalvo, professor of English at Hunter and leader of a memoir workshop in the MFA Writing Program. (She also blogs at Writingalife’s Blog.) Anyone interested in writing as a means of exploring the self will find sound advice and much food for thought in this book. DeSalvo writes

This book is an invitation to engage with your writing process over time in a way that allows you to discover strength, power, wisdom, depth, energy, creativity, soulfulness, and wholeness. . . . to use the simple act of writing as a way of reimagining who you are or remembering who you were. To use writing to discover and fulfill your deepest desire. To accept pain, fear, uncertainty, strife. But to find, too, a place of safety, security, serenity, and joyfulness. To claim your voice, to tell your story. And to share the gift of your work with others and, so, enrich and deepen our understanding of the human condition.

These are not mere self-help bromides. DeSalvo draws on a growing body of evidence from research conducted by James W. Pennebaker and others that demonstrates the beneficial psychological and physiological effects of a specific kind of writing about disturbing or powerfully emotional events. According to DeSalvo, Pennebaker discovered that “to improve health, we must write detailed accounts, linking feelings with events [the emphasis is DeSalvo’s]. The more writing succeeds as narrative—by being detailed, organized, compelling, vivid, lucid—the more health and emotional benefits are derived from writing.” (Pennebaker’s Web page at the University of Texas, Austin, has an extensive bibliography of his research, with links to free downloadable files. Click on Publications. He is also the author of Opening Up: The Healing Power of Expressing Emotions.)

DeSalvo and others, such as Sara Baker, who facilitates what she calls Woven Dialog creative writing workshops with patients at the Loran Smith Center for Cancer Support in Atlanta, Georgia, and elsewhere, also note an important caveat: this kind of writing practice, especially at the beginning of the process, can stir up strong negative feelings, particularly among those who have experienced real trauma (for example, those who have survived cancer or violent abuse). It’s important not to push oneself too far; or, as Baker writes: “We must not use our work to retraumatize ourselves or put ourselves in danger.”

Baker encourages imaginative writing—using the tools of fiction and poetry to offer what she has called “an oblique route” that may give a survivor of trauma “more freedom to connect with emotional and often buried truths” than the more direct route of memoir would provide. (Sara Baker blogs at Word Medicine.)

At the first class meeting last week, students dove right into a guided writing exercise called “My Least-Favorite Patient or Colleague.” First, each of us made up a list of nouns or adjectives beginning with the letter ‘B’ that described the person we had in mind; then another list of words beginning with the letter ‘S’ that described how that person made us feel; and a third list, of verbs or verb phrases beginning with the letter ‘T,’ that described what we would like to do to or with that person. Then, based on this material, each of us wrote a simple “list poem”—that is, a poem in which each line begins with the same word or phrase (such as “I remember…”). The last line has to have a strong twist or surprise, something like the punch line of a joke. And to cap it off, the title of the poem is written last (and is often humorous or ironic in retrospect). You can imagine how this little exercise got the juices flowing.

Stay tuned. We may be publishing some of our students’ writing on the CHMP blog in August.

CHMP’s Media Policy and Harm Reduction Panel a Huge Success: Recap #2, Policy, Health Care and Harm Reduction

Fiona Gold and Audience (photo by Martin Dornbaum)

At the Center for Health Media and Policy’s inaugural event Monday night, “Media, Policy and Harm Reduction”, a number of experts were brought together to discuss harm reduction issues in media, policy and practice. CHMP’s visiting scholars, Juanita Maginley and Fiona Gold, from the Vancouver Street Nurses joined fellow panelists Dr. Daliah Heller, Assistant Commissioner, Bureau of Alcohol, Drug Use Prevention, Care and Treatment for New York City; Dr. Chinazo Cunningham, a physician practicing at a community health care center with a needle exchange program in the Bronx; Allen Kwabena Frimpong of the Harm Reduction Coalition in New York, an advocate with extensive background in international issues of harm reduction, especially among youth; and Maxine King, outreach coordinator for WORTH (Women On The Rise Telling Her Story), a substance abuse counselor and social worker who has experienced the health care system both as an addict and as a healer.

There were a number of key themes discussed throughout the evening. The last blog post was about the importance of humanizing people living with drug use in the media, as discussed by the panel.  This post concerns the health care system and policy issues surrounding harm reduction and health care access.

This topic of discussion began after Ms. Maginley showed a 12-minute clip from the award-winning documentary “Bevel Up; Drugs, Users and Outreach Nursing,” which chronicles the Vancouver Street Nurses as they care for patients facing a variety of complex issues on the streets.  The Vancouver Street Nurses perform patient assessments, care for minor injuries, and administer medications, such as antibiotics.  Importantly, the Street Nurses provide a connection between their patients and other resources, such as community health centers, housing, detoxification programs, and mental health services.

In stark contrast to the training the Street Nurses of Vancouver receive on harm reduction, Dr. Cunningham provided insight into her own experiences as a medical student.  She said that throughout medical school and her residency she had only an hour of education on drug addiction; the material covered being the basic physiology of drug addiction, including how neurotransmitters work in the brain.  This is a similar problem throughout most nursing and medical schools in the U.S., she said.

While providers are not trained on how to have conversations about drug use and addiction, neither, she says, are the drug users, themselves.  With considerable social pressure to use the line: “I just want to quit using drugs,” this becomes the standard interaction between people who use drugs and any clinician they encounter.  There is, in turn, little meaning or thought behind this.  Programs, such as the Street Nurses, are exemplary in educating both health care providers and patients about how to have constructive conversations regarding drug use.

Dr. Heller made the point that use of Suboxone, a medication taken sublingually by a patient and used in place of methadone, would allow a primary care provider to prescribe this for patients, and then closely follow them and their physical health.  Through enabling all providers to prescribe Suboxone for patients, drug users are provided with greater support, flexibility, and likely adherence to the regimen than could be possible in a methadone maintenance program.  Dr. Heller also made the point that if drug use were thought of more as a medical issue this may also help to decrease stigma and encourage expansion of harm reduction programs, and therefore health, in drug users.

Ms. King concurred with the issue Dr. Heller raised about stigma.  She relayed a story of being pregnant, drug addicted, and then treated horribly at an appointment for her first prenatal check-up.  She said she “never went back” until she was in labor.  Upon entering the hospital she was isolated in a room by herself.  Again, she said she was made to feel like a kind of social “pariah”.  The overarching theme here is that federal, state, city, university, and hospital policies around drug addiction create an environment preventing people who need care from receiving care.  The overwhelming consensus of the panel and audience, alike was that we must increase the number of drug addicted persons who are linked to the care that they so desperately need by making changes in outdated, misinformed, and irresponsible policies.

Jen Busse, RN, MPH is an intern for CHMP and is currently working toward her MSN as a family nurse practitioner

Screening of “Bevel Up” Tonight at Hunter College

Tuesday, October 26:

Screening of “Bevel Up” with Q&A

“Bevel Up: Drugs, Users and Outreach Nursing.”
6:00 – 8:00 p.m.
Hunter  College Bellevue School of Nursing, 425 East 25th Street
First Floor “cafeteria”

Join students and faculty of medicine and nursing as well as public policy, public health and other related disciplines to watch and discuss this powerful documentary which chronicles Vancouver’s street nurses as they care for an indigent population struggling with addiction. This event is moderated by the Center for Health, Media & Policy’s Jessie Daniels.  Dr. Daniels is Associate Professor of Urban Public Health at Hunter College, and the author of two books and numerous articles dealing with media, race, gender and sexuality.  The screening also includes a discussion of using “Bevel Up” as a teaching tool.  This event is open to all students and faculty at area schools.  Refreshments will be served.

CHMP Welcomes Jessie Daniels, Ph.D. as Senior Fellow

The Center for Health, Media and Policy welcomes Jessie Daniels as a Senior Fellow. Dr. Daniels is Associate Professor of Urban Public Health at Hunter College.  She holds an MA and PhD in Sociology from the University of Texas at Austin.  Following that, she was a Charles Phelps Taft Post-Doctoral Fellow at the University of Cincinnati.

She is the author of two books White Lies (Routledge, 1997) and Cyber Racism (Rowman & Littlefield, 2009), both dealing with race and various forms of media.  She is also the author of numerous peer-reviewed journal articles, book chapters and dozens of conference presentations dealing with race, gender, sexuality and new media.

Along with writing about new media, Daniels has also worked in the Internet industry.   She was a Senior Producer with Talk City where she produced live online events for Fortune 500 clients.   Today, Daniels maintains Racism Review, a blog she co-founded with Joe Feagin, which provides up-to-the-minute scholarly analysis of current events having to do with race and racism.   A form of public sociology, Racism Review averages over 200,000 visitors per month.  Daniels was recently named on Forbes’ list of “20 Inspiring Women to Follow on Twitter.”

Currently, she is at work on a number of research projects about digital media, social inequality and health.  In one project, Daniels is examining the way the reproductive health and gender justice movement has shifted to the Internet; and, in another project, she is exploring how LGBT youth of color use the Internet, especially mobile phones.  Among this population are homeless LGBT youth who use mobile digital devices to survive on the streets of New York City.

Dean Kristine Gebbe Welcomes CHMP

It’s not new for a College to have a website with a blog, a Facebook page, and other new communication methods.  What is special about this one is the commitment to using these new media to promote the health of the public rather than promote the College or the School of Nursing.  Congratulations to Rudin Professor Diana Mason and her long-time outstanding colleague, Barbara Glickstein for taking us on this giant step toward a healthier world!

Kristine M. Gebbie, DrPH, RN
Joan Hansen Grabe Dean, School of Nursing
Hunter College, CUNY

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