What do a bus, a water fountain, and a bathroom all have in common?
The Trump Administration rescinded President Obama’s Guidance regarding the rights of transgender children to use school restrooms of their choice; many are wondering if this truly is just about a bathroom. Many civil rights and child advocacy organizations are in opposition with the Trump position due to violation of the protections guaranteed in Title IX and the Fourteenth Amendment of the Constitution. Title IX prohibits discrimination based upon sex in federally funded activities or education, however discourse continues surrounding the interpretation gender within the language of federal law. The issue of transgender youth and public school restroom use will be explored by the US Supreme Court this march, however many states have already opted to support transgender youth through local legislation.
Rescinding these guidelines places transgender youth at risk for bullying, violence, and discrimination. Both the American Academy of Pediatrics and the National Association of Pediatric Nurse Practitionershave issued statements about the hazards involved in marginalizing children: Policies that exclude transgender children from existing within their gender identity will have detrimental effects upon health and well-being. When children experience adversity and lack of acceptance, they become increasingly susceptible to a host of challenges across their life course.
Data fromWilliams Institute at the UCLA School of Law estimates that there are approximately 150,000 transgender youth and 206,000 transgender young adults in the United States. Despite the growing numbers of transgender Americans, misunderstanding persists. Curious? Tune into Healthcetera Radio as Senior Fellow Kristi Westphaln delves into the experiences of transgender youth with Dr. Kimberly Aquaviva. Dr. Aquaviva is an authority on lesbian, gay, bisexual, transgender, queer and/or questioning (LGBTQ) aging and end-of-life issues for the George Washington University School of Nursing.
So tune in on Thursday, March 23, 2017, at 1:00 on WBAI-FM in New York City or streaming at wbai.org. Or you can listen to the podcast anytime here:
Kristi Westphaln Kristi Westphaln, RN MSN PNP-PC is a San Diego based Nurse Practitioner with a passion for pediatric clinical practice, child advocacy, and nursing education. She has over a decade of experience in pediatric emergency care, with a focus on trauma and abuse. She is pursuing a PhD, and as a senior fellow, produces frequent HealthCetera Radio segments.
On February 21st, Swedish Health Services in Seattle, Washington, announced that its CEO, Tony Armada, had resigned after a report by the Seattle Times that neurosurgeons were being incentivized to increase the volume of surgeries at its Neuroscience Institute and did so at times in ways that compromised patient safety. The Times reported that as a result of efforts to increase the volume of neurosurgeries at the Swedish Neuroscience Institute, nurses in the neuro intensive care unit were often assigned an unsafe number of patients and at times worked a dangerous number of hours—in some cases, up to 20 consecutive hours. The hospital was reported to have of high rates of blood clots, collapsed lungs and serious surgical complications. One neurosurgeon noted for his high volume of complicated surgeries was hired by the hospital despite being under investigation in California for high rates of complications at another facility. When internal complaints about this neurosurgeon emerged at Swedish, the surgeon was promoted to a leadership position. Despite staff expressing concerns about inadequate patient care, inappropriate surgeries, poor documentation, a lack of accountability for postoperative complications and questionable decisions that resulted in patient harm and death, those who shared these concerns with hospital leaders often experienced intimidation and retribution.
In recent years, there has been tremendous pressure on hospitals and other health care organizations (HCOs) to grow larger, increase the volume of profitable services, and increase their profit margins. Some have done so in ways that compromise their missions of service to individuals, families and the communities they serve. With the chaos that’s surrounding the potential repeal of the Affordable Care Act, this pressure is likely to continue. In the face of such pressures and chaos, how should healthcare organizations behave and how should they be held accountable for the ways in which they operate?
HealthCetera producer and moderator Diana Mason, RN, PhD, was part of the workgroup that developed the Charter. On an upcoming edition of HealthCetera, she talks with two other members of the workgroup about the Charter, why it was developed, what it contains, and how people might use it to improve the professionalism of HCOs. Her guests are Barry Egener, MD, an internal medicine physician, Medical Director of the Foundation for Medical Excellence that led the charter development, and Chair of the Charter workgroup; and May-Lynn Andresen, RN, BSN, DNP Candidate and Vice President for QHC Advisory Group, a healthcare consulting company.
This program was to have aired on March 9th but had to be postponed. So tune in on March 23rd on WBAI, 99.5 FM in New York City, or streaming at www.wbai.org. Or you can listen anytime here:
HealthCetera is sponsored by the Center for Health, Media & Policy.
Diana J. Mason Diana is a founder of the Center for Health, Media & Policy, and HealthCetera Radio. She is the President of the American Academy of Nursing, the Rudin Professor of Nursing at Hunter-Bellevue School of Nursing, and a health policy expert and leader. Diana tweets @djmasonrn.
It would cut the Environmental Protection Agency by 31% and Health and Human Services by 16%.
The National Institutes of Health would lose $6 billion.
It would decimate support for after-school programs, Meals-on-Wheels, and the neediest college students.
And among so many other deprivations, it would kill the National Endowment for the Arts and the National Endowment for the Humanities.
The proposed cuts are all of a piece in their cravenness and cynicism, serving to boost military spending and so-called homeland security. For a strong analysis of this proposal’s radical conservatism, I recommend this piece at the Intercept.
Because I want to talk about poetry and stories.
This week the Annals of Internal Medicineannounced it had chosen “Tinnitus” by Veneta Masson as the best poem it published in 2016. On Wednesday I spoke with Veneta, a poet and essayist, a nurse practitioner, and an instructor in ethics at Georgetown University, about the value of poetry and narrative in nursing, medicine, and health policy. Our discussion wasn’t overtly political, but I’m grateful today for the quiet affirmation she offered of the arts.
I asked her about the synergies being made between the literary arts and the health care industry. The Association of Writers and Writing Programs, for example, recently held its annual conference in Washington, DC, where Veneta presented on a panel called Crossing the Line: Writing as a Healing Practice. This seems significant: for years the arts have penetrated various health care arenas, but now issues related to health and health care are making their way into the country’s biggest conference for professional and student writers and writing faculty.
“Writing gives you new energy for your work,” Veneta said. “It’s like you need to do this to resolve what’s unresolved in the mind and heart. One time I was writing about a mistake I made or what could have been a mistake and the guilt about what I could have done. I had to find a way to put myself at rest. In that case it was in the form of a poem.”
Veneta told me about a Literature and Medicine group at George Washington University that met for dinner to discuss one of her books of poems. “I had written about an immigrant woman and her child, and a man approached me afterward. He said, ‘I couldn’t say this in the group, but I felt you were writing about my mother.’ What more could a writer want, as far as connecting with another person?”
Indeed, those connections appear to be neurological, as well as sociological. Veneta mentioned an article written by physician and fiction writer Louise Aronson, Story as Evidence, Evidence as Story, published in 2015 in JAMA. Aronson writes:
Mounting data, and the entire historical record across cultures and continents, suggest that human beings are uniquely wired for story and that stories, with their linking of the cognitive to the emotive, are often both more memorable and more persuasive than other sorts of information.
Veneta’s prize-winning Annals poem is behind a paywall, but she gave me permission to reprint another poem first published in the online journal Pulse, called The Whole Story. It’s a beautiful melding of narrative momentum and lyric concision. With just a few images and happenings she makes a world I want to inhabit, one with sunflowers and war talk, plus the unexpected poignancy of a shy bride waiting her turn at the door to a funeral.
After I spent hours fretting over the proposed budget, reading Veneta Masson’s poem restored me, somehow, to my right mind and to a couple of simple truths: humans need poetry, and health care is stories.
The Whole Story
After she died
there was talk of war
the stock market crashed
the cat didn’t eat for three days
her youngest came home from school in tears
her husband grew a beard.
I do not lie when I tell you these things
nor do I tell the whole story.
I do not say that her funeral day dawned bright
or that all the sunflowers in the city
were gathered at her wake.
I do not mention the ruffled bride
also in white, waiting discreetly outside
the door of the chapel.
I do not tell how, at the gravesite
smiling children blew
soap bubbles over her casket
and how they were not buried with her
but were borne up and away,
carried gently on a light wind.
And check out Veneta’s Notebook, her observations of matters literary, medical, and otherwise. In one entry she writes about writing: “that’s where I find out what I’m thinking and (like Descartes) what’s true and what isn’t.”
Joy Jacobson Joy Jacobson is the CHMP’s poet-in-residence and cofounder of our Writing Reflective Narratives for Clinicians program.