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The Return of Nurse Ratched – because we fear strong women

By Barbara Glickstein

September 8, 2017

Poured my coffee and grabbed The New York Times Weekend Arts section to see what’s happening culturally this weekend to make plans that would provide balm for my soul.

 

I turned to page C3, Arts, briefly and this headline jumped out at me: “Netflix Acquires Series on Nurse Ratched”  a Netflix series from Ryan Murphy, the creator of the horror series “American Horror Story”, Sarah Paulson will be the star of the show. It will focus on the the character Nurse Ratched in Ken Kesey’s 1962 novel “One Flew Over the Cuckoo’s Nest”. It was adapted as a film in 1975.

 

I asked myself, why now?

 

It’s 2017, the President of the United States has been widely called out for his objectification of women – he has a tendency to criticise them for their looks – and he makes sexist remarks. This administration is back peddling on policy issues that directly impact women from access to equal pay, parental leave, and reproductive justice (to name just a few issues on a long list).

 

So Netflix is producing a 2-season 18 part horror series based on the female character, Nurse Ratched. “Ms. Paulson will play the title character, tracing her evolution from low-level nurse to the manipulative tyrant who terrorizes mental institution patients in Ken Kesey’s 1962 novel.” In the film, her nickname was “Big Nurse”.

 

In the film adaptation (and in the book) Ratched is depicted as a powerful and threatening woman who emasculates and belittles men on the unit she commands full control over. Ratched also holds absolute power over the male and female staff. She makes them do what she wants.

 

One message: When this woman is in charge. Fear her to the fullest degree.

 

The book, “One Flew Over the Cuckoo’s Nest” was written in 1962, a period of social turmoil, the Civil Rights movement and Second Wave Feminism.

 

I guess the backlash on women moving forward, nurses working towards full scope of practice is still as threatening now as it was in 1962.

 

We have our work cut out for us. But we already knew that. I’ll be tuning in as a feminist nurse media analyst.

 

I didn’t even touch on the portrayal of people living with mental health issues and how we still can’t talk about it or provide access to care.

 

Barbara Glickstein
Barbara is a founder of the Center for Health, Media & Policy, as well as a nurse, media guru & activist in New York City. She is the chairman of the board of Project Kesher and a consultant to many health care organizations and creative projects. Barbara tweets and 'grams @blickstein.

Reporting about nursing: our media fellow reflects on challenges, opportunities

By Liz Seegert

July 6, 2017

In many ways, the state of Kentucky is a microcosm of the challenges in today’s health care system. Tens of thousands of people, many in rural areas, now receive regular health care thanks to Medicaid expansion under the Affordable Care Act. But delivering that care poses its own dilemmas.

 

You may recall reading CHMP Media Fellow Melissa Patrick’s three-part series earlier this year. Patrick looked into how nurses are meeting the increasing demand for primary care in the community and in schools, at the same time the state faces a serious shortage of qualified RNs.

 

She recently spoke with Media Fellows program director and HealthCetera co-producer Liz Seegert about her reporting, lessons learned, and why full scope of practice matters.

 

Liz Seegert
Liz Seegert is a health care journalist and directs the media fellows program at the Center. She serves as topic editor on aging for the Association of Healthcare Journalists, writes for a variety of print and online publications and coproduces HealthCetera Radio on WBAI-FM. She tweets @lseegert. 

Kentucky nurses and their allies seek a mandate for a nurse in every school

By Melissa Patrick

May 9, 2017

– Advocates say move would improve learning outcomes

 

Kari Hall, Certified Medical Assistant, with a Madison County student

Putting a full-time nurse in every Kentucky school would not only provide health care, but improve education outcomes, say advocates of the idea.

 

“We need a nurse in every school because we need to quit thinking about health and education as separate entities, because they are not,” said Eva Stone, an advanced-practice registered nurse and co-chair of the school-nurse initiative being mounted by nurses’ groups and their allies.

 

One of their strongest allies is retired educator Terry Brooks, executive director of Kentucky Youth Advocates, says he is “absolutely convinced that the non-cognitive issues that kids face, like health, have as much to do with their capacity to learn as a teaching method.”

 

Brooks added, “There is only so much blood that you can wring out of a turnip when it comes to teaching methods. You always want great teaching methods, but my goodness, we have been working on that for decades with results that are a whole lot more the same than they are different. So if it is not producing significant change, we’ve got to look for something else. . . . You are not hearing me say that this is a silver bullet, that, boy, a school nurse is going to fix everything, but I think the presence of a school nurse not only impacts kids’ health, but it impacts the kids’ capacity to learn.”

 

Those assertions are supported by research, including a recent study that looked at the association between school nurses and academic outcomes of high-school students. It showed that when there was a nurse in a public high school on a full time, every-day basis, graduation rates were higher, absentee rates were lower and ACT scores were higher,” Teena Darnell, assistant professor of nursing at Bellarmine University, said about her research.

 

“And traveling nurses showed no significance on any level. So if you had a part-time nurse, there was no significant difference on academic performance,” said Kathy Hager, a Bellarmine nursing professor and president of the Kentucky Nurses Association.

 

Hager is also a member of the “Every School Needs a Nurse, Every Day” initiative that is advocating mandates for a full-time nurse in every public school, as recommended by the American Academy of Pediatrics.

 

The National Association of School Nurses supports a ratio of one nurse for every 750 healthy students. This was the recommendation of the pediatrics academy until just last year, when it changed its recommendation to a nurse in every school, saying that “The use of a ratio for workload determination in school nursing is inadequate to fill the increasingly complex health needs of students.”

 

Kentucky has one nurse for every 1,254 students, according to a 2011 KYA report, the latest data available. The Kentucky Department of Education only records nurses hired by school boards (187 this year) and does not include any hired by different funding streams.

 

Darnell’s research found that 42 percent of Kentucky’s high schools had a full-time nurse, 37 percent had a part-time nurse and 20 percent of them didn’t have one at all. Among all schools, 44 percent had full-time registered nurses; 48 percent had either RNs or licensed practical nurses.

 

State law requires schools to “make any necessary arrangement” to provide for the immediate health needs of students. Stone said they “do that for the most part, but . . . there is no system of monitoring in place.”

 

When a nurse isn’t available, student health services are often provided by school employees who are trained to provide those services. Many students have conditions that need frequent attention.

 

Out of 655,475 students enrolled in Kentucky’s public schools last year, 20,711 were diagnosed with attention deficit hyperactive disorder, 14,054 with allergies, 55,897 with asthma, 1,142 with Type 1 diabetes and 5,259 with a seizure disorder, according to the KDE.

 

Vicki Williams, RN, Calloway County

Vicki Williams, school-health coordinator and one of three school nurses in Calloway County, which has about 3,400 students, said the school system has about 150 employees who have completed medication training, and others who know certain medical procedures, like blood-sugar testing, taking blood pressure and using g-tubes to the stomach.

 

And though she is allowed to delegate administration of insulin to other employees, Williams said she isn’t comfortable doing that. “That is where I will draw the line,” she said. “I will not train anybody to give insulin except myself and any other licensed nurse in my building.”

 

She said schools have many distractions and “Too much insulin is life threatening, and I don’t feel comfortable putting that on somebody who has not had more training than a quick diabetes training after school one day.”

 

Hager didn’t question that unlicensed employees can be trained to provide such services, but said what they don’t have are the assessment skills of a school nurse. “It takes years of experience to recognize what a person looks like with a low blood sugar reaction,” which often occurs with young diabetics, she said.

 

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Melissa Patrick