Some nurses could easily be Nurse of the Week 52 weeks a year, and Lauren Underwood is one of them.
In 2018, Lauren Underwood, BSN, MSN, MPH inspired nurses and women of color everywhere when she became the youngest Black woman to be elected to Congress. Illinois’ 14th District Congressperson had accomplished a great deal prior to her election and has been busy blazing new trails since her swearing-in. Underwood is still a nurse as well, so it was clear from the start that she was not going to be the kind of representative who spends their time vying for social media “Likes.”
Underwood first was drawn to public policy as a teen, and in 2009 earned both her MPH and MSN at Johns Hopkins. Already a vocal advocate of the ACA, in 2014 the Obama administration tapped her to join their team as a policy advisor, and she quickly became an MVP in the push to obtain passage of the ACA. After Obama left office, she found a position as Senior Director of Strategy and Regulatory Affairs at Next Level Health and served as an adjunct instructor at the Georgetown University School of Nursing & Health Studies.
But what prompted her to take on the enormous challenge of running for office? As a promising candidate back in 2018, she told Janice Phillips at Minority Nurse that she had been bitterly disappointed by her predecessor during the ACA repeal frenzy after the end of Obama’s term. At a local League of Women Voters meeting, her own representative “said that he was only going to support a version of Obamacare repeal that allowed people with preexisting conditions to keep their coverage.” As Underwood herself has a heart condition – AND had worked hard to get the ACA passed – she felt invested both professionally and personally in the rep’s promise.
“When I walked into a room, even with people who didn’t share my political point of view, they knew that I was very clear on what was going on in our health care system.”
However, “A week to ten days later he went and voted for the American Health Care Act, which is a version of repeal that did the opposite. It made it cost-prohibitive for people like me to get coverage. But, she stressed, “I was upset not at the vote itself, but because he did not have the integrity to be honest the one time he stood before our community…. A representative is supposed to be transparent, accessible, and honest. And we deserve better. I said, ‘you know what, it’s on! I’m running.’”
Early this summer, Sullivan-Marx asked Underwood, “What was one of the drivers as to why you kept leaping forward beyond the usual kind of candidate?”
“Two things,” Underwood responded: “The number one issue in the election was health care and I brought expertise as a nurse. Someone who worked on the ACA. I was working for a provider—a private company. I’ve been a patient and I understood the law as it was, and I had a greater understanding of the ACA than my opponent, the Congressman, and then all my primary opponents— these six guys –they’re great guys—they just did not have the expertise.
When I walked into a room, even with people who didn’t share my political point of view, they knew that I was very clear on what was going on in our health care system. I had many solutions. They knew that I understood the problem and I understood what was going on with their families and that I had been fighting for years to try to solve it… That enabled us to walk into every room and be taken seriously, even if we didn’t agree on anything. People knew that on this issue, which was important to them, that I had credibility. The second thing is that we were willing to show up everywhere in person to engage people and build connections.
The Most Trusted Profession Meets the Most Mistrusted Profession
Sullivan-Marx also asked Underwood to describe her typical day on Capitol Hill:
Underwood: “In this Congress, I am assigned to two committees—the House Committee on Veterans’ Affairs (VA). I’m on the Health Subcommittee. The VA is an incredible health care system that has its challenges. I focus pretty exclusively on suicide prevention, mental health, and women’s health care. The VA has this unbelievable responsibility for caring for women veterans across the lifespan. I think folks forget that there are still cadet nurse corps members from World War II that are alive and they’re active and they’re getting care in the VA that has been inconsistent at best.
“I think that nurses take for granted that every elected official knows a nurse or has interacted with nurses. We assume that they know about the work that we do.
In my experience that is completely false. They have no clue what happens at schools of nursing. They have no idea the level of expertise that a BSN graduate brings.”
I also serve on a House Committee on Appropriations. The Congress has three core functions: we create programs and we call that authorizing to solve problems. We fund the federal government appropriations, including funding those programs, and then we do Congressional oversight over the executive branch. Within the appropriations committee, I am assigned to the Agriculture Subcommittee, which also has jurisdiction over the Food and Drug Administration. That’s how we fund COVID and tobacco. Trying to make sure that we are curbing the tobacco usage epidemic. And then I serve on the Homeland Security Subcommittee. There we have ICE [U.S. Custom and Immigration Enforcement], immigration, Federal Emergency Management Agency (FEMA), cyber security, and the US–Mexico border and the Canadian border. It’s fascinating and then obviously I still do health care work, too.”
Calling all Nurses…
Toward the end of the interview, Sullivan-Marx asked, “What kind of assistance would be great for nursing to give you? How can we be helpful to you?”
The Congresswoman said, “Nurses have been so helpful for us in terms of gathering and presenting evidence. Many of these problems have a local focus and for us in Congress it is very difficult to get that kind of local data. Evaluation type data demonstrating that an intervention is effective. We can build relationships with nurses, either in our communities or folks who’ve been impacted by these problems. Site visits and testimonial stories are very powerful.
“We [nurses] have got to do better about inviting them [members of Congress] in.”
I think that nurses take for granted that every elected official knows a nurse or has interacted with nurses. We assume that they know about the work that we do. In my experience that is completely false. They have no clue what happens at schools of nursing. They have no idea the level of expertise that a BSN graduate brings. They have no idea what APRNs do. They have no idea what practicing to the full extent of our education and training means. We [nurses] have got to do better about inviting them [members of Congress] in. My colleagues are very familiar with physician education. Their whole advocacy strategy is completely different than how nursing engages members of Congress and we’ve got to step it up.”
Yes, let’s step it up! The full interview with Underwood is a great read. If you have an opportunity, check out Policy, Politics, and Nursing Practice, “Eileen Sullivan-Marx Interview of Representative Lauren Underwood (Democrat-Illinois 14th District)” here.
Thanks to Eileen Sullivan-Marx for graciously sharing her interview with DailyNurse.
The George Washington University School of Nursing has just received the largest philanthropic gift in the school’s history. Through the William and Joanne Conway Transitioning Warriors Nursing Scholars Initiative, $2.5 million in financial aid is being made available to help eligible military veterans working toward a BSN degree. The gift is expected to support more than 65 students over the next five years.
Donors William Conway, co-founder of The Carlyle Group, and his wife Joanne are long-time supporters of nursing education. School of Nursing Dean Pamela Jeffries commented, “The Conways’ commitment to our military veterans is unwavering, and so is ours at the GW School of Nursing. As we celebrate our 10th anniversary, it’s gifts like these that enable us to grow our veteran student population and provide the resources they need to succeed.”
The aid program will be welcomed by veterans. Despite the assistance available through military benefits such as the GI Bill, many vets still find it a challenge to support themselves and their families when they re-enter the civilian world and attempt to pursue a degree. The Conways are happy to offer a helping hand. “The Transitioning Warriors Nursing Scholars Initiative is designed to reward the brave men and women of our armed forces who seek to continue their service to our country as civilian nurses,” Mr. Conway stated. GWU President Thomas LeBlanc responded, “We are grateful to the Conways for enabling this investment when our nation’s nursing workforce and veterans need it most.”
Founded 10 years ago, the George Washington University School of Nursing is currently the sixth ranked school in the US News and World Report assessment of online graduate nursing programs. The gift was presented in May, while the school was celebrating its 10th anniversary.
For further details on this story, visit GWToday at the University website.
WASHINGTON — Healthcare providers don’t know enough about cannabis to talk with patients about the potential risks and benefits, witnesses said at a mid-January House Energy and Commerce Health Subcommittee hearing.
“We need to have much more education with respect to how the use of
marijuana products can negatively impact or help someone,” said Nora
Volkow, MD, director of the National Institute on Drug Abuse (NIDA). “The
problem is we do not have sufficient evidence that could help us mount those
programs in a way that’s actually required. At this point, I don’t feel the
evidence is sufficient to say, ‘We’re going to recommend that this product
should be used by this patient.'” For example, elderly patients who take
marijuana-containing products may be on a lot of other medications, and little
is known about potential interactions between marijuana and prescription drugs.
“So I do believe in the importance of expanding our knowledge so we can
develop educational training programs that are based on knowledge, not on
anecdote.”
Making it Easier to Research Cannabis
Rep. John Sarbanes (D-Md.) noted that a 2015 survey of healthcare providers
concluded that the providers “perceive a knowledge gap related to cannabis
dosing, treatment plans, and different areas related to cannabis products, so
providers themselves realize the need for research and expertise to be
developed in this area.”
The hearing was held to discuss six bills on cannabis, several of which were
aimed at making it easier for researchers to obtain cannabis for research
purposes. Currently, the only cannabis legally available for research comes
from a single farm housed at the University of
Mississippi, and researchers who want to use it must get permission from
three agencies: the FDA, the Drug Enforcement Administration (DEA), and the
NIH. “We need to figure out a way to take advantage of different producers
of cannabis plants to evaluate the diversity of products out there, as opposed
to limiting us to the Mississippi farm,” said Volkow.
Rep. Kurt Schrader (D-Ore.) agreed. “The sad part is we’re not testing the right stuff,” he said. “I fail to understand why we have one bloody facility that is the sole nexus for research and analysis of CBD [cannabidiol] products. It seems to me we ought to be testing products on the marketplace.” Subcommittee chairman Anna Eshoo (D-Calif.) agreed. “I don’t understand why the three agencies before us can’t get this done,” she said, referring to NIDA, the FDA, and the DEA, which all had officials testifying at the hearing.
The Cannabis Research “Catch-22”
Several subcommittee members expressed frustration over what they called the
“Catch 22” problem that cannabis researchers face. “They can’t
conduct cannabis research until they can show cannabis has a medical use, but
they can’t demonstrate cannabis has a medical use until they conduct research.
It doesn’t make sense,” said Eshoo.
“You’ve got to help us figure out how we’re going to get out of this Catch
22,” Rep. Debbie Dingell (D-Mich.) said to the witnesses at the hearing.
“This lack of knowledge poses a public health risk.”
One issue with conducting research on marijuana is its classification as a
Schedule 1 drug; these are substances deemed to have no medical value and have
a high potential for abuse, and their availability is highly restricted.
Several bills the subcommittee is considering, including the Legitimate Use of Medicinal Marijuana Act, the Marijuana Freedom and Opportunity Act, and the Marijuana Opportunity Reinvestment and Expungement (MORE) Act,
would either downgrade marijuana from a Schedule 1 drug to a Schedule 2 drug,
which has fewer restrictions, or remove it from the drug schedule altogether.
Rep. Michael Burgess, MD (R-Texas), the subcommittee’s ranking member, said
the latter “is going too far,” adding that “using our
congressional authority to override this may be a dangerous move, especially
given the lack of research.”
So far, only one marijuana-related drug has been approved by the FDA:
Epidiolex, which contains cannabidiol, was approved
in June 2018 for treating a rare seizure disorder in patients ages 2 and
over.
Diverse Testimony from Both Sides of the Aisle
Both the witnesses and the subcommittee members seemed divided on
marijuana’s potential harms and benefits for patients. Volkow mentioned
research showing that cannabis exposure during pregnancy was associated with
low birthweight and preterm delivery, and added that it was also linked with
episodes of psychosis. She also said that there was some evidence that cannabis
may be useful in treating spasticity, multiple sclerosis, and pain, “but
otherwise there is little benefit for other indications for which patients are
using it.”
Rep. Morgan Griffith (R-Va.) said that his support of medical marijuana
began some years ago when he learned that people were smuggling marijuana into
a Virginia hospital to help a terminally ill father who wanted to be feeling
well enough to spend time with his 2-year-old son. Years later, when he told
that story at a high school town hall, one student raised his hand and said,
“They did that for my daddy too.”
“These communities were 20 years apart, 30 years apart, yet doctors
were turning a blind eye to allow marijuana to be brought into the hospital
because they recognized that for those patients who are dying, that was the
only way they would get relief and get the nutrients they needed to spend a
little more time with their children,” Griffith said.
Rep. Greg Gianforte (R-Mont.) said he was opposed to efforts to “make any Schedule 1 drug legal without adequate research.” Instead, “we should focus on combating addiction,” he said.
Alliance of Nurses for Healthy Environments at Washington DC climate rally
Just before a series of major climate change rallies were held in cities across the US, the journal Creative Nursing published a special issue on climate change. We spoke with special issue editor Katie Huffling, MS, RN, CNM and contributor/editorial board member Teddie Potter, PhD, RN, FAAN to learn more about climate change as a public health issue, and why so many nurses are attending these rallies and speaking out.
Why is
climate change important to the mission of the health and nursing professions?
TP: In nursing we are charged to create environments for people to be the healthiest individuals and communities that they possibly can be. Climate change threatens that. It threatens our patients and communities on multiple levels. The health impacts of climate change are severe and serious, and they’re happening right now. So that why it is important for us to address this as nurses.
It’s no
longer happening in some parts of the globe, or in some
geographic areas; it’s happening everywhere. Unfortunately, it tends to have
the greatest impact on communities that are already struggling to be healthy. If
I am already challenged by being homeless, for instance, not having access to
AC or heating can lead to real [health] problems, and we see people with such
challenges often suffering worst and first from climate change.
And it’s important to point out that yes, the planet is warming but the impacts are very variable. Places that used to be cool are getting hot; some places that were usually dry are getting very wet. It’s the shift in patterns that has definite health consequences. In California, for instance, you might be more apt as a nurse to be aware of the impact of fires on the air quality affecting individuals and families and people who work outdoors.
But isn’t climate change a political issue? Why should nurses get actively involved?
TP: I hope we have made it very clear that climate change is not a political issue, any more than people having adequate food or clean air should be a political issue. It’s a health issue. And we need all people regardless of their political affiliation to be part of finding solutions and part of finding a healthier future for everyone.
KH: The Lancet has been publishing for the past few years an analysis of climate change and health and they are very clear that climate change is the biggest public health challenge that we face today. It’s a health issue, and the future of our children is at stake.
Are nurses already
seeing health issues connected to climate change?
TP: In Minnesota, we’re seeing changes in our vectors. We see more [outbreaks of] Lyme disease and West Nile disease; we see more people affected by flooding and loss of housing and livelihoods related to flooding. Farmers can’t get their crops planted on time [owing to flooding] and they can’t get their crops harvested on time, so we’re seeing impacts in that area. Health care providers need to understand that there are things we need to be considering in order to protect our patients and teach families and to ensure that if a disaster is likely, that people have a plan. For example, we need to ask “What are you going to do when category 4 and 5 hurricanes come into your area?”
KH: One thing I would add is that no matter what type of nursing you do—whatever your patient population is—there’s some way that climate change impacts that population. For example, when you have extreme weather events, and you have renal patients, are they going to be able to get dialysis? Nurses working in that area have been real leaders in working on emergency preparedness. The same goes for oncology nurses—are your patients going to be able to get their cancer treatments in a timely fashion. There are some things when you first think of them, you don’t realize how it really does span any type of patient population.
“We need to be planning for these people.”
Teddie Potter
United Healthcare Workers East at Washington DC climate rally
TP: Also, there are community nurses worrying about patients who are homebound and in need of oxygen and other things that require a steady source of electricity. We need to be planning for those people. What do you do when flood waters rise, and you can’t get out of your house because you’re wheelchair-bound? And your caregiver can’t come because they’re stuck [in the flood] where they are, and you can’t even get out of bed? All of these things have to be thought about.
KH: As an example of that, here in DC it’s gotten better because the local utilities have been addressing it, but there were lots of power outages accompanying extreme weather events during the summer. And when families with children on ventilators at home don’t have electricity for a few days, they end up having to take up an ICU bed because they’re not able to be on just a general floor.
TP: As a state that has a significant rural population, [In Minnesota] we are also concerned about people working outside who harvest and pick the crops. We’re concerned about dehydration. A while ago one of our Minnesota Vikings players died from heat exposure and dehydration at the Vikings summer training camp. This is not something that we’ve had to think about in the past. Hot and humid days can impact even young people in peak condition and we are having more and more days with high heat and humidity.
Are today’s nurses
following in Florence Nightingale’s footsteps? Was she the first activist
nurse?
TP: She was an activist but also a scientist. She was deeply committed to evidence-based practice and she was a brilliant statistician. She really looked at the environment as doing the healing for patients. As she said in Notes on Nursing, “medicine and surgery can remove obstructions… nature alone cures.” And she was a great believer in and taught about the importance of good food, adequate hydration, mobility, cleanly environments, and exposure to fresh air.
In the Crimean war what got her started was that they were seeing more people dying from the care they received in the hospital than from the injuries they received on the battlefield. So it was a care issue and that was what marshalled her and other women at that time to go to Turkey and set up an alternative way of caring—fresh air, clean sheets, adequate food—and people started surviving. It is deeply at the core of the nursing profession: we work with the environment to put people in a position to recover and have a quality of life. Nurses are on the move following the same principles today.
How can nurses get—and how are they getting—involved in the movement to reduce effects of climate change?
KH: I think there are a number of points of engagement. Nurses are really can-do people. When they find a problem, they want to fix it, and so when you start to learn about climate change and its effects, it is natural to immediately want to get engaged.
Nurses and other healthcare professionals participated in Minnesota’s climate rally.
I think this is a great opportunity for nurses to get together—you know, strength in numbers—to elevate this issue and use our position as America’s most trusted profession to talk about it. Also, [it’s important to] meet with policy makers—whether it’s at the state, national, or local level—when you can speak with elected officials and help them to make that health and climate change connection. Because a lot of elected officials still don’t understand that it’s a health issue and if they want to protect the health of their constituents it’s an issue they need to be taking on.
And, it’s been very exciting to see so many nurses doing things like going to the different climate marches. It’s another way to show that nurses are leaders in the area around climate change. One of the things my organization (ANHE, the Alliance of Nurses for Healthy Environments) has been doing is we’ve created a nursing collaborative on climate change and health. This came out of a round-table we did at the White House during the Obama administration where we had around 20 nursing organizations and unions at this round table talking about what nurses can do about climate change and health. It was a really historic event. We were the first group of health professionals that they had reached out to at the time to do something like this.
After that, we decided we needed a strong collaborative effort, and that is how we created the Nursing Collaborative on Climate Change and Health. We have 11 organizations, and a couple more really large organizations about to sign on. Working together we show visible leadership among the nursing community as well as among policy makers.
Where can
nurses find out more about the impact of climate change?
KH: Well, at ANHE (Alliance of Nurses for Healthy Environments) we have tons of resources on the website, lots of free tools for nurses to engage. We’ve got talking points, academic databases and case studies, resources for pregnant women and children, and much more.
We’re also part of the Nurses Climate Challenge, in which ANHE’s partnered with Healthcare without Harm. Basically in the Nurses Climate Challenge we have Nurse Champions that sign up on the website. The champions then go out and educate their fellow nurses and other healthcare professionals about climate change and health. They have a really robust toolkit with PowerPoints with notes and posters they can customize if they want to make a presentation at their monthly nursing meeting. Then we track each event: if someone does a presentation, they note how many attended. The first year we had a goal of 5,000 nurses and other healthcare professionals educated, but we quickly grew past that so we decided to up our goal to 50,000 nurses educated by 2022. And we just started that a few months ago, and we’re already past 10,000. It’s exponentially growing!
“It’s an amazing opportunity to prevent disease.”
Katie Huffling
I’d like to bring in another positive note: this is also the greatest opportunity that we have to impact public health. These things that we can do to affect climate change can have a widespread positive impact on health. It’s an amazing opportunity to prevent disease. And I think that that’s another core feature of nursing practice—that we want to see our patients become healthier and to not have to be treating them for these preventable illnesses. When we address climate change we can have such a positive impact on health.
TP: I’ll just add in that the dean of the Minnesota School of Nursing has appointed me the first Director of Planetary Health for the school, so that nurses can learn to apply what we do to care for the environment so that our patients and our communities will be healthier.
A team of nursing and medical school faculty from George Washington University (GW) have received
a $2.8
million grant to launch a training program for nurse practitioner students.
Funding to get the program off the ground was awarded by the Health Resources
and Services Administration.
The new nurse practitioner program is called The Nurse
Practitioner Technology Enhanced Community Health program. Students in the
program will learn how to use telehealth technology, which is software used to
provide health care information and treatment from a distance, to expand access
to care in underserved populations and in rural and urban communities.
The program will be led by Christine Pintz, PhD,
FNP-BC, WHNP-BC, RN, FAANP, a professor of nursing at GW, along with six
professors from the School of Medicine and Health Sciences, Medical Faculty
Associates, and the School of Nursing. This team of faculty will design and
implement a curriculum focused on enhancing community health through technology.
A press release from GW Nursing states: “[Nurse practitioners] will be better able to provide high-quality care to patients in underserved communities who might have chronic health issues or lack access to care.”
To learn more about the $2.8 million granted awarded to George
Washington University to launch a training program for nurse practitioner students,
visit here.
GW’s new 42-credit program will teach nurses how to formulate health policy solutions and influence health care policy solutions and health care policy. The goal of the program is to increase access to better and more affordable health care.
The program will be led by Program Director David Keepnews, an expert in health policy process and influencing policy to improve quality of care, increase access, and control costs. Located in downtown Washington, DC, students will have a unique opportunity to engage with policymakers at the national level.
Students who graduate from the doctoral program will be qualified to work for public, private, and academic organizations that handle health policy. Admissions for the fall semester are open and rolling for nursing professionals with an interest in health policy.
Former nursing school Dean Jean Johnson tells GWHatchet.com, “There are many very serious health care issues facing our country in terms of cost, access and quality, and nurses need to bring their knowledge of population needs and effective interventions into the policy discussion to improve our health system and provide safer, higher-quality care.”
To learn more about GW Nursing’s new health policy doctoral degree program, visit here.
