Over the past month, a growing number of nursing associations have been calling upon members of the profession to take action against racism.
The first official remarks appeared the day after George Floyd’s death. On May 31, the Minnesota Nurses Association issued a press release stating that “nurses continue to see the devastating effects of systematic racism and oppression targeting people of color in our communities. We demand justice for George Floyd and a stop to the unnecessary death of black men at the hands of those who should protect them.”
The Board of Directors of the New York State Nurses Association declared, “As nurses, we mourn for the hundreds of Black men and women killed by the police every year, like Breonna Taylor, an EMT studying to be a nurse in Louisville, Kentucky.” The NYSNA called upon nurses to “fight against the bigotry, intolerance, and hate fueling current politics and feeding an armed white supremacist movement that threatens our democracy.”
This is “a pivotal moment,” according to ANA President Ernest J. Grant. In a June 1 statement, he urged US nurses “to use our voices to call for change. To remain silent is to be complicit.”
Calling racism “a public health crisis,” the Washington State Nurses Association said, “Racism has a 400 year history in America – and the hand of racism rests heavily on the health care system and public health. We know that people of color face systemic barriers to accessing health care and being listened to or heard. It is the reason African American women face higher rates of maternal death and why the burden of the coronavirus pandemic is falling more heavily on people of color. It is why African Americans have the highest death rate and shortest survival of any racial and ethnic group in the US for most cancers. It is why African Americans are almost twice as likely to die from a firearm than their white counterparts. And, it is why we as nurses must look racism in the face and call it what it is.”
The Oregon Nurses Association commented, “As nurses, it is our duty and our calling to protect and serve the health and well-being of the entire community. That duty extends particularly to people of color who are especially vulnerable in this healthcare system.” In an interview with Austin station KXAN, Dr. Cindy Zolnierek, CEO of the Texas Nurses Association, echoed Grant’s statement, saying, “This is core to our ethics. It’s human rights so we cannot stand on the sidelines. To be silent is to be complicit. So, we have a role in this. We have a role to play in advancing human rights – in advancing health care.”
The Kentucky Nurses Association released a seven-point action plan to combat racism both in the profession and in the culture at large. The plan includes goals such as “training for nurses regarding racial disparities,” promoting the “recruitment of African American nurses and other nurses of color to serve on boards and commissions and leadership positions within our organization as well as others that focus on health,” and the addition of “cultural competency training, bias training and disparity education in every Kentucky nursing school curriculum.”
The Massachusetts Nurses Association also spoke out: “As nurses and healing professionals… we recognize institutional racism and the systematic oppression of communities of color as both a crisis in public health and a pervasive obstacle to achieving the goals of our work in both nursing practice and in the labor movement.”
Other nursing organizations issued anti-racism action statements as well, including the American Academy of Nursing, the International Family Nursing Association, the Rheumatology Nurses Society, and the Association of Rehabilitation Nurses.
As nationwide protests sparked by the death of George Floyd enter their fourth week, the American Thoracic Society is calling for a moratorium on the use of tear gas and other chemical agents to control demonstrators.
On Thursday, ATS officials issued a statement asking law enforcement groups to stop using tear gas agents such as 2-chlorobenzalmalononitrile (CS) and highly concentrated oleoresin capsicum (OC) pepper oil due to concerns about long-term lung injury.
Concerns about the use of tear gas and other agents on the spread and severity of COVID-19 were a factor in the move, said ATS President Juan Celedon, MD, in the statement.
“The use of chemical crowd control agents is outlawed in the time of war. They cause significant short-term and long-term respiratory health injury and likely propagate the spread of viral illnesses, including COVID-19,” Celedon said.
“Based on the lack of crucial research, the escalation of tear gas use by law enforcement, and the likelihood of compromising lung health and promoting the spread of COVID-19, the American Thoracic Society calls for a moratorium of CS tear gas and OC pepper weapons use,” he added.
The statement was issued on the same day President Trump — speaking at a roundtable discussion on policing and race — praised the use of tear gas and other aggressive tactics against demonstrators in Minneapolis early in the protests, calling it a “beautiful scene.”
Sven-Eric Jordt, PhD, of Duke University School of Medicine, Durham, North Carolina, has spent years researching the impact of chemical exposures — including tear gas — on the lungs.
He told MedPage Today that a study in military recruits linked tear gas exposure to chronic bronchitis, viral respiratory illness, compromised lung function and other acute and possibly chronic lung injuries.
The study, published in the journal Military Medicine in 2014, showed that recruits intentionally exposed to CS during basic training had more than twice the risk for an acute respiratory disease diagnosis after exposure compared to before exposure.
Jordt said recent technical advances in tear gas deployment allow the gas to be dispersed over much greater areas, and the clinical impact of this wider exposure has not been studied.
Likewise, in the U.S. protests and in other parts of the world where tear gas has been widely used to disperse crowds, police tactics have changed in ways that can make exposure more problematic, he added.
“What we are seeing and what we have seen is that police are using massive amounts of these agents,” he said. “In the recent protests in Hong Kong there were days when several thousands of cartridges were used.”
He added that in many recent protests within and outside the United States, tear gas and pepper spray were deployed as a first line measure, rather than a measure of last resort.
“In U.S. cities we have seen episodes where police are boxing in protesters and then using tear gas or pepper spray when the protesters have no way out,” Jordt said.
While there are, as yet, no studies directly examining the impact of tear gas exposure on COVID-19, Jordt and Celedon both said there is cause for concern that exposure may promote SARS-CoV-2 transmission.
Someone exposed to tear gas would be likely to quickly take off protective masks due to contamination, and maintaining a safe distance from other people would probably not be their main concern, Jordt told MedPage Today.
COVID-19 patients also often report loss of sense of smell, which could increase their risk of unknowingly inhaling dangerous levels of tear gas. And tear gas makes people cough, enhancing the virus’s spread if those individuals are currently infected.
“We have seen a dramatic escalation of (tear gas) use that I fear may become normalized,” Jordt said. “We have to reassess the safety of these agents with state-of-the-art toxicological techniques.”
Following the May 25 death of George Floyd, nurses and other healthcare providers have been taking action not only to protest the deaths of Black citizens at the hands of police, but also to draw attention to the severe knock-on effects of racism on the health of Black communities, including an inordinate rate of mortalities from heart disease, diabetes, COVID-19, and other illnesses. Braving the risks of coronavirus, tear gas, pepper spray, and rubber bullets, nurses, who often see the fruits of social inequality at firsthand, have provided protestors with first aid as well as taking part themselves.
Nursing organizations have joined individual nurses in speaking out. American Nurses Association President Ernest J. Grant, PhD, RN, FAAN issued a moving statement, in which he remarked, “As a black man and registered nurse, I am appalled by senseless acts of violence, injustice, and systemic racism and discrimination. Even I have not been exempt from negative experiences with racism and discrimination. The Code of Ethics obligates nurses to be allies and to advocate and speak up against racism, discrimination and injustice. This is non-negotiable…. At this critical time in our nation, nurses have a responsibility to use our voices to call for change. To remain silent is to be complicit.”
“You clapped for us. We kneel for you.”
A mingling of professional training and empathy moved nurses such as Miami RN Rochelle Bradley to take a knee in remembrance of Floyd’s death. Bradley told CNN that “Kneeling here today for nine minutes and knowing that that’s how long George Floyd was on the ground with his airway compromised really bothered me as a nurse.”
For healthcare workers, the protests also reinforced their sense of unity in the era of COVID-19. In Boston, nurses who gathered to kneel in front of Brigham and Women’s Hospital carried a sign reading, “You clapped for us. We kneel for you.” One nurse interviewed, Roberta Biens, said, “I just want everybody to know they’re not alone, we’re with them and we’ll stand in front of them or behind them, wherever we need to be to support them.”
Minneapolis nurses appeared in force at the protests. One local ER nurse told the Insider, “COVID is a temporary and critical health crisis. Racism, through violence and disease, has been killing our patients since the hospital was built and will continue killing them long after COVID is gone.” And in an official statement, the Minnesota Nurses Association said, “Nurses continue to see the devastating effects of systematic racism and oppression targeting people of color in our communities. We demand justice for George Floyd and a stop to the unnecessary death of black men at the hands of those who should protect them.”
Hospitals in New York City united to stand behind the protests. The Gothamist scanned official Twitter posts and noted, “The six major hospital systems in the city–NYU Langone Health, Mount Sinai Health System, New York-Presbyterian, NYC Health + Hospitals, Northwell Health, and Montefiore Health System–have all posted publicly in support of the demonstrations…”
Weighing the Call to Civic Action Against Public Health Concerns
Medical practitioners are understandably divided about engaging in public assemblies while the coronavirus is still at large, but many believe the risk is worth taking. On June 8, World Health Organization (WHO) director-general Tedros Adhanom Ghebreyesus said, “WHO fully supports equality and the global movement against racism,” but added, “As much as possible, keep at least 1 meter from others, clean your hands, cover your cough and wear a mask if you attend a protest.”
Asked by Health.com about the danger of public protests, Natalie DiCenzo, an Ob-Gyn resident in New Jersey, responded that “the risk of remaining silent and complacent in the face of racism and police violence is also deadly. I believe that with the proper precautions, these protests can be done relatively safely when it comes to COVID-19.”
Nearly 2,000 US “public health professionals, infectious diseases professionals, and community stakeholders” also expressed direct support for the national protests in a widely circulated June 4 letter (initiated by faculty from the University of Washington School of Medicine). Following a statement that “White supremacy is a lethal public health issue that predates and contributes to COVID-19,” the letter recommended a series of safety measures to protect protestors from the virus. Among other issues it urged “that protesters not be arrested or held in confined spaces, including jails or police vans, which are some of the highest-risk areas for COVID-19 transmission, “ and that no use be made of “tear gas, smoke, or other respiratory irritants, which could increase risk for COVID-19 by making the respiratory tract more susceptible to infection…”
On Twitter, nurses participating in the protests offered their own practical suggestions. A DC pediatric nurse told attendees to bring gloves, sunglasses or goggles for eye protection, and “an extra mask. Yours will get hot and sweaty so switching it out halfway through is smart. If you have a cloth mask throw a bandana on top too…” Following participation in protests, some nurses have also taken the step of self-quarantining for two weeks.
The National Association of Clinical Nurse Specialists (NACNS)
recognized six special clinical nurse specialists (CNS) during the
award ceremony at their 25th annual conference.
Each of the award-winners has made a significant contribution to raising the profile of the CNS by fostering research and/or improving practice, educational opportunities and service. According to the president of the NACNS, Sean M. Reed, PhD, APN, ACNS-BC, ACHPN, “The unique expertise and consistent value these six clinical nurse specialists have contributed to health care significantly advance the CNS profession by differentiating the CNS skill-set from that of other advanced practice registered nurses. Their contributions across a broad range of health care settings and specialties are leading to improved patient outcomes as well as greater support for CNS professional development programs.”
The 2020 Award-Winners
Click the award links to learn more about each recipient.
CNS Specialist of the Year Award for outstanding professional achievement demonstrating exemplary practice in patient care, nursing and health care delivery systems:
- Kathy M. Williams, MSN, RN-BC, APRN, AHCNS-BC, Adult Health Clinical Nurse Specialist/Master Clinician, U.S. Air Force, Eglin Air Force Base, Florida
Educator of the Year Award for outstanding professional
achievement as a CNS educator and commitment to excellence and
- Gayle M. Timmerman, PhD., RN, CNS, FNP, FAAN, Associate Professor and Associate Dean for Academic Affairs, University of Texas at Austin, School of Nursing, Texas
Evidence-based Practice/Quality Improvement of the Year Award
for efforts resulting in a significant impact on nursing practice and
patient and family outcomes:
- Erica A. Fischer-Cartlidge, DNP, CNS, CBCN, AOCNS, Nurse Leader, Evidence-based Practice, Memorial Sloan Kettering Cancer Center, New York
B. Davidson Service Award for extraordinary service to NACNS:
- Susan B. Fowler, PhD, RN, CNRN, FAHA, Nurse Scientist, Orlando Health, Orlando, Florida
Lyon Leadership Award for exemplary leadership in service to
- Susan Dresser, PhD, RN APRN-CNS, CCRN FCNS, Clinical Assistant Professor and Director, Adult-Gerontology CNS Program, University of Oklahoma Fran and Earl Ziegler College of Nursing, Oklahoma City, Oklahoma
Award for extraordinary service and contributions to NACNS
and the accomplishment of its mission:
- Anne E. Hysong, MSN, APRN, CCNS, ACNS-BC, FCNS, Critical Care Clinical Nurse Specialist, Northside Hospital, Duluth, Georgia
all of the honorees for their outstanding contributions to the
profession. Visit here to find
further information on the NACNS.
The American Association of Colleges of Nursing has announced the appointment of Susan Bakewell-Sachs, PhD, RN, FAAN, dean and vice president for nursing affairs at Oregon Health & Science University (OHSU) School of Nursing as Chair of the AACN Board of Directors.
During her two-year tenure as Board Chair, Dr. Bakewell-Sachs says she plans to “support coalition building and AACN’s leadership around addressing faculty and workforce needs, building inclusive learning environments, and accelerating the move to competency-based education to improve practice, research, and education.”
Known nationally both as a scholar and as a clinical expert in the
care of premature infants, Dr. Bakewell-Sachs has previously taken
a number of key
faculty and advocacy.
her previous roles, she has served as director
of the Robert Wood Johnson Foundation’s (RWJF) New Jersey Nursing
Initiative, chair of the New Jersey Association of Baccalaureate and
Higher Degree Programs, member of the March of Dimes National Nursing
Advisory Council, and on the steering committee of the Oregon Action
Coalition. Dr. Bakewell-Sachs was an RWJF Executive Nurse Fellow,
Cohort 2007, where her leadership development project focused on
strategic effectiveness and nursing education.
Upon her appointment by the AACN, she stated, “As Board Chair, I
look forward to working collaboratively to continue AACN’s lead role
in academic nursing during this extraordinary time and to supporting
nurse leaders across the country. AACN will remain a catalyst for
excellence and innovation in nursing education, research, and
practice,” said Dr. Bakewell-Sachs. “I am fully committed
to working with my fellow Board members to advocate for quality
nursing education and research while amplifying the impact AACN has
on improving the nation’s health and health care.”
For further details on the 2020 AACN Board of Directors and
Nominating Committee, visit the AACN
Duke, Rutgers, University of Alabama-Birmingham, and nine
other colleges and universities have been recognized as the “2019 Best Schools
for Men in Nursing” by the American Association
for Men in Nursing (AAMN).
Winning institutions are selected based on the significant efforts they have made to increase the number of male applicants, enrollees, admissions, and/or retentions in their programs, and have been shown to provide a supportive educational environment for male student nurses. All schools applying for the award are accredited by the National League of Nursing or the Commission on Collegiate Nursing Education and have had a minimum NCLEX pass rate of 80% over the past three years.
2019 Best Schools for Men in Nursing
In alphabetical order, the winners are:
- Duke University School of Nursing
- John Hopkins University School of Nursing
- Lewis University College of Nursing and Health
- Nebraska Methodist College of Nursing
- Northern Illinois University School of Nursing
- NYU Rory Meyers College of Nursing
- Rutgers School of Nursing
- University of Alabama-Birmingham School of
- University of Cincinnati College of Nursing
- University of Wisconsin-Oshkosh College of
Vanderbilt University School of Nursing
- West Coast University College of Nursing
2019 Best Workplaces for Men in Nursing:
- New York Presbyterian Hospital
- Vanderbilt University Medical Center
For a full list of 2019 AAMN awards, visit the AAMN awards page.