Nursing Specialties and Career Options for Improving Birth Outcomes

Nursing Specialties and Career Options for Improving Birth Outcomes

Though there are thousands of different healthcare jobs and hundreds of differing nursing career paths, few are more rewarding than those that lead to interactions with newborns. Working with parents who are thrilled to expand their family and excited to bring a new bundle of joy home is a wonderful opportunity. It can bring a lot of happiness into your career.

It may come as a surprise, but there are a variety of jobs out there for those interested in working in healthcare with babies. Passionate people who are serious about ensuring the safety and comfort of not only the newborns, but their parents as well, can make a profound difference. Specializations such as these can vastly improve the quality of care received at the very beginning of life.

As you explore potential careers in nursing, it is certainly worth considering some of the options available. There just might be a lot more out there than you’d ever previously considered.

Improving Birth Outcomes

Working in the healthcare field as a nurse interacting with newborns and their parents isn’t just about being in the delivery room when the baby arrives. Rather, it is about all of the steps along the way and immediately after that improve birth outcomes. Being the nurse who provides recommendations on exercise and what to eat during pregnancy is every bit as crucial as being the nurse who cuts the umbilical cord.

Even with all of the modern medicine our society has, there is still an increasing trend of complications during pregnancy compared to previous decades. One study completed by Blue Cross found that a greater number of women are starting pregnancy with pre-existing conditions, and the number of women experiencing both pregnancy and childbirth complications is on the rise. Addressing some of these health concerns early on is imperative to improving birth outcomes.

Unfortunately, many of these complications are experienced disproportionately amongst minority women and women with lower household incomes. One tragic review found that the risk of death from childbirth complications was over three times higher for minority women than it was for white women. Many experts indicated that these increases are not necessarily linked directly to pregnancy, but rather to an increased likelihood of pre-existing conditions and a general lack of high-quality care to address issues. 

Specialties in Nursing

Fortunately, there are a lot of opportunities to turn these statistics around in the healthcare field, especially within nursing. It is no secret that nurses are one of the most highly trusted groups of professionals — even more so than doctors — which can make the advice and recommendations they give particularly powerful. Career opportunities for nurses to work with babies are expansive and include options such as going into pediatrics, neonatal nursing, labor and delivery, or midwifery.

For example, becoming a nurse-midwife provides an unparalleled opportunity to interact directly with expecting parents and newborns when they arrive. Midwives are instrumental healthcare providers and are expected to do several tasks such as:

  • Providing prenatal care and advice to expecting parents.
  • Creating a birth plan and educating women about their birthing options.
  • Coordinating with medical doctors and specialists as necessary.
  • Treating routine health concerns during pregnancy.
  • Assisting in delivery and coaching.
  • Helping with breastfeeding consultation and other post-partum care.

A career path such as this also has the potential to make a positive impact on addressing disparities among minority women as well. Research suggests that more professionals dedicated to helping women throughout pregnancy and postpartum care can greatly reduce health risks. This appears to be especially true if minority nurses are working with minority patients.

Surprising Opportunities

Though many of the career options described above have a lot to do with directly caring for newborns, other surprising options may seem a little more distant. They are, however, every bit as essential to improving birth outcomes long-term. For instance, lactation consultants are valuable assets who work to help teach new mothers how to breastfeed properly.

Another career opportunity is becoming a birth or postpartum doula. This position essentially serves as a ‘super coach’ for expectant mothers. They do everything from providing aromatherapy and massage to helping design an organized and effective baby nursery. Doulas can play a major role in helping mothers with pre-existing conditions plan healthy meals or monitor their conditions to ensure everything continues to go smoothly for mother and baby.

Some people even specialize in prenatal or infant massage as a means of helping mothers and babies. Prenatal massage requires special certification that teaches therapists how to relax and ease strain without harming pregnant bellies. Similarly, infant massage professionals help early babies improve blood flow and strengthen their tiny muscles. 

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There is certainly an abundance of healthcare and nursing-specific careers that can allow for direct interaction with newborns and their families. Caring professionals in these types of fields can make a substantial positive difference in birth outcomes. This is especially true in areas where access to healthcare isn’t always as prevalent.

Analysis Finds Racial Segregation Common in Urban Hospital Markets

Analysis Finds Racial Segregation Common in Urban Hospital Markets

New rankings identify the most and least racially inclusive U.S. hospitals. Sometimes they are just blocks apart.

BROOKLINE, Mass. — Some of the most and least racially inclusive U.S. hospitals are located in the same cities, according to a new ranking of over 3,200 hospitals from the Lown Institute, a health care think tank.

The Institute finds some hospitals in urban markets serve a whiter, wealthier patient mix, while others predominately serve patients of color and with lower incomes. In the top 50 most inclusive hospitals, people of color made up 61 percent of patients on average, compared to 17 percent at the bottom 50 hospitals.

“The difference between the most and least inclusive hospitals is stark, especially when they are blocks away from each other,” said Vikas Saini, MD, president of the Lown Institute. “As the nation reckons with racial injustice, we cannot overlook our health system. Hospital leaders have a responsibility to better serve people of color and create a more equitable future.”

Some of these disparities were magnified during the pandemic. “If you want to see structural racism, just look at big city hospitals during COVID,” Dr. Saini said. “Hospitals with a history of serving communities of color needed refrigerator trucks to hold bodies of deceased patients, while wealthier hospitals nearby had empty beds.”

Based on the analysis, the most racially inclusive U.S. hospitals are:

  1. Metropolitan Hospital Center, New York, NY
  2. Boston Medical Center, Boston, MA
  3. St. Charles Madras, Madras, OR
  4. Newark Beth Israel Medical Center, Newark, NJ
  5. Little Colorado Medical Center, Winslow, AZ
  6. Presbyterian Española Hospital, Española, NM
  7. John H. Stroger, Jr. Hospital, Chicago, IL
  8. Harlem Hospital Center, New York, NY
  9. Sanford Chamberlain Medical Center, Chamberlain, SD
  10. Lincoln Medical & Mental Health Center, Bronx, NY

America’s most racially inclusive hospital, Metropolitan Hospital Center, is just a short cab ride from one of America’s least racially inclusive hospitals, Lenox Hill, in New York City’s Upper East Side. Though they are close neighbors, Metropolitan serves 77 percent people of color while Lenox Hill serves 33 percent.

Only three hospitals from the U.S. News Honor Roll made the top 200: Barnes-Jewish Hospital (144), Cleveland Clinic (159), and Rush University Medical Center (178).

To create the rankings, the Lown Institute assessed how well the demographics of a hospital’s Medicare patients matched the demographics of the hospital’s surrounding communities. Hospitals underserving communities of color got lower rankings.

Additional ranking information, including an explanation of methods, is available at LownHospitalsIndex.org/inclusivity. A launch of the full 2021 Lown Institute Hospitals Index, including rankings across more than 50 metrics, will take place at the end of June.

Five Reasons 2021 Is the Year for Nurse Leaders

Five Reasons 2021 Is the Year for Nurse Leaders

Nurse leaders who will shape the future of nursing are in demand now more than ever. The fields of healthcare management, technology, clinical practice, and executive nurse leadership are calling nurse leaders considering a Doctor of Nursing Practice (DNP) degree.

New opportunities for career advancement, a higher earning potential, and professional leadership await you. There are several reasons why the time is now for aspiring nurse leaders.

1. Demand is High

The struggling U.S. healthcare system desperately needs innovative, highly educated nurse leaders with a DNP to help guide pandemic recovery efforts. As healthcare leaders look beyond 2021, they seek highly trained nurses with a DNP in Executive Nurse Leadership to take on more board leadership roles, navigating the uncertainty that has become the norm, according to the American Hospital Association.

A coalition of more than 20 professional organizations, including AARP and The Robert Wood Johnson Foundation, believe that nurse leaders are the key to improving the health of communities and the nation. That is why they started a successful campaign to have 10,000 nurses in leadership positions on boards by 2020.

This means that there are now more opportunities than ever for you to hold a position of power in healthcare leadership. Earning a Doctor of Nursing Practice, the most advanced nursing degree available, is the key to establishing yourself as an expert in a specialty advanced practice area, or as a nursing executive.

2. Supply is Low

DNP Doctor of Nursing Practice degree.

The anticipated physician shortage, combined with increases in available health management positions, means new opportunities for nurse leaders with a DNP in a specialty advanced practice area. The Association of American Medical Colleges (AAMC) projects that the United States will face a shortage of between 54,100 and 139,000 physicians by 2033.

The demographic reality of a lack of access to primary care in underserved communities, an aging workforce, and a growing U.S. population means that physicians, especially primary care providers, are in high demand. Widespread physician burnout, even before the pandemic, is also driving earlier retirement.

Simultaneously, the U.S. Bureau of Labor Statistics (BLS) predicts that the health care management field will grow 17 percent from 2014 to 2024. The result is more space for nurse leaders with a DNP in board rooms, federal or state health-related agencies, or clinical research institutes.

3. Niche Expertise is Needed

Technology is an integral part of modern healthcare. The COVID-19 pandemic only accelerated the commercialization of healthcare technology. There are now exciting and lucrative new roles at silicone-valley-style startups. These businesses capitalize on technologies such as artificial intelligence, telemedicine, virtual care, wearable medical devices, genomics, and gene editing in the healthcare sphere.

Many of these new companies are looking for executive leaders with direct healthcare experience to guide them in transferring novel technology to healthcare. DNP’s with advanced education and training in Executive Nurse Leadership are desirable candidates for growing health tech companies.

4. Health Systems Require Diverse Perspectives

There are now more opportunities than ever for minority nurse leaders in the U.S. There continues to be a lack of representation of the nursing field’s full diversity in healthcare leadership positions. In addition to the pandemic, 2020 and 2021 also witnessed growing racial tensions, the Black Lives Matter movement, and a more significant societal commitment to Diversity, Equity, and Inclusion (DEI).

Our nation’s reckoning with its history of systemic racism is now holding our healthcare systems, government agencies, academic institutions, and healthcare companies to higher standards for DEI. Minority nurses with a DNP degree are qualified to serve in leadership positions. They will lead the charge in shaping the future of nursing practice, driving necessary policy changes, and improving patient care outcomes, cultural competence, and health equity.

​​​​5. T​omorrow’s Nurses Need You

The American Association of Colleges of Nursing (AACN) predicts a severe shortage of Registered Nurses (RNs). Baby Boomers are aging, and the unmet need for health care is growing.

Leadership roles change rapidly in the fast-paced healthcare environment. The COVID-19 pandemic accelerated that rate of change. Highly-educated, skilled nurse leaders with a Doctor of Nursing Practice degree are desperately needed to help lead our healthcare system’s successful recovery from the COVID-19 pandemic.

Find the Right Program for You

With a DNP, you can help to shape the future of nursing practice and strategically earn a seat at the table, representing all nurses as you help to drive the systemic changes so desperately needed. With more doctorate of nursing programs now available with flexible online course options, and employers looking to advance more nurses to leadership positions, the future looks bright for those considering a DNP.

First Year of Covid Took Lives of Over 3,600 US Health Workers: Report

First Year of Covid Took Lives of Over 3,600 US Health Workers: Report

More than 3,600 U.S. health care workers perished in the first year of the pandemic, according to “Lost on the Frontline,” a 12-month investigation by The Guardian and Kaiser Health News to track such deaths.

Lost on the Frontline is the most complete accounting of U.S. health care worker deaths. The federal government has not comprehensively tracked this data. But calls are mounting for the Biden administration to undertake a count as the KHN/Guardian project comes to a close today.

The project, which tracked who died and why, provides a window into the workings — and failings — of the U.S. health system during the covid-19 pandemic. One key finding: Two-thirds of deceased health care workers for whom the project has data identified as people of color, revealing the deep inequities tied to race, ethnicity and economic status in America’s health care workforce. Lower-paid workers who handled everyday patient care, including nurses, support staff and nursing home employees, were far more likely to die in the pandemic than physicians were.

The yearlong series of investigative reports found that many of these deaths could have been prevented. Widespread shortages of masks and other personal protective gear, a lack of covid testing, weak contact tracing, inconsistent mask guidance by politicians, missteps by employers and lax enforcement of workplace safety rules by government regulators all contributed to the increased risk faced by health care workers. Studies show that health care workers were more than three times as likely to contract covid as the general public.

“We rightfully refer to these people without hyperbole — that they are true heroes and heroines,” said Dr. Anthony Fauci in an exclusive interview with The Guardian and KHN. The covid deaths of so many are “a reflection of what health care workers have done historically, by putting themselves in harm’s way, by living up to the oath they take when they become physicians and nurses,” he said.

Lost on the Frontline launched last April with the story of Frank Gabrin, the first known American emergency room doctor to die of covid-19. In the early days of the pandemic, Gabrin, 60, was on the front lines of the surge, treating covid patients in New York and New Jersey. Yet, like so many others, he was working without proper personal protective equipment, known as PPE. “Don’t have any PPE that has not been used,” he texted a friend. “No N95 masks — my own goggles — my own face shield.”

Gabrin’s untimely death was the first fatality entered into the Lost on the Frontline database. His story of working through a crisis to save lives shared similarities with the thousands that followed.

Brazilian nurses mourn HCP Covid deaths. A new ICN study warns that 10 millon could leave the profession.
Brazilian nurses mourn Covid-related deaths of healthcare workers.

Maritza Beniquez, an emergency room nurse at Newark’s University Hospital in New Jersey, watched 11 colleagues die in the early months of the pandemic. Like the patients they had been treating, most were Black and Latino. “It literally decimated our staff,” she said.

Her hospital has placed 11 trees in the lobby, one for each employee who has died of covid; they have been adorned with remembrances and gifts from their colleagues.

More than 100 journalists contributed to the project in an effort to record every death and memorialize those who died. The project’s journalists filed public records requests, cross-connected governmental and private data sources, scoured obituaries and social media posts, and confirmed deaths through family members, workplaces and colleagues.

Among its key findings:

  • More than half of those who died were younger than 60. In the general population, the median age of death from covid is 78. Yet among health care workers in the database, it is only 59.
  • More than a third of the health care workers who died were born outside the United States. Those from the Philippines accounted for a disproportionate number of deaths.
  • Nurses and support staff members died in far higher numbers than physicians.
  • Twice as many workers died in nursing homes as in hospitals. Only 30% of deaths were among hospital workers, and relatively few were employed by well-funded academic medical centers. The rest worked in less prestigious residential facilities, outpatient clinics, hospices and prisons, among other places.
  • The death rate among health care workers has slowed dramatically since covid vaccines were made available to them in December. A study published in late March found that only four of 8,121 fully vaccinated employees at the University of Texas Southwestern Medical Center in Dallas became infected. But deaths lag behind infections, and KHN and The Guardian have tracked more than 400 health care worker deaths since the vaccine rollout began.
  • Many factors contributed to the high toll — but investigative reporting uncovered some consistent problems that heightened the risks faced by health workers.
  • The project found that Centers for Disease Control and Prevention guidance on masks — which encouraged hospitals to reserve high-performance N95 masks for intubation procedures and initially suggested surgical masks were adequate for everyday patient care — may have put thousands of health workers at risk.
  • The investigation exposed how the Labor Department, run by Donald Trump appointee Eugene Scalia in the early part of the pandemic, took a hands-off approach to workplace safety. It identified 4,100 safety complaints filed by health care workers to the Occupational Safety and Health Administration, the Labor Department’s workplace safety agency. Most were about PPE shortages, yet even after some complaints were investigated and closed by regulators, workers continued to die at the facilities in question.
  • The reporting also found that health care employers were failing to report worker deaths to OSHA. The data analysis found that more than a third of workplace covid deaths were not reported to regulators.
  • Among the most visceral findings of Lost on the Frontline was the devastating impact of PPE shortages.
  • Adeline Fagan, a 28-year-old OB-GYN resident in Texas, suffered from asthma and had a long history of respiratory ailments. Months into the pandemic, her family said, she was using the same N95 mask over and over, even during a high-risk rotation in the emergency room.
  • Her parents blame both the hospital administration and government missteps for the PPE shortages that may have contributed to Adeline’s death in September. Her mother, Mary Jane Abt-Fagan, said Adeline’s N95 had been reused so many times the fibers were beginning to disintegrate.
  • Not long before she fell ill — and after she’d been assigned to a high-risk ER rotation — Adeline talked to her parents about whether she should spend her own money on an expensive N95 with a filter that could be changed daily. The $79 mask was a significant expense on her $52,000 resident’s salary.
  • “We said, you buy this mask, you buy the filters, your father and I will pay for it. We didn’t care what it cost,” said Abt-Fagan.
  • She never had the opportunity to use it. By the time the mask arrived, Adeline was already on a ventilator in the hospital.
  • Adeline’s family feels let down by the U.S. government’s response to the pandemic.
  • “Nobody chooses to go to work and die,” said Abt-Fagan. “We need to be more prepared, and the government needs to be more responsible in terms of keeping health care workers safe.”
  • Adeline’s father, Brant Fagan, wants the government to begin tracking health care worker deaths and examining the data to understand what went wrong. “That’s how we’re going to prevent this in the future,” he said. “Know the data, follow where the science leads.”
  • Adeline’s parents said her death has been particularly painful because of her youth — and all the life milestones she never had the chance to experience. “Falling in love, buying a home, sharing your family and your life with your siblings,” said Mary Jane Abt-Fagan. “It’s all those things she missed that break a parent’s heart.”

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

“It Happened to Me Yesterday” – No, Black Medical Mistrust Does Not Revolve Around Tuskegee

“It Happened to Me Yesterday” – No, Black Medical Mistrust Does Not Revolve Around Tuskegee

For months, journalists, politicians and health officials — including New York Gov. Andrew Cuomo and Dr. Anthony Fauci — have invoked the infamous Tuskegee syphilis study to explain why Black Americans are more hesitant than white Americans to get the coronavirus vaccine.

“It’s ‘Oh, Tuskegee, Tuskegee, Tuskegee,’ and it’s mentioned every single time,” said Karen Lincoln, a professor of social work at the University of Southern California and founder of Advocates for African American Elders. “We make these assumptions that it’s Tuskegee. We don’t ask people.”

Kaiser Health News
Originally published in Kaiser Health News

When she asks Black seniors in Los Angeles about the vaccine, Tuskegee rarely comes up. People in the community talk about contemporary racism and barriers to health care, she said, while it seems to be mainly academics and officials who are preoccupied with the history of Tuskegee.

“It’s a scapegoat,” Lincoln said. “It’s an excuse. If you continue to use it as a way of explaining why many African Americans are hesitant, it almost absolves you of having to learn more, do more, involve other people — admit that racism is actually a thing today.”

It’s the health inequities of today that Maxine Toler, 72, hears about when she asks her friends and neighbors in Los Angeles what they think about the vaccine. As president of her city’s senior advocacy council and her neighborhood block club, Toler said she and most of the other Black seniors she talks with want the vaccine but are having trouble getting it. And that alone sows mistrust, she said.

https://www.npr.org/player/embed/974059870/980308707Toler said the Black people she knows who don’t want the vaccine have very modern reasons for not wanting it. They talk about religious beliefs, safety concerns or a distrust of former U.S. President Donald Trump and his contentious relationship with science. Only a handful mention Tuskegee, she said, and when they do, they’re fuzzy on the details of what happened during the 40-year study.

“If you ask them ‘What was it about?’ and ‘Why do you feel like it would impact your receiving the vaccine?’ they can’t even tell you,” she said.

Toler knows the details, but she said that history is a distraction from today’s effort to get people vaccinated against the coronavirus.

“It’s almost the opposite of Tuskegee,” she said. “Because they were being denied treatment. And this is like, we’re pushing people forward: Go and get this vaccine. We want everybody to be protected from covid.”

Questioning the Modern Uses of the Tuskegee Legacy

The “Tuskegee Study of Untreated Syphilis in the Negro Male” was a government-sponsored, taxpayer-funded study that began in 1932. Some people believe that researchers injected the men with syphilis, but that’s not true. Rather, the scientists recruited 399 Black men from Alabama who already had the disease.

Researchers told the men they had come to Tuskegee to cure “bad blood,” but never told them they had syphilis. And, the government doctors never intended to cure the men. Even when an effective treatment for syphilis — penicillin — became widely available in the 1940s, the researchers withheld it from the infected men and continued the study for decades, determined to track the disease to its endpoint: autopsy.

By the time the study was exposed and shut down in 1972, 128 of the men involved had died from syphilis or related complications, and 40 of their wives and 19 children had become infected.Given this horrific history, many scientists assumed Black people would want nothing to do with the medical establishment again, particularly clinical research. Over the next three decades, various books, articles and films repeated this assumption until it became gospel.

“That was a false assumption,” said Dr. Rueben Warren, director of the National Center for Bioethics in Research and Health Care at Tuskegee University in Alabama, and former associate director of minority health at the Centers for Disease Control and Prevention from 1988 to 1997.

A few researchers began to question this assumption at a 1994 bioethics conference, where almost all the speakers seemed to accept it as a given. The doubters asked, what kind of scientific evidence is there to support the notion that Black people would refuse to participate in research because of Tuskegee?

When those researchers did a comprehensive search of the existing literature, they found nothing.

“It was apparently a ‘fact’ known more in the gut than in the head,” wrote lead doubter Dr. Ralph Katz, an epidemiologist at the New York University College of Dentistry.

So Katz formed a research team to look for this evidence. They completed a series of studies over the next 14 years, focused mainly on surveying thousands of people across seven cities, from Baltimore to San Antonio to Tuskegee.

The conclusions were definitive: While Black people were twice as “wary” of participating in research, compared with white people, they were equally willing to participate when asked. And there was no association between knowledge of Tuskegee and willingness to participate.

“The hesitancy is there, but the refusal is not. And that’s an important difference,” said Warren, who later joined Katz in editing a book about the research. “Hesitant, yes. But not refusal.”

Tuskegee was not the deal breaker everyone thought it was.

These results did not go over well within academic and government research circles, Warren said, as they “indicted and contradicted” the common belief that low minority enrollment in research was the result of Tuskegee.

“That was the excuse that they used,” Warren said. “If I don’t want to go to the extra energy, resources to include the population, I can simply say they were not interested. They refused.”

“If you say Tuskegee, then you don’t have to acknowledge things like pharmacy deserts, things like poverty and unemployment,” —Karen Lincoln

Now researchers had to confront the shortcomings of their own recruitment methods. Many of them never invited Black people to participate in their studies in the first place. When they did, they often did not try very hard. For example, two studies of cardiovascular disease offered enrollment to more than 2,000 white people, compared with no more than 30 people from minority groups.

“We have a tendency to use Tuskegee as a scapegoat, for us, as researchers, not doing what we need to do to ensure that people are well educated about the benefits of participating in a clinical trial,” said B. Lee Green, vice president of diversity at Moffitt Cancer Center in Florida, who worked on the early research debunking the assumptions about Tuskegee’s legacy.

“There may be individuals in the community who absolutely remember Tuskegee, and we should not discount that,” he said. But hesitancy “is more related to individuals’ lived experiences, what people live each and every day.”

“It’s What Happened to Me Yesterday

Some of the same presumptions that were made about clinical research are resurfacing today around the coronavirus vaccine. A lot of hesitancy is being confused for refusal, Warren said. And so many of the entrenched structural barriers that limit access to the vaccine in Black communities are not sufficiently addressed.

Tuskegee is once again being used as a scapegoat, said Lincoln, the USC sociologist.

“If you say ‘Tuskegee,’ then you don’t have to acknowledge things like pharmacy deserts, things like poverty and unemployment,” she said. “You can just say, ‘That happened then … and there’s nothing we can do about it.’”

She said the contemporary failures of the health care system are more pressing and causing more mistrust than the events of the past.

“It’s what happened to me yesterday,” she said. “Not what happened in the ’50s or ’60s, when Tuskegee was actually active.”

The seniors she works with complain to her all the time about doctors dismissing their concerns or talking down to them, and nurses answering the hospital call buttons for their white roommates more often than for them.

As a prime example of the unequal treatment Black people receive, they point to the recent Facebook Live video of Dr. Susan Moore. When Moore, a geriatrician and family medicine physician from Indiana, got covid-19, she filmed herself from her hospital bed, an oxygen tube in her nose. She told the camera that she had to beg her physician to continue her course of remdesivir, the drug that speeds recovery from the disease.

“He said, ‘Ah, you don’t need it. You’re not even short of breath.’ I said ‘Yes, I am,’” Moore said into the camera. “I put forward and I maintain, if I was white, I wouldn’t have to go through that.”

Moore died two weeks later.

“She knew what kind of treatment she should be getting and she wasn’t getting it,” said Toler of L.A., contrasting Moore’s treatment with the care Trump received.

“We saw it up close and personal with the president, that he got the best of everything. They cured him in a couple of days, and our people are dying like flies.”

Toler and her neighbors said that the same inequity is playing out with the vaccine. Three months into the vaccine rollout, Black people made up about 3% of Californians who had received the vaccination, even though they account for 6.2% of the state’s covid deaths.

The first mass-vaccination sites set up in the Los Angeles area — at Dodger Stadium and at Disneyland — are difficult to get to from Black neighborhoods without a car. And you practically needed a computer science degree to get an early dose, as snagging an online appointment required navigating a confusing interface or constantly refreshing the portal.

White, affluent people have been snatching up appointments, even at clinics intended for hard-hit Black and Latino communities, while people of color have had trouble getting through.

It’s stories like these, of unequal treatment and barriers to care, that stoke mistrust, Lincoln said. “And the word travels fast when people have negative experiences. They share it.”

To address this mistrust will require a paradigm shift, said Warren of Tuskegee University. If you want Black people to trust doctors and trust the vaccine, don’t blame them for their distrust, he said. The obligation is on health institutions to first show they are trustworthy: to listen, take responsibility, show accountability and stop making excuses. That, he added, means providing information about the vaccine without being paternalistic and making the vaccine easy to access in Black communities.

“Prove yourself trustworthy and trust will follow,” he said.

Published in DailyNurse courtesy of KHN (Kaiser Health News), a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

Nurse of the Week Carla Brown is on a Mission to Vaccinate North Baton Rouge

Nurse of the Week Carla Brown is on a Mission to Vaccinate North Baton Rouge

Nurse of the Week, Carla Brown, RN, accompanied by a colleague clutching a clipboard to her chest, is standing outside a house in her North Baton Rouge, LA neighborhood. “You seem kind of impatient when you get to these doors to talk to these people…” a CBS reporter remarks. “Yes,” Brown replies, “Because I feel the urgency… Today I could see you, and tomorrow, you may not be here.”

Carla Brown does not have time for nonsense. These days, in addition to her work as an RN in a hospice, Brown has also donned the mantle of a community nurse. After experiencing her own tragic Covid loss, she’s managing her grief by doubling down on what nurses do best: helping people. Now, when not on duty at the hospice, Carla is on duty in her majority-Black North Baton Rouge area, pounding the pavement (nurses are also expert walkers!) and signing up neighbors for Covid-19 vaccination appointments. And when her elderly or disabled “patients” cannot reach a vaccination site, Brown swings by in her car and drives them there.

Her own loss was the nightmare of every frontline nurse. After Brown unknowingly contracted an asymptomatic case of Sars-CoV-2 at work, she came home and infected her family with the virus. The consequences were devastating. Carla’s husband, “the love of my life, David,” fell ill, as did her 90-year-old father, and 67-year-old brother. All three—husband, father, and brother—had to be hospitalized. Her spouse, David Brown, died in the hospital at age 67.

The grim statistics in the Baton Rouge vaccination efforts against Covid-19—that 64% of the white population has had at least one shot, while just 26% of the city’s Black community have had jabs—gave the bereaved Carla a new purpose: “All I can do now,” she says, “Is save somebody else.”

The vast discrepancy between white Baton Rouge and Black Baton Rouge has less to do with vaccine hesitancy than it does with our old familiar frenemy, structural racism. North Baton Rouge (NBR) has long been underserved by the local healthcare system, and the Covid vaccines have been strangely scarce in the area. Aside from a few ephemeral pop-up vaccination sites that have been hosted by Black churches, vaccines have been available at only four sites in the district.

To attack the vaccine scarcity problem, Carla employed some special artillery. Clad in her hospice uniform, the undaunted RN stepped into a popular neighborhood pharmacy—with a CBS reporter and camera crew in tow—and asked to speak with the owner. She told the proprietor that she could provide the completed registrations, insurance paperwork, and ID confirmations for NBR locals who have been won over by her urgent campaign. “We just need,” she said, “Somebody to supply us with the vaccine.”

The result? Well, it is hard to dismiss nurse Brown even when she is not accompanied by a news team from a major national broadcasting network. In fact, after agreeing to order vaccine ASAP, the pharmacist implied he had little choice: “She’s an angel!” he said of Carla. “An angel in disguise.”

A tough angel, though. As Brown told a local station in Baton Rouge, “You want to go to your grave early, or you want to live? That’s been my sales pitch.” And when walking the streets and knocking on doors doesn’t get results, “Some [neighbors] I just physically took in my car and brought.”

See the full CBS video report on Carla Brown’s story and the health inequities in North Baton Rouge. She is also featured in a recent New York Times article.

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