The events of 2020 highlighted the inequities in health and the injustices faced by Black and Indigenous People of Color (BIPOC) in Minnesota. Many across the state have been awakened to the realities of racism and injustice. On a national level, we witnessed the devastation of COVID-19 and its disproportionate effects on Black and African-American communities.
On a local level, we witnessed the public murder of George Floyd in our city of Minneapolis. At the University of Minnesota School of Nursing, our faculty, students, and staff engaged and reflected with open eyes, ears and hearts the subsequent call to action. There is an unjust dual system that has been carefully woven into the very fabric of our society, including academia and yes, nursing. We acknowledge that white privilege and white supremacy has been institutionalized in academic settings. White supremacy is an insidious, toxic, and expansive system that must be renounced, including within our own schools of nursing.
Many schools of nursing in the United States have renewed their commitment to the courageous work of dismantling systemic racism in their schools and curriculum. The University of Minnesota School of Nursing is, likewise on a courageous transformational journey toward becoming more inclusive, equitable and diverse. As a place dedicated to educating nurses and transforming the healthcare system, our school has committed to unapologetic and unequivocal advocacy to address injustice and create sustainable change.
We, as the School’s Inclusivity, Diversity and Equity Director and Co-Director, recognized that leading a school toward anti-racism requires a combination of reflection, commitment and action. Paulo Frieree, Brazilian educator and philosopher, best known for his text Pedagogy of the Oppressed, said “Reflection and action must never be undertaken independently”. Reactive changes rarely provide the depth of understanding necessary to deal with deep issues of racism in healthcare, nor are they sustainable. We started by analyzing our school’s policies for student recruitment and admission,our systems of faculty hiring and promotion, and our fundraising and communication strategies.
U of M School of Nursing students practicing clinical skills in the Bentson Healthy Communities Innovation Center.
In our experience, faculty needed time to reflect, learn about historical and systematic inequities, and the space to unpack the complex baggage of white supremacy and privilege that persists in our nation. As a school community, we created opportunities for safe and honest sharing and learning through listening sessions and discussion groups. Faculty were provided with resources to unlearn unconscious bias and deepen understanding about institutional racism in healthcare. Similar opportunities were offered to students across programs, from classroom learning, deep day activities, to monthly affinity group forums. Reflection is necessary, yet reflection without action is essentially the same as inaction. Without action, reflection can become a passive, self-absorbed pastime and is not helpful in creating substantial and sustained systemic change. Reflective and intentional planning, coupled with committed action is needed to bring about the changes in nursing education and dismantle places in our school where inequities persist. We are empowering faculty to recognize and interrupt microaggressions in the classroom. We are providing them with resources to make curriculum changes so social justice and antiracism content can be purposefully woven throughout nursing education.
The courageous and transformational journey is not a sprint, rather it’s a marathon that requires long-term commitment. At the center of this change is community because the commitment is ours to share. There is room for each person in the school community to work for equity and inclusion – from book clubs to policy writing; from recruitment and support of students to search, selection, and faculty development; from teaching antiracism curriculum to highlighting antiracism research. Reflection, coupled with commitment and action will lead to transformational change in nursing education and healthcare systems.
In a year in which so many nurses displayed bravery, suffered hardships, and shone in countless ways, DailyNurse might easily have featured a “Nurse of the Day” instead of a Nurse of the Week.
Nurses have always gone the extra mile to communicate with patients and make them feel more comfortable and cared for, and we all know former patients who were so inspired by their nurses that they decided to enter the profession themselves. As 2020 raised the curtain on the Year of the Nurse, though, no one could have anticipated it would be a watershed year in which nurses became global icons of hope and courage.
Whether You’re a Hero, or Merely Awesome, Take a Bow…
Boston HCWs celebrate arrival of Covid-19 vaccine in December.
The public has long admired nurses, but this year, the world has watched nurses brave the pandemic to work in seemingly impossible conditions, act as stand-ins for patients’ absent families, and leave home to speed to the relief of overwhelmed hospitals all over the US.
Nonetheless, many of our 2020 Nurses of the Week (NotW) eschewed the word “hero.” If you glance at remarks from our 2020 Nurses of the Week, you might note that while they take pride in their work, few sound like they are ready to accessorize their mask with a Superman cape. Naturally, they are happy to see their work recognized, but nurses constantly go out of their way to make patients feel less frightened and alone. As frontliner Tabatha Kentner said, “This is what we do. This is why we’re here.” Nurses save lives—and when they cannot, they comfort patients in their final hours and console distraught families. It’s not an occasional phenomenon; it is an everyday occurrence. The name and photo in Wednesday’s NotW feature could easily be your own because your expertise and empathy make you a Nurse of the Week every day of the year.
On the last Wednesday of 2020, DailyNurse salutes the Nurses of the Week who made their mark during the Year of the Nurse!
Great (and Caring) Communicators
RN Emily Fawcett, Lenox Hill Hospital, NYC.
A recurring theme is nurses who use their unique talents to raise patients’ and staff members’ spirits. Some, like Marc Perreault and Lori Marie Kay, shared their musical gifts. At Lenox Hill Hospital during the height of the New York City outbreak, Emily Fawcett helped boost morale in her ICU by meeting with staff for positive-thinking “hope huddles” before starting their shifts.
Danielle Fenn applied her language skills to comfort non-English speaking Covid patients. Others, like Tabatha Kentner, have been acting as “angels” (the word angel comes from the Greek angelos, which means “messenger”) and facilitating virtual visits so patients and their loved ones can commune even in isolation (and when necessary, say their final goodbyes).
Advocates and Public Servants
RN Andrea Dalzell on Good Morning America.
2020 was a year in which nurses stepped forward, spoke up, and got involved in public and civic health. Expect to see more of this in 2021 and years to come (we hope!). Metastatic breast cancer survivor Stephanie Walker is tirelessly advocating for cancer patients and patient education in North Carolina. Another indefatigable advocate, Andrea Dalzell, is on a mission to invite wheelchair-bound people to enter the nursing profession.
NYPD’s new Special Victims Unit head Michael King is a veteran SANE—and he is determined to improve the treatment of rape victims by police and other first responders. American Academy of Nursing (AAN) “Living Legend” Mary Wakefield is sharing her public health expertise and experience in the Obama administration with the Biden-Harris transition team.
Another AAN “Living Legend,” 85-year-old Marie Manthey, is promoting frank, open dialogues between Black and White nurses, and calling upon all White allies to combat structural racism and unconscious bias.
Frontline Troopers
Anna Slayton, BSN, RN-BC
Tens of thousands of nurses this year packed their bags and took off to lend a hand in the nation’s hotspots. Reports on horrific conditions in hard-hit city hospitals were a virtual Bat-Signal for many nurses. They stashed extra masks in their suitcases, said goodbye to their loved ones, and flew to the most dangerous hotspots in the country (even nurses who had never been on a plane before!).
Texas nurse Anna Slayton, who parted from her family to spend 77 days on the New York frontlines, felt compelled to help, telling DailyNurse, “I ultimately knew it was my duty.” And in April, after flying from Tennessee to a desolate—but noisily grateful—NYC, ED nurse Kirsten Flanery declared, “I made the right decision on coming up here. I’m ready to make a difference!”
Difficult Takes a Day, Impossible Takes a Week
LPN Felicia Shaner and daughters.
Many nurses combine massive multitasking efforts with hard work to pursue their studies, and some fight to overcome dire health and financial obstacles in their quest to start a nursing career. Felicia Shaner was so drawn to the profession that she embarked on her nursing studies while living in a homeless shelter… with a toddler and a baby on board! degrees while working as hospital custodians. Rebel NurseJalil Johnson (of Show me Your Stethoscope fame) had spent his last $5 when he enrolled in an LPN program. And Brianna Fogelman had a lung transplant in her junior year of nursing school and took her nursing finals with a tube in her chest.
Is There a Nurse in the House?
Former CCN/Cardiac Care nurse Hollyanne Milley and spouse.
2020 was also a year in which nurses acted as first responders in unexpected times and places. Pamela Zeinoun saved the lives of three premature infants after the devastating August 4 explosions in Beirut. Indiana trauma nurse Colby Snyder rushed to the assistance of two people who collapsed in public within a 3-week period: the first had a seizure at her grocery store, and the second fell while Snyder was volunteering at the polls on Election Day.
Former CCN/cardiac care nurse Hollyanne Miley (whose husband is Joint Chiefs of Staff Chairman Mark Milley) is also a good person to have at hand when out-of-the-blue seizures occur. And VA nurse Maria VanHart impressed “official” first responders by her swift, efficient, and empathic treatment of survivors at the scene of a fatal highway accident.
DailyNurse salutes all of its readers, and all nurses. If you know of someone who warrants a Nurse of the Week nod, send your suggestion to [email protected]. Best wishes for a happier, healthier, evidence-based New Year!
American nurses are becoming iconic images of hope as they receive the first SARS-CoV-2 vaccinations approved for emergency use. A gathering of reporters, officials, and healthcare providers applauded when they witnessed the first vaccination in Oklahoma, as Erica Arrocha, RN administered the state’s first Covid-19 vaccination to a colleague, RN Hanna White, at Integris Baptist Medical Center. White told reporters, “Hopefully this is the start of something better.”
ICU nurse and NP Helen Cordova was the first Californian to get a Covid shot.
New York ICU nurse Sandra Lindsay, the first US healthcare worker to receive a shot, told journalists, “I trust the science,” as her vaccination was recorded and livestreamed to millions of viewers.
The first in line for vaccination in Minnesota was Minneapolis frontline VA nurse Thera Witte, who declared, “I’m feeling hopeful that this is the beginning of the end” of the deadly pandemic that has so far taken over 377,000 lives in the US and 1.65 million lives worldwide.
Why I love my job @The_BMC ! Teams of people working to safely and equitably distribute vaccines to their front line colleagues getting cheered on by their friends celebrating the arrival of the vaccines! A great day, a great place. ❤️ pic.twitter.com/XfrIthFIY5
There were even impromptu parties. When the first shipment of the Pfizer BioNTech vaccine arrived in Boston, there was dancing in the streets (or the hospital parking lot)—on a chilly Massachusetts day in December-—that immediately went viral.
The first Californian to be vaccinated had initially been dubious. ICU nurse and NP Helen Cordova at Kaiser Permanente Los Angeles Medical Center changed her mind, but she still understands the mistrust. Her training, though, prompted her to research the science behind the new vaccines: “That’s probably the best thing to do, educate ourselves, get the information ourselves,” she told ABC7 in LA. “As I started to dig in a little more, I felt more at ease. I started changing my stance on it. I went from ‘absolutely not’ to ‘sure, here’s my arm, let’s do it!’”
“It’s important not just for me, but for all of those that I love.” In New Jersey, the first to roll up her sleeve was Maritza Beniquez, an emergency department nurse at University Hospital in Newark. As state governor Phil Murphy looked on with journalists and healthcare workers, Beniquez was exuberant after receiving the state’s first SARS-2 shot on her birthday: “I couldn’t wait for this moment to hit New Jersey. I couldn’t wait for it to hit the U.S!”
And as humans cannot resist an opportunity to thrill one another with foreboding rumors of sinister events, false social media posts started to appear almost as soon as states began to vaccinate healthcare workers. So, if patients, friends, or family cite the nonexistent “42-y/o nurse in Alabama found dead 8-10 hours” later from anaphylactic shock, well, what did you expect? Share a real social media event like the Boston MC flash mob, and tell them you’re keeping your mask on even after your second vaccination, as epidemiologists say we will probably have to wait until mid-late 2021 to gauge the efficacy of the vaccines.
Boston Medical Center workers went all out to celebrate the arrival of the vaccine.
Nurse of the Week Marie Manthey is a very busy 85-year-old nurse, entrepreneur, advocate, and activist in the anti-racism movement. After the American Academy of Nursing presented her with a Living Legends award in 2015 for her pioneering work in developing the Primary Nursing model, she did not retire to rest on her laurels. Manthey continues to host her Nursing Salons (regular gatherings in which nurses meet to share conversations and support), works with the company she founded and is still an active advocate for nurses suffering from substance use disorder.
Marie Manthey, at a U Minnesota celebration of the Marie Manthey Professorship.
Manthey is also a leader among nurses in the anti-racism movement. After the summer wave of anti-racism protests, she met with DailyNurse to talk about what it means to take action against racism, her journey as a White ally, and her latest Creative Nursing article, which takes a look at trailblazing Black nurse Frances McHie (pronounced “mic-hye”) and the struggle to overcome racism at the University of Minnesota School of Nursing.
DailyNurse: How did you first hear about Frances McHie?
Marie Manthey: “The school of nursing at University of Minnesota has long had a group of very strong volunteers who have a very extensive collection and data [on the history of the nursing school]. So this group of alumni volunteers—who care passionately and energetically about the history of the school of nursing—are responsible for managing historical documents.
And in that documentation area, we found that our first African-American student, Frances McHie, had only been admitted by demand of the legislature. (We recently celebrated the centennial of her admission, which was attended by some of her descendants).”
DN: How did you become involved in the anti-racism movement?
MM: “My awareness began when, 4 or 5 years ago, the Dean of the University of Minnesota School of Nursing, Connie Delaney—who is a phenomenally transformative leader—brought in a speaker to talk about white privilege. That was the first time I had heard that term. She also brought in a university-wide task force on diversity and equity, and I attended some of their open discussions about what is happening to African-American students in our school today.
The next step for me, was I became friends with an African-American person. Her name is Tammy, and she’s a nurse in an administrative position at a local hospital. Well, we met at a statewide leadership meeting, where we made a commitment to develop our relationship and became friends. Tammy started to come to the nursing “salons” I had formed earlier—where we would have dinner, and talk, where the question would be asked, “what’s on your mind about nursing?” and at the end of the evening we would go around and respond to the question “what’s on your mind about nursing now?” After Tammy joined us, we often found ourselves discussing issues affecting nurses of color, and Tammy went on to open a Black nursing salon. We held the first one at my house, and mine was the only white face there. That was part of my leap to a different level of understanding because I listened to what these nurses were talking about. And as I’m listening to them, I’m hearing about what systemic racism really looks like! I had not understood it before; I thought it was about the way we individually deal with racism.
[At the Black Nurses’ Salon] I began to understand what the system has done. It was a big breakthrough. I could finally see where I was in the system as a nursing leader. I could see where some of the decisions I made that involved a person of color versus a White person going for a promotion or better hours, and my decision would sometimes be ‘well, it would work out better if we give this to a White person; she’ll get along better.’ And I didn’t see that until I heard these nurses talk about what it’s like to apply for better hours or something, and despite equal education, equal experience, the white nurse will get it. Also, until now, I didn’t really understand White privilege. Now—at the age of 85—I finally get how being born white has affected everything from my thought processes to my life experiences. It’s very clear to me that action is the only solution.
Tammy and I are going to start another Salon on diversity in nursing with an equal number of nurses of color and nurses who are white. To get us talking to each other.”
DN: It’s complicated. On one hand, it’s not the job of Black people to tell Whites, “this is what you need to do to stop being racist,” but at the same time, we can only learn by communicating in an open, willing dialogue.
MM: “I had to learn how to listen without judgment. At the Black Nurses Salon, I went in ready to just accept what everyone was saying without deciding whether I agreed with everything that was being said.”
DN: One of the biggest obstacles we face is that we are living in an age of “I’m not a racist” racism.
MM: “That’s very true. I discuss that in some detail in a piece I wrote on my journey toward becoming an anti-racist. I went from proudly saying, “I’m not racist!” to actually taking on responsibility for taking steps to dismantle systemic racism and acknowledging that my people with my skin color have been building this system for 400 years At the salons, I began to accept responsibility for what happened. I didn’t ask for it or personally cause it to happen, but it was part of my culture. People of color certainly didn’t ask for it either…..and both of us have experienced the impact of systemic racism.
After taking responsibility, I began to understand that the only solution—I’m a big follower of Nelson Mandela and the idea of reconciliation; it’s a big part of my value system—is reparations. I don’t necessarily mean financial, but the way I am in my world, how I present myself, how accept what other people are saying to me.”
DN: That brings us to the Frances McHie nursing school scholarship, which is a form of reparation, right?
Frances McHie Rains (1911-2006)
MM: “Yes. When the idea of a scholarship in Frances McHie’s name came up, we found a relative of hers who was a nephew and began putting some flesh on the idea. And with his help, we established the Frances McHie Scholarship for nurses of color [at the University of Minnesota School of Nursing]. That was an action step following a public apology to the McHie family. Dean Connie Delaney made a public statement reflecting that the Frances McHie scholarship was a step in reparations and in accepting the school’s responsibility for racism.”
DN: What other actions are nursing schools taking to reduce the effects of systemic racism?
MM: “Some are changing admissions criteria from a hard GPA requirement, and are taking a person’s story into account as well. I think that’s a good idea. There’s no doubt that people of color don’t have equal opportunities. I have a book that was published in 1933, [Carter G. Woodson’s] The Mis-Education of the Negro. It tells the story of how Jim Crow schools started. It says they were teaching them at a lower level, and that’s been carried on through the years.”
DN: What sorts of things can individuals do to fight racism, on an immediate level?
MM: “We can look at big-picture issues—who we elect as our representatives, our senators, etcetera, but we also have to work on a personal level. We need to make deliberate, conscious, intentional choices about the way we live our lives. What is my circle of responsibility and control, and how do I want to be in those areas? I have to look at the way I interact with my children, my friends, my family, my associates, and ask “what are the things that I can influence?” For me writing—for instance, the article [on Frances McHie] and my personal story about my journey—can help me to influence others to work toward change. I just feel that that is what I need to be doing at this point in my life. This is a personal choice we make: are we going to continue to be the way we’ve been, or are we prepared to step into an area where we can’t predict what people’s reactions will be?”
DN: Are more people sincerely examining their own views and trying to move forward?
MM: “I feel very hopeful because so many people are having these conversations. I have these conversations with a lot of my friends. A lot of [other White people] are talking to me about racism. And my company is creating a task force; we are engaged in looking at everything we do.
I’m also the chairman of the board of Directors of the Nurses Peer Support Network, which helps nurses who have been struggling with addiction and are trying to regain their licenses. I’ve been asking people, “can you help me find African-Americans or other people of color for our board?” We recently added our first Black board member, and we have two more we are considering for our [organization. And I think that I’m not the only person who is doing this. Best Buy is looking for enough people of color and women to make up 30% of their new hires. A number of companies are taking action, and I think that’s a hopeful sign.”
Marie Manthey is the author of the award-winning book, The Practice of Primary Nursing, and is a co-founder of the journal Creative Nursing. Manthey’s recent article on Frances McHie—the nurse, activist, and entrepreneur who broke the color barrier at the University of Minnesota School of Nursing—is available here.
In 1995, when they first arrived at Vista View Elementary School in Burnsville, Minnesota, RN Barbara Wardell and CNA Donita Luth knew they would spend much of their time administering medications, treating minor injuries, and coping with childhood illnesses. However, before long they also learned that nursing grade-schoolers can be a lousy experience. “Lice happens,” says Wardell. “Anybody can get it. It does not determine if you are clean or dirty or rich or poor or anything. You get it.” At first, the school principal “had to show us what head lice looked like because neither one of us had ever seen head lice,” but after 25 years, they have become grizzled veterans in the ongoing war. “Now we have a little collection on a piece of paper in the office.”
When the new school year opens, though, Luth will have to curate the lice collection with a new partner. The 65-year-old Wardell is retiring to work full-time at the apple orchard, winery and cidery she runs with her husband. Her departure will mark the end of a generation of nursing teamwork. The RN and CNA formed a tight bond as they worked to sustain a high standard of care for their young charges. After their first year, they exchanged a “pinky swear” to stay on as a team. Wardell recalls, “We just really liked working together. If I was not in the building, I knew it was in excellent hands because I fully trust Donita to be able to do stuff or to call me if she had a question.”
As school nurses, the two knew they had to depend on each other. Wardell observes, “You have no respiratory team, you have no extra nursing staff — it’s all you, your office, your call. A kid comes in in distress, what are you going to do about it?” She adds, “If we needed to take time off, we’d cover for each other. If we had concerns, we supported each other. We became bonded — it just happened.”
Luth will miss her departing colleague, and reflects, “It’s been a good combination. We’ve made a good team.”
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.
