Massachusetts Report on Nursing - December 2020

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8 • <strong>Massachusetts</strong> <strong>Report</strong> on Nursing November 2020 Eliminating Disparities Through Social Justice, Education, and Scholarship Sasha DuBois MSN, RN, President, New England Regional Black Nurses Association, Inc. Since 1972, the New England Regional Black Nurses Association, Inc. (NERBNA) has been a part of the national effort to unify, educate and increase the number of Black Nurses in this country. A chapter of the National Black Nurses Association, NERBNA, is dedicated to investigating, defining and determining the health care needs of Black Indigenous People of Color (BIPOC) throughout New England. NERBNA is committed to implementing the necessary changes to ensure that optimum health care is available to African Americans and other underserved communities. What We Stand For NERBNA offers educational programs addressing specific clinical issues affecting minority communities, ethical practice, and leadership development. Also, as a network of professional nurses, NERBNA works to maintain a database of New England's Black Nurses consisting of education, professional experience/ expertise, employment, etc. NERBNA advocates for and provides health services to the community to reduce mortality and morbidity in diseases that have a high incidence in the minority populations i.e. violence, cardiovascular disease, asthma, infant mortality, cancer, etc. NERBNA participates in local and national initiatives on Violence Prevention, Global Health, Mentorship and Brain Health. More importantly, NERBNA provides nursing mentorship and supports nursing students throughout their nursing education. We award scholarships for individuals pursuing a nursing degree from student nurse to the doctoral level. NERBNA’s Response to COVID Through the COVID pandemic and racism epidemic in the United States, NERBNA has been busy collaborating with organizations to combat health inequities, promote nursing professionalism, and fight for social justice. We recognize that our members’ priority is at the bedside and beyond to care for patients in crisis, and as a result they have saved lives while transforming their practice. Over the summer, NERBNA collaborated with the Organization of Nurse Leaders (ONL) to create a Diversity, Equity and Inclusion Pledge. Open to all nurses, this pledge was made in response for nurses to take a personal charge to contribute to social justice. This represents the first steps that any nurse can take to increase inclusivity, decrease disparities, and promote equity for nursing, patients, and their surrounding communities. The Diversity, Equity and Inclusion Pledge continues to gain support. To date, over 800 nurses from 46 states have taken the pledge. Recently, students of the MSN-CNL Nursing program at Augusta University in Georgia plan to incorporate the pledge into their White Coat and Graduation Ceremonies. In addition, NERBNA is in the 2020 cohort of the NBNA collaboration with the NIH All of Us Research program. Finally, NERBNA has collaborated with National Association of Hispanic Nurses Western <strong>Massachusetts</strong>, National Association of Hispanic Nurses <strong>Massachusetts</strong> (Boston), National Association of Hispanic Nurses Hartford, Northern Connecticut Black Nurses Association, Southern Connecticut Black Nurses Association, Western <strong>Massachusetts</strong> Black Nurses Association, and the Cape Verdean Nurses Association as conference partners for the past four years. These partners comprise the New England Minority Nurse Leadership Collaborative (NEMNLC). In collaboration we have received a $10,000 award from the Network of the National Network of Libraries of Medicine, New England Region (NNLM NER) to implement “The New England Minority Nursing Collaborative: Promoting Access to Health Information” project. Where You Belong Becoming a member of NERBNA is not just another organization in which to become a member. It is where you will understand your identity as well as grow professionally. Always inclusive, NERBNA is committed to building community and promoting nursing scholarship. We hold monthly meetings and also provide quarterly CE sessions. As a member, you gain access to online NBNA News, the national association's quarterly newsletter as well as a subscription to the Journal of the National Black Nurses Association, a bi-annual published professional refereed journal. Regarding nursing scholarship, you receive direct electronic mailing on nursing and health care issues and position papers on important issues impacting the health care of Black consumers. As a NERBNA member, you will see that collaborations are important for inclusivity and professionalism, and you will experience association partnerships with national organizations. If policy is a passion, we provide a unified voice for the profession of nursing to address public policy issues in Washington. Your network will grow as this is a network of Black nurses from around the country, the Caribbean, Canada and West Africa. If you are a member looking to expand your professionalism, you will have leadership opportunities through committees and task forces, speaking engagements at national and local conferences, and appointments to serve on external advisory committees. As a chapter of the National Black Nurses Association (NBNA), becoming a member of NERBNA automatically grants you membership to NBNA. Below are some of our upcoming events as well as our signature events: • NERBNA Chapter meetings are every third Tuesday 5:30-7:30 September to June (currently via zoom due to COVID) • New England Minority Leadership Conference: December 5, 2020 • National Black Nurses Association Day on Capital Hill: February 4, 2021 • NERBNA 34th Excellence in Nursing awards Ceremony: February 26, 2021 • NERBNA 49th Annual Spring Conference April 23, 2021 • NERBNA May chapter meeting and CE session annually hosted by Boston Children’s Hospital: May 18, 2021 <strong>Massachusetts</strong> <strong>Report</strong> on Nursing Updates Gail B Gall, PhD, RN, Co-Editor Just as most nursing teams approach problem-solving based on the good old “Plan, Do, Study, Act (PDSA)” approach, editors and staff are working on improving the newsletter. We’re striving to identify barriers to creating the best quarterly report for <strong>Massachusetts</strong> nurses. We’ve turned to ANAMASS staff and leaders as well as the abundant resources at Arthur L. Davis Publishing. We’re also gathering information from other state nursing publications. Our goal is to have useful guidelines in place for the next edition. Writing, like nursing is both an art and a science. The art lies in choosing the topic, words, and phrases, drawing word pictures and conveying the message honestly. The science is another matter altogether. We’ve tapped resources and consulted with experts in copyright protection and manuscript guidelines. We’re tracking how frequently the electronic version is viewed and what is actually read. We appreciate offerings of nurses in practice, research, and education and strive to represent diversity in perspectives and demographics of our contributing authors. We urge you to share your talents, stories, reflections, and visions for improving the newsletter. • Remember, the deadline for the next edition is JANUARY 1, 2021. • Send suggestions or comments to newsletter@ anamass.org • Enter: editorial suggestions in the subject line. WE ARE LAYING THE FOUNDATION OF TOMORROW Join Lawrence General Hospital, the best in the Merrimack Valley! We provide a strong professional practice environment for nurses who value compassionate care and each other. We are seeking experienced nurses who thrive in a teamwork-based environment where a positive practice culture is available without the Boston commute. Lawrence General currently offers the most competitive rates in the area including a $10/hour differential for night shift RN positions. You will enjoy our accessible location and free parking! Visit www.lawrencegeneral.org/careers to view openings.
November 2020 <strong>Massachusetts</strong> <strong>Report</strong> on Nursing • 9 Fostering Gender-Affirming Care – An Interview with Dallas Ducar Pamela Coombs Delis Pamela Coombs Delis, PhD, RN, CNE MGH Institute of Health Professions she/her/hers Dallas M. Ducar MSN, RN, PMHNP-BC, CNL CEO, Transhealth Northampton she/her/hers Introduction Dallas Ducar is a nurse practitioner who is dedicating her career to serving the needs of the gender diverse community. Her goal is to dismantle oppressive healthcare systems and to empower every individual to control their healthcare journey, making the path a joyous and open-hearted one. Dallas is working with a diverse group of clinicians and non-profit leaders to build a new non-profit transgender healthcare program in western <strong>Massachusetts</strong>. The program will be deeply rooted in community-based participatory action and is informed by a robust community study. I sat down with Dallas Ducar to speak more about barriers facing gender-diverse individuals and how to best provide care. What are some risks that gender-diverse people face across <strong>Massachusetts</strong>? <strong>Massachusetts</strong> has a diverse, vibrant, and disproportionately young self-identified LGBTQ+ population. Despite a strong Gail B. Gall, PhD, RN One of our new ANA MASS members, Heiu Tieu, began her health care career as a human resource (HR) coordinator at Boston Medical Center then moved to Beth Israel Deaconess Medical Center (BIDMC) as an organizational development coordinator and then as program administrator for faculty development. These roles brought her close to nursing leadership and she became interested in quality Dallas M. Ducar improvement. Hieu earned an MBA in health care and subsequently decided to become a family nurse practitioner via the MGH Institute of Health Professions direct entry program (DEN). She returned to Beth Israel in early 2017 to become a member of the Cardiac community, gender diverse folks (transgender and nonbinary people) face higher rates of discrimination and greater risk of depression, suicide, and homelessness (The Boston Foundation, 2020). In 2015, the National Center for Transgender Equality (NCTE) examined the experiences of persons identifying as transgender (N=27,715), including those residing in <strong>Massachusetts</strong> (n = 1,195). Despite Federal and State anti-discrimination laws, they reported discrimination, harassment, and/ or assault in schools, employment, housing, shelter access, restrooms, and other public places, and by law enforcement. How can we get better at providing healthcare to gender diverse patients? A strong need exists for sensitive and knowledgeable healthcare addressing the specific needs of the transgender community. The NCTE survey (2015) uncovered a concerning view of healthcare. Of <strong>Massachusetts</strong> respondents: 28% experienced denial of insurance coverage for routine care or transition-related care, 31% of those who saw a health care provider (HCP) in the previous year had a negative experience due to being transgender, and 20% feared mistreatment, and therefore did not seek care. What are some of the barriers that gender-diverse patients face when achieving care? Two problems gender diverse people have with accessing appropriate healthcare are locating knowledgeable HCPs and paying for services. Additionally, those living outside of major urban areas such as Boston have greater difficulty in accessing care appropriate to the needs of the transgender community (<strong>Massachusetts</strong> Transgender Political Coalition, 2020). Patients desire gender-affirming healthcare, a term often used in the community but not always defined. Gender-affirming care is a form of care which enables one to live their authentic gender, this can include, but is not limited to, medical care. What struggles do patients in rural settings face, in particular? Many patients in rural settings are without care or travel exceptionally long distances to receive care. A Welcome new member Hieu Tieu, MBA, MSN, FNP-BC: Influencing and improving patient care Heiu Tieu Physiology team where her focus is not only on direct patient care but also improving patients’ experiences in both inpatient and outpatient care as well as transitions between these. Hieu believes that nurses are particularly aware of the importance of care continuity in assuring optimal outcomes. By focusing on building trust within the team, Hieu, along with her NP and nursing colleagues are collaborating with physician leaders to create more seamless processes in patient triage and clinical workflow. Currently BIDMC has returned to 90% capacity and her regular clinics are fully booked. She is focusing on developing metrics to measure quality improvement processes and mentoring young NPs. Heiu joined ANAMASS for several reasons. Her HR background led her to seek out a professional organization that would provide benefits and opportunities focusing on practice and advocacy. As a board-certified nurse practitioner, access to the ANCC recertification process and professional development programs also influenced her choice. ANAMASS welcomes her membership and anticipates her success as she pursues these worthy goals. need exists for culturally humble, trauma-informed care, including available interpreters, transportation, and telehealth services. Importantly, this involves wrap-around services - one center where all genderaffirming care (primary care, mental healthcare, specialty services, holistic services, training and support groups) is housed. Gender-affirming spaces must make room for the community, include inclusive signage, implement programming based on community feedback, and include advisory boards that provide input on program design, form changes, and policy. What is one of the most important facets of genderaffirming care? Patient outcomes rely on trust, without which morbidity and mortality increase. Appropriate care is affirming care (Reisner, White, Dunham, et al. 2014). One-fifth of NCTE survey respondents postponed or went without healthcare because of past perceived discrimination, while 28% of respondents did not seek care in the past year, and 29% had to teach their HCP about transgender health issues. To eliminate barriers between the patient and the HCP, systems must hire gender-diverse HCPs, especially those from within the transgender/gender diverse community, to bring about awareness of needs and to facilitate a culture of trust. HCPs must reduce conscious and unconscious bias and reduce rates of perceived discrimination. All patients, regardless of identity, deserve a safe, secure space to ensure that preventative, urgent and/or emergent care are not delayed. Nursing Objectives for Transgender Care (P. C. Delis & D. M. Ducar, 2020) Nursing objectives for transgender care include the following: 1. Be aware of the vulnerability the patient may feel in accessing healthcare. 2. Ask the patient what their preferred name and pronouns are and consistently use them. 3. Familiarize yourself with any definitions and terms that you do not understand prior to the clinical encounter. 4. Understand that affirmation involves three steps: a. Listening b. Responding with compassion c. Paying attention 5. Remember that HCPs do not decide whether a patient feels safe, the patient does. 6. Be aware that identity does not always match definitions so always ask, never assume. 7. Examine and acknowledge personal bias. 8. Affirm the shared humanity of all patients.
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