What Can Nurses Do to Influence Health in Their Communities?

What can I do as just one nurse?

As a nurse, I have often heard my colleagues question their ability to influence health in their communities. At times I have felt this same sentiment. What can I do as just one nurse?

Nurses have a unique perspective of how a community’s physical, social, and economic environment can affect patients’ health. And as we expand our understanding of what creates health, nurses have the opportunity to be a powerful voice when it comes to influencing the health of their communities.

Nightingale as precedent.

Nightingale in Scutari ward during Crimean War/Library of Congress

Nurses working to improve health through environmental modification is not new. The story of Florence Nightingale is well-known. As a nurse, Nightingale recognized changes needed to improve the health of soldiers in a hospital during the Crimean War, when more of the hospitalized soldiers were dying from the spread of infectious disease than from war-related injuries. Through her work with a group of nurses, she was […]

2018-11-09T08:50:06-05:00November 9th, 2018|Nursing, nursing roles, Public health|3 Comments
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Babies at the Border: Reflections on Nursing on Ellis Island

Immigrants at Ellis Island. Library of Congress.

For the past few years, the nation’s attention has been repeatedly drawn to “the immigration problem” on the southern borders of the United States. This past summer, images of babies screaming for their mothers as families were separated, and photos of teens and young children peering through chain-link fences—with foil blankets crumpled in the background—tugged at heartstrings. With recent fear-mongering about a caravan of refugees making their way through Mexico toward the United States, the issue is once again taking center stage.

A nation of immigrants.

With each image, my thoughts turn to our nation’s long history of regulating immigration. After all, we are a nation of immigrants. Many of our ancestors sought religious freedom, freedom from persecution, or economic opportunity in America. That history is replete with conflicting policies: from the exclusion of Chinese, prejudice against those of Irish and Italian descent, and the deportation of those who were seen as “unfit” physically or mentally to enter the country, to decrees from the president that all immigrants be treated with respect.

A history of working with immigrants ‘in a middle place.’

For over a century, nurses have worked with immigrants in “a middle place”—balancing the needs of newly arrived families with their […]

2018-11-02T10:17:29-04:00November 2nd, 2018|Nursing, nursing history, Public health|0 Comments
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ACA Opens Enrollment for 2019: What Patients Need to Know

Open enrollment in the Affordable Care Act (ACA) marketplace opened today, despite shortened deadlines, repeal of the individual mandate, stopping cost-sharing payments, and reduced outreach and marketing for the law. And with all the noise from political talking points adding to an already complicated process, your patients might be in need of a primer on what to do this year. Here are the basics:

Where to enroll

Some states have their own exchange, and some use the federal government’s. Patients can access www.healthcare.gov, www.cuidadodesalud.gov, find their state’s page here, or call (800) 318-2596 for more info.

When to enroll

Enrollment begins November 1 (except for in California, where it began in October). However, deadlines differ in some states. The deadline for most states this year is December 15. A handful (New York, California, Massachusetts, Minnesota, Colorado) have deadlines in January. Those who wait until January to enroll should be aware that their coverage will not start until February.

What about the individual mandate?

Included in the Republican-backed tax plan signed into law last year was a repeal of the individual mandate penalty for individuals who choose not to get insurance. For the coming year, this repeal will be in effect in almost all states (Massachusetts, New Jersey, and the District of Columbia will […]

2018-11-01T13:45:23-04:00November 1st, 2018|Patients, Public health|0 Comments
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Nurses Concerned About Removal of Key Children’s Health Advocate at EPA

At the end of September, the Environmental Protection Agency (EPA), with no explanation, placed the director of the Office of Children’s Health Protection (OCHP), Dr. Ruth Etzel, on administrative leave. This sidelining of a vocal children’s health advocate as the office was heading into October, Children’s Environmental Health Month, was concerning for all who work in children’s environmental health.

The OCHP’s essential role.

The OCHP was created under an executive order in 1997 as public consciousness was increasing about the special vulnerabilities of children to environmental hazards. It is housed in the Office of the Administrator so as to be able to provide guidance to EPA leadership and ensure that children’s health protection is prioritized throughout the agency’s activities. This is essential because, as many have observed, children are not simply miniature adults—what they eat, drink, and breathe can profoundly affect their physical and mental development, while their hand-to-mouth and on-the-floor activities put them at greater risk for exposures from environmental hazards.

The office provides essential resources for health professionals and the public on environmental health issues such as environmental triggers of asthma and how parents can reduce exposures, reducing exposures to lead, and air quality in schools. The OCHP-produced report, America’s Children […]

2018-10-31T11:54:23-04:00October 31st, 2018|environmental health, health care policy, nursing perspective, Public health|0 Comments
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Quality of Life? Whatever the Patient Believes It Is

Illustration by Eric Collins / ecol-art.com

“What kind of life is that? That’s not how I would want to live.”

In AJN‘s September Reflections essay, “His Wonderful Life,” nurse Elizabeth Buckley interrogates her own judgmental response to a patient with a bluff, abrasive personality (he calls her ‘Nurse Ratchet during their first encounter) who requires nearly nonstop care to stay alive.

The patient has little hope of a meaningful recovery even if he survives the current hospitalization. The reader is surprised when, after a first grueling night of touch-and-go care, the author decides to take him on as her primary patient because she thinks it might be “a good learning opportunity.” (“I texted my friend who worked the day shift to sign me up; she replied that I was crazy.”)

A good life is in the eye of the beholder.

‘Philip,’ obese and with progressive dyspnea and multiple comorbidities, is sure he’ll soon be able to return to his bedbound existence at home watching old movies and chatting on Facebook; the physicians and other nurses are less hopeful. Gradually, over the course of five nights, the author’s respect and affection for the patient grows. He loves his life, however narrow it may seem to an outside observer.

2018-09-19T08:49:44-04:00September 19th, 2018|Nursing, patient experience, Patients, personal health practices|1 Comment
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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