Dr. Ben Danielson: Standing Up to Institutional Racism

Dr. Ben Danielson, photo by Josephine Ensign, 2015

The new year brought hope for a better year ahead. Also, it brought sorrow and anger in Seattle at the news that a beloved physician and community advocate, Dr. Ben Danielson, recently resigned as medical director of the Odessa Brown Children’s Clinic. Odessa Brown Children’s Clinic is a pediatric clinic run by Seattle Children’s Hospital. It began in the late 1960s in the traditionally Black Seattle neighborhood (because of redlining/racial restrictive covenants) of the Central District. It began from a combination of the Model Cities Program and community calls for improved healthcare access and quality for marginalized urban communities, including communities of color. Seattle Children’s Hospital was—and still is—located in the upscale, mostly gated and white neighborhood of Laurelhurst. Then, as now, there were accusations that the powers that be at Seattle Children’s Hospital were racist, that children and families of color were subjected to racist treatment–as were nurses, physicians, and other healthcare staff members of color. (Also, Seattle Children’s Hospital has been accused of not supporting LGBTQ staff and patients; see my posts on the suicide of nurse Kim Hyatt who was openly gay and who was treated poorly by administrative staff. This showed up clearly in the redacted hospital personnel files I reviewed and in conversations with her friends and co-workers who contacted me.)

According to the independent newspaper, Crosscut, which broke the news of Dr. Danielson’s resignation after twenty years as medical director, “Danielson felt marginalized and alone as the rare Black voice in a position of authority…He said Seattle Children’s would gladly place Odessa Brown, which serves mostly low-income and people of color, on a pedestal to raise money, but would not show that same level of interest when it came to daily care”

I worked alongside Dr. Danielson in the early 2000s when I was a nurse practitioner at the ‘sister’ community clinic, Carolyn Downs Family Medical Clinic. Carolyn Downs is one of our country’s longest surviving clinic begun by the Black Panthers. As a nurse practitioner who had worked at a majority Black community clinic in East Baltimore, I knew about sickle cell anemia in terms of crisis management but not longterm, chronic management. One of my teenage patients at Carolyn Downs had sickle cell anemia and Dr. Danielson helped me manage his care more effectively. Subsequently, when working on my Skid Road oral history project for my forthcoming book, Skid Road: On the Frontier of Health and Homelessness in an American City, I had the please of completing an oral history interview with Dr. Danielson. An edited version of my interview with him is available here. (The audio quality on this one is much better than the video since I wrestled with the equipment that day.)

At the end of my oral history interview with Dr. Danielson, stated, “Diversity and cultural humility and improving the lot of people who are marginalized, that happens when you do it intentionally. Waiting for people to just do it out of generosity, or out of some sense of enlightenment all of a sudden that hasn’t been there for 20 or 30 years, that won’t cut it. We have to be intentional, and we have to be creative, and we have to work hard.” He spoke of being energized and having renewed hope because of the work of young people in the Black Lives Matter movement and because of the social justice work locally of the people of El Centro de la Raza. “You’re reminded that people stepped up. They occupied. They talked about oppression and racism, and they stood up to it and made a difference.”

Get Your Words Out

Having completed reading and grading close to 150 nursing student personal narrative policy papers (based on the Narrative Matters series in the health policy journal Health Affairs) for a public/population health course, I am energized by what they wrote—and by how well they wrote about compelling and timely public health issues they have a personal connection with. The ongoing and worsening opioid epidemic and diseases of despair, immigrant and migrant health, eating disorders and other mental health issues made worse by the COVID-19 pandemic, racism, environmental justice/climate change, elder health, vaccine hesitancy, and the occupational and safety fallout from the effects of how poorly our country and healthcare system have dealt with the pandemic.

As I read many of these student personal narrative policy papers, I thought of the wise words I heard recently from the author and environmental activist Terry Tempest Williams. She said, “Anger is polemic and no one wants to hear it. Rage is a story. There’s something behind rage. Anger is a shout; rage is a simmer. A piece written out of sacred rage lasts, while an op-ed is usually anger and people wrap fish in the paper the next day.” The most effective and powerful student papers tapped into that river of controlled, simmering rage. The nursing students who wrote these papers give me great hope for not only the future of nursing but also for our collective future.

I’ve promised to help them carry their words into publication of some sort should they choose to do so. Their lived experiences, their words, their perspectives are important. Of course, some students may not have the time or energy to revise their papers and submit them for publications. Others may have personal stories and perspectives that they are willing to only share with me. That is fine and I honor their decisions. Others have written to tell me that my feedback and encouragement to publish have motivated them to pursue that. Several have told me that they are so ‘on fire’ with the content and messages of their papers that they want to work on revision and publication over the holiday school break.

So here is my advice for them and for any of you readers, nurses or otherwise, who have compelling stories to tell to a wider audience.

  1. Ask yourself if you are ready to share your personal stories to strangers—and if you are ready to receive feedback, good or bad (or indifferent) on your story, not just by reviewers/editors, but also by readers once your story is published.
  2. Ask yourself if this is your story to tell and review the ethical guidelines provided by different publishing venues. As a general rule, altering patient or institutional identities is required.
  3. Read content and become familiar with a wide variety of publishing venues to see what sorts of things they publish before deciding to submit a piece of writing to them.
  4. Sometimes it is easier to start small, with submitting a shorter piece of writing to a publishing venue you like, are familiar with, and that has a track record of providing a kind and timely response and review/decision. One of my personal favorites is Pulse: Voices from the Heart of Medicine out of Montefiore Medical Center, Albert Einstein College of Medicine. For students, submitting work to a student-led narrative medicine/health humanities journal can be a good idea. At the University of Washington we have Capillaries: The Journal of Narrative Medicine.

Dr. Alexander de Soto: Friend of the Homeless

Thanks to Hektoen International : A Journal of Medical Humanities for publishing my essay, “Gospel Argonaut,” about Dr. Alexander de Soto who was one of Seattle’s more interesting physicians and “friend of the poor and homeless.” This essay stems from the chapter, “Ark of Refuge,” included in my forthcoming (July 2021, Johns Hopkins University Press) book, Skid Road: On the Frontier of Health and Homelessness in an American City.

Gospel Argonaut

Josephine Ensign
Seattle, Washington, United States

Photo of the Wayside Mission Hospital founded by Alexander de Soto
Entrance to Wayside Mission Hospital housed on the steamboat IDAHO, Seattle, circa 1900. Photo: University of Washington Libraries, Special Collections UW6573.

Short of stature and tall of tales, Alexander de Soto was by some accounts a highly educated, skilled, compassionate physician and surgeon, and by other accounts a charlatan, medical quack, faith healer, and quixotic dreamer. Born on July 24, 1840, in the Canary Islands to the Spaniard Alexander de Soto and American Elizabeth Crane, Dr. de Soto claimed to have been a descendent of the sixteenth-century Spanish explorer to America, Hernando de Soto. He told people that as a young man in Spain he had studied for the Jesuit priesthood, fell out with the Catholic Church, and completed his education at the University of Madrid.1

In 1862, de Soto moved to New York City where it does not appear that he tried to practice medicine of either the faith or conventional sort. Instead, he became a professional gambler and a morphine addict. He lived in rooming house tenements and police station homeless shelters. De Soto cured himself of his addictions in 1890 through the Holiness Movement at the Bowery Street Mission, one of the first such missions in the country.

De Soto was living and working at the Bowery Street Mission when he caught gold fever. He led a proselytizing expedition, setting out on foot from New York City to Seattle, hoping from there to take a boat to the gold fields in the Yukon. He planned to preach on the sins of greed and debauchery in Alaska. He called their group the Gospel Argonauts.2 Upon his arrival in Seattle, likely in early June 1898, de Soto sought out local newspaper reporters to cover his missionary work.

In a half-page article titled “De Soto’s Descendant and His Proposed Christian Work” in the Seattle Post-Intelligencer on Sunday, July 31, 1898, Irving Safford described de Soto as “a little blue-shirted man” with a “cultured Castilian accent.” De Soto had plans for a floating hospital he called Christ Hospital that he wanted to have built in Seattle, transported to Dawson City, and established there as a mission hospital. “The work, it needs me you know,” he is quoted as saying, with a parenthetical addition by Safford that “he himself is a physician”—as if it just occurred to de Soto that he could become a physician as well as a captain.

At that time throughout America many people could and did become physicians, not through formal, then termed “regular” medical school training, but through apprenticeship and by simply presenting themselves as physicians. Regulation and licensing of medical practitioners were rudimentary at best, even in older cities like New York. In Washington, which had only become a state in 1889, physician licensing was just beginning.3

De Soto decided to stay in this frontier city of Seattle. He moved into an abandoned barn in the Skid Road area at the mouth of the Duwamish River. The marshy area where Dr. de Soto and his homeless patients lived was called the Lava Beds for its numerous brothels and saloons. De Soto began a Robin Hood sort of medical practice. He charged high fees for medical consultations on rich people in their homes and then provided free medical care and food for the homeless and poor in Skid Road.

By February 1899, de Soto had moved to a rented basement in a tenement building in the heart of Skid Road. He turned the basement into the Wayside Mission, presumably named for its location along the waterfront as well as for the mission’s focus on health care and other services for people who had become society’s castoffs.

After a wealthy Seattle woman died under the care of de Soto, a group of Seattle physicians accused Dr. de Soto of being a faith healer, a Christian Scientist, and not a regular physician. They pointed out that he had no documented medical education and that he had not applied for a medical license in Washington State. De Soto claimed that these physicians were picking on him because he was successfully caring for Seattle’s “unfortunate souls” when they were not.

Dr. de Soto met wealthy Seattle philanthropists and a Seattle judge who supported his idea of opening a hospital mission on a boat along the Seattle waterfront. They formed the Seattle Benevolent Association, convinced city officials to rent space to their association at the City Dock, found and bought the decommissioned former opium-smuggling side-wheeler Idaho, and proceeded to convert the boat into a hospital. De Soto likely knew about and had seen the “fresh air” boats and floating hospitals for babies and for tuberculosis patients in New York City. The Wayside Mission Hospital in Seattle opened in early April 1900.

The June 1900 United States census for Seattle Precinct 1 in Skid Road records Alexander de Soto, physician, as head of “household” of the Wayside Mission Hospital, accompanied by forty-nine “lodgers.” Of the nine female lodgers, two are listed as nurses, including head nurse, Irene Byers. Dressmaker, servant, cook, and hairdresser are listed as professions for the other women. For the men, there are six “seamen” or sailors, lumbermen, carpenters, cooks, day laborers, a steamboat captain, a saloon keeper, and a druggist.

In a late October 1900 newspaper article, Dr. de Soto is described by his “soft, feminine, gentle hands.”4 The reporter adds that de Soto’s detractors accuse him of having an “oriental imagination,” emphasizing his exotic “otherness” and perhaps Moorish influence to the majority white Seattle population. But the reporter counters this with the doctor’s “systematic plan of applied Christianity,” which had attracted many supporters of his mission work to provide medical care to those in need but “not to harbor ‘hobos.’” He is described as a “practical mystic.”

Dr. de Soto received funding directly from the city of Seattle for the care of patients addicted to morphine, as well as care for indigent patients. At the time, Seattle and King County had an agreement that the city would care for “ill paupers” if they had been in Washington State for less than six months.5 In addition, the city agreed to take care of all emergency cases since King County Poor Farm and Hospital south of Seattle in Georgetown was too far removed from the city and was not equipped for emergency care.

A Seattle area newspaper, The Commonwealth, carried an article by Malcolm McDonald on May 23, 1903. Titled “The Samaritan Spirit—Seattle’s Pharisees,” McDonald reports that the city wants to develop the land and dock where the Wayside Mission Hospital is located. “It is the only hospital in the city ready at all times to receive the poor—the utterly poor who in sickness know no relief but death or the help of the Good Samaritan.” McDonald points to the high commercial value of land along the Seattle waterfront and asks, “Is any land too valuable for the saving of a human life? Is there no room in Seattle for an institution that has pity and not profit for the motive of its existence?”

In July 1904, Dr. de Soto was forced out of his work with the mission by the city and by members of the Benevolent Association because his management became unsatisfactory. The specific concerns are unclear. Whatever the reasons for Dr. de Soto being forced out of the medical mission he had dreamed of, started, and run for four years, the floating hospital, now called the Wayside Emergency Hospital, was turned over to Fanny W. Connor and Marion Baxter, social reformers. Under their leadership, the renamed Wayside Emergency Hospital continued to operate much as before onboard the Idaho along the Seattle waterfront.6

De Soto continued to work in Seattle as a physician. At age ninety-three he married Irene Byers, mother of his two children and a former nurse at the Wayside Mission Hospital. Three years later, he died of injuries sustained in a fall in Brooklyn, New York.7

In 1907, the Idaho became too leaky to repair and the Wayside Emergency Hospital was moved to the Sarah B. Yesler building. The Wayside Emergency Hospital continued to function until 1909 when Seattle opened its own clinic and hospital downtown along Yesler Way in the Public Safety Building. On the last day of March 1909, nineteen patients were moved from the Wayside Hospital to the new Seattle City Hospital.8

Dr. Alexander de Soto and his Seattle waterfront floating mission hospital are much more than just quirky side notes in the medical history and legacy of care for homeless people in Seattle. The Gospel Argonaut, the practical mystic, through his medical mission work, forced the citizens of Seattle to not only confront the reality of an increasing number of ill homeless people in their midst but also to find innovative solutions for their care.

This piece is excerpted from Skid Road: On the Frontier of Health and Homelessness in an American City, forthcoming from Johns Hopkins University Press.

Notes:

  1. Irving Safford, “De Soto’s Descendent and His Proposed Christian Work,” Seattle Post-Intelligencer, July 31, 1898.
  2. “Klondiker’s Souls,” Evening Journal, November 9, 1897.
  3. Nancy Rockafellar and James W. Haviland, “The Broad Sweep: A Chronological Summary of the First 100 Years of Medicine and Dentistry in Washington State, 1889-1989,” in Saddlebags to Scanners: The First 100 Years of Medicine in Washington State, ed. Nancy Rockafellar and James W. Haviland (Seattle:Washington State Medical Association, Education and Research Foundation, 1989), 1-26.
  4. “Dr. De Soto and His Work,” Seattle Post-Intelligencer, October 28, 1900.
  5. King County Washington Commissioners, Beginnings, Progress and Achievement in the Medical Work of King County, Washington (Seattle, WA: Peter’s Publishing, 1930).
  6. Katharine Major, “Nursing Seattle’s Unfortunate Sick,” American Journal of Nursing 6, no. 1 (1905):32-34.
  7. “Dr. De Soto, 96, Dies after Falling into Bay,” Brooklyn Daily Eagle, November 12, 1936.
  8. King County Washington Commissioners, Beginnings, Progress and Achievement.

JOSEPHINE ENSIGN, DrPH, ARNP, is professor of nursing and adjunct professor in the School of Arts and Sciences, Department of Gender, Women and Sexuality Studies at the University of Washington in Seattle. She teaches public health, health policy, and health humanities. Ensign is the author of Catching Homelessness: A Nurse’s Story of Falling Through the Safety Net and Soul Stories: Voices from the Margins. She was a 2018 U.S.-U.K. Fulbright scholar, based in Edinburgh, for research on the history of English and Scottish Poor Laws. Her book, Skid Road: On the Frontier of Health and Homelessness in an American City is forthcoming (2021) from Johns Hopkins University Press.

The Psychology of Public Health Messaging

Source: Salt Lake County Health Department PSA

The stark, in-your-face COVID-19 public health messaging from the Salt Lake County Health Department has begun to stir controversy. In the image above, a large, white, presumably Mormon extended family is sharing Thanksgiving dinner. They are all maskless and not socially distancing. We are told that the man at the head of the table has no symptoms of COVID-19 but has had the infection for nine days. Instead of the obligatory “cheese!” or “turkey!” the woman taking the family’s photograph says,”Everybody say: I was just exposed to COVID!”

Other public health messaging in this series targets a more racially/ethnically diverse group of young people socializing together at an indoor party, and a grandmother seeing her (unknowably COVID-positive) grandson (we are told she ends up in the ICU with COVID-19 less than a week later). This series of public health images and messages brings up fascinating issues related to the effectiveness and ethics of public health messaging. These ‘ads’ are professionally produced and appear to be well thought out in terms of target groups and influential messaging to motivate people to follow public health guidelines. Thankfully, there was thought given to avoiding reinforcing negative (and false) stereotypes as to the ‘vectors’/sources of the disease, since no person of color was labeled as the identified source.

The November issue of the American Journal of Public Health includes articles on the rise of mental distress across our country stemming from the COVID-19 pandemic, the negative health effects of COVID-19-related racial discrimination of Asian Americans, and one titled “Reimagining Public Health in the Aftermath of a Pandemic” (sources below). The authors of this latter article make the case for advances in public health infrastructure, effective ways to counter misinformation, and improvements in risk communication. They state, “We already know that researchers are adept at communicating with other researchers but less skilled in reaching non-research audiences. Skilled spokespersons are needed. Generally, the public health community can learn much from business and social marketing, which tailor messages and target audience segments.” (p. 1609)

Anxiety and fear of disability and death from contagious diseases or natural disasters can be powerful motivators for individual behavior change up to a certain point. But tapping into that anxiety and fear through targeted public health messaging can backfire when it becomes too much for people to take in or becomes nagging, nanny-state background white noise.

Sources:

“Mental Distress in the United States at the Beginning of the COVID-19 Pandemic,” by C. Holingue, et al, in the American Journal of Public Health, November 2020, vol 110:no. 11, pp. 1628-1634.

“Potential Impact of COVID-19 -Related Racial Discrimination on the Health of Asian Americans,” by J.A. Chen, et al, in the American Journal of Public Health, November 2020, vol 110:no. 11, pp. 1624-1627.

“Reimagining Public Health in the Aftermath of a Pandemic,” by R.C. Brownson, et al, in the American Journal of Public Health, November 2020, vol 110:no. 11, pp. 1605-1610.

Nurses, Vaccine Hesitancy, and the COVID-19 Pandemic

University of Washington Special Collections “Pioneering Medicine” exhibit, 2016

Nurses are the most trusted healthcare professionals in our country. Nurses are the largest component of the healthcare system here in the United States and worldwide. Nurses have an enormous ethical responsibility to keep up to date on and apply evidence-based practice in their work and in their personal lives.

The American Nurses Association (ANA) recently released results of a study from October, 2020 showing that only thirty-four percent of nurse members surveyed said they were willing to receive the COVID-19 vaccine once it is approved for use. Seventy percent of nurses reported that they had mistrust in the COVID-19 vaccine approval process, and sixty-three percent said their main source of information about the vaccine was from mainstream media. (source: American Nurses Foundation, Pulse on the Nation’s Nurses COVID-19 Survey Series: COVID-19 Vaccine, October 2020.) With the first COVID-19 vaccine due to be released for nurses and other frontline workers as early as next month, clearly, we have a problem.

We all need to work to repair the erosion of respect and trust in our public health system, including vaccine research, development, and safe, equitable distribution. Nurses can and should be at the forefront of that work and should be included on President-Elect Biden’s COVID-19 Advisory Board.

Not Playing Indian

November is both Native American Heritage Month and National Homeless Youth Awareness Month. This week (November 15-22, 2020) is Hunger and Homelessness Awareness Week. Especially this year, in the midst of the pandemic disproportionately affecting Native Americans and other BIPOC people, rising joblessness, increasing evictions (despite CDC and other anti-eviction mandates), increasing domestic violence, increasing social isolation and depression among our teens/young adults, increased attention and action related to these social and health issues are important. There are many things we can all do to help. Here is my list of actions for you and your family members to consider doing—not only during November:

1. Become better informed about these national and local issues by reading through the resources included in the links above.

2. Read more books by Native Americans. My current favorites include Braiding Sweetgrass: Indigenous Wisdom, Scientific Knowledge, and the Teachings of Plants by Robin Wall Kimmerer; There There by Tommy Orange, and An Indigenous Peoples’ History of the United States by Roxanne Dunbar-Ortiz.

3. Support Native American/Indigenous owned and run social service programs, such as Chief Seattle here in Seattle. They have health and social services (including supportive housing) for urban Native Americans/Native Alaskans/Indigenous people experiencing homelessness.

4. Support Native American/Indigenous owned and run arts and crafts stores, such as the “Inspired Natives, Not Native Inspired” Eighth Generation located in Pike Place Market, Seattle.

5. Support the expansion of school nurses and mental health counselors in all of our schools.

6. Support upstream policy efforts to prevent homelessness and hunger in our country. National Low Income Housing Coalition is one source of information on these issues. Likewise, for health and homelessness national policy issues, the National Health Care for the Homeless Council is an excellent resource.

Here is a digital storytelling video I made this summer in a StoryCenter workshop. “Honor Their Stories” is about my experience researching and writing a book chapter (in Skid Road: On the Frontier of Health and Homelessness in an American City, JHU Press, 2021) on Kikisoblu, also known as Princess Angeline, who was the daughter of Chief Seattle for whom Seattle is named. In this video, I explore the ethical issues I encountered as a white woman trying to understand more of the life, and death, of a Native American woman.

Healing. But First, Grieving

Individually and collectively we need a time of healing, physically, emotionally, and spiritually. 2020, the Year of the Metal Rat, has been a year like no other. The multiple upheavals and uncertainties have taken a large toll on us. We need a time for grieving all that we have lost and continue to lose. Not only the hundreds of thousands of Americans who have already died of COVID-19, but also the mounting job losses, increases in domestic violence, gun-related violence, and social isolation, especially for our elderly and other high-risk people. As we enter the darkest days of the year here in the Northern Hemisphere, alongside a second wave of COVID-19 infections and deaths, we need ways of staying hopeful, strong, resilient, and resistant.

What we are experiencing is not simple grief. It is complicated grief. As the Mayo Clinic writers put it, “Complicated grief is like being in an ongoing, heightened state of mourning that keeps you from healing.” Risk factors for complicated grief include social isolation, past history of depression and PTSD, adverse childhood experiences, and other stressors like financial hardships. Medical treatment for complicated grief includes, not surprisingly, grief counseling and cognitive-behavioral counseling. But other treatment interventions known to build resilience and lessen the negative effects of complicated grief are arts-based therapies, narrative storytelling, and other meaning-making activities.

The feminist environmental health and justice writer Terry Tempest Williams, said recently in an interview with Pam Houston, referring to both the very real effects from climate collapse (fires in the West and unrelenting hurricanes in the South) and the pandemic, “We haven’t grieved for it, for the people lost, and if you don’t think that won’t come back at us sideways (well, you’re wrong).”

Key references/sources:

Martha Kent , Mary C. Davies, “Resilience Training for Action and Agency to Stress and Trauma: Becoming the Hero of Your Own Life,” in The Resilience Handbook, eds. Kent, Davies, and Reich, (Routledge, 2013), 227-44.

Josephine Ensign, Soul Stories: Voices from the Margins, (University of California Medical Humanities Press, 2018).

Nursing and Advocacy and Voting

Thank you University of Washington Continuing Nursing Education for the opportunity to share my ZOOM videotaped thoughts on all things nursing advocacy, activism, civic engagement and voting. And I meant what I said towards the end of my remarks: my nursing students give me great hope for our collective future. Most of them already understand the importance of this, are doing this work, and are keen to hone their advocacy, activism, and civic engagement skills. I’d also add here that we need to stand up against voter suppression and intimidation.

Stay strong and vote!

Past Presidents of the ANA Endorse Biden-Harris

Note: The following is a letter from eight past presidents of the American Nurses Association in support and endorsement of Biden-Harris in the 2020 election. It was shared with me today by past ANA president, Virginia Trotter Betts who asked that I share it widely. Nurses, nursing students, and everyone whose lives have been/are/will be impacted by a nurse need to read this. And vote for Biden-Harris in the November election.

Open Letter from American Nurses Association Past Presidents as signed below

The 2020 presidential election will be one of the most consequential decisions our nation has ever faced. Over the course of more than four decades, we, the undersigned past presidents of the American Nurses Association (ANA), led the nation’s nurses without deference to specialty or affiliation on matters of policy and politics. Instead, our work was grounded in the tenets of the ANA’s Code of Ethics for Nurses and the principles of its Social Policy Statement, venerated guideposts that establish nurses’ professional values and direct their practice, embodied in a commitment to serve all society. Our body of work compels us to speak out and express our support for the presidential candidate who we believe will best serve the people of this nation—Joe Biden.

We believe that Americans have a choice on the ballot this year between a candidate who will be inclusive and restore a moral compass with empathy for human beings or a candidate who has sewn chaos and division while showing no compassion for the American people. The Trump administration has us literally fighting for our lives as we face down the Coronavirus pandemic while sparring over our economic futures; access to affordable and equitable health care; racial equality; social justice; and immigration policy.

From bedsides to boardrooms, professional nurses across this country have always served the healthcare needs of our people. We know firsthand the value, knowledge, and skills nurses bring to the care of others. Perhaps more than at any other time over the past century, the COVID-19 pandemic has brought into focus the essential nature of nurses’ contributions to the health promotion, illness prevention, and compassionate healing of all people in need. It has also laid bare the lack of a coordinated national response to COVID-19, which has failed nurses and all Americans. A failure to promote and enforce life-saving coronavirus mitigation strategies through organized, consistent, and evidence-based guidelines and the silencing or denigrating of scientific and medical experts and institutions has denied critical public health safeguards for us all.

Utilizing nursing’s core principles, the eight of us have analyzed the positions of each party’s presidential candidate. Without question, the Democratic Party platform aligns best with nurses’ ethical values and numerous ANA positions on important issues such as promoting public health, healthcare access, ensuring racial equality and social justice, ending the epidemic of gun violence, providing humane treatment for those seeking refuge from danger, and securing a clean energy future, among others.

The choice is clear. As national nurse leaders, we strongly support Vice President Joe Biden for President. He will safeguard the future and health of our nation. Join us in support of the Biden-Harris ticket!

Signed, Past Presidents of the American Nurses Association in Support of Biden-Harris

Pamela Cipriano, RN, 2014-2018 Virginia
Karen Daley, RN, 2010-2014 Massachusetts

Rebecca Patton, RN, 2006-2010 Ohio
Barbara Blakeney, RN, 2002-2006 Massachusetts

Mary Foley, RN, 1999-2002 California
Virginia Trotter Betts, RN, 1992-1996 Tennessee

Eunice Cole, RN, 1982-1986, California
Barbara Nichols, RN, 1978-1982 Wisconsin

Teaching in the Time of Trump

As I prepare to teach public health to nursing students this fall, I am mystified by and angry at the absolute wreckage Trump has made of our public health system and of our country. How to teach in the climate of hate and discord and blatant disregard for basic human rights, for human lives, for the lives of our COVD-19 pandemic frontline nurses and other healthcare providers, for scientific evidence? How to teach in the time of Trump?

Back in January 2017, as Trump was being inaugurated President of the United States, white supremacist hate groups infiltrated our university campus. They spread virulent racism, hatred, violence, and intimidation across our campus, including inside our health sciences/hospital buildings. In some cases, they attached razor blades to the backs of flyers they posted in classrooms so that people who removed the flyers could be cut in the process. Two of our university students brought weapons–including a gun–to campus and shot and seriously injured a protestor at the ill-advised Milo event sponsored by the Republican student group–an event that was allowed to happen by our university administration. I wrote about this and subsequent white supremacist group activity on our campus in a previous blog post, “Teaching in a Time of Hate and Violence.”

I thought it couldn’t get much worse than that, but, of course, it has. Trump’s complete bungling of our country’s response to the COVID-19 pandemic has led to the deaths of over 200,000 people in the US and to the deaths of over 2,000 frontline nurses and other healthcare workers who were denied proper personal protective equipment in caring for patients with COVID-19. And, with Trump and Trump appointees politicizing/meddling with public health institutions including the Centers for Disease Control, there is now even more public distrust of and confusion over scientific, evidence-based public health individual and community level recommendations. Public health officials across the country are receiving death threats from Trump supporters.

I am dismayed by the decision by the current leadership of the American Nurses Association (ANA) in deciding to ‘sit out’ this election, in pretending to be politically neutral by not endorsing the clear choice of Biden-Harris to lead our country out of the current public health, economic, and social mess Trump has made. Shame on you ANA for being so spineless. History will not be kind to your choice.

Trump is now doing the theater piece of establishing the 1776 Patriotism in Education Presidential Commission to push for revisionist and white supremacist education throughout our country. Trump does not want the history of slavery in our country taught or anything else resembling (the truth) and having to do with anti-racism.

In addition to teaching the basic principles and practices of public health nursing, this year I will teach even more to civic engagement, the importance of being an informed citizen, of voting, of speaking up for what’s right–not only for individual patients our nursing students will care for, but also communities, our entire country, and our world. The two required textbooks will include one basic textbook on public health nursing and How to be and Antiracist by Ibram Kendi.