Ingela’s Keynote presentation provided an overview of the Legislative Conference agenda and key points behind this year’s theme and objectives. Political, Economic and Environmental Disparities in our communities are pervasive and nurses are at the front lines. Classic political philosophies of “cradle to grave” care seem to have overlooked the reality that nurses are part of every stage of life – from the delivery room, throughout the life cycle, and many times during end of life care. SEIU Nurse Alliance of California has made great strides over the years to advocate not only for nurses but for the communities in which we work and live. Our voices, individually, carry unique perspective and collectively, carry great volume. Advances in awareness, best practices, and policy are often initiated by the issues we bring to the negotiating table…and to the steps of the State Capitol!
Low income communities have less access to healthcare, and influential voice due to obstacles beyond income; census data and primary research shows that even when services area made available by community outreach programs, there are still social and language barriers which prevent eligible recipients from accessing services because they don’t know how to request proper attention, or can’t communicate with the providers in meaningful ways.
Interactions with local and state policy influencers is an area where nurses, with the backing and guidance of SEIU Nurse Alliance of California are empowered to bring attention to these deficiencies in our healthcare system in a helpful and collaborative spirit of positive activism.
Sarah de Guia shared her very personal connection and experience of growing up in an immigrant family and enduring the social disparity of having her parents raise her as English speaking only, while the reset of her household spoke Spanish. She was told that they didn’t want her to suffer discrimination at school by speaking or appearing as an immigrant. Her strong and engaging spirit eventually prevailed and she leveraged her education to not only become multi-lingual, but put her tenacity to work in researching demographic trends and clearly quantifying the extent and causes of the socio-economic disparities we see in healthcare programs today.
SEIU Nurse Alliance of California members can leverage the work of California Pan-Ethnic Health Network (CPEHN), the organization for which Sarah Serves as Executive Director, to communicate facts and figures to hospital and community leadership to help advocate for resources for their communities. One of the (many) stand-out facts in her presentation was the 2001 study in which it was shown that the US spends approximately 3 times as much on health care, or nearly 18% of gross domestic product compared to under 10% for large European countries like France and Germany. The implication here is that if we’re spending this much more than others, how does life expectancy in the US lag by 6 years on average. Sarah’s presentation illustrates how fragmentation in the healthcare system, poverty, and lack of culturally appropriate healthcare interact as contributing forces behind these measurements. The hopeful message is that we as nurses have access to first-hand knowledge about what our communities need and have a direct and respected ability to communicate those needs to community and political leaders. We are the eyes, ears…and voice for those who would otherwise go unheard. Document the environmental factors for your patients as you work with them – identifying issues like access to fresh produce, education challenges, comprehensive medical history, community characteristics which impede access to healthcare. As a nurse, the credibility of your observations goes a long way in challenging obstacles in your community.
Maribel Castillon shared the timelines and mounting evidence implicating the systemic problem of abusive business practices and lack of accountability of those who thought they could get away with ignoring known safety, air quality and pollution mitigation responsibilities as exemplified in the Excide case study. She shared the specifics on how the problem of accumulated soil pollution resulting from decades of neglect and reckless business practices have brought illness from contamination to communities who lack the resources to prevent the continuation of these practices. Meanwhile, last year, in a wealthy community, a gas leak resulted in the nearly immediate relocation of residents during the 4-month clean-up following the discovery of the incident. How do we as nurses help communities, suffering decades of (deliberate or otherwise) neglect raise their voices and protect themselves from further abuse at the hands of the unscrupulous?
As SEIU Nurse Alliance of California members, we have the advantage of overall community health issue awareness and can be diligent about asking patients about symptoms they present and symptoms they may not think are related. Maribel’s slide showing the various systems in the body and how they differ from children and adults, which are effected by the Excide facility in Southern California. Documenting the connected symptoms helps community leaders and doctors provide more comprehensive treatment, and assess community needs as clean-up efforts are implemented. Key message: Your diligence attention to the big picture of the patients you work with can make the difference between identifying the problem, rather than simply addressing the symptom.
Josh Gray built upon Maribel’s presentation by citing the example of lead poisoning in Flint Michigan. Essentially, “we are all Flint; this isn’t an ‘over there’ problem”. Nor is it a community of color problem. Flint is a multi-cultural community with a broad range of socio-economic diversity. Residential water contamination doesn’t discriminate. The positive impact (if there can be one) is that the media attention to Flint’s water crisis has brought nation-wide attention to the problem of holding civic officials accountable to the public health responsibility for which they have been elected. Josh shared a news clip and 3 web-site links which illustrate the gravity and far-reaching impact of the problem in Flint – for most it’s illness, for some it’s deadly. Lead poisoning isn’t the only contaminant discovered. Equally alarming, but trailing in media coverage, was the discovery of vectors for Legionaires disease, which was initially thought to be an unrelated incident. However, as Josh shared, evidence of this contaminant disappeared when the water system was switched. Economic disparity, shows itself in this area in the proposed remedy. According to Josh, residents in flint were asked to open a valve in their homes and let water flow for 5 – 7 days in order to flush the plumbing in their homes, and only nominally compensated for the metered rate of consuming that water.
At issue in both Maribel’s and Josh’s presentation is the injustice imposed on these communities in burdening the residents with the expense of the cleanup…especially when the problem was preventable in the first place. As nurses, we need to help our patients identify hazards in their environment and help them find information and resources. Chelating medications and dietary adjustments, in the case of the communities surrounding Excide and Flint, can help people remove pollutants from their homes and their bodies.
Mark Catlin brought to light some helpful information about protecting health care workers from infectious disease at work and in the community. Politically, best practices are easier to implement than formal regulations, and nurses are disproportionately exposed to infectious disease risk; but SEIU and SEIU Nurse Alliance have been tirelessly working to raise awareness within the health care services community about properly fitting respiration gear, pathogen resistant clothing and emerging threats like Zika and MERS carrying vectors. Mr. Catlin provided a collection of articles on the USB drive at the conference, copies can be obtained from the SEIU Nurse Alliance of California office.
Of specific note, there is an alarmingly false sense that risks for out-of-the-media-spotlight are no longer significant. Mark warns us not to follow the TB risk example as published in 1943 which stated that the “risk has managed because we haven’t seen any new cases”. Nurses are advised to confront this line of thinking and SEIU can assist with supporting information if needed. Mark also highlighted that there are two important paradigms which nurses should be aware of regarding work site safety: Occupational Health and Disease Prevention. His slides illustrate the legally regulated rights of workers for safe working conditions, and best practices which are generally accepted principals for self-care and disease prevention. The later is applicable at home, in the community as well as in the work place.
April Rovero shared her personal story of losing her child to prescription drug overdose. While some may consider this a wealthy person’s problem or dismiss the threat as concentrated to a privileged community, April shared information on how pervasive and far reaching the abuse of opiates has become…or always has been but previously ignored. Economic, Political and Environmental disparities all converge on the problem of substance abuse and addiction, and the takeaway from the presentation was that there is frustration in communities of color that it had to become real to wealthy community before significant attention could be brought to the issue. April turned her grief for the loss of her child into action and has been assisting community awareness campaigns throughout the nation concentrating mostly on schools and student populations from middle school through college.
Her slides shed light on communities where “accidental” addiction and adverse drug reactions are being discovered. Nurses have the unique opportunity to identify signs of abuse, whether accidental or deliberate. Pain management from injury treatment and dental treatment are the most common and accidental cause nurses are encouraged to recommend non-opiate/alternative pain management protocols for their patients. Often nurses are in the unique position to identify addicted users by observing the manner in which meds are requested…warning signs like excessive travel and excessive persistence to request specific pain killers are the most obvious ‘red flags’ for example.
Michelle Cabrera provided insight on the legislative process and how SEIU Nurse Alliance of California and its members can influence emerging policy discussions at the state capitol level. Her slides outline the process by which an idea in California gets authored, reviewed, developed, supported, and eventually signed into law. Nurses have the timely opportunity to get to know their local community leaders, state assembly and senate members; and offer their perspective as experienced participants in the field of healthcare delivery practices and programs. Legislators look to their constituents and especially to nurses as an excellent resource from which they learn the realities, impacts and priorities of the communities they’ve been elected to serve.
