NATIONAL NURSES MONTH SPECIAL ISSUE 2021
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Table of Contents
In This Issue 3
Editor’s Notebook
Nurse Strong
Features 4
Learning Lessons from the Pandemic By Louis Pilla
By Megan Larkin
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Nurses Take on Climate Challenges to Protect Their Patients and Communities By Linda Childers
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Catherine Natsuko Yamaguchi Chin: An Extraordinary Life By Phoebe Ann Pollitt and David Yamaguchi
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Making Political Change through the Eyes of a Nurse: Congresswoman Lauren Underwood Advocates for Communities By Julia Quinn-Szcesuil
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Elected Officials Poised to Enact Equity Legislation During the 117th Congress By Janice M. Phillips, PhD, RN, CENP, FAAN
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National Nurses Month Special Issue 2021
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Nurse Notebook
CORPORATE HEADQUARTERS/ EDITORIAL OFFICE
Nurse Strong
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hen COVID-19 hit and the world harbored in place, nurses kept marching to the frontlines even when PPE ran out in hospitals across our nation. I remember seeing the first Facebook posts of nurses asking for PPE in early March, explaining they would stop by and pick up an N95 mask if anyone had one to spare as they headed into their shift. I remember that moment of thinking, “how can this be true—not enough PPE for the frontline?” And in a moment that question went to action. On March 11th, 2020, I sent an email to the SONSIEL Board of Directors, a 100% volunteer Board of nurses, calling for an emergency meeting to discuss how we can start community support to get PPE to nurses. By March 17th, we had organized and built out a plan and a Call to Action called the SHARE (Strengthen Healthcare Ability to Respond to Emergencies) Program, issued our first press release and a process for communities, neighbors, and churches on how to get PPE to the frontlines. We quickly organized and operationalized a process to distribute PPE donations across the United States to health care systems seeking assistance. We then partnered with GloGood Foundation, a dental non-profit, which allowed us to open a GoFundMe Account: https://charity.gofundme.com/o/en/campaign/sonsielxglogood. Our success helped us to raise $100,000 and move over 300,000 pieces of PPE to nearly 146 health systems across the United States from March through July 2021.
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Nurse Strong, for us, was not waiting for others to take the lead and solve the problem; it was for us to lean in, take ownership, create a solution, and get PPE to our frontline colleagues whose lives depended on it to perform their jobs. Nurse Strong is about owning and taking action to solve the problems we face as a profession and in health care—as there is no truer innovator than nurses—together, we can transform the future of health care for the better. —Rebecca Love MSN, RN, FIEL President, SONSIEL-Society of Nurse Scientists, Innovators, Entrepreneurs & Leaders
Editor’s Note: In honor of National Nurses Month, I decided to step off my soapbox and let a nurse leader share her thoughts on what it means to be “nurse strong.”
For editorial inquiries and submissions: editor@minoritynurse.com For subscription inquiries and address changes: © Copyright 2021 Springer Publishing Company, LLC. All rights reserved. Reproduction, distribution, or translation without express written permission is strictly prohibited.
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Learning Lessons from the Pandemic BY LOUIS PILLA
With the COVID-19 crisis relenting, nurses can learn some valuable lessons. Here are some of the biggest takeaways.
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s no other disease or event in memory, the COVID-19 pandemic has pressured the health care system—and nursing. And from that stress can spring valuable lessons for the profession. From preparedness to collaboration, mental health to scope of practice, lessons can be learned from more than a year of this pernicious enemy.
Readiness
Besides staff, preparation needs to extend to supplies as well. At the pandemic’s outset, some supplies had not been rotated and were dry rotted, he says. What’s more, the United States had a dependence on other countries. “We were caught short-handed, so to speak, so it’s important that we also have some means to provide the necessary supplies and resources ourselves, so that we’re not dependent on other countries,” Grant points out. Some nurses, he notes, are still required to use N95 masks multiple days in a row before switching to a new mask.
Of the many lessons learned from the pandemic, “number one is preparedness,” says Ernest J. Grant, PhD, RN, FAAN, president of the American Nurses Association (ANA). Typically, he notes, In talking to nurses disasters involve the pre- around the country, the hospital setting and nurses in most important thing they such areas as the emergency will take forward “withdepartment or intensive care unit. They usually resolve in out a doubt” is partnerdays or weeks and “you can ships and collaboration, see the light at the end of the says Elizabeth Bridges, tunnel fairly quickly.” PhD, RN, CCNS, FCCM, By contrast, a pandemic FAAN, president of the “affects the whole health care American Association system,” Grant says. “Things that a normal disaster would of Critical-Care Nurses b o a rd o f not necessarily have had an ( A A C N ) impact on, this did. So it directors. caught people unprepared.” Nurses need to be prepared and educated “so that nurses will It Takes a Team Besides readiness, collaboknow what their role is when the next pandemic comes ration is another of the major along.” lessons learned from the pandemic. “Definitely, it has taken a team effort,” says Grant. Of the many lessons Addressing the pandemic has learned from the pan- called on the efforts of health demic, “number one is care team members ranging preparedness,” says from physicians to the housekeeping staff, he notes. Ernest J. Grant, PhD, In talking to nurses around RN, FAAN, president of the country, the most importhe American Nurses tant thing they will take forAssociation (ANA). ward “without a doubt” is partnerships and collaboration,
says Elizabeth Bridges, PhD, RN, CCNS, FCCM, FAAN, president of the American Association of Critical-Care Nurses (AACN) board of directors. That means collaboration not only with physicians and respiratory therapists, “but also all those other individuals whom we asked to step outside of their normal practice to come in and augment the care, particularly of acute and critically ill patients when we needed those members. That partnership is important because it’s broken down a lot of silos, and that’s a really important lesson going forward. We would not have gotten through this pandemic if we didn’t come together as a team.”
Mental Health and Moral Distress Recognizing the massive mental toll that the pandemic has taken on nurses is another lesson learned. With conversations occurring about moral distress and post-traumatic stress, “it’s really important that we don’t pathologize this experience,” says Bridges. Rather, such emotional difficulties can represent a normal reaction in light of the pandemic experience. While working with individuals to mitigate moral distress is important, a system approach is also vital, Bridges notes. “You have to be in a healthy work environment where resilience is supported.” Addressing moral distress can start in the nursing curriculum with instruction on ethics in nursing practice, notes Mary Ellen Glasgow, PhD, RN, ANEF, FAAN, dean and professor at Duquesne University School of Nursing. Nurses deal with
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ethical dilemmas that they may not have the knowledge or skill to analyze, she says.
Nurses experiencing mental and physical fatigue should make sure to seek assistance, says Grant. “How are we preparing nurses when they are faced with morally distressing situations so we minimize posttraumatic stress disorder? What are preventive tips nurses can take? How can they manage these morally distressing situations, what can they ask for from their institutions that is appropriate?” Glasgow asks. Nurses experiencing mental and physical fatigue should make sure to seek assistance, says Grant. A nurse should feel no shame, he says “to admit that perhaps you may need some help, especially if you’re seeing death and dying on the level that some of the members of the health care team have this past year. It definitely has been quite an emotional and physical strain on the body.”
Acknowledging APRNs Employing the skills and abilities of advanced practice registered nurses (APRNs) represents another lesson learned from this pandemic. For decades, APRNs have fought for greater practice authority, and the pandemic seems to have finally brought their skills into long-overdue acknowledgement and use. Some 23 states have granted APRNs full practice authority, notes the ANA’s Grant. Ultimately, he notes, having APRNs practice to their
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full authority will result in “a very strong health care infrastructure.” That full practice authority needs to remain in place as the pandemic ends, notes Bridges. What is not needed, she says, is that once the pandemic ends, “we’re going to put those restrictions back on you.”
Tech Adoption Another learning involves the adoption of technology. There was a lesson in the ability to “embrace technology and innovation,” says Grant, pointing to the use of telehealth. While telehealth often has been used within the purview of large health care systems,
the pandemic has shown a need to use tele-resources in settings that are not necessarily affiliated with a large corporate entity, says Bridges. This allows, she notes, for patients to remain in their own community.
“Risen to the Challenge” With the pandemic shattering so many precedents, “this is really an opportunity to think differently,” says Bridges. That might involve such concerns as how partnerships are created with families; how to bring new nurses who may have had a different kind of nursing education into the health care environment; and how wellness needs to be a
competency for nurses. “Just like everything else we learn, we need to be experts in selfcare,” she says. Glasgow points to the courage of being a nursing student at this time. “They are certainly brave to go in and take care of people during a pandemic,” she says. Nurses and other members of the health care team have “risen to the challenge and met this challenge and still are resilient,” says Grant, offering his thanks and praise for their efforts during the pandemic. Bridges also points to the critical nature of the team effort, but with a particular nod to nurses. “A bed in a hospital without the expertise of the
For decades, APRNs have fought for greater practice authority, and the pandemic seems to have finally brought their skills into long-overdue acknowledgement and use. care team, specifically a care team of nurses, is just a bed,” she says. Louis Pilla is a seasoned publishing expert with over 20 years of experience in providing content and digital products to health care audiences.
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National Nurses Month Special Issue 2021
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You are the future of nursing.
Jefferson College of Nursing acknowledges all healthcare workers near and far for your commitment and dedication throughout the past year and every day! At the Jefferson College of Nursing, we aspire to create a diverse and inclusive environment, knowing that the creative energy and innovative insights that results from diversity are vital for the intellectual rigor and social fabric of the University. Jefferson College of Nursing teaches for the future, and that requires constant imagination and investment. We’ve integrated Apple technologies into all of our classrooms and simulation rooms, so students can get firsthand experience with the clinical tech of tomorrow. Our expertise with digital technology means we’re a leading provider of online learning during the pandemic. And our faculty members advised the Department of Health and Human Services on the future of nursing education in the face of COVID-19. Along with this forward-thinking ethos, we provide all the educational advantages of our renowned clinical network, including hands-on learning in clinics, in research and with leading-edge technology. When you study at a program that’s this focused on the future, you are guaranteed to be prepared.
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Nurses Take on Climate Challenges to Protect Their Patients and Communities BY LINDA CHILDERS
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National Nurses Month Special Issue 2021
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s a school nurse working outside of Chicago, Gloria E. Barerra, MSN, RN, PEL-CSN, has witnessed how climate change is impacting both our planet and the health of her students. As the United States sees extreme changes in the weather, Barrera says health professionals are seeing an increase in patients with both new and existing health problems. She is one of many nurses across the United States, Canada, and Europe who are working to raise awareness of how climate change impacts public health, as part of the Nurses Climate Challenge campaign, a collaboration between Health Care Without Harm and the Alliance of Nurses for Healthy Environments (ANHE).
As the United States sees extreme changes in the weather, Barrera says health professionals are seeing an increase in patients with both new and existing health problems. The U.S. campaign (https:// us.nursesclimatechallenge.org), launched in 2018, hopes to mobilize nurses to educate 50,000 health professionals about the impact of climate change on health by 2022, build a national network of health professionals to take action, and educate both their colleagues and patients on the health impacts of climate change. “This is one of the most serious health threats we face
today,” Barerra says. “Every year, I notice an increase in the number of students diagnosed with asthma and recently we’ve seen how poor air quality also makes us more susceptible to COVID-19 and respiratory infections.”
“In the U.S. we know our zip code determines our life expectancy more than our genetic code, and climate change is exacerbating these health disparities,” she says. In addition, Barrera says exposure to poor air quality has been shown to contribute to premature death, cancer, and cardiovascular and respiratory harm. As a member of ANHE, Barrera has traveled to Washington, D.C. and spoken to lawmakers about the direct impact that climate change, specifically toxic air pollution from the oil and gas industry, has on public health. While climate change poses an overall risk to public health, Barrera says it disproportionately affects minorities and those who live in lower income areas. “In the U.S. we know our zip code determines our life expectancy more than our genetic code, and climate change is exacerbating these health disparities,” she says. “As part of my service work, I’ve participated in the promotion of climate literacy and heath literacy among the Latino communities and am committed to ongoing advocacy to ensure policies and resources are appropriately
deployed to address climate change and minimize its impact amongst our most vulnerable populations.”
Teaching Climate Change in Nursing School While environmental health hasn’t historically been taught in nursing school, that’s changing, with some professors and colleges integrating health issues surrounding climate change into their curriculum. As an adjunct professor of nursing at DePaul University, Capella University, and her alma mater, Saint Xavier University, Barerra teaches nursing students how they can work to mitigate the effects of climate change on their patients’ health. “I’m committed to helping future nurses understand our role in addressing critical issues related to the environment and climate change,” Barrera says. “I stress how a healthy environment is vital to optimal health and I use my experience in advocacy to bring the research to life in many of my courses.”
While environmental health hasn’t historically been taught in nursing school, that’s changing, with some professors and colleges integrating health issues surrounding climate change into their curriculum.
Adelita Cantu, PhD, RN, a public health nurse and an associate professor at UT Health San Antonio School
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of Nursing, also teaches her undergraduate students about climate change in a module called Climate Change as a Public Health Issue. “We discuss the heat, drought, even the recent freezing storm that hit the state of Texas, and how the consequences of climate change affect our patients and community,” Cantu says. “I’ve seen how rising temperatures and air pollution have led to an increase in asthma cases among seniors and how it negatively impacts their quality of life.” Cantu says she instructs students on how to help patients minimize the health risks of climate change. This can include having patients monitor the air quality index (AQI), found in newspapers and on the Environmental Protection Agency (EPA) website, AirNow. gov, and to modify time spent outdoors accordingly.
“I bring the topic of climate change into a conversation with patients in a non-judgmental way and I encourage nursing students to do the same,” Cantu says. As part of her work with the Nurses Climate Challenge, Cantu also explains to her students how burning fossil fuels can contribute to disease. Cantu has been an active climate change advocate in her community, helping to form the Air and Health Collaborative in San Antonio, and to raise awareness about the adverse effects of air pollution and measures that can be
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taken to protect the city’s most vulnerable residents. For those who might not believe in climate change, Cantu works to make the connection between changes in weather and to address any of their concerns or questions.
“I bring the topic of climate change into a conversation with patients in a non-judgmental way and I encourage nursing students to do the same,” Cantu says. Believing students are never too young to learn about
climate change, Cantu has also co-developed EcoCamp in San Antonio to raise awareness about climate change and air pollution and the Youth Leadership Air Quality Academy at UT Health, a grantfunded program that teaches
teens, many from underserved communities, how to become advocates to help improve health and air quality in their neighborhoods. Linda Childers is a freelance writer based in California.
Take an Active Role in Fighting Climate Change For nurses who want to become an advocate for climate change, Barrera recommends joining the ANHE (envirn. org) and getting involved with one of their work groups (Practice, Policy/Advocacy, Research, or Education).
Enroll for the virtual symposium, Climate Change & Health 2021: The Intersection of Climate Change, COVID-19 and Structural Racism, which will be held on Saturday, April 24. CEUs are available. Fees and the full agenda are available online. Barrera encourages nurses to join the Nurses Drawdown movement to take personal and professional action in five key areas: energy, food, nature, mobility, and gender equity. Learn how to lend your voice as a nurse and take action on climate change policy. The U.S. Climate and Health Alliance can connect you to other health professionals in your state who are working on climate change issues, show how to write an op-ed, and also communicate with your state legislators.
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National Nurses Month Special Issue 2021
HONORING THOSE WHO CARE FOR US Celebrating the Year of the Nurse Nurses have played a vital role in transforming healthcare around the world. University of Maryland Global Campus (UMGC) honors these extraordinary men and women who work tirelessly so we can be healthy and well. As we join the international community in celebrating the Year of the Nurse, we offer our deepest thanks for the compassion and care nurses give their communities each and every day. We couldn’t be prouder of the many graduates of our CCNE accredited RN-to-BSN program online.
The baccalaureate degree in nursing at UMGC is accredited by the Commission on Collegiate Nursing Education (https://www.ccneaccreditation.org).
* This degree is only open to students with an associate’s degree in nursing or a diploma from a registered nursing education program that is recognized by the appropriate State Board of Nursing. Students must reside and have an active unencumbered nursing license in an approved state at the time of admission and throughout completion of the program. For a list of approved states, visit umgc.edu/nursing. Effective July 1, 2019, University of Maryland University College (UMUC) changed its name to University of Maryland Global Campus (UMGC). UMGC is certified to operate by the State Council of Higher Education for Virginia (SCHEV). University of Maryland Global Campus, 9625 Belvoir Road, Barden Education Center, Building 1017, Room 128, Fort Belvoir, VA 22060.
We thank nurses for all they do and are glad to serve their higher education needs.
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Catherine Natsuko Yamaguchi Chin: An Extraordinary Life BY PHOEBE ANN POLLITT AND DAVID YAMAGUCHI
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National Nurses Month Special Issue 2021
T
he shades to all of the train cars were pulled down, to block the passengers’ views of what was happening outside, and where the train would be going. Outside, along all paths leading to the train, parked along Alaskan Way on the Seattle waterfront, there were sentries armed with rifles everywhere, watching the movements of the passengers heading toward the cars in a long line. Yet the passengers did not appear dangerous. For they included old men, young mothers with babes in arms; young boys, with all capable of carrying suitcases. The general public was kept back. They gawked from the passenger overpass. Black porters waited beside the cars in white jackets. But probably most curious of all was a small group of three women, two middleaged Caucasian ones, who said their goodbyes and good wishes to the young Asian one, before she too stepped away from her party to join the line of passengers en route for the train. Unlike the others, beneath her jacket which protected her from the March cold, she wore a uniform. It was a white nurse’s uniform, complete with a cap. She was a college-educated registered nurse, who had volunteered for the assignment. The ink on her diploma, framed and in her handbag, was barely dry. It had just been handed to her, three months early, by two of her nursing instructors. She boarded the train, walked down the aisle, saying hello and Ohayo gozaimasu [good morning] to those she passed. As those new to their jobs do, whatever her inward doubts, the young nurse tried to
convey to her charges a sense of confidence, that she knew her job and was up to the task. The date was March 30, 1942. There were 227 Asian American passengers on board, plus the Caucasian army sentries, and train crew. The young nurse’s first responsibility would be to see that all arrived safely at their unknown destination. Catherine Natsuko Yamaguchi was born June 29, 1920 to Tadashi Yamaguchi (Father) and Misao Ikebata (Mother) in Bellevue, Washington. She was the middle of six children; two older sisters stayed in Japan when the family immigrated to the United States, and the oldest of four siblings who were born and raised in Washington state. They all attended the local public schools. Natsuko graduated from Garfield High School in 1937 where she was an honor roll student and worked on the school newspaper.
Before World War II, few Asian American women earned nursing credentials, and even fewer graduated from college programs with the fouryear Bachelor of Science in Nursing degree. Before World War II, few Asian American women earned nursing credentials, and even fewer graduated from college programs with the four-year Bachelor of Science in Nursing degree. There were two reasons for this. The first was demography. As comparatively recent immigrant groups, by 1940 the U.S.-born children of Chinese
and Japanese families were just reaching college age. The second was racist policies limiting Asian American enrollment in schools and colleges. However, Natsuko was determined to become a professional nurse so she gained admittance to Seattle College in the fall of 1938—through the intercession of the Yamaguchi family doctor, who had connections there—and began her nursing studies. It seems likely that it was on the largely Caucasian Catholic campus that Natsuko was given her western name, “Catherine”—probably by the nuns who taught the nursing students. None of Natusko’s siblings had western names.
Chin’s graduation date from Seattle College was March 1942. She was one of about 85 Japanese American registered nurses to be forced into Relocation Centers across the country.
On December 7, 1941, after the Japanese military attacked U.S. naval bases at Pearl Harbor, Hawaii, the United States entered World War II and declared war with Germany, Italy, and Japan. Two months later, on February 19, 1942, during the spring semester of Chin’s senior year, President Roosevelt signed Executive Order 9066, mandating the removal of “resident enemy aliens.” Within a few months, approximately 110,000 Japanese citizens and residents were forcibly evacuated from their homes on the
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west coast and “relocated” into ten concentration camps from Idaho to Arkansas. Chin’s family was, of course, removed from Bellevue along with the thousands of others. Chin’s nephew, David Yamaguchi, reports that “In her final year [of nursing school] in 1941–1942, Natsuko’s days involved hands-on training and rooming at Providence Hospital.” Japanese American people living on Bainbridge Island in Washington state were the first to be evacuated. They were sent to the Manzanar Relocation Center in central California. The Yamaguchi family, including Natsuko, had relatives and friends on Bainbridge Island. When the Bainbridge Island evacuees were forced off the island in late March 1942, “Natsuko boarded the train, and accompanied the Bainbridge people to Manzanar as a nurse ... those sweet SU [Seattle University] nuns must have given Natsuko her June diploma early. I would imagine them handing it to her saying ‘Here, you’re going to need this,’” says David. Chin’s graduation date from Seattle College was March 1942. She was one of about 85 Japanese American registered nurses to be forced into Relocation Centers across the country. However, Natsuko’s entering Manzanar stands apart from those of all the other Nisei (U.S.-born second-generation Japanese Americans) nurses, for she alone entered the camps voluntarily, to accompany the Bainbridge Islanders, two months before her own family would be required to show up at the gates of Camp Harmony/ Puyallup Assembly Center in Seattle.
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David continues the story: “The young Natsuko was exactly what the Bainbridge people needed. There were elderly and babies aboard that crowded train of 227 islanders. As a JA [Japanese American] friend of the Nishinakas [a Bainbridge Island family], she was an immediate insider. Like many Nisei eldest daughters, she spoke fluent Japanese. Moreover, Natsuko had rare skills: as most Seattle Nisei were still in high school in 1942, there were simply few other university-trained Nisei nurses available in greater Seattle to accompany the Bainbridge people.”
Many older immigrants confined to Manzanar spoke only Japanese while others, typically younger siblings of the U.S.-born generation, were fluent only in English. Registered nurse Yamaguchi was an ideal teacher for the Red Cross because she was qualified to teach both classes in both languages. Approximately 10,000 Japanese Americans were incarcerated in the Manzanar Relocation Center. According to the National Park Service, Manzanar’s internees were unaccustomed to the harsh desert environment. Summer temperatures soared as high as 110ºF. In winter, temperatures frequently plunged below freezing. Throughout the
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year strong winds swept through the valley, often blanketing the camp with dust and sand ... An oil stove, a single hanging light bulb, cots, blankets, and mattresses filled with straw were the only furnishings provided. The 500-acre housing section was surrounded by barbed wire and eight guard towers with searchlights and was patrolled by military police.
responsibility of family members. The stress of incarceration, overcrowded conditions, exposure to extremes in temperature, and poor diets contributed to declining health in many of the internees.
In 1953, she coauthored an article in Nursing Outlook titled “The Unhospitalized Tuberculosis Patient.”
In its booklet Minidoka, The National Park Service reports, The quality of the food served was poor, with milk and fresh meat constantly in short supply. Inexpensive foods such as wieners, dried fish, pancakes, macaroni and pickled vegetables were served often. Vegetables, which had been an important part of the Japanese Americans’ diet on the West Coast, were replaced in camp with starches. The meals were planned at an average cost of not more than 45 cents per person per day, or 15 cents per meal. Contaminated food, water, and milk caused frequent outbreaks of dysentery in all the camps. While there were hospitals in each concentration camp, all were understaffed and under supplied to handle the health care needs of the internees. Patients with acute illness, needing surgical interventions or in labor were hospitalized while care for those with chronic diseases, including tuberculosis were not isolated in sanitoriums as was standard treatment at the time, but became the
National Nurses Month Special Issue 2021
In light of the many health concerns and limited care provided in the camp, in the fall of 1942, internees and Center officials approached the San Francisco Chapter of the American Red Cross requesting first-aid and home nursing classes. The Chapter agreed to sponsor teachers and issue certificates to students who passed the end of course tests. Women who received certificates in the home nursing class were eligible for jobs as nursing assistants in camp hospitals. More than 200 Manzanar residents completed the home nursing course and another 100 completed the first aid course. Many older immigrants confined to Manzanar spoke only Japanese while others, typically younger siblings of the U.S.-born generation, were fluent only in English. Registered nurse Yamaguchi was an ideal teacher for the Red Cross because she was qualified to teach both classes in both languages. In addition to her hospital work, Natsuko began teaching classes for the Red Cross in 1942. In 1943, the famous photographer Ansel Adams was documenting life in Manzanar. He photographed
her wearing her Red Cross cap and Red Cross pin and labeled her photograph, “Catherine Natsuko Yamaguchi, Red Cross Instructor.” Except for the Bainbridge Islanders, most internees in Manzanar were from more urban areas in California. This created some cultural conflict between the Californians and the more rural farmers from Washington. In 1943, the Bainbridge Islanders at Manzanar petitioned the U.S. Government to be transferred to Camp Minidoka, in Hunt, Idaho, where most Japanese Americans from the Seattle area, including extended family members and friends of the Bainbridge Islanders were by then incarcerated. Conditions at Minidoka were very similar to those at Manzanar. In February 1943, Chin moved with the Bainbridge Islanders to Camp Minidoka and was reunited with her family. She began work in the Camp Hospital; however, her experience and success in teaching Red Cross courses at Manzanar soon changed her circumstances. A clipping from The Minidoka Irrigator (Hunt, Idaho), May 1, 1943 explains: Miss Natsuko Yamaguchi of the hospital nursing staff has recently been appointed by the American Red Cross as itinerant home nursing instructress. She will conduct classes here during May and June. Thereafter she will travel to other centers in a similar capacity. Chin taught classes for the Red Cross at relocation
centers across the country until September 1944 when she entered Teachers College at Columbia University in New York City to earn an advanced certificate in public health nursing. After passing an FBI background check, Japanese American women in the Relocation Centers were eligible to leave the centers to pursue college level studies, including nursing. In 1943, only 20 nursing schools were known to accept these women; Teachers College was one of them. After a year of course work and clinical experiences, Chin earned her Public Health Nursing certificate, then considered an advanced degree. After her graduation from Teachers College in June 1945, the war was winding down and Natsuko was allowed to resume civilian life. She returned to Seattle and a job in the King County Health Department focusing on eradicating tuberculosis, especially among the several hundred Japanese Americans returning from the relocation centers. In 1949, she married Que Chin, a Seattle photographer, and in 1951 gave birth to their daughter Mari. By the mid-1950s, Chin left the King County Health Department and spent the remainder of her career working at Group Health Hospital on Capitol Hill in Seattle. In 1953, she co-authored an article in Nursing Outlook titled “The Unhospitalized Tuberculosis Patient.” Chin presented her portion of the article at the 1953 Annual
Meeting of the National Tuberculosis Association; her speech was published in the Transactions of the Annual Meeting. National Tuberculosis Association. In addition to fulltime work and family responsibilities, Chin was active in the Washington State Nurses Association and in 1963 was elected a Director of the organization. On April 6, 1980, in testimony before a Congressional Committee, Chin advocated for the continued funding of the U.S. Public Health Hospital in Seattle, which was in peril of being defunded. She recalled the help medical staff from the hospital gave to the thousands of Japanese Americans forced to live in renovated stables and other outbuildings at the Puyallup Fair Grounds Assembly Center in 1942.
On April 6, 1980, in testimony before a Congressional Committee, Chin advocated for the continued funding of the U.S. Public Health Hospital in Seattle, which was in peril of being defunded.
Chin retired from paid work in the 1980s and began volunteering with a variety of community nonprofit agencies. She was particularly involved with the International District Health Clinic, where she was Chairperson of the Board of
Directors. She also traveled extensively, making multiple extended trips to the ancestral family home in Fukui prefecture, Japan. Chin died on March 6, 1998. Catherine Natsuko Yamaguchi Chin was a remarkable woman and nurse. Without immediate role models, she graduated from Seattle College and became a registered nurse. She voluntarily joined the first group of Japanese Americans forcibly displaced from their homes and taken to the Manzanar concentration camp. She not only worked long shifts at the camp hospital for very low pay, but also she added the responsibility of teaching Red Cross Home Nursing and First Aid courses to her fellow internees to improve their quality of life. Her clinical, linguistic, and leadership skills were quickly apparent, and she was promoted to become an Itinerant Red Cross Instructor for all ten Internment Camps in the United States. During the War, she earned an advanced certificate in Public Health Nursing from the prestigious Teachers College in New York City. Following her incarceration, Chin worked full time, married, and raised a daughter and was active in community and professional organizations. She even found time to write an article for a professional journal and testify before a Congressional Committee. Nurse Chin’s life and work deserve to be honored and remembered.
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Catherine Natsuko Yamaguchi Chin
Phoebe Ann Pollitt practiced and taught community health nursing for over 30 years before she retired in 2019. She writes nursing history, usually focusing on southern and Appalachian nurses of all races. David Yamaguchi is a retired University of Washington professor of dendrology who currently edits the Seattle community newspaper, The North American Post. He is the author and coauthor of numerous scientific articles about dendrology—the study of trees, and he coauthored the book, The Orphan Tsunami of 1700. He is also a nephew of Catherine Natsuko Yamaguchi Chin.
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Making Political Change through the Eyes of a Nurse: Congresswoman Lauren Underwood Advocates for Communities BY JULIA QUINN-SZCESUIL
C
ongresswoman Lauren Underwood, MSN/ MPH, RN, is serving in the Illinois 14th Congressional District during a time like no other. During her current term, which began in January 2019, Underwood has seen a shift in administrations after contentious elections, social upheaval as the nation addresses racism and racial disparities, and a global pandemic unlike anything the world has seen in 100 years.
Where I am from, a lot of people see government as a nuisance or something that has to be tolerated. What I saw in that role is how government, especially when it is well done and well run and people at all levels work together, can be a great help to people in both good times and bad. But when Underwood began her run as a Democrat for the seat in the 116th U.S. Congress, she knew making change was a priority and that her professional background in nursing would give her the expertise needed to help her community. With a BSN from the University of Michigan and an MSN/MPH from Johns Hopkins University, Underwood’s passion for health care led to her earlier service as a senior advisor at the U.S. Department of Health and Human Services (HHS) during the Obama administration. Her work to help communities with disaster preparedness and public health emergencies would be put to
direct use then as she worked on the Flint water crisis and now as she works during the COIVD-19 pandemic. Underwood works with many committees, but her particular passion for maternal health led her to launch the Black Maternal Health Caucus alongside Congresswoman Alma Adams (NC-12) to call attention to the profound disparities in maternal health.
Your roles with the Obama administration included work on infectious diseases, natural disasters, and vaccines. That seems like a blueprint for working in current times. How did that preparation shape your work as a Congresswoman? There’s the obvious topical connection given the pandemic, but what I took away from that job with the Obama administration is how the federal government can be helpful to a single community. That’s something I think people know in abstract—the idea that a town can be hit by a flood or a tornado or a water crisis like in Flint. There are resources, there are experts, and there are people who care about their fellow Americans and are willing to drop everything and come to their assistance. That’s so powerful. Where I am from, a lot of people see government as a nuisance or something that has to be tolerated. What I saw in that role is how government, especially when it is well done and well run and people at all levels work together, can be a great help to people in both good times and bad. When we talk about disaster preparedness and response, preparedness comes first. You want to
have things in place should something catastrophic happen. So, we are working in communities in good times and bad. We are augmenting their capacities and resources and that’s similar to the job I have now.
How do your two roles— as a nurse and as a politician—combine? I spent my career working to connect people with highquality health care coverage, reduce disparities, and help people live their healthiest lives. That’s the work I have done with every single role that I have had and that mission continues forward from this position in Congress. I have an opportunity to not just help my community and to help them be healthier, but to make an impact for the whole country. That’s something I don’t take lightly.
And so what’s happened with this maternal mortality disparity is that it feels like as Black women, we all know someone. It’s our sister, our best friend, our sorority sister, someone who goes to our church, the girl who lives around the corner in our neighborhood, who have these devastating and difficult experiences during delivery or postpartum period. Severe morbidity or they die.
This American Rescue Plan includes one of my bills, the Healthcare Affordability Act,
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that says that no American would pay more than eight and a half percent of their income on health care premiums for Obama care plans. Even before the pandemic, people couldn’t afford their health care. It was too expensive. They couldn’t afford their prescription drugs or see a provider or get a procedure they needed. That premium price was that first health care dollar that most folks spent every month. Now we’ve created some significant savings, and it’s good because that’s part of what I came here to do. Two years into this job, we’ve gotten it done. It’s for two years, and we’re going to try to make it permanent. That was something we had lots of conversations about in my community. People are very anxious about that kind of relief.
Affordability and access are both a primary focus for you. A lot of people, even within the political space, don’t understand how much access to health care matters. Within that umbrella you have linguistics of compatibility and cultural competence. There are questions of is there a clinic nearby? Can you get there? Can you afford it? Now our conversations around health care is who pays for it all. If we’re going to be really serious about this work around ending disparities, we have to be much more comprehensive in our thinking. We have been laser focused on this work in the maternal health space that I do. We are trying to end the disparity in maternal mortality and that has to be a comprehensive approach. We are making good progress.
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Can you please talk a little more about your passion for maternal health? I went to Hopkins for graduate school and one of my good friends, Shalon Irving, from the program ended up expecting a daughter in January 2017. When I was finishing out my service in the Obama administration, she was having her baby. Three weeks later she died. In our clinical training, at a very high level, we learn about the disparity, but I was really taken aback. She was working at the Centers for Disease Control and Prevention. She had her doctorate. She was working on health disparities. She was doing everything right, and we still lost her. I knew if I were to get elected, this was something I wanted to work on.
There’s something pretty incredible about our system of government that a regular person, a nurse, can get on the ballot, earn the support of her community, and get elected to the Congress. That’s extraordinary. I’m not saying I am extraordinary, but that my story is possible. There must be many experiences you share with people in this country and that must make you feel connected to the people you are serving. Absolutely. We see these examples all the time. And I am just talking about the maternal health space, not
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even the larger challenges that we know have been persistent. The latest topic of conversation outside of politics has been Meghan Markle and her interview. I was watching that interview and watching her talk about the suicidal thoughts she had while pregnant. Here’s this Black woman with great health care and with so much privilege in the world, and she can’t get access in a time of crisis. In my state of Illinois, mental health, suicide, and substance use disorders are the numberone cause of maternal death. And in my state, Black women are six times more likely to die of a pregnancy related cause than white women. And so I am watching this and…talk about near miss. For every death, there are 70 near misses. This is another example. And so what’s happened with this maternal mortality disparity is that it feels like as Black women, we all know someone. It’s our sister, our best friend, our sorority sister, someone who goes to our church, the girl who lives around the corner in our neighborhood, who have these devastating and difficult experiences during delivery or postpartum period. Severe morbidity or they die. It’s something we have all dealt with in isolation, but when you look at the numbers, it’s so prevalent across our community.
Now that we are in a different administration, how will things change? In the last six weeks, I have seen a dramatic shift in what it means to legislate. With this American Rescue Plan on COVID relief, there was a Senate that was anxious to get
National Nurses Month Special Issue 2021
their hands on the bill, and a president that was excited to get it signed. It was a fundamentally different experience than what I have had in the last two years. That has changed things. We are now legislating with the expectation that things will have a strong path forward, which is very exciting.
If we are going to move forward, we need to have people who have a great understanding of communities and populations and improve their health status. Who better to do that than America’s nurses?
After a pandemic that has had a swift and crippling impact on so many families economically, we know we have a lot of work to do to help folks recover. We have a lot of work to do when it comes to crushing the virus, helping people with a persistent form of the disease, making sure we have true equity in vaccine distribution, and making sure that those who are pregnant or postpartum have access to a vaccine, and making sure kids do, too. There are a lot of COIVD health care disparities that remain and there’s a tremendous opportunity with the recovery package and what it really means to help rebuild our communities. You heard [President] Joe Biden talk about building back better. What does that mean concretely for a community in Northern Illinois? That’s my job. My job
is to imagine it and put it in place so that my community can benefit and go to work. That’s exciting to me.
It must feel gratifying to do the job you wanted to do. There’s something pretty incredible about our system of government that a regular person, a nurse, can get on the ballot, earn the support of her community, and get elected to the Congress. That’s extraordinary. I’m not saying I am extraordinary, but that my story is possible. Then to have the opportunity to serve in a once-in-a-century pandemic and help shape the way we respond and not leave folks behind. I can make sure I help our communities. This is a great honor and something I don’t take for granted, especially recognizing how few people like me there have been in these roles.
As a nurse, working through a pandemic, how has that influenced the way you see all the struggles in your community and in the nation? In health care circles and nursing circles they talk about health in all policies and that’s how I view my work. In my first term I was assigned to three committees. Educational labor, which is K-12, higher education, labor unions, worker protections, and employer-sponsored health care. I was assigned to Homeland Security where I did FEMA and cyber security. And then I was assigned to Veteran’s Affairs. Outside of the very narrow employer-sponsored health care responsibilities, nothing else was about health
care. I found a way to work health care issues into literally everything I did. Everything. President Trump signed into law electronic medical records along the southern border to make sure kids weren’t dying in custody, particularly of these preventable illnesses like you saw over the course of 2019. We got a number of veteran’s bills signed into law. This year, I am assigned to the Appropriations Committee responsible for agriculture and rural development and the Food and Drug Administration, but also the whole department
of Homeland Security. What my wish list looks like and the changes we want to make is to make sure that everybody had a chance to live healthy, well lives. Period. That’s what I am here for. I have found if you are creative and persistent, we can get it done.
What would you say to nurses who want to follow a path similar to yours? Yes! We need you. We need more nurses in Congress. We need more nurses in elected office. If you want to be in an appointed position, that’s
great. I recognize not everyone can quit their job, run for Congress for two years, and then do this full time. It’s not something that’s accessible to everybody, but every community has a health department and that health department is overseen by a structure or entity—oftentimes it’s a county board or a board of health. Those individuals are either elected or appointed. Every nurse has the experience and expertise to be of value to that type of oversight. Oftentimes, these roles are compensated and flexible.
They are close to home and have tremendous local impact. We have seen the effects systemic underinvestment in local public health during this pandemic. If we are going to move forward, we need to have people who have a great understanding of communities and populations and improve their health status. Who better to do that than America’s nurses? Julia Quinn-Szcesuil is a freelance writer based in Bolton, Massachusetts.
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Elected Officials Poised to Enact Equity Legislation During the 117th Congress BY JANICE M. PHILLIPS, PHD, RN, CENP, FAAN
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National Nurses Month Special Issue 2021
T
he year 2020 will be one of the most memorable years in our nation’s history. Because of the COVID-19 pandemic, America got a first-hand look at some of the inequities and disparities that have plagued communities of color throughout history. Racial and ethnic minority populations remain disproportionately impacted by the coronavirus as evidenced by their higher rates of food insecurity, unemployment, and death. Thus, any discussions during the 117th Congress (1/3/2021 to 1/3/2023) regarding the social determinants of health and health equity will have implications for reducing the longstanding disparities experienced by these populations.
Because of the COVID19 pandemic, America got a first-hand look at some of the inequities and disparities that have plagued communities of color throughout history. As nurses who care about health disparities, we must remain vigilant in using our voices and expertise to advocate for those most in need. In doing so, we must stay abreast of key legislative initiatives focused on mitigating health disparities and achieving health equity. Numerous organizations, professional societies, advocates, and others
call for a greater integration of This executive order also calls equity issues into the policy for establishing a COVID-19 making process. For example, Health Equity Task Force. Families USA, a consumer- oriented organization, has created a road map for the Given that racial ineq117th Congress. Families USA uities exacerbate health has proposed legislative recomdisparities, a stronger mendations to achieve health equity which include a focus focus on eliminating on ending racial injustice in racial disparities must health and health care and remain a high priority. dismantling barriers to living a healthy life. The Black Maternal Health Caucus introduced the Black As nurses who care Maternal Health Momnibus about health disparities, Act of 2021 to end racial and ethnic disparities in maternal we must remain vigilant health. This proposed legislain using our voices and tion consists of twelve proviexpertise to advocate for sions focused on mitigating the multiple drivers of poor those most in need. maternal health outcomes. Investments in the social deterThe new administration minants of health, funding to has started to apply an equity support community-based lens during the new congres- organizations and research sional session. For example, are among some of the key on January 20, 2021, President provisions. These twelve proviBiden signed a number of sions will address the nation’s Executive Orders to advance maternal health crisis and racial equity. Broad sweeping improve the health outcomes in scope, the “Executive Order of all women of childbearing on Advancing Racial Equity age, especially women of color. and Support for Underserved Environmental toxins and Communities through the high pollution levels have long Federal Government” requires disproportionately affected agencies to assess how they communities of color and are promoting equity in gov- low-income communities. In ernment actions. For example, January 2021, Representative one executive order calls for Cori Bush (D-M0-01), a ensuring an equitable pan- new congressional memdemic response and recov- ber and African American ery. Another executive order nurse, and Senators Tammy calls for initiatives to amelio- Duckworth (D-IL) and Edward rate discrimination based on J. Markey (D-MA) introduced gender or sexual orientation. the Environmental Justice
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Mapping and Data Collection Act of 2021. They proposed this legislation to help combat environmental racism. This legislation will establish an interagency justice mapping committee that will identify at risk communities for environmental injustice, create a data depository, and engage communities in seeking solutions. Given that racial inequities exacerbate health disparities, a stronger focus on eliminating racial disparities must remain a high priority. From the bedside to the halls of Congress, nurses everywhere can play a role in helping to reduce disparities and ultimately achieve health equity. In doing so, a few implications come to mind: • Does your employer/institution have a health equity strategic plan? What is nursing’s role in shaping and implementing the strategic plan? • How can you apply an equity lens to your nursing practice, research, teaching, and policy advocacy endeavors? • How can you leverage your expertise and experience to shape policy discussions around the achieving health equity? Janice M. Phillips, PhD, RN, CENP, FAAN, is an associate professor at Rush University College of Nursing and the director of nursing research and health equity at Rush University Medical Center.
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health-and-health-care-in-every-american-community • https://www.whitehouse.gov/briefing-room/presidential-actions/2021/01/20/executive-order-advancing-racial-
equity-and-support-for-underserved-communities-through-the-federal-government/ • https://www.markey.senate.gov/news/press-releases/senators-markey-and-duckworth-rep-bush-introduce-legisla-
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National Nurses Month Special Issue 2021
Celebrating
Enfermera/o Krankenschwester
תוחא
NATIONAL NURSES WEEK Muuguzi
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медсестра
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ENVISIONING THE FUTURE in Maryland and Beyond
The University of Maryland School of Nursing envisions a brighter, more courageous future in which we stand ready to move forward in a redesigned world. We are immensely proud of every nurse, everywhere, for your bravery, your commitment, your sacrifices, and your compassion. We honor and thank you, during National Nurses Week and all year long.
MAY 6 - 12 , 2021
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