Catholic Nurses and Abortion

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I returned from New Mexico where I visited San Felipe de Nero Church and bought a new Rosary. Not because I needed another Rosary, but because it is as beautiful and I find the faith. I was reminded that I never finished this post probably because I’m conflicted about the issue of abortion in some circumstances, but not the least bit conflicted about the religious freedom of nurses to decline to participate in abortion when they have a reexpressed objection.

Protecting Statutory Conscience Rights in Health Care issued by the Department of Health and Human Services (HHS) in April 2019 broadens the ability of HHS to enforce existing laws preventing discrimination based on conscience and essentially reinstated the 2008 rule with enhanced enforcement and clear definitions. The most significant change beyond enforcement is the definition of “assist in the performance” which is now “to participate in any program or activity with an articulable connection to a procedure, health service, health program, or research activity, so long as the individual involved is a part of the workforce of a Department‐funded entity.” It does not override existing law including EMTALA.

As part of the background for instituting the rule, HHS cited the cases of nurses who exercised their conscience rights and suffered discrimination as a result.

In 2010, Nassau University Medical Center disciplined eight nurses when they raised objections to assisting in the performance of abortions.26 Nurses in Illinois and New York filed lawsuits against private hospitals alleging they had been coerced to participate in abortions. Mendoza v. Martell, No. 2016‐6‐160 (Ill. 17th Jud. Cir. June 8, 2016); Cenzon‐DeCarlo v. Mount Sinai Hosp., 626 F.3d 695 (2d Cir. 2010). A nurse‐midwife in Florida alleged she had been denied the ability to apply for a position at a federally qualified health center due to her objections to prescribing hormonal contraceptives. Hellwege v. Tampa Family Health Ctrs., 103 F. Supp. 3d 1303 (M.D. Fla. 2015). Twelve nurses in New Jersey sued a public hospital over a policy allegedly requiring them to assist in abortions and for disciplining one nurse who raised a conscientious objection to the same. Complaint, Danquah v. University of Medicine and Dentistry of New Jersey, No. 2:11‐cv‐6377 (D.N.J. Oct. 31, 2011).

Rosary

Rosary from San Felipe de Nero Church

One can easily argue that the rule goes too far and favors the provider over the patient and that it makes it difficult for people in rural areas or areas where the only access to care is through a faith-based hospital or clinic. However, it does not prevent any facility from providing reasonable accommodations to the healthcare worker in such cases. In other words, as an administrator, if I know that a nurse objects to participating in abortion I can reassign that nurse to other responsibilities to prevent the nurse from having to violate conscience. That is not to say that the nurse could be reassigned to non-nursing duties, but other nursing duties.

What does it mean to be a Catholic nurse?

Long before I understood and deeply pondered Catholicism I knew I wanted to be a registered nurse. The decision to become a family nurse practitioner came much later, but the reasons are similar. Nurses provide for the holistic health care needs of others. The care provided ranges from education, to preventive services, to highly technical care. It can and does frequently include care for the needs of family members, addressing social concerns, and spiritual care. As a nurse, it is a privilege to walk with people as they journey through life.  However, there are times that their journey may take them down a path where I chose not to follow. As a provider, I have always ensured I understand my responsibilities so that any conflicts would be clear upfront. I’ve intentionally avoided jobs that would put me in regular conflict with my beliefs.

When I entered nursing there was no social contract that said I must give up my immortal soul to be a nurse. If you ask me to participate in abortion you are asking me to commit a mortal sin, risk excommunication, and take a life. I passionately disagree with the belief that “If you don’t want to provide abortions, don’t go into healthcare.” It is as if there is one truth and those of some faith traditions don’t know it. Of course, that lack tolerance goes both ways as anyone that has ever interacted with the “Right to Life” movement knows. Of equal importance is the fact that the vast majority of health care has absolutely nothing to do with abortions so why would one believe that a refusal to participate in abortion should be an exclusion criterion?

“Those that proclaim themselves to be the sole measure of realities and of truth cannot live peacefully in society with their fellow men and cooperate with them.”

—Compendium of the Social Doctrine of the Church

The Pew Research Center has a great deal of research on where major religious groups stand on abortion.  However, official teaching does not mean that members believe that abortion should be illegal or even that religious people don’t have abortions at the same rate as the general population. One of the beauties of the United States is that we can freely practice our religion and for the most part firmly believe we should not force that religion on others. Thus, I can be Catholic and believe that while you should not have an abortion in most cases that you currently have the Constitutional right to make that choice.

I will not block your way or give you false information if you seek an abortion. In fact, I will do my best to give you all the relevant information. That is where I part ways with the new regulation. I do believe we have a responsibility to refer a person to another provider that shares their beliefs if that is what they desire. I also believe that I must always be honest with the patient. If as a provider I am unwilling to instruct a patient on abortion I should be upfront that my beliefs prevent me from doing so. The regulation does require facilities to post or give notice about what they will not do based on religion but does not require a referral to someone that will provide the requested information or care. While it appears clear that notice must be given to the patient about the limitations of services I worry about the willingness of this administration to enforce that section.

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What would it mean to have no Catholics in healthcare?

Approximately 21 percent of the population of the United States of America is Catholic. Therefore, it would be reasonable to assume that 21 percent of all nurses in the USA are also Catholic. There are 660 Catholic hospitals and 1644 Catholic continuing care facilities in the USA alone. There are approximately 750,000 employees caring for almost 5 million admissions including 1 million on Medicaid each year. That equates to 1 in every 7 patients being treated in Catholic facilities.

If one excluded all Catholics that followed the teaching of the Church from practicing it would devastate our healthcare system. We would lose about 15% or our hospitals many of which serve already underserved areas. We would also lose about 20% of our nurses and physicians which means many would go without care.

A rational solution not based on hate of those who choose life.

As nurses, we have the ability to see the world in a way few can. We have walked with those that are rich and poor, from many cultural backgrounds, many countries, and just as many perspectives. We have seen people experience great pain and great joy.  We have cared for the victim of violence and the person that committed violence. And, we have always tried our best to provide compassionate care.

I believe that Catholicism made me a better human being just as Soto Zen practice does. In stating our beliefs, we may find common ground that brings us together to find solutions that don’t criminalize acts of fear and desperation or ignore the needs of women whose beliefs do not equate abortion to wrongdoing.

Here is what I believe:

  • Women are fully human – not less than men or human embryos or human fetuses.
  • A human embryo has all the genetic material of a human being but is not sentient from the time of conception.
  • The human embryo/fetus is drawing its life from the mother.
  • Self-determination should be a right for all sentient beings – rights come with responsibilities to make moral decisions.
  • Pregnancy is a choice in most circumstances – rape, incest, and the life of a mother are special circumstances that force choices between the good of the human embryo and the human fetus and the good of the mother.
  • Contraception meant to prevent implantation is not equivalent to abortion – it does violate the teaching of the Church, but can result in a reduction of abortions.
  • Poverty, abuse, lack of childcare, fewer education options for women with children, fewer job opportunities and discrimination against women with children, and inadequate support for those that are pregnant impact a woman’s decision to have an abortion.
  • Abortion is a moral and healthcare decision – women are endowed with consciences and can make moral decisions.
  • Pregnancy is stigmatizing – society values fertility, but not always the pregnant woman especially if she is unwed or poor.
  • The objective act of abortion being immoral does not equate to the person carrying out the act as either good or evil.

The compassionate solution cannot be to build a wall between women and legal and safe abortion and expect it will end abortion. We should begin with compassion and start by passing laws and making policy changes that will encourage giving birth and value pregnancy.

  • Paid maternal leave for six months
  • Affordable childcare based on income
  • Educational support for pregnant teens and new moms
  • Adequate nutritional assistance for all women of childbearing age
  • Free adoption
  • Women’s health care in all communities that is free to all women of childbearing age
  • Corporations that don’t disadvantage women with children

Nurses must practice in a manner that gives great consideration of the patient’s needs. This requires carefully working with an employer in advance to ensure one’s views don’t unreasonably compromise access for a patient.  Nursing is a big profession with many options so it is important to consider options.

  • If a portion of a job violates one’s conscience think carefully about the extent to which one’s views impact the care of the patient.
  • Make any conscience objections known in advance and in writing.
  • If one’s views would prevent providing life-saving care then it is inappropriate to take the job.
  • Always show respect for the patient which can be done without violating one’s own conscience.

Like no other, the nurse has a direct and continuous relationship with patients, takes care of them every day, listens to their needs and comes into contact with their very body, that he tends to. –Pope Francis

Let us as nurses show the same compassion to and respect for each other.

 

Catechism of the Catholic Church on Abortion

Abortion

2270 Human life must be respected and protected absolutely from the moment of conception. From the first moment of his existence, a human being must be recognized as having the rights of a person – among which is the inviolable right of every innocent being to life.72

Before I formed you in the womb I knew you, and before you were born I consecrated you.73

My frame was not hidden from you, when I was being made in secret, intricately wrought in the depths of the earth.74

2271 Since the first century the Church has affirmed the moral evil of every procured abortion. This teaching has not changed and remains unchangeable. Direct abortion, that is to say, abortion willed either as an end or a means, is gravely contrary to the moral law:

You shall not kill the embryo by abortion and shall not cause the newborn to perish.75

God, the Lord of life, has entrusted to men the noble mission of safeguarding life, and men must carry it out in a manner worthy of themselves. Life must be protected with the utmost care from the moment of conception: abortion and infanticide are abominable crimes.76

2272 Formal cooperation in an abortion constitutes a grave offense. The Church attaches the canonical penalty of excommunication to this crime against human life. “A person who procures a completed abortion incurs excommunication latae sententiae,”77” by the very commission of the offense,”78 and subject to the conditions provided by Canon Law.79 The Church does not thereby intend to restrict the scope of mercy. Rather, she makes clear the gravity of the crime committed, the irreparable harm done to the innocent who is put to death, as well as to the parents and the whole of society.

2273 The inalienable right to life of every innocent human individual is a constitutive element of a civil society and its legislation:

“The inalienable rights of the person must be recognized and respected by civil society and the political authority. These human rights depend neither on single individuals nor on parents; nor do they represent a concession made by society and the state; they belong to human nature and are inherent in the person by virtue of the creative act from which the person took his origin. Among such fundamental rights one should mention in this regard every human being’s right to life and physical integrity from the moment of conception until death.”80

“The moment a positive law deprives a category of human beings of the protection which civil legislation ought to accord them, the state is denying the equality of all before the law. When the state does not place its power at the service of the rights of each citizen, and in particular of the more vulnerable, the very foundations of a state based on law are undermined. . . . As a consequence of the respect and protection which must be ensured for the unborn child from the moment of conception, the law must provide appropriate penal sanctions for every deliberate violation of the child’s rights.”81

2274 Since it must be treated from conception as a person, the embryo must be defended in its integrity, cared for, and healed, as far as possible, like any other human being.

Prenatal diagnosis is morally licit, “if it respects the life and integrity of the embryo and the human fetus and is directed toward its safeguarding or healing as an individual. . . . It is gravely opposed to the moral law when this is done with the thought of possibly inducing an abortion, depending upon the results: a diagnosis must not be the equivalent of a death sentence.”82

2275 “One must hold as licit procedures carried out on the human embryo which respect the life and integrity of the embryo and do not involve disproportionate risks for it, but are directed toward its healing the improvement of its condition of health, or its individual survival.”83

“It is immoral to produce human embryos intended for exploitation as disposable biological material.”84

“Certain attempts to influence chromosomic or genetic inheritance are not therapeutic but are aimed at producing human beings selected according to sex or other predetermined qualities. Such manipulations are contrary to the personal dignity of the human being and his integrity and identity”85 which are unique and unrepeatable.

Are Nursing Instructors Too Harsh

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It has been 30 years since I began my nursing education and I laugh about what I once found stressful, but I’m never sure if I laugh because I think it is funny or out of a stress reaction. I wonder how many nurses from my era cried over care plans/maps or a thousand pages of reading assigned in one week? How many of us went to our clinical rotation after having been up most of the night preparing all the while wondering how we would ever do this for eight patients at a time.

Six months out of school everything seemed easy. I moved from wondering how I would ever do it all to why I ever thought it was hard. Therein lies the problem. I moved from a student who felt the stress to a nurse that was thinking “suck it up”. We all survived and are better prepared to care for patients as a result of those stressful and sleepless nights. But, are we?

When are we asking too much

Having worked at four universities I’ve never made it through a year without a student expressing concern about the workload and the lack of flexibility. Usually, the concern stems from an unexpected emergency, conflicting student activity, or the need to work to help pay tuition. Much of the workload cannot be helped nor can student conflicts. There is a minimal amount of content that must be taught for a student to successfully pass the NCLEX and a minimum number of clinical hours for a student to learn the necessary skills. It is a challenge for faculty and students.

When is the extra assignment too much

I think it would be good for faculty to ask what assignments are actually necessary to facilitate learning and which actually interfere with the ability to learn. If we have students spend all their time reading and doing exercises and no time remaining to reflect on the content is it as beneficial as it could be? Increasingly I believe the answer is no, but I have not found any evidence in the nursing literature to support or refute that belief. Much like the number of clinical hours and the need for content to practice safely and effectively we don’t seem to study it.

If I had an hour to solve a problem I’d spend 55 minutes thinking about the problem and 5 minutes thinking about solutions. – Albert Einstein

I have always thought it would be great to have time to sit and think about the book or the article I am reading, but even now I feel the need to push on to the next task. It is what my nursing education modeled for me?

A Chronicle article from January suggest that 5 pages were sufficient. Obviously, in nursing that is a ludicrous suggestion, but so is the belief that a student can read 500 pages in a week and have multiple assignments. I can imagine a world where we get together and coordinate reading and assignments so that it is reasonable and thus it is possible for the faculty to give more attention per assignment and the students to be able to read, think, and then apply.

What do we do when an assignment is missed

I have almost always had a statement in my syllabus that essentially says that the due date is the latest possible date due so if one is prone to illness, accidents, or the heartbreak of procrastination they need to plan ahead because late work will not be accepted. Of course, it was somewhat dishonest because I clearly intended to make exceptions for births, deaths, accidents, illness, marriages, and all manner of life events. Students are people too and life happens to them. The question is always whether to adjust the grade for the extra time that their peers didn’t get or in the case of a clinical experience whether to add extra work or a makeup day.

As I have gotten older I have mellowed. I don’t think there is any evidence that a single missed clinical day has a measurable impact on performance as a nurse. I do think that adding a makeup day or assignment unnecessarily stresses the student and the faculty member. If we can’t show that it makes a measurable difference and it clearly causes student and faculty stress then why do it?

There must be a creative way to build in a late assignment or absence without encouraging either. If you know the answer please share.

Another Day Another Terrorist With A Gun

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“For God has not given us a spirit of fear, but of power and of love and of a sound mind.” 2 Timothy 1:7

I can’t remember the last time I have gone a day without reading about the tragedy that is gun violence or a month without hearing of a mass shooting. This morning I woke to reports of a mass shooting only to realize it wasn’t El Paso, but Dayton. Each time social media is filled with hateful people that cannot, or will not, have a civil conversation about a serious topic. Respectful disagreements can help move people to common ground, but what is most often reflected in society is matched in Congress and the result is more dead bodies and more grieving families. The policy changes that are needed will not be easy, but they are doable without changing the 2nd Amendment. More importantly, we are capable as individuals of changing our neighborhoods and ourselves. We cannot let fear be the enemy of reason. The House of Representatives has taken the first step, but the Senate refuses to do anything, but pray. Clearly, God has answered them with legislation from the House, but they do not have ears to hear.freed-heart-understanding-mind.jpg

For those of us that have lost someone, we love to senseless gun violence each new incident is a reminder that brings the pain rushing back. If you love your guns and the 2nd Amendment more than your neighbors then it will be impossible for you to understand my pain and the pain of every other person who has ever been impacted by gun violence. Each year on September 30 I remember my twin brother who was shot four times (two in the chest, one in the side, and one in the back) and died on my parent’s living room floor.  The bloodstain on the carpet is forever etched into my memory. He was not killed by an intruder, but rather in an argument with our brother. They had fought many times before resulting in typical injuries from fistfights. The problem was that a gun was lying on the table.  Without the gun, he would probably be alive. The police called it a “family matter” and did nothing. In fact, because my other brother was never charged with a crime he legally purchased many more guns.

The argument that the 2nd Amendment is without limit is not true and is usually followed by the statement that “guns don’t kill people, people kill people.” It is reposted without adequate consideration to what this actually means.  In fact, people who own guns are more likely to kill people either accidentally or intentionally. Not all gun deaths come from People with guns do kill people.

This year alone there have been:

  • 33,028 incidents
  • 8,734  deaths
  • 17,308 injuries
  • 251 mass shootings
  • Of those, 390 were children and 1,796 were adolescents (http://www.gunviolencearchive.org/)
  • And how many thousands of grieving families, lost incomes, children without parents, wives without husbands, and parents without children?

Additionally,

In the civilian population deaths from firearms are believed to be a good indicator of firearms violence. The rate of nonfatal gunshot wounds is estimated to be 2.6 times the rate of fatal gunshot wounds. You can find the death rates from firearms by state at http://www.statehealthfacts.org/comparemaptable.jsp?ind=113&cat=2.

The 2nd Amendment is our Constitutional right, but it does not mean that one should own a gun.  I have the right to own a gun and choose not to because I believe they are implements of violence and are designed to take life and only bread evil in one’s soul. Yet this isn’t the only right we have that we can and should decline. Let us decline the right all actions that take a life – abortion, the death penalty, and war. If we value life then sometimes we make decisions not because it is our legal right, but because it is a moral obligation.

It is true that it takes a person to pull the trigger, but without a gun, it is much harder to kill. People do kill people, but people with guns are more likely to do so either intentionally or accidentally. “The dignity of the human person is the foundation of a moral vision for society” (USCCB). The sanctity of human life and the inherent dignity of the human person cannot merely be about abortion or assisted suicide, but must include protecting all life and that means stopping gun violence and all violence.  My wish is for a day that no American chooses to avail themselves of the 2nd Amendment right. Peace is an amazing feeling and it begins in our own homes and hearts. Put fear aside, love your neighbor, and choose life. Don’t let the lust for an instrument of evil that has taken so many lives and caused so much pain replace reason and compassion. Don’t let your fear win.

What is a Worthy Celebration Nathan Bedford Forrest, A Racist

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The first time I heard of Nathan Bedford Forrest was in Tennessee history in Junior High School. I’m not sure how much of his background was emphasized, but I also don’t remember him being presented as an honorable man. Prior to the Civil War, he was a repulsive human being who amassed his wealth as a cotton farmer that depended on slave labor and selling human beings into slavery among other business endeavors.

As a Civil War Army General, he was considered to be a good military strategist though clearly not an honorable one. Under his command, he ordered the massacre of Union soldiers, mostly black and some white Tennesseans fighting with them. Even at that time killing people who had surrendered was not honorable.

After the Civil War ended and all of those who had been held as slaves were freed Nathan Bedford Forrest continued a life that dishonored the state of Tennessee and the United States. Since he could no longer hold slaves he became the first Grand Wizard of the Klu Klux Klan which terrorized people of color. He denounced the violence in his later life, but even then apparently lied about his role. All he actually did was change his focus to a different form of slave labor.

After he left the KKK he secured the use of people who had been convicted of crimes to clear his land and work the same land. He used 117 prisoners to grow his wealth. Forced labor of prisoners is a stone throw from slavery at best. It should not go without notice that the majority of those people were black and in that era, the chances they had a fair trial was slim to none. They took black men and women out of the illegal chains and put them in the chains allowed by the law of the time which was incarceration.

It is true that state law in Tennessee mandates an annual proclamation, but it states:

Each year it is the duty of the governor of this state to proclaim the following as days of special observance: January 19, “Robert E. Lee Day”; February 12, “Abraham Lincoln Day”; March 15, “Andrew Jackson Day”; June 3, “Memorial Day” or “Confederate Decoration Day”; July 13, “Nathan Bedford Forrest Day”; and November 11, “Veterans’ Day.” The governor shall invite the people of this state to observe the days in schools, churches, and other suitable places with appropriate ceremonies expressive of the public sentiment befitting the anniversary of such dates.

Tennessee Code 15-2-101

The governor has the ability within the law to interpret appropriate ceremonies expressive of the public sentiment and befitting the anniversary of such dates. It is clearly within his authority to add language to the proclamation that states that it is appropriate to use this as a reminder of the evil of racism, our history of slavery, and the disgrace of being the home of the first Grand Wizard of the KKK. He could use the proclamation to call for a day of service to promote racial justice or as a day he gives clemency to deserving prisoners. There are many ways the law could be fulfilled that don’t continue to celebrate the man that had no honor and does not deserve our respect.

Until the day the Tennessee representatives change what is clearly a law that celebrates our racist past we should all ask and expect the governor to act with honor by preparing an appropriate proclamation. And if he refuses to act in an honorable manner there is nothing that stops us from planning now to make this a day that addresses racial justice in our communities.

When the elected officials refuse to lead with honor it is should never be the case that the citizens remain silent and do not act. We have a year to prepare. Let’s get started.

Help at the Border

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We can each find a way to help children at the border.  I remind myself often to give of my time, talent, and treasure. When I was young I had time and as a nurse a skill that many shelters needed. As my career progressed I had little time, but more money. We each have something we can do to help children at the border. What can you do?

Here is a list of some of the places that you can donate money or your skills.

Humanitarian Respite Care needs donations. They accept donations of time, money, or supplies through Amazon Wish List. If donating money it goes to Catholic Charities of the Rio Grande Valley and notes on the check that your donation is designated for humanitarian response.

USA Today published an article on how to assist, How to Assist Families and Children at the Border.  

Rising Together has a list of needs from lawyers wishing to volunteer.

Humane Borders has regular meetings in Tucson. They provide water drops and other activities and accept groups to join them. There was recent media coverage of a person being arrested for water drops and as provoked by the devil as I believe that arrest to be it is something that requires a person to consider the risk they are willing to take for their belief in humanity and justice.

The National Network for Immigrant and Refugee Rights provides a list of border advocacy groups. You will find a list of organizations actively working for just and humane border practices in the United States and Mexico. Many of them have volunteer programs while others provide advocacy tools and ways to get involved.

There are makeshift clinics providing care and volunteer physicians and nurses. The best way to find the clinics is to speak with local advocates.

The Asylum Seekers Advocacy Project has opportunities to donate, get updates, and apply for jobs and internships. Follow them on Twitter @asylumadvocacy.

The Women’s Refugee Commission improves the lives and protects the rights of women, children, and youth displaced by conflict and crisis. They research their needs, identify solutions and advocate for programs and policies to strengthen their resilience and drive change in humanitarian practice. They have a useful list of resources.

The National Association of Social Workers has a list of ways to volunteer to help children separated from parents. It is one of the better lists I’ve seen.

 

Scoop and Run: A Plan for the 4th on the National Mall

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The first time I attended the July 4th fireworks in DC it was with a friend’s family who attended every year. As we were on the metro headed to the mall she informed me that when the final volley of fireworks began to “scoop and run”. Pick up all of your stuff and run to the metro as fast as possible to be on the train that would be waiting. Otherwise, we would be stuck in the crowds for hours.

My advice to anyone attending the July 4 celebration this year is to be prepared to scoop and run. Know your exits, know where the metro is, know your way to walk across the bridge if it is too crowded and for goodness sake don’t drive. But also know where there is a safe area close to you. What shops and restaurants are open where you can get through the door and out of the crowd? Be prepared that some places in the event of mass demonstrations will go into lockdown quickly. If you are in you will stay in and if you are out you will stay out.

Events of civil unrest in cities across the United States raise awareness of injustice in our society and they appear to be on the rise. Yet, it is those moments when civil unrest occurs that we often fail to recognize the human dignity of every person. Civil unrest can lead to physical violence as it did recently in Portland. Our instinct may be to respond as we would in a disaster and seek help from police and places like the medical aid stations. However, this may be the wrong action during the unrest. Because of heightened tension between the police and the general population they may view your rapid approach as a threat rather than fear. The presence of police in the medical aid station may not be possible and even if possible, it may only attract the unrest to the area and thus be undesirable.

I doubt there will be any civil unrest at the July 4th fireworks in DC, but if I were ever going to encourage caution this would be the year. Anytime a large, nationally televised event is politicized it increases the risk of clashes. Politization may include the “baby Trump” balloon, flag burning, and white supremacists. We also know that inequalities in society, culture, and finance have resulted in civil unrest, rioting, and intentional violence throughout our history. When one group is given special privileges at an event that has always been egalatarian it increases the risk of problems.

10 tips to a safe July 4th on the National Mall

  1. Stay hydrated and be aware that there are sometimes long lines at vendors. Dehydration alters your ability to think clearly.
  2. Wear sunscreen just because I’m a nurse and we remind you of the obvious.
  3. Dress appropriately for long walks and hot weather. Running or walking shoes will be better than sandals.
  4. Bring your fanny pack first aid kit or put a small one in a bag.
  5. It is always better at large events to carry your belongings in a clear plastic tote bag so that everyone can see there is nothing of danger in it.
  6. Do not bring anything with you that could be perceived as a weapon.
  7. If you see people with weapons other than police move away as quickly as possible and notify law enforcement.
  8. Be aware of your surroundings and know where the exits are located.
  9. Do not engage people who are protesting. Even if you think you agree with them sometimes people surprise you with what offends them and when you are hot and tired your own response may even be a surprise.
  10. Be cool, be calm, be alert, be gone if trouble begins.

I hope everyone has an enjoyable July 4 and remembers that the day is a celebration of our independence. It is a time to celebrate a great nation and remember that children will be present.

Nurse Leaders’ Response to Civil Unrest requires preparation. It is a good time to go through your checklist before the events begin on July 4.

 

Book Review: Voices of the Dead

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I received a free copy of Voices of the Dead by John Babb, a retired U.S. Public Health Service, Rear Admiral. I read his first book Orphan Hero which I enjoyed, but this one is different. It is a historical novel set in 1878 and tells of Yellow Fever in Memphis and New Orlean. I could feel the humidity as I read of the nurses and physicians responding to the deadly virus and risking their lives to serve others.

There are plenty of nurse heroes in this book, but also everyone from physicians to Sisters, from Priests to Madames stepped up to help their neighbors and some lost their lives in the effort. Whether you are a lover of historical novels, or epidemiological investigations, or an infectious disease nerd this is a great book.

Of course, it could be that I liked it because it had all the things that fascinate me, steamy southern cities, infectious diseases, legislation like the Quarantine Act, selfless physicians and nurses, and the Marine Hospital Service which lead to the Commissioned Corps of the U.S. Public Health Service. It dealt effectively with the fears of quarantine and what citizens do when quarantine is ordered. In many ways, it is a case study of epidemics prior to modern healthcare.

I don’t want to spoil the book, but if you are a public health worker I think you will love it.