It’s funny how even when you know something terrible is coming, it can still give you an awful shock when it arrives, like a slap in the face or a bucket of ice water dumped over your head. That is what it felt like reading the leaked SCOTUS draft. Those of us who have been anticipating the ruling were not surprised: the slap is always shocking, even if you see it coming. Then there’s the aftermath, which is usually even worse than the initial shock. The whirlwind of statements, news coverage, opinion pieces, rallies, webinars, community dialogues, strategy sessions… Before you can even fully register your own shock, much less have time to sulk off and care for your wounds, you are thrown into a whirlwind of activity. It can be easy to lose ourselves in this frenzy, in this whirling, swirling, buzzing dust storm of activity. To lose the ability to see beyond the swirl, to imagine what’s next beyond the continuous, never-ending struggle for justice.

Inhale

Exhale

It’s funny how the first thing that goes is the most fundamental, breathing; how we hold our breath, shoulders and jaw clenched, brows knitted. BREATHE

Inhale

Exhale

I cannot tell you how often I have to remind myself to breathe… to allow myself the space and grace to tend to my wounds. These have been some HARD years and I am afraid that things will not get easier anytime soon; it is more important than ever that we take care of ourselves and of each other. That we show ourselves and each other a little grace in this struggle. This is not another call to action; it is an invitation. I invite you to take a moment, if you have not already, to reflect on what has happened. To really allow yourself to sit in your grief/ anger/ sadness, whatever it is that you are feeling. I invite you to acknowledge the sting of the slap and do what you need to do to tend to the wound (ask for a hug, call a friend, binge a show, write in your journal, go to the rally, cry, scream) whatever it is that you need to do to slow the swirl.

Inhale

Exhale

This is an invitation to be in gratitude for those who have come before you in this struggle, for those who have sustained you in this struggle, and for those who you struggle for so that they will not have to continue this struggle. I am grateful for this community. Each time I have an opportunity to learn more about one of you through a Member Spotlight or I hear about the work that a Chapter is doing I feel so deeply moved and deeply grateful that I am a part of this community. Thank you, thank you, thank you for all that you are and all that you do. Remember to keep breathing.

Rimsha Syed, NSRH’s Digital Outreach Coordinator, had a conversation with Kiernan Cobb (RN, BSN), Director of Nursing at Trust Women in Oklahoma and Kansas, about sexual and reproductive health, the ins and outs of providing abortion care, and the importance of advocating from inside the movement. Kiernan was recently a panelist at NSRH’s Critical Thinking for Critical Care conference and continues to shed light on political pressure in the reproductive healthcare landscape.

Rimsha: How does SRH show up in your life?

Kiernan: SRH shows up in my life as a queer person working in healthcare. I am simultaneously facing and working to dismantle barriers to care for queer people. In a political and cultural climate that is reversing rights in all areas of sexual and reproductive health, it is more important than ever for me to be visibly queer doing this work. I have always been out as queer with coworkers, am working on being out about my gender journey, and disclose with discretion my work in abortion care. Working in an at-will employment state that is also very hostile to abortion and queer folks, I hold these identities close at times to protect my job and my family. Workers’ rights are also closely linked to reproductive justice. I work in both emergency and abortion care which can be very tense but very rewarding settings. I am often seeing people at one of few access points they have into the healthcare system. Both ERs in general and my abortion clinic specifically are often providers of last resort after people have been turned away from or lack the resources to access other providers, after the healthcare and political systems have failed them. Oklahoma criminalizes self-managed abortion while imposing harsh restrictions on access to medicalized abortion care. This is a struggle in both my abortion clinic and hospital practice. We cannot serve every patient who needs abortion care and there is always a chance I will see folks who fell through the cracks in our crumbling healthcare system in the ER. 

It is incredibly hard to work under constant political pressure and threat of losing our abortion infrastructure and ability to serve our patients. The job is easy but the work is hard. Before starting in nursing, I worked as an abortion counselor and wanted to expand my scope in this setting. Pursuing my RN allowed me to do a lot more clinically in abortion care. Now, I am facing this problem again, working at the top of my RN license. I’m thinking about how to expand my scope into advanced practice nursing and be able to provide abortions myself. 

Rimsha: Have you received any professional SRH education?

Kiernan: In the same way all nursing is psych nursing, all nursing is sexual and reproductive health nursing. At no point across the lifespan and in no practice setting is SRH not relevant. Yet, schools are reluctant to teach or start these conversations. I received no instruction about abortion care in my nursing school education. Our one lecture on contraception was full of stigmatizing language and incorrect information. The only queer education in my program was from projects I did where I insisted my group be LGTBQ+-focused. I was chastised by a nursing instructor for working in abortion care. This is a disservice to learners and our patients. 

Rimsha: Can you tell me about a day in the life as an emergency and abortion care nurse?

Kiernan: Yeah, my more interesting days are when I was doing double duty at clinics. So for a while, we didn't have a lot of staffing in Oklahoma City. So I would come in at eight or nine to Trust Women, start getting patients pre-medicated with their miso and other things, start IVs, pop in for a few procedures. And then I would leave at 12:30 over to my hospital and work my mid shift from one p to one a over there. Those days were kind of crazy. Luckily, staffing is better now. Right now, I'm full time doing abortion care and PRN in the ER. I'm covering Oklahoma and Kansas clinics starting IVs and giving meds, doing moderate sedation, monitoring, and recovering our surgical procedural abortion patients, and doing some admin stuff as director of nursing. Like today, Wednesday's are always my big day of meetings with our clinic and admin leadership. Working on projects today - I was working on and tracking down all of our PUL (pregnancy of unknown location) patients that had blood draws done, so we can do good follow up care for them, make sure nobody has an ectopic or anything like that. Then I'm working PRN now in the ER. A few days a month, I will go over there. My ER is a level one trauma center and I work on the medical side. Usually from the time I roll in at about 12:45 I'm just going until I leave at 1:00 in the morning.

Rimsha: Wow. Thank you for answering that. My next question is, what does sexual and reproductive health mean to you on a personal level?

Kiernan: Yeah, for me personally, as a queer person, it impacts every area of my life. Something I'm always thinking about when I'm out with my partner, I make a point to be visibly queer in all the spaces that I can until it becomes a safety issue. I'm also out at both of my jobs, I make sure especially in my hospital that I have some kind of queer-coded stuff like a little rainbow pen, things like that, just so that patients feel safe with me. Especially in Oklahoma, where it's not always a very friendly place for queer folks. Obviously, my job in abortion care is completely centered around sexual and reproductive health. It's sometimes hard to bring that into an emergency care situation just because I don't have the time with staffing and with medical emergencies to be able to have those conversations with every patient. But when it's relevant and desired and when I have the time to I'm trying to incorporate that, especially if we get a miscarriage patient. My hospital [helps patients] under a certain number of weeks [of pregnancy]. I don't remember what the cutoff is. Some pregnant patients will come to the medical ER and some will go over to the children's ER, where labor and delivery is. So I still do see a few pregnant folks over there and I try to kind of gravitate towards those patients if other people are not as well versed in sexual reproductive health. I try to make sure that they're getting really good care.

Rimsha: Right, thank you for sharing. So broadly speaking, how do you feel about self-managed abortions, especially seeing more and more states implement such harsh abortion bans and restrictions?

Kiernan: Yeah, so broadly, self-managed abortion is a great option for some folks. Oklahoma is one of the states that criminalizes SMA, so I can't say anything about it in an official capacity to patients. Self-managed abortion is not inherently unsafe, but the criminalization of people experiencing pregnancy loss in Oklahoma makes patients reluctant to seek care. 

And if we have someone that comes into the ER that is suspected of an SMA it is really reminiscent of the case that Texas just had of a medical provider who reported her for that. And Texas doesn't even criminalize it, so it's just a whole can of worms to have those patients come in. As states are restricting abortion access, SMA is a good option. But there are still a lot of folks who either need institutional medical care or just want that familiarity and that kind of backup from a provider. I'm glad that we are, for now, still here and able to provide that care.

Rimsha: Right. What recommendations do you have to nurses and allies who want to challenge these oppressive bans and restrictions, not only in Oklahoma, but also across the country?

Kiernan: I think people need to make their medical practice into activism as well to advocate for their patients to make sure that they're getting good and appropriate care, to make sure that they themselves are trained in a trauma informed way, to make sure that they know what the regulations are in their area [that] they have to work around. And you have to just advocate for patients. A lot of ERs, especially if they're kind of siloed from traditional reproductive care, don't provide the best support to those patients. So just making sure that we, as the providers, are advocating for them and are really well versed in that kind of care.

Rimsha: And how comfortable are you being so vocal and unapologetic in your work? Do you ever have any worries?

Kiernan: Yeah, I do. Basically my entire professional career has been in repro. I started out doing campus organizing stuff for Planned Parenthood. So that was a place that I really learned how to be vocal because that was the whole job. I was never shy about working in abortion care, it's something I'm really passionate about. I was super thrilled to come back into nursing to do abortion care. Working as an abortion counselor in a clinic in Texas is really what got me into nursing because I wanted to be able to do more medically. And I think it's just important to have folks that are really public about what it looks like from inside the movement because we obviously have more than enough people outside saying what they think is going on. [We have] to just push back against  those dangerous narratives and just say we're a part of healthcare, we're here doing this. I have a very unique name and I have my nursing license, all my medical credentials, and stuff are in my name. I'm not hard to find, but it doesn't really stop me from being outspoken in the movement as much as I can.

Rimsha: Right. What does being part of the NSRH community mean to you?

Kiernan: Oh, my gosh, it's so important. I did the Critical Care conference this weekend, I got connected to a bunch of really awesome nurses and nurse practitioners, and the DON (Director of Nursing)  at another clinic. It's a lot of contacts that I wouldn't have had before. When I came on at my clinic, I was the only nurse working here for a really long time. A lot of other folks had colleagues, like medical assistants and doctors and the clinical directors all had other people to lean on. I was the only nurse for a long time. And all the nurses that I knew that were doing abortion care before were at a clinic in Texas that obviously had to shut down to really, really limit capacity after SB8. So having the community of other providers and the educational resources from NSRH was really really helpful for me kind of finding my own way to start out as an abortion nurse.

Rimsha: That's great to hear. Where do you see yourself five to ten years from now?

Kiernan: Well, man, hopefully the landscape is better for abortion access than it is right now in five to ten years. I'm working on applying to master's programs to become, I'm thinking, a family nurse practitioner. As much as I love being in the Midwest and doing care here where it's really really needed, none of the states here let mid-levels do abortions. I would ultimately like to be in a place where I could be the abortion provider in addition to being a part of the care team.

Rimsha: Okay, so what do you find healing? How do you take care of yourself so that you don't burn out doing this work?

Kiernan: It's been hard through COVID to find those things. I was playing roller derby before and I have just started getting back into it. Another thing that was isolating, being the only nurse here, I had to be particularly careful to not get sidelined by COVID or something like that. So yeah, getting back to doing derby. I have a whole bunch of animals that I hang out with. We have foster kittens all the time. Taking care of my little zoo at my house is really healing for me too.

Rimsha: If you were to highlight what you're most proud of so far in your nursing career, what would that be?

Kiernan: Yeah, I think getting the director of nursing job at Trust Women has been the highlight of my career. I had kind of a backwards route to get here, my hospital experience is trauma and critical care and I haven't done anything outpatient before this. I had a strong background in abortion care in general before I got here. And like I said, abortion care is what got me to nursing. I had kind of planned for it to be my retirement job, where I could just hang out, push meds, monitor patients, and then all hell broke loose in the repro landscape. So I got thrust into it really quickly. It's been a big learning curve on the administrative side and also the clinical side. But I think we're doing a really good job. Me and the team here at the clinic are helping to rebuild a lot of our infrastructure that was missing. Doing that, and being able to provide this care in the middle of just a human rights crisis in the Midwest has been really, really important.

Rosie Laine, NSRH's student engagement coordinator sat down and interviewed our 2022 Karen Edlund Future Leader Award Recipient - Lana Keusch (she/her/hers), ABSN May 2022 from Duke University School of Nursing. You can read below or listen to the conversation here. 

Rosie (R): Hi Lana. Thank you so much for joining us at NSRH. We’re really excited to celebrate your KE (Karen Edlund) Future Leader Award, and we’re really excited to talk to you and learn a little bit more about your career pathway so far and your chapter organizing work.

Lana (L): Awesome, well thanks so much for having me here.

R: Tell us about your pathway to nursing, and more specifically to your interest in sexual and reproductive healthcare and advocacy?

L: Nursing is a second, or even maybe a third, career for me essentially. I started my career in public health. I got my MPH a little under ten years ago now, and I’ve been working in public health ever since, and even before that really. My advocacy and my work in that world kind of always revolved around sexual and reproductive health. In college I started out as a peer sexual health educator with a really awesome group called “Sex Out Loud” and that’s really what sparked my interest and my ability to move forward in the world of sexual and reproductive health. I bounced around in public health for a number of years. The great thing about SRH is that it encompasses and it includes all aspects of healthcare. Wherever you land, wherever you end up, there’s going to be some aspect of SRH that comes into play with your work. So I really loved that aspect of it, that uniting factor. Just how much I've been able to learn and grow as I’ve come to nursing as my ultimate goal. I was actually working for the Boston STD clinic. I was volunteering there at first while I was doing my grad school, and that led to a part-time paid position as a student, and it was affiliated with a number of other clinics that were in the same area: the STD clinic, the refugee clinic, infectious disease, travel health, and all of those things. Working in that area of the hospital at Boston Medical Center was just incredible. I was really inspired by my coworkers who were majority counselors and nurses. We had RNs and NPs that were affiliated with our clinic Working with them on a daily basis was just amazing. To see the relationships they established with our patients, with our clients. How much work and energy they put into making sure that people had access to the services that we were offering. Making sure that education was handed out, and that people were just aware of all their options going forward whatever that might be, whatever they might need, and connecting them with those resources. That drew me to nursing, but it took me a few more years to get up the courage to actually go to nursing school.

R: That’s a really interesting pathway. I think you’re completely right in saying that sexual and reproductive health intersects with so many different fields, which makes it really exciting work. That’s great to hear your perspective on that.

Along those lines, within SRH what issues are most important to you? What opportunities have you had to engage with these topics in your nursing, or public health career so far?

L: The start of my work in SRH focused a lot on reproductive justice, and really unlearning a lot of things that I had been taught growing up in the environment that I grew up in. Realizing that services were not available to everyone, access was a huge issue, and that we really needed to focus on that intersection of social justice and reproductive health. That was really the starting point for me, and that has remained really critical for me in all the work I’ve done since. I’d say when it comes to individual topics, obviously abortion is a huge issue. We actually had one of our members [chapter participants] write this amazing op-ed talking about how “abortion is not a dirty word.” I think we really need to encourage people to be speaking out loud about it. Just being really open and able to discuss it freely. So that’s a really major part of my work, for sure. I’m looking forward to doing my preceptorship at Planned Parenthood very soon. On top of that there’s a lot of other issues. There’s fertility, and particularly queer spaces within fertility. I think that’s a really important issue, and something I’m hoping to learn more about. On that same note, gender-affirming care within nursing, I think, is really critical. I love to see that that’s kind of a subset that is growing. I recently saw, there’s a graduate program that is actually focused entirely on gender-affirming care, which I think is amazing. So I hope that continues to grow. And then, I’m also really interested in forensics and forensic nursing, which I think is a relatively new and slightly unknown field within [SRH] nursing, but it overlaps in so many ways. So it’s not just SANE nurses, although SANE nurses are amazing and incredible, and I hope to become one someday. But there’s a lot of work that can be done within forensics that incorporates all of those important factors such as trauma-informed care, person-centered care, and again gender-affirming care. So, all of those things, and I’m sure more… I couldn’t list them all!

R: One of my favorite parts of my job working with students is seeing all of the different ways people are thinking about SRH and the directions they’re taking it. I think you’re a great example of that in thinking really broadly about SRH, but still really thinking about how to bring that Reproductive Justice framework to whatever you do.

In terms of your involvement with NSRH, how did you find out about NSRH? What inspired you to start a chapter and get involved?

L: I actually came to NSRH through doing research about abortion care. A few months ago I was just searching around within google to figure out what would my potential abilities to provide abortion care as an RN be based on what state I was in, or what arena I was in… and that led me down this pathway to finding the NSRH website. I just came across it and I was searching through all of the different tabs, all the different opportunities and options, and then I saw of course that there was this free student membership. So I was like “Yes! Let’s instantly sign up for this!” Because what a great resource and how accessible and wonderful that is. So that’s how I came to find the website, and the more I looked through it the more I realized that there wasn’t an organization yet, at Duke Nursing at least, that focused specifically on sexual and reproductive healthcare. So we have a number of awesome organizations that already exist that focus on a lot of things that fall within SRH, but the broader scope I felt might be a little lacking in terms of student organization and opportunities outside of class. So, I thought to myself, well you know maybe this could be an option. Just to see if this was a path forward within the Duke Nursing program, and I started to explore it. And you guys just have such amazing resources for chapters looking to get started. So it just went so fast, and there was incredible support from the Duke administration and then of course incredible support from the students. People were so interested. So we just had a massive sign-up- people were so excited to get started with this.

R: Yeah your turnout at Duke has been amazing to see, and I’m sure that is in large part due to the team you’ve built and your leadership. Even just listening to you talk about these issues it's clear that you can bring people together in that way, so that's been wonderful to see that get established at Duke.

So, I’m curious to hear, like you mentioned you started this chapter this year, it wasn’t really existing at Duke before. So I’m interested to hear about what your experience was like in both leading and establishing this chapter? If you were to give advice to students who were interested in organizing, but not sure where to begin, what might you say to them?

L: I think the key when it comes to any kind of leadership or organizing that I’ve always found, is communicating with existing organizations and not reinventing the wheel. Utilizing resources that are already available. Reaching out for help when needed. So the way I got this started, because I literally had no idea where to start on the Duke side of things. It’s not like there’s a website that says very clearly “here’s how you start an organization.” So, just reaching out to fellow classmates. I knew a classmate in a cohort above me who had started her own organization very recently. I didn’t know her super well, but I sent her an email that just said, “Hey I’ve been thinking about starting this chapter. How did you do this?” And she was able to give me some great advice and resources about what might be involved in that, and the time frame that that would need to happen in. And then it kind of snowballed from there. Again, you guys provided really excellent resources for helping me to keep us organized as we got things started. So I really just recruited from my friend group essentially for the e-board to start out with, because it’s so easy to work with people who you already work with on a regular basis. I’ve found a really wonderful gorup of students within my cohort who are very excited about sexual and reproductive health, and want to go into something related to maternity or SRH in a broader sense. But we really also wanted to bring in students from not only just outside our cohort, but not just within the ABSN program. Duke has a really robust graduate study body, but we don’t get to interact very much, One of the things I wanted from a student org was to interact and network and get to know more people who were at school with me in the same time frame, but maybe I’ll never see them unless it was for this organization. So I reached out and put it out there. Who among the grad students would be interested in a leadership position with this new org? We happened to get two wonderful people who joined up with us. We have a PhD student and a MSN women’s health nurse practitioner student who joined up. The great thing about having them on board as well is that they’ll be able to continue this work, after I and my other two four-semester officers graduate in just a couple of months. They’ll be around for much longer and the continuity will really be able to keep going. So, I love that!
I think one challenge our student leaders often face is how quickly nursing students turnover and how busy of a time it is. You all have a lot on your plate. I think it’s interesting to note that you’ve managed to recruit students pursuing different types of nursing degrees. I think that can be pretty difficult. Do you have additional advice on how to maybe close those gaps to have more of a robust chapter in that sense?

I mean I think the interest is always there. That’s the great thing about SRH. People hear that and they’re like, “Yes! I really want to do this.” I think the opportunity is always available, it’s just about creating that pathway. And creating the pathways is just about creating the pathway of least resistance. I reached out to faculty members who were the advisors for other programs. So obviously I know who our ABSN advisors are, but reaching out to faculty for the other programs and just saying, “Is there anyone who pops into your mind right away that might be interested in this?” And so, that made it less of a cold email. It was really targeting people who might have already been identified as potential leaders. And then, again just making it as easy as possible, and understanding people’s commitments. All of us have crazy schedules that don’t overlap very well. Being extremely flexible and understanding that life sometimes gets in the way. You know, one of our officers just had to take her qualifying exams for her PhD so she had to focus on that for two whole weeks and couldn’t do anything for her role for those two weeks. And so, we stepped up. The other officers filled in. And then she was able to come back and we’re able to continue on with that. So it’s about making sure that school comes first, family comes first, and we’ll support you in any way we can. It creates this family dynamic almost. I feel really close to all the people who’ve joined us so far.

R: If you were to highlight what you’re most proud of in your nursing career, as a student, or drawing from your time working in public health, what would you say you’re most proud of?

L: Well if I can pull from the last few years then I guess… because my nursing career is just getting started obviously. I would say I’m really proud of the networks I've built. Not only built but maintained. I love the fact that with this organization I’ve had the opportunity to grow it even farther than I might have been able to otherwise. You know, the pandemic created a really unique situation where it's very hard to meet people even within your own school program. We were virtual for the first two, of four semesters, then we broke into small groups So you may not interact with some of the people in your cohort at all! The networks I’ve built and maintained over the years, they span across the globe. And I’ve managed to maintain those families essentially. All of those people that I've picked up along the way who have changed my life for the better. People who I can call up and say “Hey, I’m going to be in Spain or Morocco in two months. I would love to meet up and see how you’re doing.” And it’s as if no time has passed.

R: To pivot slightly, what has been most challenging?

L: The fear of failure. Definitely. I wouldn’t call myself a perfectionist by any means but I certainly have large shoes to fill both within my family and then expectations that I have of myself. I think that’s why it took me so many years to finally get up the courage to take the prerequisite courses to go to nursing school. I wasn’t always the greatest student. I always loved learning, but being a student, that’s a totally different aspect of things. Having hit some challenges when I was younger, it was definitely scary to go back and face that again, and potentially face failure again. But actually, having had the time to branch out and do other things in the ten years between my last degree and this one… and that included traveling the world, and being a bartender, and working in retail, and I was an au pair for a hot second… I got to do all these different things and they’ve shaped me. After going through all of that, coming back to it knowing that this is my future. This is the path that I want. It made things so much easier to sit down and actually focus on the hard stuff.

R: I think that’s such a wonderful perspective to bring. Because I think especially when you’re trying to find your pathway, you worry about wasting time in between one step and the other, and I think it’s so valuable to realize that each experience will make that pathway more valuable once you do figure it out. So I think that’s great to highlight.

What does leadership in nursing mean to you?

L: Being a leader in any field, but in nursing in particular, is about helping to maintain momentum when we hit difficult paths like we have in the last two years. I’m new to nursing so I can't speak to what it’s like for somebody who has been working in nursing for years and then had to go through the pandemic. But I did get to watch from the outside and see how painful and challenging it was. So, I think a good nursing leader is someone who is able to maintain that motivation and make people feel not only needed in their role, but also cared for. Helping people to know that it’s okay to ask for help. Advocating for the needs and resources that are required to be able to do our jobs well. There’s a lot of work yet to be done but I see a huge amount of momentum within the nursing field right now. I’m excited for what the future is going to bring. I think there’s going to be a lot of changes for the better. Really just to inspire people to keep going forward and to keep doing what we’re doing. It’s such an essential task, and it’s so critical to the well-being of the world at large.

R: What’s next for you? What are your plans for after you graduate? What do you dream about?

L: I think I might be a never-ending student even though I wasn’t a good one for a very long time. I’m hoping to go back to school in a few years. I would really love to be a midwife. So, getting on that pathway means working on labor and delivery, maybe getting some cross-training in a bunch of other fields. I mentioned my interest in forensics so I want to move forward with that and advocate for better forensic education at the BSN level and awareness in general that forensics is a pathway that people could take. I think there’s a lot of need and there’s a huge gap in what’s being offered in terms of forensic nursing. And then… just more adventures! The great thing about nursing is that it’s flexible. It can take you just about anywhere. A long term goal of mine is maybe getting to work for an organization like “Doctors Without Borders” or “Physicians for Human Rights” in the nursing role and really advocating for that nursing role. Making it more of a “Clinicians Without Borders” situation so that people think of nurses more readily.

We can’t wait to see what’s next for you Lana! Thank you for your organizing work at Duke University. Congratulations for your recent award as the KE Future Nurse Leader Award!

2021 has been a battlefield for reproductive justice, explicitly regarding SRH and abortion access. This month our communications director Erica DC sat down with NSRH member Estephanie Charria, R.N Clinical Research Coordinator who is based in Orlando, Florida. Estephanie has been mobilizing and creating community in our NSRH community and within her direct network. Get to know “Steph” as she covers her passions, how she celebrates, and her hopes with merging communities.

Erica: What made you want to join NSRH?

Estephanie: I just wanted to be with like-minded people. And, you know, to be more actively involved in reproductive rights and justice. At the same time, I have been considering what I can contribute with my hands with you all. NSRH is aligned with my main goal, as I recently created a group called Champions for Health Equity. Currently, the group has  34 members right now. This group is a place where we (healthcare professionals) can have open dialogues with other healthcare professionals regarding systemic racism and reproductive rights, justice, LGBTQ, queer health, disability health, etc., so we can be better. Just because our system is not inclusive of our kind people. (NSRH Disruptors) 

Erica: What is your why behind being in your choice to become a nurse? 

Estephanie: My involvement with reproductive rights and justice started way before I was even thinking about becoming a nurse. I was heavily involved with Planned Parenthood doing community organizing for them. When I was in college, one of my electives (womens’ studies) required working with an organization (I chose Planned Parenthood) and learned of all their resources around SRH and abortion access. As a person who has had an abortion (at the time unaware of Planned Parenthood), during that time, I felt isolated with no one to talk to, so I was grateful to see the work they have been doing for abortion access and the supports around that. I was relieved to be around others who have had abortions and were pro-choice. My passion stemmed from my story, telling it, and how vital these narratives are for others to hear so they know they aren’t alone. I’m currently in neuro research and have learned the importance of advocacy, specifically for SRH and reproductive justice.

Erica: What are some things you hope to do within NSRH and Champions for Health Equity?

Estephanie: Soon, I hope to start a podcast to bridge the gap of conversations around the needs of healthcare workers and patients. I want to share patient stories just so we can have a conversation together asking, What do you need from us (as healthcare professionals?) Our patients have stories that need to be heard.

Erica: Given all that’s happening around abortion rights and access, how do you feel about the long game that's ahead?

Estephanie:  I know it’s going to be a process, and I've always believed that you're going to have to go into the lane of policy and lobby specifically for abortion access and rights in actual change. It's just so difficult because it is a systemic issue. With my group Champions for Health Equity,  I love facilitating things around this matter, from conversations with my colleagues to webinars. Unfortunately, at the same time, I don't think it's enough for any systemic change to occur within our hospital or in general. 

Erica: Have there been offerings equipped for these conversations within NSRH?

Estephanie: Yes! THE SYSTEM ISN’T BROKEN AT the RJ Series Member Event in November with Zena. It’s working how it’s supposed to. I have bought her book (The Care We Deserve) and am already halfway through it. I have even reached out to Zena, and as I know, she has a background in research (the field I am currently in). I’ve been a fan since that event. It was just what I needed.

Erica: Our value for this month is to Celebrate. How do you take time to center pleasure and celebrate?

Estephanie:  I will take a day to myself. I like singing and dancing or treating myself to my favorite meal.

By June 2021 there were already 561 abortion restrictions filed, of which 165 were abortion bans. These restrictions spanned over 47 states (Guttmacher). A few short months later, SB-8 went into effect in Texas. This onslaught against reproductive access and freedom in combination with the COVID-19 pandemic’s exacerbation of nursing exploitation has created a unique set of circumstances for nurses who are motivated to turn their politics into action. NSRH’s Training in Abortion Care Residency (TAC) is a concrete opportunity for registered nurses to re-imagine their nursing career, and gain experience in a sector that provides an alignment of our values with our work. 

The othering of abortion care as separate from reproductive healthcare and healthcare more generally has lasting and insidious ways of impacting both individuals and the systems that we trust with care provision. We as nurses are not taught about the medical process of abortion care and may only rely on high level (potential misinformation). We are doing an active harm to our patients when we pass on that misinformation (thinking about referring to CPC’s here). And a harm was done to us in not receiving comprehensive, medically accurate sexual and reproductive health education in our nursing programs. 

NSRH knows that this othering of comprehensive sexual and reproductive health is ubiquitous both in nursing school and throughout the profession. It is our commitment to interrupt, fill the gaps and advocate for comprehensive SRH in all sectors of nursing. NSRH is working to address the lack of education directly at the source through our Student Organizing, and building the next generation of nurse leaders through the Karen Edlund Future Nurse Leader Fellowship.

However, we know that this othering and lack of education surrounding SRH, especially abortion care, continues within the professional nursing sector. Our inaugural TAC Residency is another part of NSRH’s commitment to providing professional development opportunities for nurses in SRH. This residency program provides hands-on clinical abortion care training to registered nurses as well has monthly individual and group learning around the broader intricacies of abortion care. Similar to how a multi-pronged approach is needed to achieving health in our patients, a multi-pronged approach to normalizing sexual and reproductive health, specifically abortion care is needed in nursing. The TAC residency is a critical piece of that puzzle. NSRH recently completed first of its kind research documenting the severe lack of training opportunities for nurses in abortion care. Our research found that there are limited training opportunities for advanced practice clinicians (APC’s), but that the TAC Residency is the only clinical abortion training program for registered nurses in the US. NSRH stands in our commitment to developing necessary, creative, evidence-based programs and education that address and normalize abortion care. Applications to the TAC Residency are now open for RN’s in Tennessee and Kentucky and the program will launch in March 2022!

I joined NSRH in the early Spring of 2020, right as the COVID-19 pandemic was beginning to take hold, excited about the opportunity to contribute to a small but mighty team of folks who shared my passions for reproductive health, rights, and justice. I thought I’d work throughout the summer and leave NSRH when I began my Master of Public Health program at Boston University that fall. Now, nearly two years later, I have finished my Master’s degree and I am saying farewell to NSRH as I begin my next journey. 

I’ve been honored to be part of the NSRH network and to have seen all the ways our community has grown together. Since I joined, we’ve fully launched our Membership Program, grown the Online Institute, began our inaugural cohort of Karen Edlund Fellows, and revamped and relaunched our Training in Abortion Care Residency. I am so proud of all we have accomplished and can’t wait to see what’s in store for NSRH in the future. I am confident you all will continue to do innovative, important work that centers the needs of our community and prioritizes equity and justice. 

It’s been such a pleasure and a privilege to work with our community of disruptive nurses. I have loved interacting with all of you, uplifting your voices on social media, and learning from the incredible work you do every day to make compassionate, comprehensive SRH care accessible for your communities.

It’s bittersweet for me to leave NSRH; I have enjoyed my time here and have learned so much from each and every one of you. The passion for reproductive rights, health, and justice that brought me to NSRH in the first place has grown exponentially stronger since I joined the team in 2020. Though I am sad to leave, I am excited about what’s to come. I won't be straying too far from NSRH’s mission in this next stage of my SRH journey - I’ll be joining a program working to increase equitable access to contraception through, among other things, provider education. I hope to cross paths with many of you in this role and anywhere else my career takes me. It would bring me so much joy to be in community with you again one day in the future.

With love and gratitude for all that you do,

Lily Acton

Part II of our Fellow Series with Leslie Chase brings our focus to her work, some specifics on her project, and be sure to look out on the NSRH Social Hub App (on google play and the App Store) for ways to support her fundraiser to assist with supporting the necessary work Leslie discusses below.

NSRH: How did you recognize the need for this service, and how did you center those most impacted in the development of this project? 

Leslie Chase: Through my work with Planned Parenthood, we initiated gender-affirming hormone therapy at our affiliate. With that came the search for many different resources in all of our regions for that population of patients that we were starting to serve. I was involved in that search. In that search, we created a relationship with the Transgender Health and Wellness Center, and actually, my work with them pointed out this specific need. A lot of their clients were sex workers who needed services. So that's how I identified this specific population. I think my work in my master's program when I was working on SRH and looking into that worldwide. It's just something that kept coming up. This need existed. 

NSRH: What are some of the biggest misconceptions you hear within the nursing and health profession related to people who engage in sex work/bodywork? 

Leslie Chase: Unfortunately, I see a lot of evidence of stigma in general, especially around sex. there's a lot of assumption that people who engage in sex work or bodywork are irresponsible or don't care about their own health, or they somehow deserve any adverse health outcomes because of the "risk associated with their work." There's a lot of that kind of language, and that somehow it's our place as nurses or providers to judge them instead of caring for them. It's pretty heavily laden with stigma. I see that a lot, especially from other students who maybe have only worked in primary health care settings or urgent care settings. Another assumption is assuming that every sex worker does not want to be in sex work. Like in any other job, some find it to be empowering, or they see it as their job, or some don't want to be in it. I think that it's essential not to assume that every person who engages in sex work does or does not want to be in sex work.

Another thing is it's important to reinforce to some of my colleagues that sex work is work, full stop. I think people forget that. Just like any other patient, they're deserving of our non-judgemental care and respect, and it's our job to deconstruct our stigma around it. 

 NSRH: What frameworks or education models do you think would be helpful in classrooms for people becoming health professionals who may work with patients engaging in sex work?

Leslie Chase: I think harm reduction is beneficial. Substance use disorder and sex work often overlap, so I think that's an excellent way to frame it. I believe that the harm reduction model applies to how we approach youths to engage in what we've labeled as "risky behaviors." I also try to view all my work through a health equity framework. That's been helpful in just removing yourself from any personal or moral judgment or attachment, and doing it through health equity or reproductive justice framework is powerful as well. 

NSRH: What are the most significant barriers to care you see through your work with sex workers? Has the pandemic illuminated this?

 Leslie Chase: In our initial survey, many folks mentioned that they need help getting connected to services in mental health specifically. Even if they can get connected to a therapist or someone similar, a lot of that service still comes to judgment and stigma. I think a huge barrier to them is accessing non-judgmental services. There's a specific request for, "how can I get services from providers who have had experience with sex workers, who are sex workers themselves, or did do sex work previously?" So that they can not only relate better to specific challenges or experiences of sex workers but also ensure that they were not getting care. A considerable barrier is not knowing if it's safe to divulge your activity in sex work to whatever provider you're going to get care of. It's a huge barrier. 

Through the pandemic, there's a lot of language about irresponsible people, not wearing masks, not social distancing, and things like that. This population is being forgotten. We're calling other professions that have had to continue to work through the pandemic heroes but giving very little understanding to people who do sex work and have to continue to live through the pandemic. They have no other choice. The population is being disproportionately judged, stigmatized, and left behind because of the stigma around sex and sex work during the pandemic. 

* Leslie's virtual fundraiser to build and issue out these essential care kits is set for 11/13/2021! More details to come on how to support this amazing project!

Our Student Engagement Coordinator, Rosie Laine, recently sat down with one of our NSRH Student Chapter Presidents, Tara Teipel. Tara (she/her) is a third-year undergraduate student pursuing a BSN at the University of Pennsylvania’s School of Nursing. U Penn’s student chapter has over 100 members, and they continue to be leaders in SRH student activism. Tara sat down with us to discuss her experiences as a nursing student and chapter president. 

Tell us about what brought you to nursing, and more specifically to your interest in sexual and reproductive healthcare and advocacy? 

I always knew I wanted to do something in the sciences. My mom, dad, and both of my older sisters do something in the sciences. They mainly focus on engineering, but when I found out about all the different roles that nurses get to do, I realized that was the perfect balance of learning all about the human body but still working face to face with people and having that close and immediate change. Since then, everything I’ve learned about nursing has made me love it even more. I got into sexual and reproductive health because, at my school, we teach a lot of sex ed through a program called Teen Prevention Education Program or Teen PEP. As a junior, I was selected to teach a special health class to become an expert in safe sex, healthy relationships, gender identity, and leadership. Once a month, we would go into freshman health classes. We would do skits and write songs, and it was supposed to be a way to make the freshman pay attention more than they would if they were reading it out of a textbook or hearing it from their health teacher. That made me realize how many questions there were and how there wasn’t a lot of education. These issues are often pushed aside for later on. When I came to Penn, on the first day of orientation, they had the NSRH Chapter table, and through that, I’ve learned more about SRH. And I’ve learned more about it through my classes. Through those experiences, I’m pretty sure that's what I want to do. 

What brought you to your involvement with NSRH? 

I realized that coming onto campus, the whole world of nursing was wide open, and I felt comfortable talking about SRH issues after my experience with Teen PEP.  I realized not many people had that same sense of comfort, so I decided to join the club after seeing it at the student organization fair. I decided to take on a leadership role because I felt that I wanted to be more involved in decision-making and be more hands-on with the projects that they were doing, and the meetings and events that they were holding. Our previous chapter president (who is now an NSRH National executive board member), along with the whole student chapter board, graduated, so I became president after that. Before I joined it was very focused on accelerated nursing students who had only been at Penn for about two years, so they had even higher turnover than a typical college club. Now we have a whole new board and a new advisor, so it’s been a big transitional year. 

Tell us about what it’s like to lead a student chapter? What advice would you give to students interested in starting or joining an NSRH student chapter? 

It’s definitely a lot of time management because you also have classes. It’s a lot of scheduling times and creating boundaries between schoolwork and organizing. A lot of people at my school are involved in multiple organizations. Also, it’s important to have time to relax, so it’s important to have those boundaries for yourself and respect other people. When I first became the only returning board member, I felt like I had to do everything. We ended up making new positions for the board and delegating tasks. Before, I would try to do everything and then ask the rest of the board, “let me know if anyone can do this?” But when we made roles for the board members, everyone was so happy to do their part. I think delegating is hard for some people to let go of control, but then everyone has more time to do the things they're the best at, and you’ll see more progress. I learned a lot, and since then, it’s been way easier to manage. 

What sustains your work and activism? What drives you to continue showing up?

Creating communities within the academic organization helps to prevent burnout. Instead of having all of our meetings focused on speakers, and learning workshops, and so on (although those are all super interesting and teach us lessons we may not have gotten out of school), we take the beginning part of the meeting to go around and check in with everyone and learn everyone’s names. It’s a great way to 1) get to know other people who are interested in the same things that you are, and 2) to keep you engaged in a way that isn’t just strictly education-based. 

What are some of the events or speakers that you’ve been most excited about or most proud of? How did you approach student organizing during the pandemic?

Because of the pandemic, we’ve been limited to virtual organizing and events, but we organized one really cool event in collaboration with multiple organizations in the nursing school. There's a film called Belly of the Beast, which is about forced sterilizations with women in prison. I think it’s hard to make virtual events engaging. Movies and documentaries are a great asset, but then people are on zoom for three-plus hours. So we gave an access code that everyone could use to watch the documentary on their own time. Which, for me, felt like an interesting break from my study time. I got to watch an interesting movie about a topic that I didn’t know much on. Then for our actual event, we had a few speakers on Zoom. We probably wouldn't have been able to get them in person. So that event was flexible but still synchronous. 

Are there events or speakers you have in mind, or general advocacy goals, you have for the upcoming year?

Yes. I definitely want to make the Papaya Aspiration Workshop happen because I haven’t gotten to participate in that kind of event yet. I think it’s a great hands-on experience. Also, at Penn, there’s a minor called Gender, Sexuality, and Women’s Studies. It’s through the college, not the nursing school, but after talking to the head of the department, she said she’d seen a huge surge of nursing students looking to get this minor. So we’re going to bring her in and do event detailing and provide class recommendations not limited to the nursing school that would allow nursing students to explore sexuality, queer theory, and gender. So I’m excited about that. 

Do you have tips or thoughts for students interested in starting a chapter, but it’s not yet established, so they need to focus on recruitment? Do you have advice on how to recruit new students?

When I joined as a freshman, the club was pretty well established. Still, because our core cohort of accelerated nursing students graduated and with covid, we now have a whole new group of student participants and leaders. I just finished my sophomore year, and half our board includes first-year students. I had taken my maternity class this past semester, and I reached out to our professor, who is also the head of the Center for Global Women’s Health. She’s super involved and taught the maternity class in an LGBTQ+ friendly lens, which is very new, especially in a field where it’s very gender-biased. She was a huge asset not just in knowledge and collaborating with the Center for Global Women’s Health, but also because she offered extra credit for students to come and attend our events. Afterward, we would send an email to them, asking them to join our newsletter.  That all really helped, because every student has her eventually, and her classes are so related to the topics we cover. She’s been a great asset. I would say if students are starting a new club, they should reach out to a professor who agrees with a lot of the content. That’s a great method to get new students involved. 

Can you share the best ways to select a faculty advisor?

Similar content to the classes is ideal. A lot of our events coincided with what we were learning in classes. That helped students and made it easy for our faculty advisor to plug our events in class. Besides that, reachability is very important, especially when you’re starting a new club. I knew we needed a very hands-on faculty advisor that would be able to attend a lot of our board meetings and respond to our emails. So that’s been super helpful. Maybe a more established club could have a more laissez-faire advisor, but we needed all the help we could get. Also, we’re so lucky that our faculty advisor has so many connections in the field. She knows speakers at other universities that have come in via zoom. That’s one of the pros of Zoom; you’re able to meet with so many different people that may not have been able to come in person. Those connections helped us a lot. 

Our value this month is Integrity. How do you think about integrity in relation to nursing, specifically within sexual and reproductive healthcare? 

All healthcare has sensitive information, and it’s essential to keep patients’ privacy and be there for them. I think within sexual and reproductive health, it’s especially that way. Many patients may come to you with huge insecurities or big secrets that even their friends and family may not know about them. Nursing is known as the world’s most trusted profession, so I think it’s important to uphold that and to keep your patients’ priorities as high as your own. 

What is your favorite fall activity? 

This is so niche, but I like cooking pumpkin seeds. I love carving the pumpkin and cooking the seeds. That’s what makes me think of fall. 

What is your favorite school supply for back-to-school shopping? 

I think I need colored pens. I just think they logistically help make notes stand out, but they’re also just fun. 

Interested in joining NSRH National as a free student member? Apply today! Interested in starting an NSRH Student Chapter on your campus? Contact [email protected] for support and more information. 

What We Need to Remember this National Hispanic Nurses Day

Author: Melina Lopez*

There’s no better time to think about what being a bisexual Mexican and Puerto Rican nurse means to me than when Bisexuality Awareness Week, Latinx Heritage Month and National Hispanic Nurses day happen at the same time. It’s hard, though, because I can never reflect on these identities as mutually exclusive. It’s even harder when I think about how within the greater scope in which these identities exist (i.e. bisexuality in the LGBTQ community, heritage in the Latinx community, and nurses in the healthcare field), each of these identities have long, deeply rooted histories of erasure and subjugation. 

For bisexuality, it’s the tendency to question the legitimacy of the sexual orientation and consider it less valid than being gay or lesbian. For heritage, it’s the phenotypical hierarchies of power that values lighter-skinned over darker-skinned Latinx people in sociopolitical contexts. For nurses, specifically Latinx nurses, it’s the use of gender as a rationalization to subject nurses to the male-dominated field that is medicine. 

I don’t have the privilege, or rather the ability, to separate these histories from one another since separating these realities would mean erasing their marginalized truth. In thinking about these identities, I’d like to specifically hone in on the role of U.S. imperialism in the history of professional nursing in Puerto Rico.

Puerto Rico, formerly a colony of Spain, became and still remains a colony of the U.S. under American Protestant missionaries seeking to bring salvation and civilization to Puerto Rico in the early 20th century by introducing hospitals and nursing schools to the island. These nursing schools adopted racist admission policies that excluded Afro-Puerto Rican women by arguing that allowing women of color into the nursing program was not in the best interest of the hospital, nor to the women. White nursing advocates for these ‘whites-only’ admission policies reveal an interesting acknowledgment, compliance, and continuation of women of color’s marginalization in nursing because they claim that Afro-Puerto Rican admission into these schools would not only undo all of the work to advance white women’s political power as nurses, their admission would be unfair to them because they would still be considered socially and professionally inferior to white nurses based on the island’s classification of race, which is a fluid hierarchy based on phenotypical registers of Blackness where money and education have the power to essentially ‘whiten’ Puerto Ricans and grant them higher social status. 

These imperial and local ideologies of race, in conjunction with the belief that Afro-Puerto Rican’s presence in nursing would weaken the white nurses’ political power in health, suggest that gender and social class superseded race when it came to the professionalization of Puerto Rican nursing. It’s important that we acknowledge these intersections this National Hispanic Nurses Day to show that while yes, Latinx nurses have made incredible strides in the advancement of nursing and deserve to be celebrated, we cannot deny how the execution of Nightingale nursing was done at the expense of Latinx, specifically Afro-Latinx, women. 

So, as we celebrate Bisexuality awareness week, Latinx heritage month, and National Hispanic Nurses Day, I urge you to pay special attention to the role American nurses have played in establishing the state of nursing in Latin America. I also caution us from celebrating the myth of homogenized, universal “Latinidad” this Latinx heritage month. Rather, let us all look at the US role as facilitators of these countries’ socialization into American norms and practices through the nursing field. 

Ellen Walsh, “’ Called to Nurse’: Nursing Race, and Americanization in Early 20th Century Puerto Rico, Nursing History Review 26 (2018): 138-171. 

* Melina Lopez is an inaugural NSRH Karen Edlund Fellow, providing insights to the NSRH Community for Bisexual Awareness Week (September 16-23) and Latinx Heritage Month (September 15- October 15)

This week NSRH’s student engagement coordinator, Rosie Laine, spoke with Leslie about what brought her to nursing and SRH specifically, and about our monthly value (Power) 

Stay tuned to learn about the amazing work Leslie is doing to support sex and bodyworkers through her Nurse Leader Project in Karen Edlund Fellowship 

NSRH: Tell us a little bit about your SRH journey? What led you to study nursing and how did you become interested in the intersection of nursing and SRH?

Leslie Chase: I always knew that I wanted to be in the medical field from a really young age. I think what really led me to sexual and reproductive health is I graduated college the month after the 2016 election, with my first undergraduate degree. I had always been comfortable talking about sex and answering my friends’ questions, giving them someone to talk to about topics t they were embarrassed about, or they felt a lot of unease about. Right after the 2016 election, I became really motivated to work in something that made a difference. I ended up applying to Planned Parenthood, and I knew that’s exactly where I wanted to be. I’ve been working with Planned Parenthood since I graduated with my undergraduate degree, and it’s done nothing but bolster my interest in SRH. There are so many avenues within it, and you can see really concretely where you’re making a difference in people’s lives. It just felt like a very natural progression of things. 

NSRH: You mentioned that you were interested in nursing, or the medical field, from a pretty young age. What led you to think about this health education degree as something to supplement? 

Leslie Chase: I think really it’s my work with Planned Parenthood. I think often people think of nurses as individual contributors. What I really liked about my exposure to Planned Parenthood is that because of my work on the administrative side, I got to see how organizations like that enact change on a high level, and the impact that you can have to change an entire health landscape with the community. I really liked that idea. I liked my master’s program in health education because it helps you learn how to take your knowledge of being an individual contributor, to assessing the needs of an entire population, or community, or region. I learned how to build projects and programs that have a high impact and impact a lot of people. I liked that perspective of service. 

NSRH: To play on the NSRH Value of the Month - Power - if you had a superpower, what would it be and why?

Leslie Chase: I think teleportation. I love to travel, and I love the experience without all the cost, waiting around, and the carbon emissions. So I think teleportation.

If you read all 8 of our Trusted Community series, way to go sticking it out with us as we laid out our plans to launch NSRH membership next week! As Lina mentioned in her Still Weaving blog, the team has been working the long-game to build programs, education and a membership program that can bring our nursing community together. 

There are so many clichés about good things come to those who wait or the rainbows come after the storms… we would like to express our gratitude for your patience with us as we worked through the global pandemic, the uprising, and team transitions to bring us to where we are today. Starting next week (it’s really here!), nursing students, nurse professionals, SRH advocates and allies, and retired nurses all have a home with the Nurses for Sexual & Reproductive Health! We’ve prepared content for our Online Institute for members to tap into immediately. The NSRH Social Hub is buzzing with opportunities for more members to gain access to our safe, trusted community social space. And we will constantly be planning more and more to deliver to our members, we want to care for you. 

Performative activism or action is the fast path to losing trust in a person or organization. NSRH shows up in ways that create impact, not performance. Ways that can make the difference for a nurse on their path to delivering the inclusive SRH care they desire to learn and share. Our goal has always been, and will continue to be, providing you with the knowledge, skills, and support to take direct action and make meaningful, lasting contributions to your community.

Becoming an NSRH member will give you the resources necessary to initiate and maintain meaningful change in your clinic and community. We offer online education that can fulfill CE needs, and resources to build your advocacy skills. When you look back at our origins, you’ll discover that our focus has always been to offer resources to students to advocate for changes in curriculum and policy. NSRH started with passionate, young nursing students with a fire for change, and the next generation of nurses & SRH advocates that will continue that legacy of action . We transitioned our membership program from student chapters exclusively to offering community to nurses (students and professionals) and allies that can share the same space. That shared community offers opportunities to contribute and participate in a variety of ways!

Are you interested in action and contribution for the SRH community? We are SO CLOSE to being able to invite you to apply for membership with NSRH. Stay tuned, we will be opening applications and we can’t wait to welcome you to our action-oriented community!

Think about a glass of water that you are given at a restaurant. What makes you know that water is safe for you to drink? Is it because you know exactly what tap it came from, or that you’ve eaten there before or know the staff? Maybe. I bet it could also be that it is served in a clear glass and the clarity of the water helps you trust that you are drinking a glass of safe water.

While that is a superfluous example, having clarity into situations and systems allows for us to build trust more quickly compared to viewing obstructed information or feeling like we don’t see the whole picture. NSRH is committed to creating a community built upon a foundation of trust. Transparency and clarity in our actions fosters our shared understanding that uplifts nurses and promotes SRH education and connectivity. We understand that it can be hard to build trust when just starting in the SRH field or if you are entering a community new to you. That is why we will be sharing our Trust Levels system in detail with members to help grow trust in NSRH and trust within our community of disruptive nurses. Check out the Trust Level system overview.

NSRH offers clarity around our vision and values to help nurses understand quickly if this is the right space for them. We strive to remove ambiguity from our work to bring all our members together to share in NSRH’s goals for supporting nurses today and the future of nurses passionate about SRH. Trust and Integrity are two of our core values, and through clarity we are able to embrace those values openly.

We invite you to ask questions, make suggestions, and challenge us. We can ignite the revolution in SRH when we know clearly where we stand. Members play a key role in shaping the future we demand. This is your association, and we are here to support and serve you. Get ready to participate and engage with your fellow nursing community through the membership network of NSRH!

Some months ago I wrote an article Weaving Community where I likened building community to weaving. I employed this lovely metaphor of community as an "intricate tapestry". Here is what I did not say, weaving is REALLY hard and can be terribly frustrating. Threads get tangled and break and you make a LOT of mistakes that cause unwanted gaps and holes and imperfections in the final project. You start out with this lovely plan where you decide on the pattern and the length and width of the cloth. You have this wonderful vision in your head of how things are going to go and then you sit down at that loom and it all goes to h***. You find that you have to keep deciding which errors to fix and which ones you will pretend were a part of the original plan. Well, that too is a LOT like building community. You start out with all of these wonderful plans and intentions and then life happens.

This is a pic of my latest project which has been an absolute nightmare. Notice all the little knots? Those are where I had to keep going in after I had supposedly finished threading the loom to fix broken threads.

There has certainly been a whole lot of "life" happening lately. As a nation we continue to navigate a pandemic, made more severe by "leaders" who place their political aspirations above public health. We continue to wrestle with the myriad impacts of white supremacy and hetero-normativity as it manifests in our economy, socio-political institutions, culture, and ultimately, our bodies. We continue to struggle against restrictive laws and policies that seek to control our ability to reproduce if, when, and under the conditions that we choose. NSRH, like many non-profit organizations, has also had to overcome a number of challenges. A lot of the things that we thought would happen (programs that we would launch, events that we would hold…) needed to be put on hold in order to attend to… "life". Believe me when I say there were times when I just wanted to crawl under the covers and hide from all the "life" going on. But then I would see some article about what nurses and other medical professionals were going through out in the field and I knew that, if you all could do it, if you could continue to show up even when our policies and institutions failed to keep you safe; I could certainly keep showing up for you. You are what kept us going. The good news is that we have come out on the other side stronger, more focused, and better organized. We want to be the best that we can be so that we can better serve you.

This has been a tough year and a very busy and fruitful year for us, and finally, yes finally! we are gearing up to launch our Membership Program to the larger community THIS month! I know I said that it was supposed to happen in March, but… "life" happened. In November 2020 we were able to successfully launch our pilot Membership Program and recruited 68 amazing Founding Members, which has allowed us to test various elements of our Membership Program in preparation for the full launch. In addition to this pilot launch we also:

1. Received accreditation through the California Board of Nursing to provide continuing education (CE) credits/ contact hours for our content. YAAAAAH! This was an incredibly heavy lift for us and the process took about half a year.
2. Completed a series of beautiful interactive SRH Education modules, which are available to our Members. Check out this sample course from our SRH & Nursing module.
3. Created our own private and secure social Network, NSRH Social Hub, which is only accessible to our Members (think early Face book sans the Zuckerburg shenanigans).
4. Continued to grow our Team in order to better serve our community. We went from 4 staff at the beginning of the year, to 3, to 2, to 4, to 5, and now 6! (Plus 3 amazing Assistants).
5. Implemented a monthly Members Only Newsletter
6. Launched our Karen Edlund Future Nurse Leaders Fellowship

While things did not work out quite as we had originally planned, we have managed to produce something beautiful. Is it imperfect?... Yes. Are there holes and flaws?... Most definitely yes, however, we are still weaving!

This is a pic of my last and largest project thus far. It turned out nice but it was a nightmare to make and I literally changed up the pattern midway through because I figured out that I did not like the initial pattern that I designed, which is why the one pattern transitions to a different pattern. 

Those of you who have attended our activist conference have felt the power of the NSRH network. For more than five years now, NSRH has brought together nurses and midwives from across the country to hear from one another, expand their knowledge base, and build community. The activist conference is a cornerstone of NSRH’s commitment to building a strong and trusted community, and it continues (although interrupted by COVID-19) to provide an invaluable opportunity for nurses in SRH to reconnect and forge new connections.

These connections persist beyond the walls of our conference. Members of NSRH are able to attend our in-person events, and they will receive 24/7 access to an online community of students and professionals. Despite working, studying, and living in cities across the country, our nurses and midwives connect, whether virtually or in-person, with one another. This is because we share a common commitment of ensuring just, dignified, and comprehensive SRH care for all. Joining NSRH means joining a network of clinicians, researchers, students, and advocates who are as passionate as you are about fighting for change in our healthcare system. As a member, you will gain access to not only our catalog of educational, advocacy, and professional development resources, but a community of allies ready to stand alongside you as you navigate your journey through the SRH field.

At NSRH, our community has been a central part of our history, and it is core to our mission. Whether it be through our campus chapters, the NSRH rotations, or our activist conference, we have and will continue to unite disruptive nurses from different cities, different sectors, and at different points in their professional careers for a common goal. Our community is as strong as it is unique; because we support all nursing professionals and nursing students, connections are developed and knowledge is passed between nurses and midwives of varying backgrounds, credentials, and sectors. Joining NSRH is an opportunity to unite and mobilize, and we can’t wait to connect with you! To learn more about our membership program and the options available to all types of SRH students and professionals, reach out to Nikki at [email protected] to see where you fit.

In the past year, we have all had to learn and re-learn techniques to heal, hold, and care for ourselves and the people around us. Some of us have looked back to learn how our communities have traditionally held each other, some have looked forward to imagine different possibilities for care. At NSRH we have done a little bit (a lot!) of both. We were reaffirmed that there are ways in which nurses have always been foundational to the care of their communities; and, we see that there are other ways of knowing and caring that need to arise. In planning our educational offerings, we have kept all of this in mind. Part of this process has involved learning from the natural world and its ability to regenerate and survive.

Consider the structures of a spider web: Spiders are able to adjust the consistency of their web based on function and need. The edges are sticky to trap food, the center is smooth to allow for mobility. Incorporating our values in our education program creates trust and allows for a center that encourages curiosity and discovery. From the nurse just beginning their journey into sexual and reproductive health (SRH), to the ‘SRH experts,’ we all need trust as a foundation to allow for comfort, mistakes and growth. Our web encourages all of us to lean into the sticky discomfort of unknowing, learning and cultivating a practice that celebrates sexual and reproductive care. Whether someone is using our online education platform to learn about comprehensive pregnancy options counseling for the first time, or a seasoned SRH vet is revisiting a topic after noticing moments where their theoretical knowledge hasn’t matched their practice, our education web holds all of that.

Spider webs are formed from single threads connected to function as a whole. We know that the education needs of the nursing community are vast. In order to transform healthcare to robustly celebrate SRH, we need to engage and support different learning styles and diverse education needs. From our Karen Edlund Nurse Leader Fellowship, developing the leadership capacity of nursing students from underrepresented communities, to online learning with CE’s that can be done on shift, to the Training in Abortion Care Fellowship for registered nurses to gain experience in abortion care, to in-person education sessions with partners in this work, each component of NSRH’s education functions as a thread strengthening the collective web of nurses in SRH.

Finally, one of the most magnificent elements of spider webs is their incorporation of beauty. Research has shown that the design of some spider webs are not just for function, but for beauty as well. This is a clear reminder that pleasure, beauty and differences are critical in shaping the whole structure. Prioritizing complexities as a means to pleasure is foundational to NSRH, including our education program. We know that not every community or every nurse has the same needs or vision. Rather making space for and celebrating our different shapes and structures is what makes our web capable and beautiful.

We caught up with NSRH founding member Alli Mitchell, RN, IBCLC, PHN, SNM, to discuss identity and the role of intersectionality in comprehensive SRH care. Alli (she/her) is a registered nurse, lactation consultant, and student midwife based in San Leandro, California.

What are the intersections of your identity?
I am a biracial, Black & Latinx cis-gendered woman. I am a registered nurse, a lactation consultant, and student midwife. I am the daughter of an immigrant and 1st generation Bay Area native on my mother's side. I definitely feel that the intersections of my identity allow me to foster deeper connections with my patients.

How does intersectionality impact your work in clinical practice?
Intersectionality helps me to relate to my patients. I am fortunate to be able to serve my home community here in the Bay Area, which is made up of large numbers of Black and Latinx people. I know that when I am supporting patients, they feel safe, seen, and cared for because we come from the same background and share similar life experiences.

On a day-to-day basis in the clinic, how can nurses and midwives better honor and respect their patients’ multiple intersecting identities?
I feel the best way that nurses and midwives can honor and respect their patient’s intersecting identities is by listening and holding space for them. Allowing them the chance to share their concerns and goals surrounding their care.

How can we use identity intersections to provide more comprehensive care?
Comprehensive care should be driven by an individual’s need and identity intersections. As providers, we should be tailoring care based on our patient’s individual needs and experiences.

Do you have any resources about this topic that you would recommend nurses look into?
I recommend the following resources: Black Mamas Matter Alliance, The Black Maternal Health Caucus, Expecting Justice, PostPartum Justice, and SisterSong.

Commitment to the mission has always been at the heart of what we do, driving us forward and navigating our changing landscape. Our mission reads, “NSRH provides students, nurses and midwives with education and resources to become skilled care providers and social change agents in sexual and reproductive health and justice.” We were founded by disruptive nursing student advocates who aimed to improve care and provide inclusive, full spectrum healthcare, and that is still at the core of what we do.

We invite you to celebrate, collaborate and commit to patience, learning and growth through NSRH membership. To share our collective growth edges, so we can all strive to bring better care to those in our clinics and community. We know that breaking into a new space (like membership or SRH) can seem difficult, but we are here to support you and make it easy and rewarding for you. We have a powerful network to build resource sharing and collective learning. We have downloadable advocacy tools for promoting change. We have online education to enhance nursing skills and we have CE credits for many of our courses. Plus, we are here to create and develop new resource ideas that YOU bring to us. As a membership group, NSRH’s community will aid in driving future content that engages and resonates with nurses passionate about providing robust, inclusive care.

We commit to listen as we are here to support nurses across their careers, from students to professionals to emeritus or retired. Unsure if membership is the right fit for you? Give us a call at 651-207-7293 or send us an email, get to know NSRH, we’d love the opportunity to care for you.

Nursing Students for Choice started in 2006 with a group of passionate nursing students who stood up for inclusive, full-spectrum sexual and reproductive healthcare. For well over a decade, nursing students have held the torch and marched toward changing their communities and curriculums to include comprehensive sexual and reproductive healthcare. Students are capable of so much and the competency earned and shared with chapter members created a foundation for nurses to come together to learn. Check out the full history and evolution of NSRH here.

It is because of our competent student leadership that we have been able to sustain and grow over time and we are excited to launch the full membership program to bring our nursing students and nursing professionals & educators together in community for support, continued education and connection. As individuals, we are capable of impacting change in our immediate circles. When we bring together the brain trust of experience and education, the community will have shared competency to influence change on a grander scale.

NSRH stays relevant by evolving our organization to expand impact and bring more knowledge around the needs and opportunities when providing SRH care. We are humbled by the wisdom of our sage nursing professionals and refreshed by the energy from our student nurses. Interested in sharing ways that NSRH can support and serve you with membership, send us a message at [email protected], we’d love to hear from you!

When you come across a great path in the wilderness that leads to a hidden spot with a lake or a view, do you ever think about the people who walked that path before you? The trail-makers who knew or felt that going a specific direction would lead to a better spot. Someone with unique knowledge knew to take those first steps toward their goal even though the beauty of their journey was still obstructed. They showed up time and time again to stomp down the path for others to follow.

At NSRH, we encourage trail-makers. By providing support and resources, we encourage them to take the challenging path with confidence to stop situations or institutions that are harming, marginalizing, or ignoring our community’s needs. Disrupting the status quo alone is isolating and can leave us feeling overwhelmed, and that is why the community of nurses at NSRH continue to demonstrate the constitutional changes that need to be made in healthcare. Our nurses come together to learn from each other and build the characteristics essential to delivering comprehensive care in the moments where the path is not clear.

In times of uncertainty, NSRH will stay true and take on the difficult tasks that will impact and improve the lives of nursing professionals and the communities they serve. NSRH does the hard work that needs to be done for nurses fighting for comprehensive sexual and reproductive health, reproductive justice and rights. It is through our dedication and character that we build the ongoing trust of our community, we are here for you.

If your constitution pushes you to get involved with like minded people, NSRH membership is the community for you! Get connected with us on social media by following us at @NursesforSRH on Twitter, Instagram, LinkedIn & Facebook and stay tuned for our membership program launch coming soon.