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.

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!

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.

Have you noticed how some leaders seem to have organic followings that people are magnetically drawn to? Identify a few of the great leaders in your life, what made them special to you? Most memorable leaders share a common trait, they lead with compassionate care for the community that embraces them. By focusing on the needs of others, leaders are able to grow the talent in their communities.

We are more likely to trust and engage with leaders and communities that prioritize the greater good. Groups that have rigid structures don’t account for the tenderness needed in human relationships or the beauty in being benevolent. At NSRH, we put the needs of passionate, disruptive nurses to the front of our vision. We prioritize caring with compassion for our members, celebrating your victories and holding space for the challenges faced in daily life as a nurse.

We all have spaces in our life where we can bring our authentic selves and thrive. Third Space Theory is a sociocultural term to designate communal space, as distinct from the home (first space) or work (second space). NSRH aims to be the third space for our members to grow and realize their potential as compassionate, inclusive nurses. We strive to be a third space that fosters compassion with accountability, to provide education that develops inclusivity, and a safe space to have crucial conversations about what is going on at hospitals and clinics that can impact patient care or outcomes. It is when we gather in a collective third space that we can bring our lived experience and our learned experiences together to grow in a safe community together.

Features of the Trusted Community of NSRH are built on the foundations of compassion, benevolence, and tenderness. We move forward with our hearts and ears open. If this sounds like a community you want to be a part of or know other nurses interested in connecting, get in touch with us at [email protected] and join NSRH membership when we launch this summer!

Here is an example of an artistic representation of Third Space.

To honor and elevate the history and relevance of providing care with love to populations that have been stigmatized or marginalized, we invited a guest author, Kristopher J. Jackson, to share his voice on the COVID-19 and AIDS crisis. 

Kristopher J. Jackson, MSN, ACNPC-AG, CCRN
PhD Candidate, University of New Mexico College of Nursing, Albuquerque, NM
Acute Care Nurse Practitioner, UCSF Medical Center, San Francisco, CA

“Across the United States, wards of patients admitted to the hospital with an unusual pneumonia became more commonplace. Little was known about these patients’ condition, their projected illness course, or how to treat them.”

For those who have worked in the acute care setting during the last fifteen months, these statements certainly sound as though they were intended to describe the thousands of Americans hospitalized with severe COVID-19. However, the sequestration of patients afflicted with a poorly understood viral illness is not a novel practice. For those in clinical practice four decades ago, many may recall a different viral illness that created similar panic and confusion among healthcare professionals: the beginning of the AIDS epidemic. Undoubtedly, AIDS patients who presented with pneumocystis pneumonia in the 1980’s differed clinically from present-day COVID-19 patients today in a myriad of ways. Clinically speaking, the two diseases have almost nothing in common at all. Despite the overwhelming number of differences between AIDS and COVID-19 as clinical entities, there are some poignant similarities in the American public’s reaction to these two pandemics and they tend share a common theme: a fear of the unknown.

As both pandemics began to ravage communities in the United States, providers and public health officials found themselves having to answer challenging questions: How is the virus spread? How do nurses, providers, and hospital staff care for a patient with a potentially deadly disease? What protective equipment do providers need to take care of these patients? Who should take care of these patients? Meanwhile, the American public had many questions of its own: How do we protect ourselves? Where did this virus start? Who is to blame? Who should we ostracize? As both pandemics began to jeopardize the “American way of life,” fear and anxiety plagued a nation.

In the early 1980’s, more patients died from a disease initially referred to by scientists as “gay related immune deficiency” or “GRID” and – more colloquially – “gay cancer.” In 1982, one particularly reprehensible reporter and White House correspondent, Lester Kinsolving, once mockingly referred to the disease as the “gay plague” in a press conference with former President Ronald Regan’s acting press secretary, Larry Speakes. Despite the thousands of American deaths, Kinsolving’s remarks were met with jokes and laughter by members of the White House press corps. While reporters and government officials in Washington D.C. amused themselves with commentary about those suffering and dying from AIDS, these patients were being abandoned and spurned by their families and communities. Fearing what they did not understand, some physicians and nurses refused to see or care for patients living with the virus. Other members of the American public felt an HIV diagnosis was some sort of karmic punishment for the gay men and intravenous drug users that contracted the first cases of the disease. These are beliefs that, to this day, remain deeply embedded into the very fiber of some sects of American society.

Nearly forty years later, in December 2019, early reports emerged of a bizarre coronavirus-associated pneumonia in China. As the World Health Organization and international public health experts began to investigate this new virus in the weeks that followed, the American public prepared a response of its own. Videos of Asians or individuals of Asian descent consuming bats or “bat soup” plagued the internet. Much like the early years of the AIDS epidemic, the American “way of life” was in jeopardy and the American people needed to hold someone accountable. Former President Donald Trump would later come to refer to COVID-19 using a variety of derogatory, xenophobic, anti-Asian epithets including: “China virus,” “Wuhan virus,” “China plague,” and the “Kung-Flu.” As the leader of the free world ‘dialed-up’ his anti-Asian rhetoric to provide Americans a target for their rage, Asian-Americans faced more violence and more racism; hate crimes committed against Asian-Americans became more commonplace.

While decades apart, the early failures and relative inaction of the executive branch of the U.S. Federal Government during the beginning of both the HIV/AIDS and COVID-19 pandemics are well documented. The first cases of HIV surfaced in 1981 and the virus itself was isolated in 1983. Sadly, President Ronald Regan would not publicly utter the word “AIDS” until 1985. According to the Centers for Disease Control, more than 50,000 Americans would be diagnosed with HIV between 1981 and 1987 when President Regan formed the Watkin’s Commission to investigate the AIDS epidemic. More than 95% of Americans diagnosed with HIV as a result of President Regan’s flagrant disregard for the disease died during this same period.

In early 2020, as international public health experts warned of the severity and virulence of the novel coronavirus, the executive branch of the federal government failed to heed these warnings. However, perhaps more disturbing, is that former President Donald Trump offered the American people false assurance and abject lies. On April 7th, 2020, President Trump told the American people: "…so, you know, things are happening. It's a -- it's -- I haven't seen bad. I've not seen bad." The day before this announcement, the death toll of Americans who had succumbed to COVID-19 surpassed 10,000. By April 11th, more than 20,000 lives had been lost to COVID-19. The Federal Government also failed to issue a federal mask mandate or mandatory guidelines regarding social distancing, instead allowing individual states to choose how they would respond to this public health emergency. This leadership failure translated to a highly partisan response to a deadly virus, as well as unnecessary death and human suffering. To date, nearly 600,000 Americans have died as a result of COVID-19.

Despite the early failures of the U.S. Government to lead or act during either of these viral pandemics, everyday heroes worked to answer the desperate calls for help from patients, providers, and their communities. One of the first specialized AIDS wards in the country was opened at San Francisco General Hospital using an all-volunteer nursing staff. Shortly after the formation of Gay Men’s Health Crisis in New York City, the oldest AIDS organization in the United States, nurses offered volunteers trainings on basic caretaking skills. Over time, as HIV care transitioned to the outpatient setting and overburdened clinics, advanced practice nurses answered these calls for help and now play an integral role in the treatment and management of HIV in the United States today. Decades later, as COVID-19 wreaked havoc across New York City, more nurses answered pleas for volunteer assistance in the city’s overburdened hospitals than could be processed. During the last year, nurses across the United States stepped out of their outpatient clinics and lower acuity settings and into makeshift intensive care units to care for our country’s sickest and most vulnerable patients.

The AIDS and COVID-19 pandemics are merely two examples of public health emergencies where nurses have worked —proudly — on the front lines in their communities. While government leaders and policymakers may have been slow to respond to these crises, nurses were among the first to care and advocate for these vulnerable patients. Unfortunately, new threats to public health continue to emerge, almost daily, that further jeopardize the status of sexual and reproductive health care in America. Unlike AIDS or COVID-19, we as nurses know what these threats look like; we know how these threats will adversely affect the health and well-being of our patients. Taken together, these crises represent public health emergencies that require the same diligence and commitment to our patients that we have shown throughout history. The future of person-centered, quality sexual and reproductive health care in the United States rests on our shoulders.

The following is a summary of a conversation between Victoria Fletcher, MSN, ARNP, FACNM and Nikki Duffney, NSRH Director of Membership about the similarities from her history and lived experiences between the HIV/AIDS crisis and the COVID-19 pandemic. Edits have been made for length and clarity.

Victoria Fletcher, MSN, ARNP, FACNM is a certified nurse-midwife, NSRH founding member, and NSRH board member. She was contracted in 1990 to provide health education to healthcare professionals in the beginning of the HIV/AIDS crisis. Topics included etiology, transmission, prevention, treatment and caring for patients with HIV/AIDS. We sat down with her to discuss her experience working in healthcare during the HIV/AIDS crisis and COVID-19 pandemic, and what similarities and differences she has noticed between the two.

In the early days of the HIV/AIDS crisis and the COVID pandemic when little information was known, it invoked similar human reactions: stigma, shame, and fear. Health outcomes were driven by lack of evidenced based information, limited access to care, and health disparities. There are overlapping emotions that came to light as these two very different pathogens took hold of populations:

Stigma

Stigma toward the population that seemingly started it or had/has the highest incidence of infection was felt during both crises. HIV/AIDS saw initial stigma pointed at gay men and the LGBTQ populations, and Chinese people and government had the global finger pointing at them as the source or reason for the COVID-19 pandemic. Some even called COVID the “Chinese” virus, which can be directly tied to the increase in Asian-American Pacific Islander hate crimes.

Unknown transmission

At first, people didn’t know how HIV/AIDS or COVID-19 was transmitted and this ignorance led to fear, wide-ranging theories of transmission, and irrational ways to prevent transmission and to treat the diseases. Since there was early information about HIV/AIDS compromising immune function, the first AIDS patients who were hospitalized were cared for in protective isolation; staff and visitors had to gown and glove before entering their rooms to prevent a vulnerable person from contracting infections from staff or visitors. This changed as people received effective treatment for HIV/AIDS, hospitalizations were decreased and severe immune compromise avoided.

Having celebrities and athletes testing positive for HIV/AIDS gave the general population a different perspective on who could get the virus and how the virus could be transmitted. Magic Johnson, a pro-basketball player and considered a vision of health, revealed his status in 1991. Freddie Mercury died from AIDS related illnesses in 1992, the same year pro-tennis player Arthur Ashe’s status was revealed and traced to a blood transfusion. One year later Philadelphia, the first major Hollywood production on the topic of AIDS, was released.

Actor Tom Hanks contracted COVID-19 while filming in Australia in March, 2020. A study found that public opinion surrounding the then-new coronavirus shifted after he was diagnosed, with some individuals taking the coronavirus more seriously as a result. Most participants wrote that the virus now seemed like more of a serious threat in their minds, and one said they felt “panicked” because Hanks “is rich and protected. He can get it. Anyone can get it.” (source: Huffington Post, 2/6/21)

Lack of education

There was a surprising lack of education and research available to professionals. Treatment options available in both the AIDS crisis and the pandemic were under-shared and left people uncertain about their options. Studies have shown that it can take up to 10 years for new medical guidelines and practice standards to reach doctors and nurses and become the standard of care. That timeline must be shortened, as we don’t have the luxury of time in situations like the AIDS crisis or COVID-19.

With COVID, there is a similar lack of information about transmission and treatments. There are Rx options like monoclonal antibodies for people who test positive that could lessen the virus’ impact and prevent hospitalization and death. Many healthcare providers and potential recipients don’t know about this option, and the treatment modality is not universally available throughout the US. Where is the standardized training related to COVID-19? What education and training needs to be mandated and required for all healthcare workers?

I wish I could believe that similar diseases are not on the horizon and it would be another lifetime before we encounter novel diseases such as the two discussed above. What is needed are rapid cycle strategies to identify new potentially devastating infectious diseases, mechanisms to crack the code on mode of transmission, identify prevention modalities and evidenced based treatment options. Also required is a clear, accurate communication plan for healthcare professionals and the general public especially the most vulnerable populations. We need to broaden our definition of emergency response to include protracted crises that last several months or even years. If we can accomplish this and reside in a state of perpetual readiness, then there is hope that we can learn from past experiences and improve response to the next pandemic or crisis.

This story is shared to capture the personal experience and feelings of a nursing professional that has offered support and care through these two unique and difficult periods. 

Do you have a story to tell? We welcome you to submit your story or blog idea to us so we can feature you in our newsletter or on our blog. Email us at [email protected] or message us on social media @NursesforSRH.

Networking, community, connection, synergy, contacts, friends, colleagues, comrades, buddies, or companions. We have so many names and ways to categorize connectivity with other people, yet the basics of how to make friends and build relationships can be challenging for many of us. Why do some people buzz in the middle of the room or have a large presence on social media? Is it because they are better in some way than others? I think not; they have often done the hard work at some point in creating their community intentionally, and I’d like to share a few ideas of how this can be done.

Networking plays an important role for nurses. From attaining that clinical rotation and building a network of nurses to support each other in getting jobs, to specific needs like having a doctor vouch for you when working on a complicated medical case if you are an APRN. Networking in nursing can even affect how people are able to get care. Not to mention, nurses need community! When you’ve worked three back-to-back 12 hour shifts, it’s important to have people in your corner who understand what you are going through.

Here are 3 ideas that may be helpful in your work or social space to expand your community intentionally. 

1. Show up in the places that bring like minded people together.
• This can feel overwhelming at first since you could be showing up to a room full of people you don’t know (yet!). Take this first step and ease into connecting with others by asking questions, sharing experiences, or offering to help.
2. Start asking questions.
• Learning the group norms by asking questions can help set us up for success when building relationships. By understanding how the community interacts with each other, we are more likely to connect with others quickly.
• Once comfortable with asking group questions, start asking people relationship building questions. These questions don’t need to be too personal; start with more generic, accessible topics. Easy examples can be:
• What brought you to this group?
• What do you do with your time outside of this group?
• Why do you like to participate with this group?
• Remember that we are all experts at ourselves, so asking someone an open ended question about who they are can show you some of the important factors in their life. We can ask about family, pets, hobbies, or sports & recreation.
3. Be direct and ask plainly for your needs.
• If you are looking to build a dynamic relationship that involves exchange of information or mentor/mentee opportunities, go directly for it!
• Be transparent about your goals and interests
• Ask pointed questions that get you results, that could be “What is your biggest challenge outside of time or money?”

Lastly, meeting new people and tending to young relationships is FUN! It can feel a lot like dating, and there is potential for let down or disappointment; however, the connectivity with a community reaps such great rewards. It is worth the minor risk.

Wondering where you can build community with like minded people? Join the NSRH membership to gain access to a trusted community of nurses disrupting the status quo to serve patients with dignity and care. We are here to support you.