Sarah
This is At the Core of Care, a podcast where people share their stories about nurses and their creative efforts to better meet the health and healthcare needs of patients, families and communities. I'm Sarah Hexam Hubbard with the Pennsylvania Action Coalition and the Executive Director of the National Nurse-Led Care Consortium. On this episode, Shukriyyah Mitchell-Hinton moderates a conversation about Black maternal health in Philadelphia, and beyond. Shukriyyah is our Senior Director of Outreach and Advocacy here at the National Nurse-Led Care Consortium. She's joined by Imani Davis, a lived experience expert and community specialist for organizations including Strategy Arts and Community Action Network. And Saleemah McNeil, a reproductive psychotherapist and founder of Oshun Family Center in Jenkintown, Pennsylvania.
Imani, Saleemah and Shukriyyah talk about their own lived experiences and their efforts to research, advocate, and raise awareness around Black maternal morbidity and mortality. They talk about addressing these issues through funding, creating and implementing a variety of strategies related to mental health, home visiting, peer support, training and education for health care workers and more. It's important to note that we're bringing you their conversation to coincide with this year's Black Maternal Health Week. Virtual and in person events are starting Thursday, April 11, through Wednesday, April 17th. And to learn more about what we have going on in Philadelphia, the full schedule and more information are available at BMHWphilly.org. That's BMHWphilly.org. Now we'll go to Shukriyyah to start off the conversation.
Shukriyyah
Hello, I'm Shukriyyah Mitchell-Hinton, Senior Director of Outreach and Advocacy at the National Nurse-Led Care Consortium. I'm here with Saleemah McNeil and Imani Davis during Black Maternal Health Week 2024 to talk about our work in the Philadelphia area and beyond. First, we wanted to share a little bit about how and why we got into this work. For me, I was introduced to the concept of Black maternal health and the health disparities that impact Black birth and people during my first pregnancy about 15 years ago. I was a nursing student at the University of Pennsylvania. It was during that time that I was drawn to public health nursing, and knew that I wanted to be a part of the work that seeks to impact Black maternal health and support Black and underrepresented families. Saleemah your reproductive psychotherapist, for our listeners who might not be familiar with what that looks like, how do you support birthing people in their families in that role? What inspired you and led you to your work initially, and then to expand to advocacy, fundraising and reform?
Saleemah
My name is Saleemah McNeil. I'm the founder and executive director at Oshun Family Center, a reproductive psychotherapist and maternal health researcher, a retired doula lactation consultant, overall maternal health disruptor. And I came to this space by way of a head that I will be celebrating, which is my 18th parents anniversary that will happen next month. And that little person that’s not so little anymore, is the reason why I do this work. Being a survivor of a traumatic birthing experience in looking at my postpartum journey really helped catapult me into this field of maternal and child health and wellness. When we talked about advocacy and fundraising, I think I stumbled across those things just in the midst of doing the work. I'm not a policy person. I don't really like politics at all. But it's a necessary task that needs to be done in order for the voices of the people to be heard. Fundraising came because I went viral in 2020. I have no fundraising experience. I posted something on Instagram that I was looking to help combat the weekend of terror that we experienced in the wake of George Floyd, Ahmaud Aubrey, and the aftermath that happened here in Philadelphia. I asked for $5,000 so I can overburden myself with treating the Black population of people who are displaying just such anger and pain. And then from that $5,000 ads we raised over $100,000 that summer. It really was able to create jobs and sustainability for the organization. So thank you for asking.
Shukriyyah
Wow, Saleemah, thank you so much. Thank you for the work that you're doing. Imani, your lived experience expert and the Community Specialist at Strategy Arts. How does your role, your organization tie in here and how did you get into the work?
Imani
I am a mother of three and my oldest is fifteen. And my youngest two are five and I also have a one year old. And I'm sorry, since my little one in the background. After I had my five year old in having not such a great birth experience. I wanted to find out the different things that I could do to assist with Black maternal health and just helping other mothers to have an easier time. A friend of mine actually introduced me to CAN, the Community Action Network. And that's how I got started with going to different groups and becoming a part of the CAN and go into their groups focused on like maternal health and reducing some of those disparities in maternal morbidity and mortality is how I got connected and more aware of the situations that were going on. And also, just within their work just became aware of so many different opportunities, but also aware of how dire the situation is, and how many hands on deck are needed to help with like, let's say, health and reducing these disparities.
Shukriyyah
Thank you Imani. We are grateful to have you here and doing this work as well. So let's just jump right in and talk about this Black maternal health crises that we have here in the United States. More than half of the maternal deaths happen in the postpartum period, while after a birthing person has gone home. And NNCC the National Nurse-Led Care Consortium has two nurse home visiting programs, the Philadelphia Nurse Family Partnership, and the Mabel Morris Family Home Visiting Program. Through home visiting, we are meeting families in their homes and in their communities. And evidence has shown that home visiting programs positively impact birthing people in their families. Imani, we've talked about this before home visiting really affected your life and your family's life. Can you talk a little bit about that?
Imani
After then my oldest daughter who is now five, I kind of was in a place where I was stuck in the house because unfortunately, I had her right before the pandemic happened. So I was looking for different programs that I could get into and I became aware of Nurse Family Partnership. I was put on a waiting list and thankfully it wasn't too long. I was contacted by a wonderful nurse, nurse Aviana. And she's no longer with the program. But she was a great help to me. Being at home during the pandemic, it was a really hard time because, of course I have this little not even a toddler yet she was about nine months. And it became quite an instance of being stuck in the house and not being able to get out much except for like local parks. And even with that still being really cautious and afraid of just interacting with the public, having a home visiting nurse and she wasn't able to visit. But it was virtual, was a great help to my mental health. It was a great help to my family. And also just those meetings with her, which is such a relief to be able to connect with someone, even though it wasn't in person. I felt like she was right there with me. She made things so easily to talk to, to get in contact with her. She didn't make me feel any type of way if I contacted her if you didn't have a visit if I just wanted to talk, if I just needed resources, she was always able to send me things, drop things off. And I can honestly say I've been an advocate of the program and telling other mothers about it because it was so helpful to me and my family just to have that personal connection with someone knowing that they care, knowing that they can help me with resources and also, on the health side just answer questions and be available for me. That was so very helpful to me and my family during that time. And also, since I have the little one. We're back started again with the home visiting program.
Shukriyyah
Thank you Imani. And I know that your experience in terms of Black maternal health does not just stop there. You're also doing some work with the Early Warning Signs Program. Can you tell us a little bit about that?
Imani
Yes, it's actually through the Department of Public Health. It was started with a grant for Merck for Mothers. This program has been going on for a few years now. But basically what I do, I'm a co facilitator of the Early Warning Signs training, we've provided many different trainings to different facilities. The last one was for the school district. The trainings are to help mothers advocate for themselves and also to teach others who are in their immediate circle, whether it be birth and partners, parents, birth workers, nurses, anybody who can come in contact with a Black and Brown birthing person to help them be aware of signs that could lead to more dire conditions, or even potentially save their life because as you stated, a lot of the deaths unfortunately do happen in the postpartum period and after that six week period. So these early warning signs trainings are basically given to people who can help women advocate for themselves and to look out for signs which would lead to morbidity and mortality.
Shukriyyah
Thank you Imani. Saleemah, you're working on a study that is ongoing right now, that includes Early Warning Signs. But it's so much bigger than that, who are your partners and how's it set up.
Saleemah
So the change of heart study that we came up with you I and other members from the maternal wellness village a few years ago sitting around that table that I referenced quite often in West Philadelphia, coming up with the solutions to help reduce and ultimately eliminate Black maternal morbidity and mortality. And through those efforts, we have entered into community based participatory research CBPR collaboration with Temple University to help combat those issues. So we are funded for five years. And with that program, we get the opportunity to attack on each level what the issues are as it pertains to Black maternal morbidity and mortality. Overall, we want to improve heart health, because that is one of the top five reasons that Black women perish and then one year postpartum. We also have an institutional level and interpersonal level, the institutional level really focuses in on our diversity, equity and inclusion efforts to help providers become more aware of their positions, and the overall miseducation of a nation. So they can understand that treating Black bodies, although similar to the general population of humans, very different in our individual experiences. And that's why it's really important to have Black led curated research that's done on Black bodies to help bridge the gap and create a safer haven. Because as we know, our tenure with the health system as Black and Brown people have not been great. We've been utilized and practiced on in terms of research in order to help advance the human race when it comes to the dominant culture. And so when we look at those things, and how we curated the study with Temple, the research that we're doing, has three different levels, the institutional, interpersonal, and individual level, and on our interpersonal level, we have doulas, lactation consultants and mental health professionals. In those capacities, we help rep our families and services, because we truly believe that building out your village does help in the fourth trimester to reduce those negative outcomes.
Shukriyyah
Thank you so much for describing the change of heart study. I'm so grateful to be in partnership with you and the community with you, as we go through this study and are supporting the women and the families in our community. You testified at a city council hearing, what was that experience like? And how does that highlight some of the obstacles at the government level to making progress.
Saleemah
My duty as a constituent is an overall maternal health advocate activism and disrupter is to show up and help our legislators know and understand our plight. Therefore, I do participate in these opportunities to highlight and uplift the work that we're doing. So I testified for city council a few weeks ago, and for me, the experience was very frustrating, because I sat on a panel with women who are doing work in the community. There were other panelists, I have literally had been on several different hearings, and we've been on the panels together. I've done several of these talks. And it seems like we are not moving the needle in the right direction, because we're talking about the same things over and over and over again. But we have the solutions. And although there are new legislators and they need to learn, they need to understand we already know what the problems are. Those things have been overstated. Why are we still talking about the problem? Why aren't we talking about how the solutions that are being implemented are actually effective and showing the efficacy in the program's? Why are we not talking about how we can leverage resources and give funding to organizations that are on the ground doing the work to help highlight and uplift the community. So those things for me are very challenging because I think it's a gross misuse of time of executives who come down there to share our stories of ourselves and our clients. When we already know what the issues are. Utilize us in a different way utilize us to talk to different legislators who can actually support with funding this maternal health issue, because reproductive justice and rights and birth equity issue is a bipartisan issue. We need both sides, the left and the right to come together to know that Black birthing bodies are worth fighting for.
Shukriyyah
Saleemah, you sound frustrated and understandably so I too am frustrated. It's important that we share our stories. But how do we move beyond just sharing our stories? Imani, you've also had frustrations with elected representatives and making your voice heard.
Can you tell me a little bit about that?
Imani
The frustrating part is being able to connect with the politicians and policymakers in regards to having just a meeting. Unfortunately, I guess due to time constraints and their schedules, it's been a very difficult time trying to get a meeting with them just to sit down and express myself and let them know how positive of an impact the home visiting program has been to me and my family and also helping just in general with mental health, with the health of my children. We've been trying for months now and have not been successful in being able to get a meeting with them. So we're still trying and still being diligent in that but I would love to just have an experience where I can let them know how important it is to help out Black and Brown birthing women, especially during the postpartum period.
Shukriyyah
Speaking of legislators and policymakers just this week, state representatives, Curry, Mayes, and Cephas is introduced the Pennsylvania Momnibus, which is a set of bills seeking to address the Black maternal health crises. Saleemah, you mentioned that this isn't the first time some of these bills have been put for what's happened in the past that it didn't become law. Do you expect things to go differently this session? How will you address this? When you go to Harrisburg later this month for Black maternal health week to advocate and meet with the lawmakers?
Saleemah
I can't speak to why it didn't become law. But this Momnibus that was 2.0. This may introduce I have a lot of excitement about because this is predicated on some federal bills that have been introduced. So to see that we'll have a Pennsylvania version of the Momnibus that will expand Medicaid, doula reimbursement in diversity, equity and inclusion for our hospitals is really important. There's about five bills that are introduced in that package. And what we need overall is the support from both ends. I enjoy going to Harrisburg to be able to advocate because we have the opportunity to prep the community to better understand what we could be advocating for. We lean in on the educational part of it, because I'm also learning as well as a community member as a constituent. How do we interact with these legislators? How can we get a meeting with them? What is the process to do it? And when you get in front of them, and you have 15 minutes? What are the most important things for you to get out? What are you looking for support with and I really enjoy being able to thrive in those environments with educating the community on how we can talk to our legislators, because ultimately, our tax dollars pay for them, they work for us. We are the constituents. And so we have to be able to get in front of them. Like Imani is saying it shouldn't take so many grand efforts to get in front of your legislators. Because if they are not talking to us to understand what the plights are of the people, then what are you actually working for? That's a disconnect.
Shukriyyah
Absolutely. I 100% support that statement. You also mentioned diversity, equity and inclusion. Let's talk a little bit about that the state has pushed forward DEI training focused on maternal care has been effective.
Saleemah
Well, we know that as nation Diversity, Equity and Inclusion (DEI) trainings have been undertake Black live minority led organizations are also under attack. It is the shifting of affirmative action and also putting us in a space of we're being discriminatory because we're trying to uplift and empower voices of Black and Brown communities that have been impacted by the injustices that have gone forth within our health system. So when it comes to diversity, equity and inclusion, we have people who are on the left and on the right, who think that if they agree that DEI training is applicable, that we should have it automatically makes people racist. Those two things are not synonymous. We're all a part of a very failed system, we have been miseducated as a entire nation. And so we have an unlearning process and relearning process that has to take place. And that requires training. There are so many of us that work in the DEI space, that know the efficacy and understanding of this and the psychology behind change. There's a pre contemplative phase, there's a contemplative phase, there's the execution phase. And if we can move people into a contemplative phase where they are now understanding, hey, you know what, I do play a role in this. And as a DEI, an instructor, I tell people all the time, my goal is to call you in. Because we're in this together, I am also a part of a system that has been ingest to my people, which means that I'm also a part of that problem. My goal is to bring people along with me, so those people can better understand that. No, it doesn't mean that you're racist. If you can see that the textbooks that are physicians, clinicians, and other support people are taught out of say that Black woman's skin is thicker, say that we can experience pain at different rates and our white counterparts, which is just simply not true. Based on our own human experiences, I need you to understand what my experience in this Black body is. So you can best treat me as a collaborator of my health care. So there is another bill or a third effort for this DEI training and inclusion, that we're hoping to garner some support because that literally means life or death.
Shukriyyah
Absolutely. Thank you Saleemah for that and Imani, you mentioned a little bit earlier about your own mental health and your experiences given birth to your children. And Saleemah I'd be remiss if we didn't talk about mental health is you are a reproductive psychotherapist. According to the key findings in the 2020 Philadelphia Maternal Mortality Report in over 45% of the pregnancy associated deaths, mental health played a significant role. So this question is for both you and Imani. Saleemah, what are some of the other systemic barriers that you're seeing, particularly to addressing maternal mental health? And Imani, we're gonna start with you. So what were some of the barriers for you in terms of addressing your mental health?
Imani
Awareness definitely is key. Because unfortunately, a lot of women are in the postpartum period, you're dealing with the baby, you're so focused on the baby, you're not even thinking about yourself, or your mental health. We also do talk about dating, early warning signs training, when women are not feeling well, if you're having thoughts of hurting yourself, or hurting someone else, or just not feeling normal. I also think lack of accessibility, or connection is really hard to take the time when you're taking care of a baby, and yourself, to stop and say, Well, hey, I need to see a therapist. And then even if you're going through that process, how can you be connected to a therapist, if you don't have those resources, or if you don't have someone to say, hey, here's someone who's good to talk to. Thankfully, I was aware of being able to contact the therapist because I know I'm susceptible to depression and anxiety. So just for preventive measures, I definitely wanted to have someone to talk to in that postpartum period. But I feel like a lot of women don't have that connection, they don't have someone to advocate for them, they don't have the time to sit and make different calls and reach out. Sometimes you might not be able to get an appointment for months, and then you're left without any connection to any type of psychotherapy or psychologist or any type of help. That's where Saleemah comes in and organizations like Oshun, they are very helpful in our community with connecting women with doulas and health care and mental health professionals. And unfortunately, insurance, I think that can be a big barrier because a lot of times people are having state insurance and certain practices just don't take it. So again, you're left without. You're left without the connection, you're left feeling helpless or hopeless.
Saleemah
Thank you for sharing that. As a member of the Maternal Mortality Review Committee, when the reports come out, we debate back and forth to figure out what we could have done differently to help circumvent this outcome for this family. And mental health accessibility, reducing systemic barriers, and insurance with managed care organizations are the top three ways that we can all collaborate together to reduce those barriers so the families have access to the services. Every therapist, doula, front desk person, and back desk person are all trained or will soon be trained as their new hires in perinatal mood and anxiety disorders, not because everybody will treat perinatal mood and anxiety disorders, but to be aware and understand the signs. So you know how to respond to that person, when you see that you may say something that's a little off, you have more education and understanding as to why that's happening for them. So to address those barriers, we have created a centralized location where Black and Brown people can come get the services that are near and dear to their heart and not feel that they're being judged, stigmatized, or labeled as crazy. We deal with regular people going through hard times, they need help with their transitions from one phase of life to the next over the years. Like being a doula and lactation consultant, I used to be a part of a home visiting program. And seeing all of that I realized that mental health was the piece that was missing. Because I will often wonder, okay, I can advocate to get this person housing, I can educate to get them food, we give them diapers, and wipes and all of the things, but I was scratching my head as to how these people would recidivate so much. When I was working in a correctional facility now, like what is missing? What is the barrier to them being able to successfully access these resources, and it is the mental health of the person, because you can be guided to all of the resources but if mentally, depression is saying stay in the bed that day that you might miss your appointment with your case manager for welfare or Social Security or a housing program, right? And then we start to label them with words of like noncomplying or non-adherence. And because mental health was so pervasive, especially in the Black community, we know that it exists, we know that it's here, but we didn't want to treat it because then that means that you're crazy. But no, I tell people all the time. I am a therapist for the culture, which means when you show up, you're going to get an experience that is similar to a centralized Black or Brown experience.
Shukriyyah
Imani. I'm so glad that you brought up Oshun, and Saleemah I am just so proud of your organization and the work that you're doing to see progress really being made at the community level, where community members are taking care of other community members. So it's important that we talk about that progress that's being made. Can you talk a little bit about the impact of having people with lived experience at the table? So this question is for Saleemah, and then we can throw it to Imani.
Saleemah
We tell the stories that help people understand. Unfortunately, we have to share our personal experiences and our trauma sometimes for people to get it. And I'm also almost sick and tired of it. When I testify in front of the council people I said, I'm specifically not telling my story again, because I believe most of you have heard it, have read it, we don't need to build on the trauma that has already been experienced. But we can build on the lived experiences of those people, as they are putting forth solutions. People who have been experiencing, they have ideas or how or what can be created. So they never have to go through that again.
Imani
Before answering, I also wanted to thank Saleemah for creating a wonderful facility like Oshun and being able to help out community members, and that stemming from your lived experience, knowing that it's a necessity to be able to help other mothers in our community. But like you said, unfortunately, it comes down to sometimes having to relive your own trauma or just state the traumatic experiences that you've been through. A lot of times I do address some of the experiences that I had when I did the early warning sign trainings just to let other mothers know. You know, sometimes you may have a certain health experience or a health scare or something traumatic, which makes you more aware. But I would love to see other mothers from experiencing what I have in the hospital, even though it may happen and may not have been traumatic as some people have experienced, going in front of policymakers, in front of legislators, they need to hear the voice of lived experience experts. I mean, it's fine to hear statistics, it's fine to hear numbers, it's fine to hear the report of the maternal mortality review committees, all of those things are very important. But I think what kind of can drive it home is just hearing the voice of someone who's actually been in that place, who has had those traumatic experiences. And I can tell you the ways or things that would have helped.
Shukriyyah
As we talk about the importance of having people with lived experience at the table, informing and driving initiatives. Let's look ahead, what are some of the new or forthcoming initiatives that you're working on that you're excited about? Saleemah?
Saleemah
We're in the thick of a capital fundraising campaign to acquire our first brick-and-mortar location in the Germantown area of Philadelphia. Where families can come and feel supported in their endeavors to survive that fourth trimester. We are curating our own maternal wellness village that will be standing center in Philadelphia. And the most important thing is that we are not replacing maternal health care. We are an enhancement to the standard of prenatal care. And we work in collaboration with our midwives, with our doulas, and our health care systems to provide those supplemental services. We understand that providers only have a limited time to do what they need to do. And we are dedicated to them focusing in on helping those families survive while we help them thrive. We are very much so a village and look forward to collaborating with so many birth workers across the city and institutions and not for our first brick-and-mortar location. So if you all want to help us out in those endeavors, please go to our website, read more about our journey, and help us raise this money to get this brick-and-mortar location.
Shukriyyah
Thank you for sharing. I'm so excited about our brick-and-mortar location. I can't wait until it comes into fruition. Imani, Is there anything that you'd like to share about the future in the work that you're doing?
Imani
I do work on a number of different committees and projects. Besides the community advisory board for Nurse-Family Partnership, I'm also on a steering committee for an upcoming project in the city. It's called the Philly Joy Bank. So I'm on that steering committee. And this is a pilot project where we are giving I want to say around 200 families a guaranteed income of $1,000 monthly and hopefully, this will help those families in the prenatal and postpartum period. And that is specifically for Black and Brown parents and families. So there's one project that I'm really excited about in the existence of it, how it actually helps families.
Shukriyyah
I think that’s the theme to this, right? Not just surviving but thriving. I just want to take that opportunity to thank you both Imani and Saleemah for having this conversation with me today. I look forward to continuing to read about you and to join in community with you around Black maternal health and wellness. Thank you again.
Imani
Thank you so much. I really appreciate this conversation and being able to speak with you ladies. It's always a pleasure when I see you virtually or in person, and I look forward to seeing you in person during Black Maternal Health Week. I will definitely be there and see you both hopefully very soon.
Saleemah
100% Black Maternal Health Week will be hands down lit this year. We have a good time every year, but we have some special things in store. We've got a lot of support from our sponsors for this year to put all the bells and whistles for every event that we have. So go to our website at bmhwphilly.org to register for events for Black Maternal Health Week. We will see you there.
Sarah
Many thanks to Imani, Saleemah, and Shukriyyah for taking the time to share their expertise and perspectives. You can find our most current and past episodes of At the Core of Care wherever you get your podcasts or at paactioncoalition.org. On social media you can stay up to date with us through our handle at @nurseledcare. This episode of At the Core of Care was produced by Emily Previti of Kouvenda Media and mixed by Brad Linder. I'm Sarah Hexam Hubbard with the Pennsylvania Action Coalition and the National Nurse-Led Care Consortium. Thank you for joining us.
SARAH: This is At the Core of Care, a podcast where people share their stories about nurses and their creative efforts to better meet the health and healthcare needs of patients, families, and communities. I’m Sarah Hexem Hubbard with the Pennsylvania Action Coalition and the Executive Director of the National Nurse-Led Care Consortium.
This episode is part two featuring a panel discussion that we recently hosted with the Obscured Journalism initiative. The panel explored law enforcement interactions with the community and how to implement a harm reduction care model. If you haven't heard part one we recommend that you go back and listen to that episode first. Here’s part two of the discussion from our partners at Obscured.
EMILY: This is Obscured the podcast from Kouvenda Media about critical issues that don't get much attention because they're complex, overshadowed, and unfold largely out of the public eye. On this limited series, From Words to Weapons, we’re focused on survivors of law enforcement trauma. I’m Emly Previti.
STEPHANIE: And I’m Stephanie Marudas. This is part 2 of a panel discussion about harm reduction in the context of interactions with law enforcement and solutions that could better promote community well-being. If you haven’t heard part 1 yet we recommend you go back and listen to that episode first before continuing with this one.
EMILY: The discussion we’re about to hear was moderated by Stephanie and Namaijah Faison from the Pennsylvania Action Coalition and National Nurse-Led Care Consortium. As we heard on the previous episode, the three panelists are Talitha Smith, Chad Bruckner, and Laurie Corbin.
STEPHANIE: The three of you have a lot of overlap, as we heard and, you know, have your unique experiences.
We heard a lot about how the three of you are in, positions to help and what that means. What we'd like to go right to now is about how do you do that help, and how do you keep the trust between law enforcement and the community? And what we also heard was that there has been a breakdown in that trust, and how do we regain that?
CHAD: I think this is a great topic because we have moved the goalposts back.
I think in so many professions, but we're here talking about law enforcement is the lack of transparency. The lack of honesty. If we're lying to ourselves, if we're lying to our teams, if we're lying inside our building, we will lie outside the building that will happen. So, we need to get back to that morality of telling your people lie in a leadership role is not okay.
Telling the community white lies in the name of justice or service is not okay. And I know we have talked ourself into those things are okay because we're serving people, we're protecting people. But that's a goalpost. We continue to remove that back. And if we could tell a white lie today, something could be a bigger lie tomorrow.
And I just think getting back to trust, it's like our relationships. If my wife lies to me, I'm going to have a trust issue. Same, same, vice versa. So, being honest, sometimes that direct candor, that respectful candor. I call it is some people get offended by it. I think just being honest and direct and open and engaging is this is the situation. This is the problem. It's not about blaming. It's about, this is what we're dealing with.
What my experience has been, and I'd love to know what you guys think is, when we're culpable, when we have a little things that we're to blame, we're responsible for. That's where that fear comes in.
That's where that shame. Well, I don't want to get in trouble. I don't want to give up my job. So, that goalpost moving has now presented an opportunity to Tell a little lie to get out of this or, or, or twist the truth or operate in the gray a little bit. So for me, I just come from a place of transparency.
Absolutely. Trust, honesty, directness, and, not hiding, things that could be uncomfortable to people.
LAURIE: I think that's great. I think there has to be a place where. There are real honest conversations, like, with local police districts, you know, and community members, and what does that look like? And really, For the, and I'm going to say law enforcement to really listen and hear what people are saying.
Not, and not do the perform, oh well this is what we, no, let's take the mask off because everybody's wearing a mask. And let's be, goes back, so let's be real honest and, but it has to be ongoing. Can't be one and done, you know, can't be just this, you know, event. But also, how do you integrate police in a positive way, even into like community events?
Because again, you know, if you're having the block party, if you're having, whatever that may be, whatever the church is having, whatever the community center is having, whatever, you know, whatever that thing may be. How to engage, so that way the police really get to know who the community members are. You know, because again, it starts on the relationship level.
And that starts bringing down those walls of, of trust or mistrust that are so up there. I think the other thing is it's, I think the law enforcement, it's us versus them. And I think, you know, sometimes they're doing. Law enforcement is doing their job, but not realizing that as somebody who's not law enforcement, you're just trying to find out like what's happening, like what's going on.
It goes back to transparency. And there's no communication, even when there's an event happening. There's no communication.
CHAD: So I think this gets back to authority. It's.
Yeah, just because I'm in this authoritative role doesn't mean I have to be an authority figure, you know And I think that's where we have gotten wrong is yeah, like if I'm gonna introduce myself, I wouldn't say hi.
I'm officer Bruckner You know, why would I do that? That sounds so I mean, I know fortune 100 CEOs who just say their first and last name Right, but in policing we're officer so and so and I'm in a uniform Oh and you're sitting in your police car and I'm standing over you all these subconscious things of just create authority And I think you're right.
I think most times we don't try to be that way, but it just naturally goes that way. You have an uninformed citizen who maybe has lack of resources, needs support, and we're in this authoritative role. And it's like, no, take the mask off, take the uniform off, ditch the officer. How can I help you? Yeah, I love that.
TALITHA: I would say, you know, I know police, like I said, I know their job's hard. So, just as far as myself, I just want to be kind. You know, when's the last time you went up to the police officer and gave them some flattery? So, I just like to do it like a sandwich. And I'm like, oh, officer, thank you for being here.
Because when the police come where I work, against a ghost town. So, you know, I can walk down to the corner and say, Oh, I'm so glad you're here today. You know, thank you for helping us feel safe. And then what's going for me is I'm a nurse. Guess what? Everybody respects nurses and they think we're like great people, right?
So, I want to use my sphere of influence. I want to be like, I'm the nurse here and then I want to lead by example. If they see me dealing with this person that's all over the place and I'm still down there on the ground wrapping up their wound and I'm not getting angry, I'm leading by example.
So that's my, sandwich, you know, I make it pleasant. Little feedback and then lead by example. I love that. Most cops too think that's a great point. 'cause most police, I think, have, the media hasn't done a, a favor in that regard. And I think a lot of cops think that the public right or wrong is already coming into the encounter, not liking them or not respecting them.
LAURIE: Right.
CHAD: And that subconscious, uh, I think rhetoric. When you layer it all together with the authority and the lack of transparency all just created this perfect storm of well, they don't care about they don't respect us. Well, how do you know that like you're we hold on? We got to get some community conversations.
I'm sure most of the citizens in this town wherever the town you live in respect you. So we can't go into it thinking that they don't respect you. If you go into it already thinking that, then it's going to create a negative encounter and that comes from the culture, that comes from the leadership.
If we have really empathetic, engaging, influential leaders at the top reminding the officers, it's going to be all right. They love you. They respect you. They're going to hold you accountable just like I am. You know, that, that level of collaboration is, I think it's the only way we get, get to where we need to get to.
We have to, like you said, take off the masks and let's have some real conversations.
NAMAIJAH: And that's a pretty good segue into my next question. I know this is probably something that everybody wants to touch base on, but if you all are not aware back in, I think sometime in August, there was an incident with, um, a young gentleman, his name is Eddie Jose Irizarry, am I pronouncing it right?
Where I know if most of you have seen the footage, there was an incident with him and a police officer and him sitting in his car and due to misunderstanding, misinterpretation that young man unfortunately lost his life due to the understanding or thought of him having a weapon in his hand that could have threatened that police officer's life.
And Chad, I know you can probably speak a little bit more about this, but I wanted to get everyone's opinions and thoughts on this. You know, when the camera footage came out, when we found out that the officer wasn't actually cooperating with the investigation that brought a lot more of mistrust with community members.
And it also kind of was a deja vu because this is not the first time that something has happened, not only in Philadelphia, but in other cities, other states, countries. So, what are your current perspectives on that incident along with the discrepancies that have followed the initial reporting?
And kind of how, going back to trust with community members and police officers, how has that incident... either change your perspective or just made you become a little bit more aware, especially in your incident, Chad, with, you know, now that you're no longer working in law enforcement and being able to see it from a different perspective.
CHAD: Yeah, it's a very sensitive topic and that's frankly, when I was on the job, I was thinking the same way I think now as I was trying to advocate and train and encourage police officers to lead that same way. So I don't, I didn't see the video. I don't know everything about it, but I do know the story and I read the news release, what I'll say about that situation, which I think is context to all the other issues that happen in America. Lack of training. There's a lot of fear in police officers, a lot of fear. I was again, just from my experience serving in combat, leading combat missions.
When I came home to Montgomery County to work and be a police officer, I was like, great. You know, I was I served in those those tough environments overseas, lost, you know, been around the loss of life been around some really traumatic events. So when I came home, I was an honor to serve my citizens.
Some of the cops that just generally that you work with over time that I worked with. It had that us versus them mentality. And I would remind them again, these are our brothers and sisters, you know, I fought the enemy over there. This is not that. But if you don't have that perspective, you don't have that experience.
And then you have leaders on top of that, they're encouraging the SWAT mindset and just that tactical military militarization mindset. It just creates a situation where you get a 22-year-old cadet with a high school diploma or maybe 60 college credits, not a lot of life experience, immerse him in this or him or her in this culture and tell them that this is the way it is. Of course, they're gonna go along and get along. And, um, so we, we really got to focus on the culture to, to attack that because the fear is a real thing. Policing is a dangerous job, but not everyone's trying to hurt us and not every situation is a dangerous situation.
And a lot of cops, I think, without the lack of support inside their agencies and that, that robust mental, emotional health, uh, health, you know. Facilitation. They have just a lot of them have become very fearful of media attacks, citizen attacks. Everybody's got a weapon or a lot of people have weapons and it's just, it's created a really, you know, toxic situation for them.
And I feel bad for and I know so many of these young police officers that are dealing with that.
LAURIE: I think what we also have to talk about is racism and bias because again, that's still there. And so, again, it's, it's us versus them, but it's those people versus. You know, it's, it's, it's, I'm sorry, so much of it is still tied up in racism. And again, if people look a certain way or present in a certain way, they are going to be treated differently than other people.
And so that goes back to culture and training. So it brings, so, you know, that's the initial response. It's like, this is racist. This continues to be the racism that happens. You know, how do we, how do we change? Like, not everybody's not going to not be a racist. Let's call it what it is. Okay, let's be honest. There will be people who always will be racist, but how do we minimize the number of those folks who are doing this type of work?
And how it goes back to relational, like sometimes folks have never met another person outside of their culture. You know, I just, I just, like I always say, like not in my lifetime, we're not going to get past… like people always talk about when Obama got elected, you know, we're going to be a post racial… I don't think, no, because it's a racist country, let's call it what it is.
And so, how do we really begin to address those issues, and then when those things happen, how do those things get addressed disciplinarily within departments? And it's not tolerated, and it's not accepted, because that's what happens. You know, and I think that's where my concern is.
TALITHA: I think, like, they're always on administrative pay with, you know. It's like we get punished so hard when poor people do stuff.
LAURIE: Yeah!
TALITHA: They look at the fines, the book thrown out. So I just don't think we can understand that you're off with pay until the investigation. I just, and I don't want to throw everybody away because we all make mistakes, right? I know nurses, we can't, they're like, oh, you can't make a mistake because you would kill somebody, like that's what they teach us at school.
You know from the door and do they teach police officers that? Like, no, you can't make a mistake because you can kill somebody. So I think it just needs to be another perspective shift.
And we can make all the policies and procedures we want. You know you still got somebody at your job that don't act right.
LAURIE: That's right.
TALITHA: Right? But, as the organizational culture shuns that, you don't need a policy or a procedure. We don't do that here.
LAURIE: That's right.
CHAD: Preach that one.
STEPHANIE: And this might come back to Laurie, what you brought up about, you know, police crisis response, right, like in the case of, uh, this, you know, that had a social worker or somebody been deployed, quote, unquote, right, and that it was a militarized response.
LAURIE: It was a militarized response. And so again, how do we get away from the militarized response? So you, you know, you can get the crisis person, but also how do you train and how do you build the culture? That this is what we do and this is how we act. And yes, mistakes will happen, but if it does, you know, again, then you get shunned and you get disciplined and you don't get paid.
And I can sit here thinking, I'll say, we don't value life. We, we don't, you know, at any level. And so it just, again, it gets played out. So even having that conversation, when you go out on your job, police officer, you have the ability, if you act incorrectly, to take someone's life.
Same as a nurse. If you act incorrectly. It may happen by accident. I get it. But to kind of keep that in mindset, yeah, it can be fearful. But if, I think once you lose that and realize that somebody's life is valuable. Everybody's life is valuable. And I think that's where I also look at it…
CHAD: I've wrote about this in the book because I think it's important to understand. We talked about adverse childhood experiences and then on top of that, police officers are dealing with traumatic events in this, in the community.
So they're constantly going through changes and a lot of pain. They have a lot of pain points. And especially if they didn't deal with their childhood stuff. So, I write this section of my book about, I really studied narcissistic personality disorder. I'm not a clinician, but I just wanted to read and learn more about it. And I actually put it in my book, a little bit about it.
But, I just want to highlight, narcissism really stems from deep pain. And you are now chasing professional or personal pursuits to fill those voids, to fill that deep pain. It's unhealthy because oftentimes you will take hostages and you will do bad things along the way to fill that void.
But really it stems from pain. So if we can really understand human behavior and understand why people are doing the things they do. Tell me about your pain. What can I do to help you? And that's kind of what we're doing with police officers. Stop telling me about them and putting the finger at them.
Tell me about you. Where have you been? What have you seen? What have you done? And I guarantee when we do that, all that stuff, we're going to value human life more. We're going to have better relationships. We're going to love the community.
I mean, we've got to get back to, to police officers are not the corral of the community. We don't rope and dope everybody. You know, we are just here to provide public safety and services. The citizen we stop for speeding, that person has a full time job, most likely. What makes their job any less significant than the job of the police officer? It doesn't. So when we had that collaboration, now it's not all for so and so.
I'm like, Hey, John, sorry to pull you over. I'm Chad Bruckner with the police department. Dude, you were flying down Main Street, brother. I'm sorry. I'm going to work. All right. Can you slow it down a little bit? Yeah, right. That was a relation, that was a conversation.
I still have the authority to cite him if I wanted to. I didn't need to tell him I have the authority. I don't need to remind him, like we know that stuff. And that just comes from a very, uh, Sigma male. I've been really studying a lot about Sigma males. I don't want to get off the rails here, but because I really want to help a police officer. I'm really going to dive deep a little bit, though.
I really want to help police officers. We have this thing. We love alpha males. We celebrate alpha males and we do all this stuff like it's a great thing. There's nothing wrong with being an alpha male, but not everybody is that, not every male is an alpha male. So if you're a sigma male like me, very stoic, confident, you can move in the shadows, take the lead in the limelight, come back into the shadows.
I don't need it to be about me. There's a very powerful thing being a sigma male and I want to help cops. I know there's a lot of cops that are Sigma males that they have been culturally, for whatever reason, told that that's not okay or not acceptable. Because what the Sigma male does is they throw an absolute wrench into an alpha male's plan.
You can't coerce a Sigma male. Alpha males use fear and dominance and other strong things again, but in policing, I really think we get, it's done itself a disservice by having such aggression or toxicity.
I always say I can fight with the best of them, but I really wouldn't rather. I'd rather love it. Yeah. Love on you first. But if I need to, I will. And I'm going to do it 100%. But I don't need to lead that way. And I don't want to tell you I could do that. Like, and a lot of police, I think comes from fear, shame, all these things we wrapped together.
And it's, you know, they kind of turtle up and there's a lot of fear if we could just help them become, tapping who they are as people, as human beings. Because a lot of them, I don't think you even know that this is what I do for a career. This is my vocation. I'm a cop. What am I gonna do? Bro, you gotta stop thinking that way.
You're a human first. You're a son. You're a brother. Right? You're all these things before your job. Because when you start to identify with your job guarantee, I don't know how much time or how long it's gonna take, but eventually you're gonna hurt somebody because your job is the job. My job. My job.
It's a job. It's a vocation. You could love it and you could be passionate. I loved it. And you could do all that. You could burn the candle at both ends to serve people. If you want, you could do all that. But when you're starting to affect other people's lives, hurt people, that's not okay.
We need to be self aware to say, you know what? I need to stop. I need a break. I need to figure this out. And we got to surround ourselves with people that hold us accountable. Culturally, we haven't done that. I think we're starting to get to that point.
NAMAIJAH: Yeah, and that kind of brings us to our next point, Chad. You mentioned a lot about self awareness and police officers, uh, basically not taking care of themselves and not acknowledging the fact that they need help.
And from a person looking in, you know, community members, we don't realize that, we don't realize that a lot of police officers are hiding what they have dealt with in the past, and they're putting that out on these community members that they have daily interaction with.
CHAD: So can I share a quick story? I'll do it for like two minutes if that's possible.
NAMAIJAH: Yeah, no. Yeah, that's fine.
CHAD: Some of that. I want to just kind of give you what I was feeling as a police officer to show you what that was like. So in 2019 I was working Thanksgiving 2019. I was very depressed. I was suicidal or I had suicidal ideation. But I work with a great mask.
I was smiling, joking around. Always a positive guy in the community and stuff like that. But you didn't know that, you didn't know what I was thinking and feeling. You would have never known. Why would I tell you that? Why would I show you that? It was from a place of fear and judgment stigma. I don't want you to know.
You see me to be Mr. Positive. So how can I be anything other than that? There's a lot of cops that deal with stuff like that. And then they're going on call. So I got a call for a disturbance and an elderly lady lives alone. It's coming home from Thanksgiving dinner. She found some male in her bed. She lives alone and she has to be in her eighties.
Of course, she's gonna call nine one, freaking out. Now the male was intoxicated and he lived two doors down. He just was so drunk. He went to the wrong apartment, not the wrong road, and not not the right house. So he wasn't violent anything, but he was very drunk.
You can imagine the, the right, we get back to this, this communication, if we don't communicate share, everybody's coming at it from their perspective. That guy thinks he's in his house and here I am as a police officer telling him, you gotta get up. Right? Who's right? Who's wrong? I mean, really, you know, this is where it becomes less about enforcement and more about communication, conversation. She was upset that this guy was in her bed. He didn't realize he was in somebody else's bed, right?
So, again, the old days, we'll arrest this guy, we'll throw him in jail, call him a burglar, call him a sex addict or a rapist. We do all these things and we just label people and not think about it. That guy had no idea he did anything wrong. And on top of all that, I was dealing with my own stuff. So I wasn't the best.
So instead of dealing with it the way I want, I started wrestling with him on the back deck when he started to resist me. He just pulled away from the handcuffs. That's all he did was pull away. He didn't fight me, he didn't punch me, all he did... Who would want to have handcuffs put on? Nobody would want that.
And he just pulled away, and I immediately went into defensive mode. I didn't strike him, but I grabbed him to gain control. We started wrestling around on the deck, and I was able to get handcuffs on him. It lasted 30 seconds, because he was really drunk.
But I look back at that situation just as a microcosm of… Every police officer, not every, so many police officers, are in those spaces. You're dealing with lack of information on the call, confusing calls, you don't know what's going on. So, I just wanted to share, thank you for letting me share that. That's kind of some of the, you know, what they're dealing with behind the scenes.
NAMAIJAH: What is your experience that you've had with community members or people that you helped in, the stories that they've have described to you when it comes to their various interactions with law enforcement figures or experience that you've had with law enforcement figures in your current roles or past positions that you've had.
Like, do you see a commonality when it comes to the description that some of the people that you interact with, you know. Are there commonality characteristics or types of interactions that you notice is a common theme, especially when talking about police officers and the aggression that people have experienced and things that they're hiding inside and just putting their anger or frustration out to community members when it can be handled a different way.
TALITHA: We deal with people who are post-incarcerated, so everybody's been arrested. They really don't have a positive outlook when it comes to dealing with the police and even at the Allegheny County Jail. It is horrible when people come out and they tell me the stories.
t's like they're all animals and they're just locked up and I don't even know if the Officers see their own humanity. They’re there and they make them do double shifts and they keep them there. And I'm just like, Oh, they need a hug. So again, I'm always going to go back to…
Everybody needs a little bit more love and maybe if they had somebody that showed them compassion, they would be better off doing their jobs. Because at this point, like what can you expect from a person that they make do double shifts, five days a week. Like that's unreasonable. We can't say things like, oh, they have no reason to act like that because if you're hungry and you're tired, you're not your sweetest self.
But it's a shame that, um, people are scared of the police or just automatically think they're going to hurt them. And, you know, if you had somebody think about you in that way, wouldn't you be hurt? And when you are hurt, like, you turn to anger if somebody always thinks you're a bad person.
So I just try to look at everything from both ways. And I just always remember that even a broken clock is right twice a day. So we have to listen and hear everybody out. And we need changes on both sides.
It's not that they don't need help too. Because police officers need… everybody needs help, like I said. But they need help to be better police officers, better selves, better to the community. So... everybody's not looking at them like that.
Um, I was thinking about cops like and how we see police officers and how we watched them and that was glorified. It just has to be a different way and that needs to be glorified.
What do we value? We value the police officer coming to the community event. Like those sort of types of images. People say like I need to see people like myself doing great things so I know that I can achieve them or, you know, children. So we need to see police officers doing these things. So we know like, oh, we don't always have to be afraid all the time of them.
CHAD: You bring up a good point about glorifying, you know, police work. I don't, I don't even know why we did that as a society. But you're right. We had TV shows and I would say they trained, like this isn't a cool job. This is roll your sleeves up and get muddy.
Almost at a detriment, big time. We make TV shows and we get tattoos and you'd be cool. And you wear cool sunglasses and you get paid a lot of money in some areas compared to other areas. We get paid a fraction to what you're making it to very, uh, interesting, uh, profession. I almost can think that 20, 25 years ago, we started to really professionalize policing where we expected executives to get degrees.
And then we expect them to get master degrees and. We have police leaders who are seemingly spending less time than before with their guys and girls and training and momentum because they're out chasing their stuff. There seems to be this class separation of the executive at the top and then these double shifts and everybody, the officers working.
It's kind of a microcosm of a lot of areas of society and this is what my passion has been really going after the chief executive role and really understanding like that is the most important job. It's not sit on your, you know, rest on your laurels, you made it there. It is the most important job.
It's the most hardworking job. We need the most moral men and women in that position. There is no negotiating on that. There is none. If we want to fix it, that's what we have to do. And that's a solution. It's easy to say, but it's really hard to implement. And I'll just keep keep drumming the beat with it.
We have to do it. And if that means current chiefs in their current roles aren't in chiefs two, three years from now, I know that's scary and that's sad, but we have to make some changes. We have to figure it out because this society, our country needs good police officers, good, moral minded police officers.
And this is this problem has been going on for years, so I don't act like [00:26:00] I'm gonna be able to fix it. But, um yeah.
TALITHA: One bite at a time.
CHAD: One bite at a time.
LAURIE: I was going to say two things. Um, to piggyback on what you just said about the culture change, I had an uncle who was, who was a retired Philadelphia police sergeant.
His daughter wanted to become a police officer, and this was about 35 years ago. He told her no, because the culture had changed. He said it wasn't the same police department. You know, when he started, that it was when she had an interest. Now it's very, you know, and it sticks in my mind. It was just like, I remember Uncle Kenny told her, no, no, she's not going to do that.
It's a whole different world. It's a whole different culture. He did not think, and she really desired and wanted to do that because she kind of wanted to follow her, follow her father's footsteps. So I think it speaks volumes to how things have changed over time.
CHAD: So my PI firm, one of the jobs we do, we screen police officers.
We do their background assessments for. And it's been really alarming the last couple of years to see, you know, some of the applicants who are really good applicants to watch their chain of command to try to destroy them because they're leaving their agency and going to another department. Because we'll be honest, if we really study and understand organizational culture, people don't leave a job and go to another job in the same profession for a better opportunity.
Let's be honest. It's the people. It's the people. You just want to get away from those people. You love the job, you didn't like the people, so you went to another company. So... That, that's the issue we're dealing with. We have a people problem in the profession. We have, uh, just too much at the top where, where, you know, I have a bunch of friends who colleagues who are minorities in police roles, the stuff they dealt with, the stuff they continue to deal with, racism.
It's insane to me. I'm like, dude, how you're the chief. He's like, it don't matter. I'm like, wow. And those are comments from other chiefs who maybe don't look the same way, you know. So we just, we love to eat each other alive. It's a noble profession and we need it. I believe it. That's why I'm fighting for it.
But to say we don't need to make drastic changes would be grossly inappropriate, I think.
STEPHANIE: Just any, you know, final recommendations that you might have for practitioners, researchers, stakeholders. who are thinking about how do you support law, enforcement trauma survivors.
You know, what to kind of keep in mind. We've heard a lot about humanity today, love, openness, transparency, talking, culture change. But, if there's anything here that, to think forward about how we provide support in this space.
LAURIE: I mean, I always think when you're talking about, you know, support, it's like you have to let people tell their story and what their experience and respect that.
Because again, I think what happens also, people have had experiences and people, you know, oh that didn't really happen or let people tell their story. That's, that's the first step in them and then regaining their humanity, I think engaging with them and, you know, listen to their story, you know, what kind of, how can I support you?
What are some things that we can do? What would you like to see happen? And sort of walk with them on that journey. Because I think everybody's journey is going to be a little bit different. And everybody may be looking for something different. But again, you know, also reinforcing with them, like, you know, you may have had a bad situation, but you're not a bad person.
You know, and also what you encountered, you know, it wasn't about you, it was really about them. And that's really hard, when you have to step back and say, it's not about you, it's about them. And I think to have those conversations, that would be one thing I would encourage. I just would encourage my Patients to report it, you know, sometimes they think they can't say anything like who's going to listen to me.
I'm going to listen to you and we're going to do the same exact thing we would do if you were not in addiction and you had a regular job, we're going to report it. And the next person we're going to report it. We're going to keep reporting it until we have a document trail on whomever this person is. Because if they hurt you, they are going to hurt someone else.
So, I just want to make sure that everybody knows they do have a voice and they have the right to do what any other person is doing. Drug addiction doesn't take away your rights.
CHAD: I just want to piggyback on what Laurie said, because I really think that's awesome, um, storytelling and affirmations. Like, is it really that hard to throw to more affirmations or validations to people? People have been through, like, I've been through my situation and I didn't really get into it. But the police department though, I just wanted a validation.
Does somebody see what's happening here? And guess what? I still never got it. So, um, because that, and that, that's, that's, that's, that's traumatic for me. It's like, wow. I think that kind of fuels me a little bit. We have to just. Affirm and, and make these, attempts to be more human. We just have to do it.
You see the world, you see the world is seemingly on fire in many places. And it's, it's, where's the humanity? And it's, it's, it's not to say that things aren't bad or there's not reasons we do things, but to listen more and to, to affirm. Hey, I'm sorry that happened to you. Uh, just thank you for sharing that with me.
I think that goes a lot to letting people feel like, okay, all right. Well, I got somebody, I got one ally that's listening to me.
STEPHANIE: Special thanks to Talitha Smith, Chad Bruckner, and Laurie Corbin for taking the time to be on the panel and their presentations. As well as to our partners at the National Nurse-Led Care Consortium and the Pennsylvania Action Coalition for their collaboration. We also want to thank the Law Enforcement Action Partnership for their assistance and the Independence Public Media Foundation for their support of the panel discussion and the production of this podcast episode.
EMILY: Next time on Obscured, the discussion turns to compensation and support for people who've been exonerated. We covered that theme in episode three of our series about Chester Holman III and the politics of wrongful conviction.
On our next episode, we're bringing you a panel discussion produced in partnership with the Quattrone Center for the Fair Administration of Justice. You'll hear from Chester, Pennsylvania Speaker of the House, Joanna McClinton, and Herman Lindsey who's also been exonerated and is now executive director of Witness to Innocence.
JOANNA: I always like to look at the challenges with our criminal justice system and the progress as it totally being a marathon. Not at all or one around the last sprint so with each piece of legislation that is able to get through the house and then the Senate. It gives us the next goal because none of these statues are perfect because they have to become palatable to our Republican control Senate so that they can even consider taking it up.
STEPHANIE: In the meantime for more about Obscured and the rest of our work keep up with us on social @KouvendaMedia
EMILY: Obscured’s From Words to Weapons series is produced by Kouvenda Media and mixed by Brad Linder. Malik Calhoun composed the music for this episode and the rest of our series.
STEPHANIE: Special thanks to Obscured’s fiscal sponsor, Media Alliance which is one of the oldest media change organizations in the United States and helps our podcast receive tax-deductible contributions. And we're grateful to Obscured’s founding supporters who've made donations to support our journalism initiative.
EMILY: You can help more people discover Obscured by leaving us a review on your favorite podcast app and sharing it with others who might be interested.
STEPHANIE: I'm Stephanie Marudas, Kouvenda Media’s Executive Producer and Obscured’s Co-Creator.
EMILY: And I'm Emily Previti, Executive Editor and Co-Creator of Obscured. Thanks for listening.
SARAH: This is At the Core of Care, a podcast where people share their stories about nurses and their creative efforts to better meet the health and healthcare needs of patients, families, and communities.
I'm Sarah Hexem Hubbard with the Pennsylvania Action Coalition and the Executive Director of the National Nurse-Led Care Consortium. As part of a special collaboration with the Obscured Journalism Initiative we recently hosted a panel discussion to explore law enforcement interactions with the community and how to implement a harm reduction care model. We’re excited to share the panel discussion with you. Our partners at Obscured have put this podcast episode together featuring Part 1 of the discussion.
EMILY: This is Obscured the podcast from Kouvenda Media about critical issues that don't get much attention because they're complex, overshadowed, and unfold largely out of the public eye. On this limited series, From Words to Weapons, we’re focused on survivors of law enforcement trauma. I’m Emly Previti.
STEPHANIE: And I’m Stephanie Marudas. This is part 1 of a panel discussion about harm reduction in the context of interaction with law enforcement and solutions that could promote community well-being and mitigate trust.
We partnered with the National Nurse-Led Care Consortium and the Pennsylvania Action Coalition to hold the discussion with support from the Independence Public Media Foundation.
On this episode part one, we're going to hear presentations from each of the panelists.
EMILY: And then on part two will hear a moderated question-and-answer discussion between the panelists.
The first presentation we’ll hear is from Talitha Smith. Talitha is a nurse navigator with RIvER, which stands for Rethinking Incarceration and Empowering Recovery. It’s a clinic within the Allegheny Health Network’s Center for Inclusion Health, the same clinic we heard about in episode 8 of our series with Talitha’s colleague, Divea Bn. We recommend you check out that episode if you haven't already.
STEPHANIE: Talitha has long-time experience working with marginalized populations and found her passion in community health after becoming a nurse as a second career. In her work, Talitha actively promotes harm reduction and conducts related education. She also advocates for access to comprehensive quality healthcare for all. In addition to her work at the RIvER clinic, Talitha is an adjunct professor at Carlow University and works as a local travel nurse.
TALITHA: Hello everyone. Good morning my name is Talitha Smith and I arrived here from Pittsburgh, PA. Got to be like, “Go Steelers”. Got to do that shout out so going first is intimidating but I hope I, “understood the assignment” as they say. If not, this is my interpretation, my life and work as I see it. It's my hope I can leave you with valuable knowledge, questions to consider, and goals to work towards. So currently I am a nurse navigator at Allegheny Health Network. I work under the non-profit arm, the Center for Inclusion Health (CIH) directly for the RIvER Clinic. AHN is one of two large health systems in Pittsburgh but AHN is special, not just because I work there but because of the CIH. CIH has services not offered by other health providers and in particular RIvER Clinic. I really don't know if there's another place like us across the country. RIvER stands for rethinking incarceration and empowering recovery. But before I get more into the RIvER I just want to give you a little overview of CIH and if you like more information you can go to AHN.org and search “Center for Inclusion Health”.
CIH was formed in 2014 as one of the nation's first comprehensive programs of its kind focused on meeting healthcare needs of individuals in underserved or marginalized populations and to reduce costs.The programs are delivered in several ways so we have Crisis Center North which is a partnership and we assist people who are experiencing intimate partner violence with counseling and resources. The Center for Recovery Medicine helps with substance abuse treatment for patients and families. We have homeless healthcare and they provide health care on the streets, in hospitals, shelters, just about anywhere where people have unstable living conditions and we call that “people who sleep rough”.
The Positive Health Clinic does HIV testing and comprehensive care for people affected by HIV. We also have a mobile unit which goes out and does HIV and Hep C testing. Food insecurity we have a few food banks in different areas and we give out free healthy foods and free nutrition counseling. There is immigrant and refugee division to help people from different cultures to receive care they can understand, no matter what language they speak and this even has families who would like to participate in that.
And we do transgender healthcare and there's a range of research-backed medical and surgical services to people who are transgender, non-binary, or gender diverse. And lastly, perinatal hope and that provides a safe space for pregnant and postpartum women who have substance use disorder.
So now let's talk about RIvER, my passion. Like I said it's one of a kind in our region and as far as I know probably the country. Our programming is aimed at rapidly, effectively, and compassionately meeting the health needs of individuals following release from incarceration as well as connecting them with social support that can help them get a better fresh start. Our patients receive care regardless of their ability to pay immediately following discharge from jail and when I say immediately I truly mean that. On any given Tuesday you can find myself and my team outside of the jail but soon as the releases come out I'm asking, “Do you have a PCP? Do you have any substance use issues?” and I'm making appointments and setting them up to come to our clinic.
The reason that this is important is that former present inmates are at a high risk for death after release. Their 12.7 more times likely to die than the average population especially in that first two weeks. The leading causes were drug overdose, cardiovascular disease, homicide, and suicide.
So how did this all get started? My boss was resident and she did part of that in the jail and she saw how poor the healthcare was. So she teamed up with another internal medicine doctor and they decided they wanted to do something about the statistics. So I'm thankful that AGH also recognized the need because they provide the funding for my clinic. And AGH is also the provider now for the jail. We had a lot of people die at our jail just from basic healthcare needs. You know and a lot of people go in and go through withdrawal with no comfort medicines. So it was really kind of brutal.
So following getting discharged from the jail, a lot of people lack adequate assistance with assessing and coordinating healthcare and other social services. You know they might not have been taking care of their health before they went to jail and they face challenges advocating for their health needs. The RIvER Clinic seeks to close this gap between incarceration and reentry into normal life.
So there are a few terms that are big for me and during this presentation, the gap is the first one because that's what I stand in for my patients and their families. While we provide healthcare, we're standing in the gap, my team. So I see this as a religious term but I can't…I think it's perfect for people who are dealing with recovery. People who suffer from use disorders often alienate their families and their families are like, “I'm done with the shenanigans”. And so sometimes you know it takes an outside person to still be there.
Yesterday, I added this because I visited my nieces in New York and their father suffers from use disorder. And he was like, “Yeah I'm getting out of jail. I'm gonna come work at your restaurant and focus on my sobriety” but he hasn't showed up.
He hasn't made the actual plans and my nieces were joking like, “Yeah I'm going to tell them to get dressed. I'm going to come down to Pittsburgh and get them, then I'm not going to show up for three days”. You know, ha ha. You know, that's funny, but it's trauma-based funny, right? So I just know that I was like, “Yeah, girls, this is what I do at work when people can't take it anymore cuz their family members are a mess, I'm right here you know dealing with that mess till they can get theirselves together”.
So individuals most commonly engage in primary care with us. They have a lot of medical comorbidities, substance use disorder, and we see a lot of hepatitis C and women health issues. 99.9% of the people we serve connect, need to connect with mental health services even if a few times. Even if they don't have a diagnosis. If you use drugs you're going to have some posttraumatic stress. They need to learn to deal with their addictive behaviors and just everyday life sober. We often push to get off drugs, but those drugs have sometimes been masking a lot of pain and hurt and it's heavy once you stop using. So what do you do with that? But like I said I'll be looking for my brother-in-law once I get back to Pittsburgh so he can reconnect with my nieces in a positive manner when he's ready.
So what does RIvER’s work look like in action? On a daily basis our team is out and about working directly in high incarceration areas. We have two physicians, a community health worker, a health coach, a peer recovery specialist, a social worker, and myself. On Mondays, we have a clinic at a homeless shelter right down from the jail. Tuesdays, like I said we're outside the jail doing follow-up from clinic.
Wednesdays, we go to a community food kitchen and we sit there, we give out safe smoking kits, wound care kits, toiletries, Narcan, fentanyl and xylazine test strips, condoms, dental dams, lubrication, anything you could think of alcohol wipes, I'm giving out harm reduction.
Thursday, we go to Roots, which is an outreach center where people could just walk in. They sleep hard, they can do needle exchange there. They get resources like free vet clinics for their pets and legal help and on Friday we have clinic all day. We provide PCP and MOUD.
So a major part of the work we do includes harm reduction. As I mentioned we give out safe smoking kits, we even created a safe snorting kit. And I can't tell you how grateful my patients were for these things.
Like you know people's like, “What is this?” and I'm like, “Oh that plastic piece? That's so you put it on the pipe so you don't burn your lips. So you don't share the same pipe with somebody else. So you don't get herpes”. And I can see their brain like, “Y’all really made these kits, liike y’all really giving out chore”. Yes, we are. So those small things, I can see in my patients, they made, they felt like we cared about them, because we do.
And you know some people would say, “Oh you're helping people smoke crack” but I'm not and I would never. What it comes down to is perception, in my opinion. And so I have to work to change the perception of my patients, communities, law enforcement so that we can see people's humanity and see the importance of harm reduction to preserve health for when they may be ready to begin recovery from addiction.
So I have a question for everybody just to think about. Now if I ask for a volunteer today to come here like, “Meet me outside and I want you to meet me outside in your underwear”. Everybody would be like, “Oh she's crazy, ain’t nobody going outside in their underwear”. I know it’s cold, so let’s just say it’s 80 degrees would that change your mind? No? Okay, nobody's going outside in their underwear but if I said, “Hey meet me outside. I'm going to take you on vacation we're going to the beach”. Eventually, I'm going to have you outside in your underwear, right? Because you going to be in a swimsuit. A swimsuit is nothing but underwear made out of swim material, right? So safe smoking kits are nothing but healthcare made out of love for humanity.
My focus is to keep people whole and safe as possible for when they're ready and capable to make better choices. My first job as a community health nurse was at a Christian health center led by a pastor. We had Bible study, we prayed every morning, but guess what we also did? Reached out to the LGBTQIA+ population.
Dr. Gloucester was big on servant leadership. I'll never forget one Bible study in particular. He said, “when Jesus healed people, he never asked them questions”. He didn't ask them, “what were you doing before this? Who was you hanging with? How did you get like this?” He met them where they were. And that was my start in community health. It wasn't my start in the nonprofit world, but it was my start to look at people without bias, which I thought I did before, but I didn't.
So like I said, it wasn't my first rodeo at serving. I just learned to serve without bias there. And, working in the service field and knowing how to serve are two different things.
I think a lot of people get jobs, like where I live in non-profits, they're so big, a lot of people work there. You have to have an idea about yourself, who you want to become based on your likes, dislikes, and personality. But as I look back on my career, I've been helping people my whole life. And I remember I had wrote a speech, they asked me what's the most important thing in the world, and I did it on help, because no matter your standing in life, we all need help at some time with something.
And we often have cultural competence training at our jobs now, you learn like you can't give this person the same thing you give this person, right, because of their cultural background. Everybody can't get the same kind of help. Our help has to be culturally competent and drug addiction is a culture.
Um, I help people all over the United States and I've, I've seen, you know, we got a million different cultures and we have to just recognize that, you know, drug addiction is one of them. People's been using drugs since the beginning of time. So, I said all this to say that in my 20 years in the non-profit world, my dedication to mirror what would Jesus do, my life experiences combined, they all brought me to work at RIvER.
And about a month ago, a young man asked me why I did this work. I told him, well, as far as addiction, my auntie overdosed from heroin by herself on the side of the road when I was a toddler. After using heroin since she was about 14. And even though I was a baby when it happened, it still hurts me to this day.
You know, my family will say, “Oh, you look just like your auntie. Oh, you're so smart, like your auntie Willa Mae”. And I always fantasized about meeting her and being with her. And I just wonder, like, if they had Narcan back in the day, would she be alive? You know, if they were doing harm reduction back in the 70s, would somebody have told her, don't use alone when you get that good batch?
You know, maybe I could have got her on Suboxone, and she'd still be alive. You know, we would still have her. So. As far as jail, I've been going to the jail since I was a baby. My mom was taking me to go see my dad in jail. My daughter's father did 12 years. Um, my first love did a bit. My husband's a felon.
And I've been to jail. And I was thinking, like, what was I going to share today? Because I don't talk about that a lot. But I figured today would be good to share it.
So, that day when I got arrested, the officer pulled me over for a traffic violation, which we often see, right? And he, the system was down because there was a thunderstorm and he told me, “If you call somebody to come get you, I'll let you go home.” And sounds great, right? I didn't have anybody to call to come get me. My mom never had a driver’s license. I have a small family. My sister never had a driver's license. I didn't even know who to call.
So by this time, his partner comes and he's angry, you know, just comes off the rip angry like, “Oh, you're playing around. He was being nice to you. I'm going to take you to jail.” And I'm explaining to him, sir, like, I don't have nobody to call. I tried to call my friend. She didn't answer. Like, we were young. We didn't have money to have a car. And the crazy thing about that is, I went to jail, I called my mom. She got her friend's grandson to come get me or something. But guess where I also didn't have a ride to? College. I caught a Greyhound bus to college with a laundry bag of clothes. Because I didn't have anybody to take me.
So for that officer to think that he was giving me something, this great opportunity, he wasn't. Because if I didn't even have a ride to go better my life, how was I going to get a ride, you know, to get out of that situation? So, that just brings me to talk about empathy. You know, I don't even think that cop lived in the city. Did he know anybody like me? You know, could the first cop not continue to show empathy because the second cop was turned up? You know, those are the questions that swirl in my head when I think about that. But, you know, that's dangerous. Downright dangerous, because we've seen what can happen with just a simple traffic stop.
The four attributes of empathy are perspective taking, staying out of judgment, recognizing emotion in another person, and communicating the understanding of another person's emotion. I was definitely crying when I was getting arrested. I was embarrassed because I was too poor to take what seemed a simple way out.
When actually I just lacked the resources, but I just think if they lived in the community, they would have probably understood the resources were lacking. So you know, I know my work is hard. I know the police is. They have a hard job to do, and it's hard to remain free from bias. I have a patient now that's the same age as my daughter. She comes from a great family, and I just want to shake her and be like, “Get yourself together.”
It's so easy for us to, if a person had a bad life, to say, “Oh, I can understand how they got on drugs, and maybe we'll be more empathetic.” But when I see this girl that came from this, well, I'm like, and I have to stop myself.
So I'm sure, you know, sometimes the police have to stop their self too. But um, you know, even Mother Teresa, when her letters came out, everybody was like, “Oh, she's the icon of giving care. And she was like, this stuff sucks.” So what are us normal, regular people going to do? You know, what can we expect from police officers?
But in addition to working at the RIvER Clinic, I work as a professor at Carlow University. And I just had an assignment for my students to identify a policy that would benefit the population they serve. So, as far as policy, like, I really promote police officers living in the communities that they serve.
Some of us are more naturally empathetic than others, but it is something that can be taught. We have, um, these special neurons in the front of our brain that click when we do an activity, and they also click when we see another person do that activity. So, there is training that can be done to teach people to be more empathetic.
And I'm like, you know, “Why wouldn't police officers want to be empathetic?” But sometimes they got to block it out. When you're always dealing with trauma, you know you can get burned out if anyone of us work in jobs that serve. So, you know, sometimes they have to block that out. But there's learning and there's training where you learn to look at things in a different perspective so you can block it out so it's not too much of a burden for you and you can still be empathetic.
And I don't know what training they get. I think they need it. I think people should volunteer, in different communities, read in fiction books, helps you look at people's lives from a different perspective. So, the best way to gain exposure is to be there. You know, I know there's recruitment problems with police, but an able body and a good worker are two different things. And how can we change how police view harm reduction? They, it has to be perceived as healthcare and critical to keeping people who use drugs alive and as healthy as possible.
We have to help everyone, police, other people, see those people as capable of being healthy. A lot of times when somebody's on drugs, people will say drug addict. They're not just a drug addict. They're a mother, a father, a doctor, a cousin. They're a ball of potential. I got seven personalities. My husband can tell you that. So, I know that people have all of these things inside of us, and if they choose to, when they recover, they are a prayer, answer, a testimony, a role model, a leader, a change maker, and more than any of us could probably even imagine. Thanks.
EMILY: Now we’re going to hear a presentation from Chad Bruckner. Chad is a retired police detective. He began his career in the U.S. Army, rising to the rank of staff sergeant and serving overseas.
STEPHANIE: After the military, Chad started a career in policing in Montgomery County, PA. He worked first as a patrol officer and was then promoted to the rank of a detective. He also served as a senior field training officer, a squad leader, an undercover officer, and a coordinator for the Montgomery County drug task force.
EMILY: Chad retired from the police force in 2021. He now owns and oversees a private investigator firm and is a coach and recovery specialist. Chad reflects on his policing experience in his first book that came out recently, called, “The Holy Trinity of Successful and Healthy Police Organizations: Improving Leadership, Culture and Wellness.”
CHAD: Ooh, I got a ride on the coattails of that. It was awesome. Wow. Um, and thank you for sharing. It's hard. It's hard, still for me, to listen to people's experiences and stories because I think about my experience. I think about where I was as a police officer. I think about the experiences, the situations that we were in and did we do the job the way it should have been done? Or did we go a little heavy handed? Or were we not as empathetic as we could have been? And those are things I think about all day every day. I really do. So I'm pleased to be here with you. I'm Chad Bruckner. I'm representing the LEAP: Law Enforcement Action Partnership.
It's a criminal justice, reimagining reform movement. I'm really happy to be a part of it and give me one second. I'm still processing. Seriously. That was, uh, wow. That was like, That was awesome. Thank you. Empowering. Um, I was almost gonna cry thinking about it because when you talk about the empowerment of people that kind of hits me tremendously.
So, I spent 13 years in law enforcement, Montgomery County, Pennsylvania here. Previous to that, I was in the army for eight years and for 21 years, I served. Went in the army at 17 and for 21 years I served community, served our country, served people. And always as best as I could try to meet them where they're at.
Unfortunately, when you work in systems and organizations like that, you're ripe for getting shot with arrows in the back. And anybody that's ever done advocacy, I think, can attest to when you're sticking up for somebody or fighting for people. If that goes against the popular notion, you know, good luck.
So, but that's why we're here. That's where change is. So I'm happy to be a part of this.
Bear with me here.
Anyway, excuse me. This is a very raw topic for me. Very raw issue. I'm in recovery. And a lot of the stuff that Talitha said is stuff that I can relate to 100%. So bear with me as I just work to process some of the stuff she said. I think harm reduction is some of the most… We're missing the mark so much in law enforcement and the policing profession and societies in general.
I can't tell you how many situations I've been involved in where we use stigmas, biases and judgments to, not meet people where they're at, expect people to meet us where we're at. In that situation with your car and not having a license. And I just, I cringe, I grit my teeth when you're telling that story and it's, you know, what do you do to somebody that doesn't have the resources?
You know, I'm giving you this great opportunity. I'm not meeting you where you're at. I'm asking you to come to me. And, you know, what do you do to people that don't have these resources? It's a, it's a tough thing. And, so I come in from a place of how can we make it better? How can we use harm reduction in the policing space as a performance coach is what I do now.
I'm a small business owner. I have two small companies. One's a private investigation firm and one I own a performance coaching company and I try to work with police officers, coaching them how to be resilient, how to be empowered, how to be more empathetic and come back from adversity and treat people with more respect and really focus on relationships and service.
And it is a challenge because that is really; we have drifted away from that into some respects, to some degree, we have drifted away from service. We have become very transactional. We used to be very relational. I share these stories as somebody that I led my agency into arrests. I was very proactive, led the community in arrests, created an undercover drug unit to, to target our open air drug market that we had at the time, was very successful. We made a lot of arrests. I'm very proud of that because it was rooted in service and keeping the community safe.
So living in this space, I think, to light this at the best of, there's good things and bad things and living right in the middle of it, which is what we're doing in our professions, in our community. It's challenging. And I think if we just understand that there are good things and bad things happening to us every single moment of our job and living in that middle space, filling the gap.
I love how you said that. That's incredible. So my experience, the last couple of years, has taken me left, right, up, down a long journey. And I’d like to share a little bit with you real quick. I was the guy that was making a lot of arrests, making a lot of great relationships, wanting to do the good job, really being noble, being virtuous, got promoted detective in four years, got my master's while I was taking one class at a time while I was being a detective, raising three kids at home. My wife.
Trying to be, you know, working towards being the next chief of police. That was my goal. There became an issue there at the agency I worked with, that merit stopped being something that we attach ourselves to. Service, selfless service. Selfless service was something that we stopped doing. And as a selfless oriented person who cares more about the community than myself, when I started to watch self serving behavior happen inside our own agency, it was such a moral injury to me.
And I don't know if you guys ever heard that term, moral injury; I'm sure you have in health care and nursing, but it's rather new in my space from the police and military space of PTSD, a form of PTSD. And I think so many of us subconsciously have been exposed to situations. And I can explain mine where when I began to watch the system and organization, it's not just my agency, by the way, it was a policing profession. As I started to watch transactional relationships become more important in relation, to watch taskmaster skills become more important than service.
There was a gentleman who got released for double homicide from prison. I remember meeting him for coffee. This is towards the end of my career, maybe 2020 during Covid in the height of 2020 or, um, 2019. He asked me to meet him in a coffee shop. Now he looked different than me, and he was a convicted felon and murder. That didn't matter to me. I didn't care about any of that. The guy asked to meet. Sure, you want to meet? You're asking for a meeting and have help? Sure, absolutely. The level of targeting and bullying I got from that, from just members of my own police, you know, hanging out with the enemy, you know, it was crazy.
And I just wrote a book actually three weeks ago, and what I say, and it's really apropos I think to this conversation is, I fought the enemy. I fought a real enemy. And these American citizens, our brothers and sisters, are not the enemy. So we got to figure out a way to get back to bringing our communities together to not give somebody anxiety, or some sort of shame, for not having the resources that wasn't her fault.
I'm sorry. I get a little passionate because this is really a serious topic. I think there's so many good Americans, so many good people living right here in this community, right in this country, that are getting marginalized and shifted upon because they don't fit a certain mold or they don't put in a certain box a certain way.
And it's not right. It's just not right. And I'm proud of all these organizations that are coming and doing this, because I think by connecting and by talking and by listening; I almost thought of excusing myself. At one point doing where you were saying, because I was just, I thought I was going to cry and I don't want to do that.
But I said, you know what, in my head, I got to sit here and listen to this. I got to look her in the eyes. I got to sit and listen to this because I got to learn too. So I'm learning every day and I appreciate that. So as a performance coach, I really advocate for empowerment and I'm doing this in the recovery space for police officers, which I think is really neat.
I actually put a section of my book about harm reduction because I think it is so important. I speak from the police experiences of myself. Um, I'm in recovery. And it's not just from alcohol, it's from mental and emotional health. That's how I describe it. I'm a certified recovery specialist here in Pennsylvania, so I can help people in recovery on the recovery journey as a CRS, as a performance coach, working with first responders and military and some athletes.
Now, I'm realizing that help probably more than anything, empowerment is the fundamental thing. We got to stop telling people, sorry, yeah, you're down. Sorry that happened to you. Yeah, we can say that, we can be empathetic for sure, but how can I help you? How can I walk with you on this? How can we help you get to where you want to go?
I know that happened to you. I'll sit with you as much as you want to talk about that. But at some point we got to move because I know inside you, you have something special and maybe nobody ever told you that. Maybe nobody ever developed you or poured into you or identified you as a future leader. That stinks. But I'm right now telling you today you are that.
So now we can't go back and say, oh, that happened to me 15 years ago, 20 years ago. I know it did. But today is today. And I think it's great with the harm reduction space. I tell police officers, “I drink a six pack every day.” Okay, how about just drink three drinks tonight? “How's that gonna help me?” It's better than six. It's better than six. “That's ridiculous.” Don't do that to yourself. Let's do one day, today. Drink three beers tonight. “You're telling me to drink three beers.” Are you gonna drink six? “Yeah.” Drink three. And these conversations I'm having, it's an education.
They never heard this kind of conversation, never heard this topic. They think, like I did, there is something wrong with me. I'm broke. And there's a lot of shame that gets rolled into it, and then we start to treat citizens badly. Because I'm ashamed of myself. Of course I'm going to treat a citizen badly.
If I'm not loving myself. So I tell cops, do you love yourself? You know most cops can't answer that question? I said, do you love yourself? Look in the mirror. And I did it to one cop and he goes, I'm not looking in that thing. And I looked, I know somebody that avoided mirrors in 2019 to 2020 because I was so ashamed of myself in my house. I avoided mirrors. I know what that feeling's like.
And we got to help these cops. I'm doing that now to tell them you're okay. But what's not okay is to take it out on people. What's not okay is not to be a good servant. You got to find another job if you're not going to do that. But if you're going to put the work in and you want to grow and develop to serve people, meet them where they're at, I'll help you do that.
But you have to do it yourself. It's a choice. It's an action. I will meet you there and I'll help you get there, but you got to do all the hard work and heavy lifting, but I will be there to give you real feedback, honest, caring feedback, direct feedback, so you can make the change you need to make and keep going.
This is a road that it's new. It's very new for law enforcement. There is a lot of blowback in the coaching space and the mentors space and in the therapy space. I have four therapists and I tell cops I have four therapists: psychiatrist, psychologist, an E.M.D.R. therapist, and a trauma-protocol therapist. And they all do different modalities.
They all do different therapies to help me succeed, help me grow, to help me stay in the fight because that's the most important thing for me. And I want to share with these cops that the citizens need you to stay in the fight. We need law and order. But what we don't need is chaos. What we don't need is targeting people.
What we don't need is a lack of understanding where people have come from and what they've experienced. And that's what's happening. One of four police officers have childhood adverse experiences in their life. And I put this in my book because I think we should be talking about this. I think this affects a lot of us.
Those childhood experiences are adverse experiences. We bring them into our adult life if we don't deal with them, if we don't heal them. That is baggage and it's okay, but that is baggage if we don't acknowledge it and be self aware and fix it. We could be dealing with unhealthy perspectives, which a lot of police officers can bring, solely from stuff they've been through in their own personal life.
And we start to work through that with them and understand the childhood abuse, growing up low income, poverty, domestic violence, alcoholism or drug abuse. A lot of cops have seen this stuff as children. And it's why we choose these service professions, probably like health care. My sister's a nurse and I'm so proud of her.
And growing up low income like we did, you know, I think, I never asked her about this, but I think she and we all charted a course to help people and serve people where we're at in our own different ways. And harm reduction is such a powerful thing that we can help police officers to stop the shame.
I leave a chapter in my book called Shame, solely because I think we're not able to make the change as quickly as we need to make, as much as we need to make. Because we've got to start from inside. We've got to start from helping the officers heal their personal shame. We have a leadership crisis in this profession.
No doubt about that. We don't have nearly as good executives leading our police departments. And everything flows through our culture. Everything flows through the leadership and the culture. So, in my book I reference, if you want to have an empathetic police department, it's very simple what to do. Hire an empathetic chief.
And give him or her two or three years. And watch what happens. That's it. But that is not an attractive quality. What we like is we like SWAT officers. We like people who lead the department in arrests. Those are metrics that we can get behind. So I think we need to start changing the community narrative.
We need to stop having our communities ask for those kinds of leaders. Not to say those experiences are valuable. They're tremendously valuable. We're gonna need to tap into that if we need it. But SWAT calls are part time. Unless you're in Philadelphia, you have a full time SWAT unit, in the surrounding counties it's not a full time SWAT unit. So you might get one call a month, two calls a month. So that's a very small part of your job.
What are you doing in that other majority part of your job? And we have to help leaders or stakeholders, elected officials start making better decisions who they hire as chief. We have to start leading with empathy, with care, with heart.
Influence and leadership is a tremendous, tremendously powerful thing. If we want to start good cultures and mitigate harm reduction, we need to start looking at the leadership running our police department. We need to start looking at how we influence our officers, how we train, how we mentor. What about when the officers are going through a tough time at home?
Are we meeting them where they're at and helping them through it? Because all that has a derivative effect on how they interact with the community.
Okay, I think I'm done for now. I'm very passionate. I'm sorry, and I can keep going, so thank you.
STEPHANIE: And the final presentation we’re going to hear is from Laurie Corbin. Laurie is Managing Director for Community Engagement at Public Health Management Corporation, or PHMC. She oversees a range of programs that provide social services, prevention, intervention, treatment, and education to at-risk individuals and their families.
EMILY: Laurie explains how these programs focus on diversion from incarceration and advanced release from incarceration, treatment readiness, and recovery support for people who are justice involved. She also oversees several social services programs that provide outreach to people experiencing homelessness and individuals living with HIV and AIDS.
LAURIE: Good morning everyone. Happy to be here today, and I'm also a little bit under the weather, so please excuse me. I am Managing Director for Community Engagement at Public Health Management Corporation, actually the facility that we're in right now is one of our community based locations.
We do a wide range of services that really we build to create and sustain healthier communities. And so we really work with a range of populations and programs and services for most populations, I would say with, except the senior citizen population specifically. So again, I have worked for the organization for more than 13 years. I'm a social worker by training, and have had the privilege over the last 13 years to be in the position to lead our continuum of criminal justice programs that serve a range of individuals.
In my larger role as Managing Director for Community Engagement, I actually oversee a continuum of programs that really serve most of our most vulnerable individuals in the community. I always say I have three buckets of work. One is the criminal justice programs. Second, we do a range of services for individuals who are experiencing homelessness. And that includes, you know, working with the individuals in the shelter. We also do permanent supportive housing. We actually have a housing program probably five minutes away, for anybody's local at 47th and Wollaston Avenue. HelpUSA that we partner with. And we do a lot of rental assistance and utility assistance for individuals to stay in their housing.
Because again, one thing sometimes people don't realize in the housing services realm, one of the things you want to do is prevention. You really want to prevent people from becoming homeless. There are things that you can put into place that sometimes people just need help with rent or help with other resources to maintain that household.
And then the third bucket I talk about is that I run a recovery support center in North Philadelphia. We talk about harm reduction. It's actually been in place, or that program's been around since 1997-1998. But it was established for harm reduction and a place in the community where we serve people who do not have to be abstinent from substance use and most have mental health challenges.
The only thing we ask is that you not use right before you come into the program, because we also want this to be a safe space for everyone. Because we know that harm reduction does work. And the goal with that particular program is we want you to come, we want to support you, you can get a hot meal, you can attend groups, we do, you know, life skills, we'll connect you to services. But on that day that you are ready, that I want to do something different than how I've been living my life and I may want to go into treatment, we will hand walk you into treatment.
So again, you know, harm reduction really is at the core of the work that I do. My staff will sometimes talk about how passionate I am about the work, because I really do believe in what we're doing and how we're doing it. I forget which one of the two panelists really talked about, you know, substance users or some people with use disorders are really looked down upon in our community.
Well, I work with people who have behavioral health or substance use concerns and those who are involved with the criminal justice system. Okay. You know, a great way to sometimes start a dinner conversation with folks. People will say, oh, you work with those people, and it's like, oh, no, those people are like your brother or sister or your family member, because let's be honest about it, we all know somebody who's been involved with the criminal justice system, and we all know somebody who has an addiction issue, and we may not have called it addiction.
You know, as a little girl, I had an aunt who was an alcoholic. She was a functional alcoholic, you know, worked Monday through Friday. Friday and Saturday she drank, Sunday got herself together and worked every day, but she was an alcoholic. Okay, we all have that, we don't talk about it though, we don't talk about it in families because there's shame and there's blame that goes along with it.
And so I think again when we talk about harm reduction we really need to talk about how we keep people safe. Because when we're keeping individuals safe, we keep our communities safe, we keep our children safe, and then safety also allows people to then really deal with a lot of their experiences including the traumas that they've had throughout their lifetime.
So what I want to talk to you a little bit about this morning is some of the work that I do in the criminal justice realm in Philadelphia, provide some information about some innovative and promising practices which are occurring locally within our behavioral health system, as well as our police department, and then some national models to think about at the both local and national level.
And so the original program that I began working in 13 years ago is called the Forensic Intensive Recovery Program, otherwise known as FIR, F I R. It's one of the oldest prison deferral programs in the country. It's been in place since 1993. What's really neat about this program, it is a collaboration, and when I do real formal presentations, there is a slide that is pieces of a puzzle, and it really shows all of the collaborating agencies that have worked over the years to really support people who unfortunately get involved with, you know, some type of activity that causes them to get incarcerated.
But the goal is really to get people out of jail as quickly as possible or divert them from jail. Get them connected to behavioral health services. And then we also provide case management services. Again, this came about 30 years ago. Prison overcrowding. You know, the city was actually under both a state and federal consent decree, like, you have to reduce your prison population.
So in the wisdom of city leadership bringing together, you know, parties from the behavioral health system, law enforcement, the community, legislative officials, you named the bodies as well as non-profits, treatment providers, and said, we need to come up with a model of how we can get people out of incarceration and connected to the services.
And that's how the program really started. Started with serving about 250 individuals in 8 treatment programs 30 years ago. Right now we're serving several thousand people a year. We have a network of over 80 service providers that provide behavioral health services to individuals.
Our work is that we actually do, behavioral health assessments behind the walls of the Philadelphia, Department of Prisons. Prior to the pandemic, my staff were going actually in doing face to face visits. We are doing those by way of Zoom. I will almost guarantee you we're probably, if one, if not the only place in the country that's probably doing that type of work by way of the Zoom platform.
And we transitioned to that pretty quickly, you know, everything shut down in March of 2020. First we started doing telephone by May and then by July we were doing Zoom calls. And so we're doing this interviews with individuals, we get some background, we find it out. And, and the referrals come to us through, the public defender's office.
They identify individuals according to the types of crimes that they commit. And we work with, nonviolent felony offenders. What kind of, crimes they have committed, and really, you know, determine whether they have a behavioral health concern that may be beneficial through the program. We do an assessment.
We determine, you know, the level of behavioral health concern. Our focus is primarily substance use disorders, but we actually partner with the behavioral, the Department of Behavioral Health if we have somebody who strictly has a mental health disorder. You said earlier that. Or I think, again, I forget who said it, that you really can't tease the two apart because again, they're very, you know, enmeshed with each other.
However, we talk about primary diagnosis being really substance use disorder. We make a determination of what level of treatment that person should receive. Is it outpatient? Is it inpatient? Is it, intensive outpatient? Do they need housing? Recovery housing? Again, a lot of people languish in jails because they don't have anywhere to go.
And so, you know, and what's going to be good for recovery support for them. Because that's really key. Because when you come back into the community, you want to be in, you know, and it's, and our communities are really damaged in so many ways, but you really want some supports around you to help your recovery to be successful.
I should also say. As a practice, I actually ran a drug treatment program for about seven years for, women and children. So I also know the impact of treatment and how people can really change their lives, and the impact on their children, especially when I run into, clients who 30 years later are, like, first of all, I don't recognize, secondly, their kids are doing phenomenal things and that's the perspective I bring to my work
We also make sure that they have insurance to pay for the treatment upon release, and that they know specifically where they're going.
So therefore, when they're released from, jail, actually the sheriff's transport them to their treatment program. And, or the recovery house. So again, it's a direct link, because we know people fall through the cracks, given the opportunity, you know, unfortunately, we've lost people to overdose primarily coming out of jail, because again, that's when people are at highest risk.
Or overdosing is once they've been incarcerated because they don't have the drugs in their system, and unfortunately, we have had people who pass away from that, but we get them connected to services right away, and then I have a team of case managers who provide support to those individuals once they're back in the community.
Again, and it's their plan for their life. You know, we like to have control over our lives. We don't want people necessarily telling us what to do, how to do it, where to do it. A lot of the folks that we work with, that's all they've experienced in their lives, you know, from a very young age.
And it's really hard sometimes to engage folks like, you know, like how, you know, this is your recovery plan. We want to work this with you, what are your short term dreams, what are your long term dreams? And we're talking about it as goals and dreams because we want people to have those goals and dreams because we know we all need those things in order, and we've needed those things to get where we're at, at whatever point in our life that we're at.
And so we're actually trying to instill those things into the individuals we work with once they are released from incarceration. The other thing about, um, I would say about the individuals that we're working with who are in incarceration, many of whom are, opioid users, unfortunately, the Philadelphia Department of Prisons does have a robust, medication assisted treatment program.
And so, many of our individuals, even if they were not inducted on MAT prior to incarceration, they do get inducted while they're behind the walls. And we make sure that we get them connected to treatment services that will continue that upon release from incarceration. But Talithia talked about the healthcare needs of individuals as well, really sick.
Sometimes I'm wondering, like, I don't even know how these people did crimes. Because, you The love, the acuity that they're showing, and some of it, unfortunately, I think also gets exacerbated by being incarcerated, which is also another form of trauma, um, that people don't really think about, but it's, it's, you know, if anybody has gone to jail, as I always say, on the just visiting side, you know, it's a little stirring.
I go to jail, I, you know, I've gone to meetings, you know, I've been blessed, I've never been incarcerated, but it doesn't mean, you know, but I've just been blessed in that way, that has just not been my experience. However, even visiting, you know, a correctional institution, it's it.
It can be traumatizing that, but just imagine if you're living there, just imagine some of the living conditions that people have. And so what we see is that we may interview somebody within their first month, six weeks of being incarcerated. They may not get out of jail for months later. 'cause again, and for people to get out of jail and get.
It has to be signed off by, the judge, and the judge has to be in agreement, and the client has to be in agreement as well. But it may be 11 or 12 months later, we get calls from our treatment program saying, Oh, we didn't know Laurie had her, you know, head falling off. We didn't know Laurie had this severe, you know, diabetic problem.
We didn't know either. When we interviewed Laurie, you know, back in August, you know, she didn't present with any health concerns. A lot of these things have come to light during the time of being incarcerated. So, that's one of the things that we will work with our individuals with once they come out of jail.
We'll get them connected to healthcare services. PHMC actually has six federally qualified health clinics, including at this location. , I'm doing a commercial announcement here. Uh, IOP remunerations, I didn't do so. Um, and so we, we connect them to services in the community. Many people don't have a primary care provider.
They're usually using an emergency room. That is their care provider. And so we really want to instill in folks like, hey, well, you know, making this connection, it's really important. You're important. You are important. When I have the opportunity to speak to individuals, there's a program that, you know, that , the feds, local government, state government [00:48:00] does when individuals are coming back into a certain police district in Philadelphia that, and these individuals are high risk for reincarceration, I have the opportunity to talk about our programs and services.
And the one thing I talk about is don't be afraid to ask for help. Talithia talked about that because people are really scared about asking for help. And then I said, and it's usually, you know, no bias here, but it's just sort of what we know the data to be. Primarily men, and men do not take care of their health in the same way.
We see healthcare providers in the same way as women may, you know, I preface this by saying, you know, it's important for you to take care of your health in order to take care of your family and you want to be here for your family, but you also have to care enough about yourself because many of our individuals, they just don't, you know, it goes back to, you know, a lot of, I don't want to say a lot, a lot of individuals that we work with in these programs don't care about ourselves.
A lot of ourselves, we don't care about ourselves, you know, and then so again, and then that's due to the trauma that we've experienced. the way that we've grown up, you know, and again, you know, how, you know, and, and just having the resources or accessing, you know, healthcare in the community is not always accessible and bad experiences.
That's just another whole presentation that we could talk about, and just around sort of, you know, the challenges with that and why people do not. access, health care services. But in our work with our individuals who are coming out of prison, we really want to do it in a holistic way because we really want to support them.
And really, you know, we also will link people to very specialized services, to address the issues of trauma, many of which develop in, childhood. I'm glad that, you know, um, the ACEs was talked about, the adverse childhood. Exposure that all of us have had some type of adverse exposure as a child.
It just depends on where you fall out on the scale. And many of the folks that we work with fall on the very high side of the scale, and and and I would offer that many of our police officers are also going to fall on that higher side of the scale as well, and it's not just, you know, it's just not really been assessed and acknowledged in that way, and I think that's something else that we need to look at as we're talking about this work and sort of reducing harm to individuals who are involved in the, criminal justice system.
I want to talk about one particular program that I just love, and my staff hate when I say this, because they hate when I pick out one program over another. And it's a newer program, it's called the Accelerator Misdemeanor Program. All of our programs have really complicated names. We refer to it as AMP Court.
And it's one of the things that really is nice about this program, it is a neighborhood based court program. That actually the court hearings happen in police districts. Really cool concept, actually for anybody who's looking for Philadelphia. , Seth Williams, who was our DA before he fell from grace and ended up being incarcerated, really actually taught, really helped to implement this model.
And I think, again, it was a way of, looking at individuals who were having quality of life crime. Now, coming through the Regular Trial System, getting connected with social services supports behavioral health assessments linked to services, with the goal of, you're gone be in the program for a relatively short period of time, we're going to assess to see what kind of supports that we can provide to you, get you linked to those supports.
Once you've demonstrated, for example, you know, Laurie gets assessed and needs to go in and substitute treatment. Once, which we will, people now, originally how we set it up, it took a little bit longer, but right now, we can do same day, next day, within the week, get you an appointment. We've actually walked people to appointments.
If, once you, you know, demonstrate that you're going on a regular basis. Your case can be dropped in a relatively short period of time, so you may end up being involved with the court system for two months versus many years, which is what happens with many of the individuals that we work with. Again, it's a collaborative effort between the court system, the district attorney's office, the public defender.
We are the social service, social service behavioral, health provider. I go out to those court hearings, post COVID. We are happening, it's happening at the 24th and 25th police district. Near, and it serves a lot of individuals who are from the Kensington area, which you know, again, we know, which is a very high drug use area.
It is incredible to sit in that courtroom and just to, number one, hear, you know, first of all, how people get involved with the criminal justice system, but also,
The brokenness that people present with, but also to see over time how with the support of really engaged judge who will talk with those individuals on a one on one basis, empathetic, very empathetic, will share themselves a little bit about themselves. We really say like, I, you know, I really want you to do well, like you're 60 some years old.
You know, you know, like we've lived a long time, you know, we, we, you know, really want to help you. to do better. You know, you've got a couple kids. What does that look like? I remember one hearing, Liz was the last person in court, and it was only court staff. It was my team. It was the judge. We always have a sheriff in the room.
We'll have police, you know, coming in and out. Literally, you could hear a pin drop, but the level of emotion, with this individual who literally just broke down and just said, I need help, but I really want to thank you for the opportunity, because it's the opportunity. It's an opportunity to do something different, and I think it's a model, it is a model where the judges Who sit that court will advocate for this program in a way I've never seen judges advocate for a program because they can see the impact that makes a difference in people's lives.
And on the, on the, and the big carrot on the, , for the ending, for people who are successful in this program, they can apply to eventually get their records at sponge. And one of the things that was keeping people in the program pre pandemic was the ability to pay court's fines and costs, and there's now money from the managing director's office.
to actually do that. That's one of the things that keep people, caught up in the criminal justice system, the ability to pay court sponsored costs. That's another whole session that we can talk about. So that's a really, interesting program , and again, right now we're doing it at the 24th and 25th Police District, and then we do one day of court at the Criminal Justice Center here in Philadelphia.
I'm going to switch a little bit and talk about, a few of the initiatives that are run by the Department of Behavioral Health and Intellectual Disabilities here in the City of Philadelphia. I would be remiss if I didn't say that my programs get funding and have a very close relab collaborative relationship with, DBHIDS, , and their team in doing the work that we do.
So they really have looked at, through their Behavioral Health and Justice Division, looked at police. programs, sorry, police based initiatives that provide supports and strategic opportunities to divert individuals from the justice system in Philadelphia by working in partnership with the police department and then with the managing director's office and the managing director's office of criminal justice programs.
The first is the Crisis Intervention Training for Police Officers, and you talked about training for police officers. And again, it's a national model. It's been, , it's been implemented for quite a number of years here in Philadelphia, and there are cohorts of, police, officers who go through the training.
And the goal is really around violence prevention, de escalation, and community collaboration. Those are three key things. You know, one of the things that I always talk to my team members around is one of those skill sets that we try to build up in, in the folks who are doing direct service work, or even, even for myself at my level, is how you de escalate situations.
So some of the, you know, harm reduction also is related to de escalation. You know, some of the, of the, the encounters potentially between police and community members could be reduced. If police officers really hit the skill set in order to deescalate incidents versus sort of egging it on, you know, for lack of a better word, you know, you can see where sort of, you can see where things are kind of getting out of control versus like, you know, lowering your voice and, you know, there's ways to engage people to de escalate situations and I think that's a really important piece.
And then the other, you know, violence prevention again as related to like how do we reduce the level of violence in the community, violence that's, you know, sometimes, you know, it's a combination of factors, it's between the police and the community and things of that nature and how do we look at sort of that intertwining there.
And then community collaboration. You know, again, having, police living in the community, I think, you know, again, I think that's a really important, thing for us to really think about, you know, where, you know, they are embedded in the community, they live in the community, people know them as people.
know people as people. Is that relational? piece that's really important, and I agree, we, we don't have relational pieces going on in our larger society. , and I just think, you know, what's happening, you know, in our police departments, I think what's happening in our communities, it's just a mirror of sort of some of the larger dysfunction that's happening in our, in our larger communities, and I think we really need to talk about what those relationships should look like, and how do we build that going forward.
So, again, that's something that, you know, the, the, one of the initiatives that DBH is working in, working on. The other one is a 911 triage system. Again, for any of those who are local, people may remember several years ago, I believe it was 2020 or 2021, sorry I'm losing track of time here, Walter Wallace was the individual who lived in southwest Philadelphia, not too far from here, who was having a mental health crisis.
Family called for help, there was engagement with the police, and unfortunately Mr. Wallace was killed. You know, you know, there's, there's a couple, there's so much, you know, wrapped up in this, but with that being said, you know, the city really has taken it upon themselves to really look at how dispatched and who are the appropriate people to be dispatched.
Is it the police that you're dispatching or are you dispatching a behavioral health worker and somebody from a mobile crisis team, which we now have more of, to go on the scene to kind of assess what's going on? Because in many instances, you know, this person was getting treatment, actually. This person was.
I mean, had a diagnosis of mental health disorder, had been receiving treatment. Family just did not know quite how to handle the situation, which is why they called the police. Again, you know, this is the other piece of it, that how do we put supports in harm reduction? How do we get supports into the hands of family members and community to help, help also?
Because it's really scary when somebody is really in a mental health crisis. I remember being new as a treatment, director. And, you know, the residential program that I ran, where this mother lawyer decompensated in front of my eyes. You know, all the, and, and very scary experience. So and I was a trained professional.
So a lot of, if you're, you know, if you're just a family member and this is my child and this is my brother, this is my sister, how do I handle those things? So again, they're looking at, again, you know, co locating behavioral health worker along with an I 1 1 dispatch, assessing the situation and sending out the appropriate team.
It's still in the early stages, I think there's still work to be done in that area, but I really, and it's based on some of the, there's models across the country where this has already been existing for quite some time, and so again, you know, it's good to see, but we just need to see more of this, um, more robustly happen, and really also then to begin to also inform the community about what also is happening as well.
So then a couple of national initiatives, and Philadelphia is doing some work in it. One is the Stepping Up Initiative, and it's a national, program. to reduce the number of individuals with mental illness being incarcerated there's 500 counties nationally that are being involved in this program.
And it's just a number of different initiatives. Like, what are ways that we just don't incarcerate people who have a mental health concern? You know, talking with the Chief Medical Officer, of the Philadelphia Department of Prisons, he will tell you, we run the largest mental health hospital on the prisons, than in Philadelphia.
We don't have an institution in the city itself. That handles the number of people who have mental health disorders, that we do at the prison. Something wrong with that. I mean, again, I think that just goes back to a larger issue that we have our priorities really messed up in terms of our society as a, as a country.
Kind of piggyback, the last thing I want to talk about is piggybacking on my comment a minute ago about how do we help community members. How many people have heard of Mental Health First Aid? Okay, well if you haven't heard about it, I would really recommend that everybody be trained in mental health first aid.
It really helps people, it's a skills based training that teaches people, um, how to understand it. It's how to identify, understand, and respond to signs and symptoms of mental health and substance use challenges. And this can be help support with your peers, your co-workers, your friends, um, all of my teams go through it.
I've been trained in it. Just like everybody, you know, a lot of us are trained in how to do first aid. This is on the mental health side. This is a tool because, again, it's really scary when someone is having a mental health crisis. It's really scary. And somebody may be withdrawing from, a high on opioids and what do I do and how do I do and how do I help.
This is something that we as community members. can do. Because again, it's going to take the larger community in order to address, these issues and, to, to move forward harm reduction. Now, the last things I would like to say is that we've talked about trauma and the impact of trauma, throughout all of our panel presentations.
I just want to emphasize, you know, we've talked about our, individuals, participants, clients, community members really being impacted. Want to emphasize again around also our law enforcement also, , impacted as well. That was spoken about earlier. I was at a presentation within the last year or so, there's a researcher who's really talked about how the brain, functioning of police officers change within three years of them being in a police force.
And I think that's something that we really need to think about, like, you know, because again, the stressors and the trauma and how do we, , help them, you know, in ways. There has to be, you know, we, you know, again, we, we need law enforcement, but we need a different law enforcement and how do we support people who are working in some of the most stressful work that you can work in.
I'll leave it at that. Thank you.
On June 14, 2023, the Pennsylvania Action Coalition (PA-AC), The National Nurse-Led Care Consortium (NNCC), and the Geisinger School of Nursing hosted participants from around the country at the Clinical Faculty and Preceptor Academy (CFPA) Summit following the National Forum of State Nursing Workforce Centers’ Annual Conference in Arlington, VA.
The Summit provided an opportunity to engage in discussion around the advancement of training, preparation, and availability of clinical nursing faculty and preceptors. The PA-AC, NNCC, and Geisinger shared updates from the CFPA program, convened a panel that discussed how the CFPA will be an asset to academia and clinical practice, and shared a sample of the curriculum.
| Presentations |
| Lunch |
| Welcome from NNCC and PA-AC |
|
Geisinger Reviews Year 1 and 2 |
|
PA-AC Reviews Year 3 and 4 |
|
Panel: Academic Perspective with Fallon Hughes |
|
Panel: Clinical Practice Perspective with Amanda Cresswell |
| Q&A for Speakers |
| Snack Break |
| Curriculum Module Sharing |
| Feedback and Q&A |
| Wrap Up and Closing |
SARAH: This is At the Core of Care, a podcast where people share their stories about nurses and their creative efforts to better meet the health and healthcare needs of patients, families, and communities.
I'm Sarah Hexem Hubbard with the Pennsylvania Action Coalition and the Executive Director of the National Nurse-Led Care Consortium. On this episode, we're going to hear about nurse-led research on the lived experience of sex workers who identify as women and their healthcare needs.
Joining us are two of the three researchers who were part of this research initiative, Kimberly Trout and Saumya Ayyagari. Kim is an associate professor of nursing at Villanova University and a certified nurse midwife in Philadelphia.
Welcome Kim.
KIM: Hi Sarah, and thank you so much for inviting us to be here today. It really is a pleasure.
SARAH: And Saumya holds a dual masters in nursing and public health and is the nursing workforce development manager for us here at National Nurse-Led Care Consortium. Saumya, great to have you here.
SAUMYA: Yes, I'm excited to be here and thanks for having me.
SARAH: The research article you both published along with Dr. Wendy Grube, who's now retired from the Penn School of Nursing is called In our Own Voices: The Lived Experience of Sex Workers in Philadelphia who Identify as Women. Broadly speaking, what got you interested in pursuing this topic?
KIM: So I have always been interested in health promotion for women. I feel that women especially bear a lot of the burden of work in our society and are undervalued and need opportunities to promote their health. So most of my work prior to this has centered around nutrition and diabetes and women.
But I was actually approached by the executive director of the Community Center at Visitation, Sister Betty Scanlon who came to me and said, Kim, at our center, we have women who are sex workers who come in to get a hot shower and a cup of coffee. And I feel we can do a lot more for them. So, can you do something about this? Can you find out what they would like. And so that's how it sort of started was this nexus of an idea from Sister Betty that more services needed to be provided. And the first thing that we did was a needs assessment, just a general community survey to see what was available in that community before we actually embarked on the study where we were going to ask the women to describe in their own voices what their needs were.
SARAH: And Saumya. How about you?
SAUMYA: Well, similar to Kim, expanding access to reproductive healthcare has always been a passion of mine, and my background in nursing is in reproductive healthcare. And as I've gone on in my career, I've broadened that to include expanding access to healthcare in general and improving quality of healthcare services in general.
And something that's really important to me is that healthcare really be designed for the people that it's intended to be delivered for, and that their voice be driving the design and the delivery. And when I heard about this project, I thought it was a great opportunity to hear from a population that really isn't heard a lot in general, and certainly isn't heard a lot regarding how they would like to receive their healthcare. And I jumped on the chance.
SARAH: And as part of your research, you established a relationship with Prevention Point, a Philadelphia based public health organization that provides harm reduction services. What led you to end up partnering with Prevention Point?
KIM: Part of why we ended up at Prevention Point, as I said, prior to doing the study, we did a community needs assessment of what services were in the area already and what facility might best accommodate this type of research. And after really investigating, it really seemed like Prevention Point was the best place and their whole harm reduction philosophy really worked well with what we were trying to do. So part of that was, finding out about Ladies Night and choosing Ladies Night. And part of what we had to do was get to know the women and the atmosphere. So, we hung out at Ladies Night ourselves, and we attended workshops that were presented by Project Safe to find out certain things that were important to know, such as there's a bad date list that is circulated so that the women know this person's a bad date. They have been abusive in the past. Don't go with this person. You know, different types of supports that were available and, and we volunteered and, and hung out. So, that's how we started and I think that was really important in terms of developing a rapport with the community.
At one point, I heard a woman say to somebody who was there as a volunteer, think you're better than me? And I heard that and it really was chilling to hear that comment because it's so important when you're doing this kind of work to have an attitude of I am one of you, I'm one of your community. I'm not a sex worker, but I am a human being like you and I want to relate to you as a human being and support you as a human being. And no semblance of oh, here I am, somebody better than you. So I felt that was so important.
SARAH: And you were able to speak with and actually survey individuals who dropped in at the organization's weekly Ladies Night program, which at the time Blue Laurano had co-directed. We're actually going to hear a bit from Blue right now about this initiative.
BLUE:
SARAH: Now that we've heard Blue's description about the Ladies Night program, what had you intended to learn as part of this study? What was it like to draft some of those questions?
KIM: We wanted to ask open-ended questions that would allow the women to feel free to describe in their own words. How have you felt about interactions with healthcare providers? Why? What do you consider good healthcare to be and why? When seeking healthcare, what is the most important for your healthcare provider to know about you? Those types of open-ended questions that would allow them to speak freely and go off on tangents if they wanted to. Some of the questions initially that we were going to ask after discussing with the social workers there thought, you know, those particular questions might be re-traumatizing. And so, we took out any questions that potentially could be re-traumatizing. Certainly, that could happen at any time, but certainly we didn't want to have any questions that would make that more likely to happen. And it made us also think about, because it could happen at any time because, these women had been traumatized to some extent. We wanted to make sure we had resources and places to refer them for help if they needed, if they wanted counseling, if they had a psychiatric emergency. You know, we had a plan to deal with all of these things because we knew there was that potential for re-traumatization.
SARAH: What were some of the self-identified concerns that you heard, that you were recording for your study? Saumya, if you want to take that first.
SAUMYA: One thing that really stood out was the desire to be seen as a person. Just as Kim mentioned, our efforts to be connecting on just the basic human level with the participants. And I think the participants really overwhelmingly said, you know, all healthcare concerns aside, I just want to be seen as a person. And then social determinants of health also came through regarding housing, in particular. And you know, it was a little bit surprising to us 'cause we thought the concerns would be all around like sexual and reproductive health. For example, STI testing, various, reproductive appointment access points, things of that nature. A lot of folks really emphasized like, I want to just be able to go to a primary care doctor, like, I have asthma, or I just want to be able to, if I'm not feeling well someday, to be able to go somewhere to get a checkup and my whole identity not be seen as a sex worker. So that's what jumped out for me. And I can leave room for Kim to share sort of what jumped out for her.
KIM: Thank you, Saumya. Yeah, I think you really hit the essence of it that, being seen as a person was sort of the major finding, being seen as a whole person and accepted for who they are was really important. And as you said, many of the women had chronic health conditions that required primary care for chronic health condition maintenance, such as asthma, hypertension, diabetes, Hepatitis-C those were some of the major conditions that the women were affected by.
In terms of the qualitative data. What also stood out was that women felt it was really important to have time, time and attention, and that connoted respect. And too often when they were describing what good healthcare is, they would say somebody who really listens to me, someone who doesn't just throw a pill at me. And bad healthcare is someone who just looks at the computer screen and doesn't even look at me. Someone who doesn't take the time. And it's clear with those types of cursory interactions, you're not going to get someone to reveal and trust. It's just not humanly possible in those hurried situations for people to be completely honest. And an environment where the women can feel safe. And that is part of the reason Ladies’ Night is sort of where these women can feel safe for just even a few hours each week.
SARAH: The responses here are actually quite universal among what people are looking for in healthcare and from healthcare and from a good healthcare experience. And as we're going to hear again from Blue, one of the confirming results was the need for more healthcare, which Prevention Point was ultimately able to implement on-site.
BLUE:
SARAH: And so clearly, underscoring, you know what you had sort of seen reflected in those responses. Sort of looking big picture at the study, what were some of the key findings that you came away with?
KIM: Some of the other themes that we found, the first was one day at a time and it was clear there was not the opportunity for much advanced planning. Participants talked about functioning from moment to moment, and that seemed to be a pervasive theme. There was also a theme of the system works against me and I heard multiple stories. You know, I'll read one quote. ‘I try applying for jobs, but you get none. They look at you, you know, and then they could tell you they’re homeless or whatever. So it has been really hard trying to get a job. So that's why I'm doing what I'm doing right now.’ Another theme is hustling and surviving, doing whatever they can to make money. Panhandle, go on a date, which is the term the women use for transactional sex it's a mean of survival and thank God I'm still alive, was another theme that came up. You know, I thank God, you know, I take one day at a time. And here's another quote, almost dying from overdosing Oh many times. And when I reevaluated my logic, once I found out methadone can help with pain, I just, I finally had an epiphany and got my shit together.’
SAUMYA: And I would just say that in the section of good healthcare versus bad healthcare, there was one section where folks described bad healthcare as being in a situation where the healthcare provider isn't allowing someone to feel comfortable, telling what's going on with them. And good healthcare, being in an environment where someone is feeling comfortable enough to be honest, and that seems intuitive for many of us. But it was great to actually hear that and now to share that with you all, so that we can continue to emphasize that point in creating that safe space for our patients. So that they can actually share what's happening and we can actually support them to the best of our ability.
SARAH: And that seems to come back to that harm reduction model of care and what we heard from Blue and learning about Prevention Point. How do you think the research could be useful to primary care providers going forward? And how they think about care for this community and others who have traditionally experienced stigma?
SAUMYA: So there's not one right way to interpret and apply what we found. But I think going back to what I just mentioned about creating the safe space and the comfortable environment is really critical. In nursing, we talk a lot about therapeutic communication and building rapport with your patient. And I think this goes back to the basics of nursing in creating that space. And we actually did a little bit of a literature review to look into other models that were incorporating similar ethos that our participants were asking for. And there was one model through something called the Empower Study and they had certain recommendations which, we found to be very helpful and also affirming. Because within reproductive healthcare and reproductive healthcare visits, this is how providers are taught to treat patients. So going into the details now, one example is, you know, when you talk to folks, make sure that they're fully clothed. When you're asking them questions, unless it's necessary, you don't need to talk to somebody when they have their clothes off. Another option to think about incorporating is like, ensure that if you're making contact with somebody or touching them, always ensure you're asking consent. Always ensure that you're explaining why you're doing what you're doing. You know, making sure that you're making eye contact with folks, making sure that you're adopting trauma-informed care principles. So, these elements that I'm mentioning did not come directly from our study, but they are valuable tools in the toolbox for moving in the direction that our participants seem to want to go.
KIM: Just a few more things that came out of the Empower Group about not blocking the door, making sure that the patient can always see that they can access the door, avoiding typing or appearing distracted. And I think there's a tendency when providers are doing their notes, especially in a population that has felt stigmatized, like they don't know what this person is writing about them.
SARAH: In many ways, your research is adding a new perspective. I mean, sort of building upon this body of work, but certainly bringing to light this new perspective that hasn't been heard before about street-based sex workers who identify as women. But at the same time, this population has been there. Why has it taken it this long? And why do you think the community hasn't been heard before?
KIM: That's a great question. And quite honestly, I feel a lot has to do with the place of women in our white dominated, patriarchal society, where women are objectified and seen for their utility to the people in power and not treated fully as human beings. And of course, if you have women of color, you have that intersectionality of racism as well.
So I think that a lot has to do with society's view and stigmatization of these women. And I feel really glad that we did this work, Saumyam because I feel it is lifting their voice and hopefully will help these women to obtain better care for themselves.
SAUMYA: Yeah. I feel like Kim took the words right out of my mouth. I would also like to say that our population that we looked at for this study, in particular, they were speaking of intersectionality, they're the intersection of sex workers who identify as women, folks who use IV drugs, folks who are homeless.
And so all three of those demographics are groups that are heavily stigmatized and they belong to all three of those groups. And working within healthcare myself, when I was in the inpatient setting, someone from any of those groups, let alone all of them would come in, like you could just see the sense of staff rolling their eyes or people feeling uncomfortable when, when such a person was their patient assignment.
And I think part of the reason why it's taken so long to actually ask folks, you know, what do you actually want is because of this stigma and not seeing people as people, which is really, you know, what the participants said that they wanted. And I wonder too, if some folks in healthcare, have this viewpoint. Now I'm just purely speaking off the cuff here, you know, not based on evidence, but I think that a lot of people in healthcare haven't been exposed to this population knowingly anyway, or haven't really like viewed their patient as like a fellow human being, let alone a patient who might come from some of these demographics. That's what I would say.
KIM: You raised some really good points, Saumya. And I was just, as you were talking, taking note of the percentages of those things that you talked about that contributed to that intersectionality. 82% of the women in our study were homeless, 90% had food insecurity and 76% were in substance abuse treatment. So, as you said, imagine all of those things coming together and thinking about how most often they have been treated by healthcare providers. Of course, why wouldn't they stay away? And I think that's the beauty of Prevention Point, is they really do feel safe and respected there. And that's why it was so important to bring these primary care services to them at Prevention Point, at a place where they knew they could feel safe.
SARAH: What do you think could happen sort of on the front end as we're training providers to maybe change course here, you know, to speak to Saumya's point that, that maybe that exposure hasn't existed. So how, how do we change those preconceptions and avoid the stigma in that, in early education and training.
KIM: That's a great question. And I think we are using simulation for so many different things in nursing education that I think this is an area where it's really ripe for development. And you've given me a great idea for my next project, which is to write a simulation, to educate nursing students about how do you deal respectfully with these situations. As you said, Saumya, are so unfamiliar to most of the people that are in the profession, entering the profession. That would be one way.
SAUMYA: Yeah, I, I think there's myriad ways. The simulation Kim offered is a great idea. I also think. when someone is in school to become a healthcare professional, there's so many things on their mind that they need to complete. It's a, it's very task-based, like task-oriented type of training. And healthcare providers students have a lot on their plate. And, I think that if there was some opportunity to allow more space for reflection, after patient interactions or some way of perhaps building in a non-clinical volunteer experience with certain populations where like, say a student didn't have to have a specific assignment or write a care plan or develop some sort of documentation, but just like the free time to relate on a human being kind of level like Kim and I did at, at Ladies' Night. Perhaps it could count for their clinical hours, but the responsibilities would not necessarily be the same. Maybe that would allow for a little bit of just the mental space to be able to have that reflection and internalize that and move forward.
SARAH: So what do you hope this research will lead to? You’ve eluded to a few things, but you know, what's next?
KIM: I would love to see facilities like Prevention Point replicated throughout the US where you start with a harm reduction principle as your basic philosophy, and from there you treat people with dignity and you provide them the services that they request. But providing that safe space is the key factor where they feel they can be accepted for who they are as a whole person, just as they are.
SAUMYA: I think it would be great to also continue our model of thinking about healthcare design. So, continuing to encourage when thinking about delivering healthcare to a certain population, the first thing is it's important to make sure that population is at the table and having a say in how the healthcare is structured.
Because that's what's going to work best for that population and they're the experts of their own life. And I think embracing that philosophy when it comes to research and when it comes to designing how services are rolled out is really important. So that was more of a broad brushstrokes answer, but I think that's a key element here that we need to emphasize.
SARAH: Well, thank you so much for the work that you did and for sharing it with us today.
KIM: Thank you, Sarah.
SAUMYA: Thank you, Sarah.
SARAH: And special thanks to Blue Laurano for taking time to talk with us. For more about Prevention Point and the organization's approach to providing harm reduction services, log on to ppponline.org.
You can find our most current and past episodes of At the Core of Care wherever you get your podcasts or at paactioncoalition.org.
You can also stay up to date with us on social media by following @PaAction and @NurseLedCare.
At the Core of Care is produced by Stephanie Marudas of Kouvenda Media and mixed by Brad Linder.
I’m Sarah Hexem Hubbard of the Pennsylvania Action Coalition.
Thanks for joining us.
SARAH: This is At the Core of Care, a podcast where people share their stories about nurses and their creative efforts to better meet the health and healthcare needs of patients, families and communities.
I’m Sarah Hexem Hubbard with the Pennsylvania Action Coalition and the Executive Director of the National Nurse-Led Care Consortium.
We’re closing out our special series taking stock of the COVID-19 pandemic with Letha Joseph and Adeline Kline. They are members of our vaccine confidence advisory committee, and will talk about the importance of relationship-building with community members to help promote health and wellness goals.
Letha is joining us from Durham, North Carolina. She is a nurse practitioner, a program director at the Durham VA Healthcare System and consulting associate at the Duke University School of Nursing.
And Adeline is on the line with us from Honolulu, Hawaii. She is a family nurse practitioner and clinical educator for Hawai’i Keiki, which is a partnership between the University of Hawaii Mānoa School of Nursing and the Hawai‘i Department of Education.
Our producer Stephanie Marudas spoke with Adeline and Letha.
STEPHANIE: Thanks Sarah. Adeline and Letha, welcome to At the Core of Care.
ADELINE: Happy to be here.
LETHA: Thanks for having us.
STEPHANIE: We've heard that the federal government is considering lifting the COVID-19 public health emergency. And you both have been involved with the Vaccine Confidence Advisory Committee at the National Nurse-Led Care Consortium, and we'd love to hear why you both got involved. Letha, could you lead us off?
LETHA: You know, the Vaccine Confidence Advisory Committee of NNCC, I think that was one of my highly productive professional ventures. So the COVID-19 pandemic created unique needs. Of course, we knew the patient needed support, and every area was affected. However, support for the professional community, it was a significant need. And from the beginning of the pandemic, I was involved in activities including educating healthcare professionals on emerging best practices for pandemic management, as well as resilient strategies. And once the vaccine became available, improving vaccine acceptance became an additional focus. As a nurse practitioner working with all the veteran populations, a patient group that was disproportionately affected by the pandemic, vaccine acceptance, getting more and more people vaccinated, that became my primary focus. So, the Vaccine Confidence Advisory Committee, its mission and its goal, that really aligned with my interest.
STEPHANIE: Thank you Letha for sharing your perspective. And Adeline, what about for you?
ADELINE: So it's interesting, you know, thinking about the close of something, right? Because there's this implication of an end. And so what we know really is COVID-19 is here to stay. As we move into the world of endemic versus pandemic, it feels as though we're going to smooth life out a little bit, which I don't know that that's happened, but you know, we're, we're all trying the best we can. What I really appreciated about the role with the Vaccine Confidence Advisory Committee was being connected to all these people across the country and hearing the similar challenges and how they played out in different geographical areas. Like it may have been a different patient population, but you know, we still had the same conversations around trust, around safety, around efficacy. And being able to come to the table and provide high quality evidence and the latest research and the upcoming updates were just invaluable in a time where information was flying heavy from every direction. And it was really nice to have a really solid grounding source and connection that I could then bring back to my colleagues and the community we serve here in Hawaii.
STEPHANIE: What I'm hearing is having this group that can vet information, be supportive, provide resources, and something that we've heard throughout our series is the word ‘trust,’ and how to cultivate that within the health community and for people to get vaccinated. And I wonder, Letha, a lot of your interests over the course of the pandemic has been focused on how to motivate people to get vaccinated. And so, from your perspective, can you tell us some key considerations that you've studied along the way, especially since you have a journal article out on this topic now?
LETHA: Yes, Stephanie, that's an area of my interest. And I did some work on vaccine hesitancy and improving vaccine uptake. And I was able to reach a national audience using different platforms. And we all know that vaccine hesitancy is not a new phenomenon. And you know, we hear about the comeback of vaccine-preventable diseases, including the measles and the polio. And also, we see every year the resistance to get annual flu shots, and we know these vaccines are not new. They are familiar vaccines, but still there is vaccine hesitance. Then what happened with the COVID-19, there was a surge in misinformation about the disease. So, when a new vaccine, which came probably the so-called record time, the misinformation and the skepticism, everything existed. So, the COVID vaccine acceptance, we cannot expect that to be an automatic process for people to wholeheartedly get it. Now speaking of vaccine hesitance alone, we tend to label people who belong to minorities as historically vaccine resistant. We categorize people and then we forget about them because we don't want to get to the root of the problem. We just mentioned about the big word, trust. That is exactly I want to highlight here. So, as we explore the factors which are leading to vaccine hesitancy, we realized that that people's lack of trust is the central issue.
People's past healthcare experiences made them lose faith in their healthcare providers and probably the healthcare system itself. And we might think they are referring to historical experiences and mistrusting the system. No. The person in front of you, they had experiences which are not very present. They have experienced discrimination. They have experienced several shortcomings in their care, so they developed mistrust. So, restoring that trust is essential if we want to improve vaccine confidence. If we want to improve the vaccine acceptance, it's actually not just for the vaccine, for any treatment, it is not just for the COVID vaccine, just for any vaccine. So the, the trust is the basic issue.
STEPHANIE: And, you know, thinking about what Letha just shared, Adeline, in your work, how have you seen these trust issues play out in school-based settings, given that you advise school healthcare providers, staff and families on health decisions.
ADELINE: So yeah. Letha, I love that perspective ‘cause I think you're right. It does come down to trust. What's so interesting in medicine is so often it's this pre-planned visit, right? You have a doctor's appointment or a nurse practitioner. You see a P.A. You go in. It's almost a position of power as the patient, you're waiting for them in the room. They come in, they're busy. What's so different working in the community setting, which all of us that are school nurses or nurse practitioners is we're working with people at their day in and day out. So, the students go to school, the teachers come to work, the front office staff, the custodians, the cafeteria, along with the communities that surround our children.
So, here in Hawaii, often it's parents or aunties or uncles. There's a lot of intergenerational households here. And so by being that medical person in a non-sterile setting, there's a bit more of that relationship building, and it's been so interesting to me throughout the pandemic how it's played out just by having an open door. So often people are dropping in, ‘Hey, what do you think about this?’ ‘Oh, I heard there's a new vaccine.’ ‘Should I get this dose or this dose?’ Right? Lots of conversations around safety and lots of opportunities to really talk to people in an informal setting as a medical professional with a wealth of knowledge, and really bring the information I have in an equal dialogue to the table. And that's been huge because it sort of creates opportunities for conversation, discussion, and input, and really does build on that.
LETHA: Yeah. It's interesting, Adeline, that you said, because you have that open door and people are actually approaching you for input that shows the trust they have in you and their faith in your knowledge or expertise. So they take your words for granted because they have good faith in you and they know that you want the best for them. So having that confidence, developing that trust, it is applicable in any setting. And unfortunately, the setting where we are so much creative, focused or disease focused, we may not have time to address or create the trust. Have that conversation where patient feels valued, where patient feels like a partner in care.
STEPHANIE: But how do you talk about it now? Especially with the shifting climate where we don't have vaccine mandates anymore.
ADELINE: So being in the school setting, so just addressing the students, we have requirements to sort of piggyback our CDC childhood vaccinations, and you're actually required to have them in order to attend school here in the state of Hawaii. And when we changed the laws a few years ago to include seventh grade for HPV, meningococcal, and Tdap, it, of course, was a year before the pandemic. So we had this interesting change in routine childhood vaccinations that then got put on pause, and now we're getting back to a world where now we're checking those vaccinations and we're saying, you know, if your child's not compliant in HPV, meningococcal and Tdap in seventh grade, they're not going to be allowed to come to school. And I bring that up because COVID-19 is not yet required for school entry for children. And at one point, staff had mandatory either vaccination or testing, and that sort of was lifted here as well in the state of Hawaii. So now it's part of the bigger conversation of, okay, you're sick. Oh, when was your last booster? How old are you? What are your risk factors? Let's pull up the CDC calculator. Let's talk about it in the context of your regular annual physical, you know, connecting people back to that. Starting to think about health maintenance again and COVID-19 vaccination being a talking part of health maintenance, the same as all these other routine vaccinations that we do.
And Letha, I just want to touch back on your conversation around not novel. I had that conversation so many times where I was like, no, really, this technology actually was developed at University of Pennsylvania and it's been there. You know, we tried it for all these other diseases and I would describe it to people as, think about what we could accomplish if we were always allowed to cut through the red tape. There were no steps in the safety process that were sacrificed. It really was just the bureaucracy that often time gets in the way of innovation and development. And as we move forward in the world post COVID-19 pandemic, I would love to see some of that not go away completely. I mean, the fact that we're sitting here on Zoom recording a podcast, right? That wasn't really standard practice four years ago. But now I think that virtual meetings are a part of our life, allowing us to sort of have a little bit more work-life balance. And so we don't need to drop everything, drive across town in order to attend meetings in-person.
There are still some really valuable things that are important to hold dear, and I'm so happy to have opened up the world. But I'd also like to see some of that innovation that came out of the pandemic really move forward and not disappear in terms of both vaccinations, technology, you know, access to care.
We talked about that, Letha, with our seniors. You know, I think that telehealth has really exploded the market and improved the ability for people to have care. And that really did come out of this crisis that we dealt with over the last couple years.
STEPHANIE: As you mentioned, and to hand it over to Letha, you know, what are you seeing in your work in the veteran population along these lines?
LETHA: Yeah. So I mean, COVID-19 definitely had a lot of benefits or positive outcomes as well. It was not all negative. It had some positive aspects. So the telemedicine, telehealth, my workplace, we had telehealth, but once we became the pandemic situation, the use of telehealth has expanded. So, once you expand a program, there are going to be improvements happening on the way. We don't need to have these patients getting ready and traveling long distance and then coming with the family and able to navigate all these struggles. So now, unless they really need to be seen face-to-face, we can manage their care using the telehealth. So, you know, that is one advantage. And of course, the work-life balance is there. Use of technology is there. And now Adeline is from Hawaii and I'm from North Carolina. We are collaborating on this without that effort and so lot of knowledge sharing from place to place. Even NNCC, we talk about what is new happening in our workplaces. So, people who are interested, they're adapting, and the collaborations to work together and bring that knowledge out and testing new things. So all these things are good about the COVID-19 and you know, the resilience concept got a lot of momentum with the pandemic. The burn down or burn out, whatever we call that, that distrust was not new.
It existed years ago, decades ago, everybody knew we were burning the candle from multiple ends and we are going to really burn down or burn out. But COVID brought that situation into light. So now people know that healthcare professionals experience burnout. And healthcare professionals are really not ashamed now to agree that, yes, I need help. And lot of resources came up for healthcare professionals. And then we started looking into workplace safety and workplace support. So now, rather than asking people to be resilient, we need to create the workplaces conducive for healthcare professionals, supportive for them so they won't have to think about their burnout and resilient strategies as much.
Cause here now, like the president of American Nurses Association said, we talk about resilience, we ask people to be resilient when we don't try to do something to fix the workplace issues. We can't expect people to be resilient. So, a lot of new dimensions focuses came out because of the pandemic. These are not new issues, but these issues got recognition. So, once we recognize these problems, I think we are going to do something about it.
STEPHANIE: Yeah. As you indicated, this was a time of a lot of turning points and like Adeline said too, you know, how do you keep some of these innovations going forward? What did you both learn in terms of messaging around vaccine confidence? As you both mentioned, there were previous vaccines to talk about. But, what did you find that worked?
ADELINE: You know, I wish there was like a one word answer to this, right? What we found out what worked is that it is an ongoing, I think it comes back to that root of trust. Because it's always having that ability to be open and have those conversations and try and hold that space without judgment, which can be very hard. Because when you have something that as you're training and your medical background, you go, this is amazing. Like everyone, everyone, I want to protect you. I want to protect my family. I want to protect the community at large. You know, part of you sort of wants to pick people and shake them and say, why wouldn't you get this? And that's the human part. But from the healthcare provider side, it is reasonable to have fear and mistrust, anything that's new, it's human nature. So, I think patience. I think time. I think meeting people where they're at, not trying to force opinions, because as we all know, the second you just start spouting facts and you don't hear what a person's concerns are, they shut down and they're not going to listen to you.
So, it doesn't help for me to just give you all the facts in the world if you have already made up your mind. What I need to do is create that open space where you can continue to have dialogue and discourse and conversation. And it's challenging. I think that informal messaging on the walls, I think that that formal messaging in media posts and newsletters. I was pregnant when I got my first COVID, actually, the first series, I was pregnant for both of them, and I would tell people that, right? And then after my daughter was born, I would show pictures of her. And so just to really reassure that, not, is this only something that as a healthcare professional I believe is safe and I believe all the research, but I also personally have walked the walk and talked the talk and done it with all of these other extraneous circumstances and want to encourage you to feel comfortable asking me your concerns because concerns are valid and sometimes people still say, no, I'm not getting it. And you just got to meet them where they are.
LETHA: Yes, Adeline, you're right. We have to meet them where they are. So that is my part of the messaging, also. There is no one size fits all concept here. Messaging needs to be individualized. I generally go with health belief model for crafting my message. The susceptibility of the diseases or the chances of contracting that disease, and the consequences of having that disease and the benefits of taking vaccine, all these things matters. Now again, the message needs to be individualized based on where the person is in his or her decision making process about the vaccine. Like if the person is in pre-contemplation stage where the person is not at all thinking about the vaccine, we probably should not talk about the vaccine because it's not going to work. And if the person is in contemplation stage, maybe that is the time we need to give more information on the vaccine. So, Adeline is absolutely right about telling personal stories and making people think this is the person who lived that experience and the person is doing fine. So, then maybe that is going to be good for me, too. And so this person who has done all this healthcare work and has the healthcare knowledge is trusting that vaccine. That means probably this vaccine is trustworthy. Why not me? All these things are there. So, it is difficult, as Adeline said, there is no one word answer. It's a constant process. And that effort. That dedication. It comes from healthcare professionals and I'm so proud to see how people really worked hard to improve vaccination, especially risking their life, risking their comfort and everything.
STEPHANIE: Both of you have been talking about the theme of relationship building, cultivating trust. And it's interesting to consider that you could have had moments when the patient said, I'm not ready. I'm not there yet. And when we were preparing for this interview, Letha, I think you shared about the importance of being heard, cause you want people to come back and keep engaging with their health and wellness. So, if there's anything you wanted to say to that?
LETHA: It's an important concept and it's the most important part of vaccine conversation. If we make the patient feel that we have an agenda and we are working to get it established, we will probably have more resistance because our vested interest can make the patient suspicious. So, my approach is always that of the motivational interviewing. Any vaccine refusal or any resistance to any type of treatment recommendation. I consider it as an opportunity to explore the underlying problems. If they are even mentioning a misinformation about vaccine or misinformation about COVID, it is not just that misinformation. What is making them consider that misinformation over the healthcare professional’s recommendation? That is that mistrust. Maybe they heard it from even more trustworthy sources like their friends, their family or their favorite football player or their favorite actor or actress, these people have influence on them. So, they have trust in these type of celebrities over the healthcare professionals because they don't have that much trust in healthcare professionals.
So again, we are coming to the core problem of lack of trust. So, as I mentioned earlier, their lack of trust originated from their previous experiences. So, if that patient is in that precontemplation stage, not even considering the vaccination because the person doesn't believe in vaccine, or the person doesn't believe that that vaccine is safe. Now my focus is shifting from encouraging the person to take vaccine to sitting down, talking to the person, finding out what is actually bothersome. How was his previous or her previous healthcare experiences, whether there are some unmet needs, whether there are certain hurt feelings.
So, developing that trusting relationship, that is the most important. So, vaccine conversation is not a one-time encounter, it is a process. It might take several encounters before we are successful, but if we get successful, probably this person is going to be one of the best people who can convince other people who have skepticism.
STEPHANIE: How about for you, Adeline?
ADELINE: Yeah, I mean, I think, you know, we've talked a lot about trust, right? And building those relationships. I've had many different fields in healthcare, so I've worked in ICU, I've worked in urgent care as a nurse practitioner, and now in the school setting. I just keep thinking back to patients I saw. Maybe the first time they saw, they didn't know me, they didn't trust me. They didn't know who I was. They didn't know if I knew what I was doing, and then I'd get something right. Right. I'd diagnose their gout or their shingles and then they go, ah, hey, you made that better.
And so like Letha is saying not closing the door because of one misinformation they have around the vaccines and sort of getting buy-in from them on whatever that world is. And maybe it'll be then someone they know gets sick and didn't have the vaccine, so they come back to you again and have that conversation of, oh, you know, my buddy Joe just got really sick, didn't have the vaccine. Like, do you think it's going to help if I get it?
I mean, whatever the opportunity is that presents it to have the conversation. The other approach I always took was just being consistent, regardless of your age, race, gender, what you were in for sort of asking that question. Have you had your COVID-19 vaccine? Okay. Do you want to talk about it? Allowing them to have sort of the power in leading the conversation if they were interested and if they weren't, I wouldn't necessarily poke and prod.
With our students. Where it's interesting sometimes is if you have two family members that disagree that have access, because under 18, right, you need permission from a guardian. So, we did have situations where maybe one guardian wanted to get the vaccination and the other didn't, and that was the one who won out. And so those conversations I found a bit harder to have. Both from a healthcare perspective as well as a family perspective, because one, you want to do what's right, you want to share the information and you want to protect our most vulnerable. So, to see a younger child not get coverage due to parental beliefs, those were a little bit more challenging and I don't have an easy answer for how to approach them.
But I think again, just remaining non-judgmental, open door and sort of just very factual. So, it's just like smoking. Do you smoke? Do you vape? Okay. You know, that's really bad for your health. And hopefully, that over time they hear that message enough from trusted sources of individuals that they're going to come back and go, you know, I've heard you. Like I really want to get that vaccination, or I want to talk about it, or, I really want to quit vaping. Right? All of these big picture things that play out in our health over the long term, because we are, at the end of the day, the health experts. I meant that’s why we went to school and our onus, or we would say in Hawaii, our Kuleana is to help these people, right?
We don't do it just for a paycheck. I don't know anyone in medicine that went into medicine because they just want to get paid well. It's because we have a bigger goal, and that really is to help and serve.
LETHA: Yeah, I really like that bigger goal, the purpose approach from Adeline. The purpose makes us going. I also wanted to add what Adeline said, maybe a patient is talking to us about misinformation or even refused the COVID vaccine and next we are hearing he was really sick with COVID. So now he's back to the clinic. We need to be really compassionate and supportive. Never be trying to bring back the previous conversation and make the patient feel ashamed.
STEPHANIE: As we come to the end of the show, just would like to open up to both of you, whether you have any final thoughts to share. Adeline?
ADELINE: Thank you for listening to us, first of all. I know it can be tiring to hear about COVID-19. COVID-19 vaccination. And just really reflecting on the fact that at this point it's a picture of bigger health. So, along with your vaccination, what are you doing both as a medical professional to take care of yourself, finding that time to prevent that burnout, getting outside, exercising, spending time with family, and then staying vigilant yourself.
You know, I really have to stay vigilant on reminding myself to check the CDC booster calendar. It's really a useful tool to go on and see what the current recommendations are. We're not in this information overload all the time, but it is still part of our life. So I just encourage everyone to sort of remain vigilant. Keep an eye out for just like your annual flu vaccine, whether or not you're due for a COVID-19 vaccine, and thanks for showing up to the table.
LETHA: From my side, again, thank you for listening as well as since Adeline highlighted looking for CDC updates and following that. I would probably remind about, no, we are still living with COVID. We do have COVID. We do have the risk for contracting the disease, so masking, hand washing, physical distancing and boosting your immunity. Either by vaccination or the booster dose as it is applicable so that we can probably get a little more relaxed restrictions because we are going to slowly reaching that end of the tunnel.
STEPHANIE: Thank you Adeline and Letha for joining us on At the Core of Care.
ADELINE: Thank you.
LETHA: Thank you.
SARAH: Our special Vaccine Confidence series was funded in part by a cooperative agreement with the Centers for Disease Control and Prevention or CDC. The CDC is an agency within the Department of Health and Human Services also known as HHS. The contents of this resource do not necessarily represent the policy of CDC or HHS, and should not be considered an endorsement by the Federal Government.
You can find our most current and past episodes of At the Core of Care wherever you get your podcasts or at paactioncoalition.org.
And for more information about related upcoming webinars, COVID-19 resources, and upcoming trainings for nurses to obtain continuing education credits, log on to nurseledcare.org
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At the Core of Care is produced by Stephanie Marudas of Kouvenda Media and mixed by Brad Linder.
I’m Sarah Hexem Hubbard of the Pennsylvania Action Coalition.
Thanks for joining us.
The Pennsylvania Action Coalition (PA-AC) hosted a webinar series to share resources that we provide nurses across settings and how we can work together to advance healthcare in PA.
This webinar highlighted the impact of the PA Nurse Residency Collaborative (PA-NRC) and how we can help you improve nurses’ transition to practice at your organization. The PA-NRC was established in 2016 as a partnership of the Pennsylvania Action Coalition and Vizient, Inc. to implement nurse residency programs in Pennsylvania and to provide an additional layer of support. All hospitals and health systems in Pennsylvania that have purchased the Vizient/AACN PA-Nurse Residency Program (NRP) are members of the PA-NRC. Learn WHY the PA-NRC was founded, WHO the PA-NRC is, and HOW we can help you in bolstering the success of your NRP. Additionally, if you do not have the NRP at your institution, we invite you to learn more about the PA-NRC and how we could partner to better support nurses in their transition to practice.
Audience: Nurses, healthcare providers, and public health advocates who may or may not come from healthcare organizations who participate in the PA-NRC. This training is for non-members, brand-new and “seasoned” PA-NRC members who are interested in a refresher and/or would like to learn about upcoming opportunities for engagement.
SARAH: This is At the Core of Care. A podcast where people share their stories about nurses and their creative efforts to better meet the health and health-care needs of patients, families and communities.
I’m Sarah Hexem Hubbard with the Pennsylvania Action Coalition and Executive Director of the National Nurse-Led Care Consortium.
As part of our special vaccine confidence coverage, we’re taking stock of how the COVID-19 pandemic has evolved. Through our series, we’re hearing about lessons learned and what some of the latest trends are as we enter the third year of this public health emergency.
On this episode, we’ll be exploring the role that non-traditional health settings and partnerships have played in recent years to promote vaccine confidence.
Joining us for this conversation are Monica Harmon and Jayatri Das.
Monica Harmon is the Executive Director at Drexel University’s Community Wellness HUB and an assistant clinical professor. She’s a public health nurse and serves as the Co-Chair for our Pennsylvania Action Coalition’s Nurse Diversity Council, in addition to being the chapter president of the Southeastern Pennsylvania Area Black Nurses Association.
And Jayatri Das is the chief bioscientist at the Franklin Institute, a science museum in Philadelphia that leads science education programming and research efforts. Jayatri has helped oversee the Franklin Institute’s involvement with a nationwide initiative called Communities for Immunity to help educate and engage the public during the pandemic.
Monica, it is great to have you back on At the Core of Care and welcome Jayatri.
MONICA: Thank you. I'm so excited to be back.
JAYATRI: And I'm so glad to be part of this conversation.
SARAH: So here we are heading into the third full year of the COVID-19 pandemic. Over the past several years, both of you have been involved in educational and public health outreach within the community. So I would love to just hear from each of you a brief recap of your efforts. Monica, what was the early COVID response like?
MONICA: It was chaotic. Early COVID response has definitely been chaotic. From what do I do? How do I do it? What do we say? Am I saying the right thing? Will the guidance change? And how quickly will it change? How quickly can we get the information out to community members, to other nurses, so that we can all be empowered for this thing. Just understanding COVID. So it's been chaotic for sure.
SARAH: And then how has your own engagement changed? Or really the educational programming at the Community Wellness Hub? How has that evolved?
MONICA: So that has evolved from just preventing infectious disease, COVID, to making sure that community members have access to testing and to the vaccines. And now, how do we continue the vaccines now that we don't have the funding from the government? But we're utilizing partnerships with a program with the Sun Ray Pharmacy and then also with the colleges within the university. And then the other piece is, now how do we say, okay, COVID vaccination is a part of routine vaccination, which is a part of preventative health.
SARAH: Jayatri, can you talk about some of the programming that the Franklin Institute has carried out over the course of the pandemic and how did the museum get involved with Communities for Immunity?
JAYATRI: In some ways, museums are really following the lead of what all of you do as nurses. We find ways to make information relevant and accessible and engaging for people. So, certainly in the early days, chaotic is a great word to describe it, Monica. You know, we were not only just trying to keep up with the information, but also trying to pivot very quickly from being a very place-based organization to suddenly thinking about how do we engage in the digital space? How do we reach our audiences and what do they want to know? So in those early days, we were really thinking of our role as that familiar translator. There were so many new voices in the space with so much information. And what we tried to do was try to consolidate what we were hearing and present it in a way that felt understandable and friendly in a time that was very stressful for everybody.
So, we started out doing live Facebook broadcasts every day at the beginning as information was just coming out in overflow. And then we started to kind of pull out, okay, what are the important things that you're hearing and how do you make sense of it? You know, I did one with my daughter who I guess she was 10 at the time, as a way to engage families with kids and letting kids have a space to ask questions. And over time, we've really tried to just help people explain the process of science because we've seen how much that lack of engagement with how science works has influenced people's perception of the vaccines.
And so knowing that we have always been this resource for understanding science, it wasn't that big of a shift to say, ‘Hey, we've always talked about how that process works, how experiments work, how we tried to prove ourselves wrong and what is the level of evidence that we need to move forward?’
And so we were able to kind of carry that story into how we engage with people about the pandemic. And this is a role that science museums have played for a long time, and recognizing the value of cultural institutions like museums and libraries. The Communities for Immunity program was a federal government program that was a partnership between the CDC and the Institute for Museum and Library Services to really think about how do we really build the capacity for these cultural institutions to become a place where people can come for health and public health information?
And so the Communities for Immunity program was really an initiative that recognized that each one of these cultural institutions across the country has its own relationship with the places that they are. And so it was a great collective effort to take kind of the centralized information and disperse it to these organizations who could really tailor it and customize it to the particular audiences that they were reaching.
SARAH: Could you share some specific examples of what maybe you thought were some impactful efforts for public outreach?
JAYATRI: One of the things that we did in our project was to partner with the Philadelphia Department of Public Health. So at that time, as the project started, they were really going out to community block parties and gatherings. This was about a year, you know, once the vaccine was out, about a year, a year and a half into the pandemic. And what they recognized is that they had information, but it wasn't necessarily being presented in a way that was engaging and accessible in the environments where they were encountering people. So for instance, when you're at a block party to give somebody just an eight and a half by eleven sheet of paper that has some frequently asked questions in very scientific language, well, that's not really, interpreting the information in a way that fits the encounter.
And so we worked with them because at that point we were especially thinking about how to reach young adults as an under-vaccinated segment of the population. How do we create this information in simple language in a way that's designed to look like it's targeted to that population? And how do we fold it up in a form that, you know, somebody can get on the street and stick in their pocket instead of being an eight and a half by eleven sheet of paper that they don't know what to do with and they're just going to toss it at the next trash can. So, that sort of information design, bringing that to the actual information, that's really important in helping people digest information. So that was our project.
But there were other projects in rural areas. There were museums and libraries who had mobile vans that had vaccination clinics out in their communities. There were children's museums that designed some hands-on activities that could help kids feel comfortable getting vaccinated. So, we all really looked at our communities, looked at the partners we were working with in our communities and tried to design projects that met the needs of where we were.
SARAH: That’s great and I love speaking to how you start with the community, it's reminding me, Monica, of the listening sessions that you were hosting for us early on. I mean, any of the examples that Jayatri gave that you've seen as being impactful, either specifically with this initiative or with our other community partners?
MONICA: I think, for sure, meeting people where they were, where they are at that time, that moment in time. I think we were all trying to figure it out. You know, the one thing I think I appreciate as a public health nurse that I don't think many people did is that sometimes people won't come to your institution, or at least they won't think about your institution initially as a place for healthcare and for healthcare information. So being able to tie everything in, you know, all hands on deck. So, you know, working with Jayatri and the team, just thinking about how we get the information out using different props. We have a program I think I can share we're working on together for the Communities for Immunity with the school nurses. Because in that community, for sure, you know, the nurse is the authority on healthcare. And when COVID hit, those nurses were answering the questions for not only the families, but also the staff in the schools and trying to work within a district that was trying to develop a policy.
SARAH: These are moments when our producers will remind me that we have several episodes you could even listen to. Hearing from actually school nurses in that moment when this was all happening. Monica being one of them. And then even further into the pandemic. So yeah, definitely, were on the frontline in a lot of senses.
MONICA: The other thing though, I think what Jayatri and the team did at the Franklin Institute is that they also developed teaching modules that were in different languages. And that's so important. You know, not just the ones we think about, English, Spanish, French. But so many different ones and that's such a help, you know, when you're trying to meet the needs.
JAYATRI: And that was really something that we heard from the nurses that we were collaborating with. Again, knowing that we don't have a window into every community. We don't necessarily know what people need. It was by asking them and learning about the communities that they were working with. You know, at that point, we were able to come up with these resources and translate them into the languages that they need. And one of the things that we heard from them was that, especially in communities with a lot of immigrants, that a lot of the source of misinformation was because they didn't have access to high quality information in the languages that they were familiar with. And so, we were really glad that that was a resource that we could provide.
MONICA: So were we.
SARAH: Can you tell us about what NNCC is doing with the school nurses and the Franklin Institute?
MONICA: So NNCC has partnered with the Centers for Disease Control. We are working with nurses in the communities they serve to decrease vaccine hesitancy and increase confidence for those communities and for the nurses who are working with those communities. And so, we decided to partner with the Franklin Institute to deliver this information to school nurses because the CDC recognized that with the new authorization of the COVID vaccines that children, that population, would be the next to get vaccinated, so that five to 11 year-olds at that time. So, we partnered with the Franklin Institute to create education kits for school nurses with the School District of Philadelphia. I will tell you that project was so successful that the CDC said, well, who else can you expand with? And so, with two to five authorization at that time, we knew it was coming. We said, ‘Well, we need to work where two to five year-olds are. We also need to work with those nurses who work with them.’ So the Headstart programs. We also partnered with the Please Touch Museum as well early on. So we had story hour. It was a panel with myself, an author who wrote a book about her experience with her child.
And the book is called Mommy, Can I Sleep with You? The idea was that with COVID in the beginning, you didn't know, you had to be isolated at the time. And you know, children just didn't understand that. And then we had another community member, a child with special needs. And then trying to get him to work with the mask and why people are wearing masks. And if you can't see facial expressions, not knowing what people mean. So, it was all these different things we were able to talk about that helped these nurses and community members understand what's going on with COVID.
And so now with the two to five year-olds, you know, the nurses and Headstart programs, the teachers, nurses partnering with the programs as well. Because we recognize, and I think Jayatri talked about this, that children go home with the information they learn. And that's where some of our greatest public health challenges have been addressed. Whether it's recycling, you know, that started with children. You know, Mothers Against Drunk Driving. It was the mothers talking with the children, you know, about drug use, alcohol, you know, all of these things. The Great American Smokeout. It all started with children, and sometimes we say the children will lead them, you know, as well.
And you know, being able to see the world through their eyes and hear through their ears has meant so much with understanding what children need. Cause they'll tell, for sure.
JAYATRI: And I think it's a great partnership for us because when we're working with nurses, they already know the science. They're experts in the science. What we can give them is the strategies to be educators about science. Most often, nurses are working in the role of direct care. And so, they don't necessarily feel comfortable with the skillset of how do I deal with the whole classroom of kids at once or things like that. And we can give them those strategies, those tools, and really make it easy for them to be that educator in kids' lives and give them the toolkits, the communication strategies. How do you ask good questions? How do you let kids lead the conversation? These are things that we do every day on the museum floor that actually work really well when you're talking about health in any kind of a setting.
SARAH: Throughout this pandemic, we've been learning about how important it is to have that wide range of trusted messengers and messages that folks can understand. And that's been really just paramount in promoting vaccine confidence. Do you think that's a trend that we're going to see more of, you know, in healthcare at large? Monica, you want to take this one first?
MONICA: Absolutely. It's a trend that is long overdue. So I think, for sure, we will see this trend with these partnerships. You know, healthcare occurring in non-traditional spaces. These partnerships, I'm excited about this because I think museums, libraries, they're sources of information that community members trust. But health underlies everything we do. So it just makes sense.
SARAH: Jayatri?
JAYATRI: I would add that this idea of trusted messengers and communication is actually something that we've been thinking about in science communication much more broadly for a while now. Over the last 10 years, and I think particularly in thinking about climate communication, there's been a lot of research into thinking about strategies for effective communication that's been informed by the social sciences, from psychology and communications and economics, to think about how do you get through to people in a way that makes sense to them? And what are the factors that can help people change their minds about something? And the identity of who they are hearing that information from really matters because it has to be somebody that you identify with. So, that's something that has been in the science communication research for a long time.
And so I think that really informed the science communication approach to the pandemic. And I think it's here to stay for sure. You know, even from a bigger picture, more broadly I work in science education and when we think about how do you diversify what the face of science looks like in the future? The best way to do that is with role models. And so, not only is diversifying communication effective for getting messaging out, it's also effective for really showing the next generation of scientists about who's at the table.
SARAH: I love that. We think a lot about building the pipeline in nursing and certainly, you know, in all of the healthcare fields; all of the health fields, so important. Certainly, your partnership exemplifies this. But we've seen the pandemic has really required us to innovate and work with the unexpected partners. And, you know, expand into venues like museums, which, you know, from Jayatri’s perspective, of course is the norm. But you know, those of us in the nursing field, maybe that, that doesn't come to mind. To what extent do you think that those kinds of tactics are here to stay?
MONICA: Well, I think, being able to expose health profession students. That it's not work in silos. You know, that was always one of my biggest challenges. I think as a public health nurse, we always work with other professionals, paraprofessionals. In acute care, not so much. And it's sad to me, but I think, those are opportunities that my discipline, nursing, hasn't always explored. But public health nurses, we've always done that in our specialty, so.
JAYATRI: I think that public health is such a great collaboration for museums because we're not really in a place where we can respond to acute crises because we're just not equipped to have that level of responsiveness. And we found that out in our collaboration as well is that we couldn't keep up that daily dose of information, because we’re not a news service, right? We're not seeing people day to day. What we can do is tell the bigger story, and that's what public health is. It's that bigger story of how do we keep everybody healthy every day over the long term, sustainably? And so that type of education I think is a great space for museums to partner with.
SARAH: Yeah, absolutely. Sort of taking a pause here to zoom out. I think we're highlighting a lot of the successes, a lot of the wins. Probably worth noting, at least as we're talking now at the end of January 2023, the climate around COVID has shifted a little bit, right? So, you know, I definitely think, we're seeing that COVID fatigue. We're seeing that the risk remains heightened and especially in certain populations. So, wanted to hear from both of you, but Monica, you run a community wellness center, you know, what are you seeing? What are you hearing?
MONICA: I'm still seeing a lot of people now saying, ‘Why do I need to get a booster of the COVID vaccine?’ You've already given me how many immunization series for this. Why am I having to take more? And that's the conversations we were always having about the influenza vaccines and to some extent, pneumonia. I think the other piece, now we're kind of moving to a tripledemic, if you will. So not only are we seeing COVID, we're seeing RSV and we're also seeing influenza, an uptick in all three of those. In addition, Monkeypox. And so as a center director, I'm thinking, okay, how do I get this information out? How do I help community members make the best decisions for their health? But then also, I'm working with different generations at the same time, so how do we have this intergenerational care, education? Working with students from different disciplines, so how do I prepare them to get these skills, this education, but be able to apply it in their future careers?
Because the future is now. We're living it. But also working within an institution as well, right? So making sure that we continue community engagement. I'm fortunate I do work for a community engaged institution. You know, that is about social justice and anti-racism, which are huge to breaking down barriers with community members, particularly, with community and academic partnerships, which can be, I'll say a challenge. But also opportunities for greater healthcare outcomes.
SARAH: And Jayatri, tell us where’s the museum now? You know, in terms of COVID protocols? Are mask requirements still in place? I mean, how does it look from your perspective?
JAYATRI: So we always take our guidance from whatever the public health guidance in Philadelphia is. So, we do not have mask requirements right now. You know, we have certainly continued our messaging around the importance of vaccination, especially through this kind of programming that we're working on with Monica and the National Nurse Led Care Consortium team. But our day to day is much less focused on the pandemic. And that's partly because, you know, of course, COVID fatigue is real. And people see the museum as a place to find joy. And we want to be that place for them in, you know, coming out of this really hard time. So, we've really focused on thinking about how do we make sure that our spaces are well ventilated? Some of the kind of behind-the-scenes ways that we can minimize risk to people, and we think that's been effective. But interestingly, what we're also seeing now is that people are looking to us to help them understand some of the long-term effects of the pandemic, particularly around mental health. So we're about to start working on a new exhibit around the human body and we just finished up doing focus groups with six groups of middle school and high school kids.
And the number one topic that came out of all of them was mental health. Because they've really been through a hard time, and I think that's changed the conversation around mental health and they're looking for ways to understand that. So that's, I think, a new piece of the conversation that we are really learning about and thinking about how do all of these pieces tie together? From the effects of the pandemic to the impact of that on these kids as they grow older.
SARAH: And so where do you see the path forward? I mean, how do we go forward with vaccine confidence? What do we even tell people about, you know, getting boosters? How do we focus? Where do we prioritize?
MONICA: I think for me, what I've seen is, from community members is this appreciation for just solid information. You know, down to how does the body develop its own immune senses and that understanding of science, but also how vaccines are developed. You know, how they come to market. And then also how is this a part of preventative health? Because I tell community members often you don't see certain diseases anymore because we have a vaccine for it. We have a vaccine for that, right. So, you know, I also talk about what those diseases look like. So Polio and you know, different ones and, you know they appreciate that understanding a bit more in plain language.
JAYATRI: I think that's absolutely right. I mean, that's one of the things that we've seen through our children's vaccine education project with the nurses is, you know, we're very open in giving nurses the resources to share with families. That when they're doing these programs about vaccines in school, it's really just sharing about the science of the vaccine and what we hear from the nurses is that that kind of information first approach opens a door to a lot of conversations. And I think the other thing that we've learned that really resonates with how we do things in museums is that I think we have to continue to just think about how that messaging about vaccination and preventative healthcare and really just caring for each other is in a way embedded into a lot of different things we do, rather than just being kind of like one message that we're beating people over the head with, because there's no one thing that is necessarily going to change someone's mind. It's exposure to that message in different places from different people. And how can we be creative in giving people organic spaces to kind of think about it and counter it. Maybe think about it some more. Go look something up and, and make that journey on their own.
SARAH: Thank you both so much. I mean, I think, I have to actually just say that even hearing the energy here, because I know that, you know, many of the people that we've been talking to, even in this sort of mini-series, you know, you've been there, you've been doing this work for the last couple of years. And so, just thank you for continuing to bring that energy and creativity and solutions focus. I'd love to just hear, you know, any final thoughts that you would want to leave our listeners with as we wrap up today.
JAYATRI: I'll say that I think one of the things that I have loved, particularly, working with school and community nurses who work with kids is hearing from them how much kids can advocate for their own health. And then taking that message home to their families. That's been really inspiring to me because we work with kids all the time, but before this, we hadn't really thought about how do we empower kids to go through that decision making process about themselves. And so that's, it makes me think back to, you know, when I was a kid, I remember my older sister coming home with information about the Great American Smokeout and that kind of public health campaign that really embraces kids as messengers of health. And I feel like that's another opportunity that we're really leaning into right now.
MONICA: I think for me, I just appreciate the collaboration and how it just jumpstarts so many other avenues for care, and for community engagement. You know, all of the things that we need to do. I also appreciate just the different perspectives. I think of Jayatri and the other scientists, too. What they bring to the table in terms of education and how I can use that information and translate it so that it makes sense for community members. Right now, I'm preparing for story hour with some two to five year-olds. So I'm nervous.
JAYATRI: It’s going to be great!
MONICA: Thank you. I need all that positive energy. But I think, you know, what the team has provided me with is you know, how do you teach this lesson? How do you keep the attention of children? But then also, how can I make it so that it's at a level that they would understand and they can take home to their families, too. So, it's just exciting, those kind of partnerships because, without any one part, this wouldn't work. And so that's what I hope to see more of for the future. And I would like to leave, if organizations are thinking of doing this or not, they should be. And then also that we need to get some funders as well, to continue this work because sometimes it's rough, but we make it happen with the resources that we do have. But overall, it's been an exciting ride.
SARAH: Well, whoever's listening, you heard her. It’s great work.
Thank you again both so much for making time to join us on At the Core of Care.
MONICA: Thank you.
JAYATRI: Thanks so much for having these conversations.
MONICA: Absolutely.
CREDITS
SARAH: Our special Vaccine Confidence series was funded in part by a cooperative agreement with the Centers for Disease Control and Prevention or CDC. The CDC is an agency within the Department of Health and Human Services also known as HHS. The contents of this resource do not necessarily represent the policy of CDC or HHS, and should not be considered an endorsement by the Federal Government.
Stay tuned for more episodes in our vaccine confidence series. We’ll continue talking to health care professionals and frontline workers who are promoting vaccine confidence and addressing ongoing issues.
You can find our most current and past episodes of At the Core of Care wherever you get your podcasts or at paactioncoalition.org.
And for more information about related upcoming webinars, COVID-19 resources, and upcoming trainings for nurses to obtain continuing education credits, log on to nurseledcare.org
You can also stay up to date with us on social media by following @NurseLedCare.
At the Core of Care is produced by Stephanie Marudas of Kouvenda Media and mixed by Brad Linder.
I’m Sarah Hexem Hubbard of the Pennsylvania Action Coalition.
Thanks for joining us.
