inclusion – GW Nursing Magazine

November 1, 2021November 10, 2021

Amid Pandemic, Working to Address Health Disparities and Vaccine Hesitancy in Washington, D.C.

For the past few years, GW Nursing Assistant Professor Erin Athey, D.N.P., FNP-BC, RN, FAANP has been working with United Medical Center (UMC) in Washington, D.C., running its mobile clinic program. Before COVID-19 struck, she partnered with the District of Columbia Housing Authority to provide primary and preventative care to people in Wards 7 and 8 public housing. The UMC mobile vans, out of which she operates the clinic, help to address health disparities and improve access to health care for the most underserved populations in D.C. These clinics also provide a unique and vital opportunity for GW Nursing students to get clinical hours and serve these communities.

COVID-19-era work

Once the COVID-19 pandemic hit in early 2020, the mobile clinic program received federal funds through the Coronavirus Aid, Relief, and Economic Security (CARES) Act to support its ongoing work and to equip it for the new challenges posed by COVID-19. By July 2020, the mobile clinic was going into the community two to three days each week. Dr. Athey and her students conducted extensive PCR COVID-19 testing during the summer and fall of 2020 while continuing to provide care such as HIV testing, general health care screenings, and referrals.

Beginning in 2021, once the COVID-19 vaccines received emergency use authorization, Dr. Athey used the vans as vaccination clinics, going to family properties throughout Wards 7 and 8. As was the case throughout much of the country, there was initially a huge demand for the vaccine, but in summer 2021, Dr. Athey and her team began to encounter fewer people willing to take the jab and more resistance to vaccination. This phenomenon is known as vaccine hesitancy.

According to Dr. Athey, the two main issues now leading to vaccine hesitancy and low vaccine uptake are access and trust. She said that even the complicated issue of misinformation can be broken down into having access to the facts and trusting the source enough to believe them. Overall, access issues can be greatly mitigated with the mobile clinic, which takes the shot directly to the people who might not have the time or means to get to the pharmacy. Trust, however, takes time to build. The strategy of the clinicians and students running the mobile van: Make connections, bring the facts, keep showing up. Dr. Athey said, “I do feel like it matters to go out, to show up… It’s not overnight that it’ll get fixed, but being there continuously over time makes a difference.”

Wards 7 and 8 have the lowest vaccine uptake of all of D.C., and given that these are primarily Black communities, this is a matter of health and racial equity. In D.C., Black people make up 56 percent of COVID-19 cases, 71 percent of deaths, and 46 percent of the total population, but they have received only 43 percent of vaccinations.ⁱ Continued vaccination efforts like those of the mobile clinic are crucial.

One unique way that Dr. Athey and her team have sought to reach new populations with the COVID-19 vaccine in recent months was the Beat the Streets program, a community outreach event in which they partnered with the Metropolitan Police Department. Outreach events like this allow Dr. Athey, the students, and other clinicians to talk to people in their own communities and help inspire confidence in vaccine safety, an approach that has been most successful with people who are still on the fence about the vaccine. With those who are firmly opposed to the vaccine, talking about its merits often has limitations. However, as vaccine mandates become more and more common among various employers—including the D.C. police, health care institutions, federal government, and many private businesses—there has been an influx of vaccine acceptance. Tapping into this, Dr. Athey and the mobile clinic team recently held a clinic downtown for restaurant employees as new mandates went into effect for their places of work.

The future of the clinic

The mobile clinic will continue to operate throughout the pandemic, providing testing and vaccinations, and building trust with the community. Dr. Athey hopes that the program will continue to grow. She is looking for grants, donors, and foundations to help fund the clinic’s care of the underserved communities in D.C. Furthermore, although UMC has not previously seen children, Dr. Athey is hopeful that the clinic can soon expand its services to include wellness exams, prevention, and vaccinations for kids. She also would like to expand the partnership with the D.C. Housing Authority and begin creating place-based clinics at some of the public housing properties. This would follow the cost-saving “minute clinic” model, utilizing nurse practitioners, nursing students, and resident navigators to continue to build trust and provide access to care.

GW Nursing is proud to be in partnership with Dr. Athey, UMC, the D.C. Housing Authority, and so many others who are working to advance health equity in our community. It is important for nurses and our GW Nursing community to be innovative and committed to equity, continuing to create new models of health care that build trust and increase engagement with disenfranchised communities. The mobile clinic is just one such model. As the most trusted health care professionals, nurses are in a unique position to lead this movement. Dream big and take action!

i. Nambi Ndugga, Latoya Hill, and Samantha Artiga. Latest Data on COVID-19 Vaccinations by Race/Ethnicity. September 2021. https://www.kff.org/coronavirus-covid-19/issue-brief/latest-data-on-covid-19-vaccinations-race-ethnicity/

AUTHOR Meredith Lidard Kleeman

November 1, 2021November 10, 2021

Student nurses seek systemic change, form Antiracism Nursing Students Alliance

chalkboard with word racism being erased

There is no neutral space between racism and antiracism, according to Ibram X. Kendi, a history professor at Boston University and author of “How to Be an Antiracist” (2019). One is either racist and endorses the idea of racial hierarchy, or one is antiracist and endorses racial equality.

Racism is a public health issue, and a dedicated group of GW Nursing students wants to address and resolve the racism that exists in health care institutions through the formation of a new student group, the Antiracism Nursing Students Alliance (ANSA).

While health care providers, educators, and researchers have focused on reducing health disparities for many years, a primary driver of those disparities—structural racism—has been absent from the conversation.

Last fall, Lynette Flaherty Glover, BSN ’22, and Madison Upshaw, BSN ’21, approached Sandra Davis, Ph.D., DPM, ACNP-BC, GW Nursing’s former assistant dean for diversity, equity, and inclusion, with their idea to form a student group. They had already been involved in the White Coats for Black Lives student organization at GW School of Medicine and Health Sciences, but wanted a group that focused on the nursing school.

Dr. Davis put the two in touch with other advocacy-minded students, and the group officially launched last December. “We all came with our ideas of things we want to change in the nursing program and in general to raise awareness of racism in health care,” Mrs. Glover says. “How can we educate the future health care workers on solutions to what they can do to help be an ally?”

“How can we educate the future health care workers on solutions to what they can do to help be an ally?”

– Lynette Flaherty Glover, BSN ’22

The group developed plans to host a speaker series to address historical racism in health care and encourage meaningful discussions. They welcomed two GW faculty members to speak in the spring semester. Nemata Blyden, Ph.D., a professor in the GW Department of History, presented the inaugural lecture in January, celebrating the life and legacy of Dr. Martin Luther King, Jr. Sherrie Wallington, Ph.D., an assistant professor and health disparities researcher at GW Nursing, discussed her research findings on the social determinants of health and health disparities.

Several of the ANSA founding members have experienced racism because of their ethnicity, while others were recently drawn to advocacy work after the high profile Black Lives Matter protests of 2020. Billy Baron, BSN ’21, admits to having grown up in “a bubble under a rock,” but was deeply affected by the protests after police officers killed George Floyd. “I lived four blocks from the Capitol building when a lot of the riots happened,” Mr. Baron recalls. “I felt very paralyzed, I couldn’t think, I just laid in bed, I didn’t know what was happening to me.”

“I spent the first sessions listening, but near the end of the sessions I was a main speaker, talking and challenging a lot of the faculty members with questions.”

– Billy Baron, BSN ’21

In-person instruction and clinical rotations were canceled due to COVID-19, and Mr. Baron was worried about how his mental health would affect his class work. After confiding in Dr. Davis about his concerns, she invited him to participate in Continuing the Conversation, a series of open forums that took place virtually at the school throughout the summer. “I went to every single one,” Mr. Baron says. “I spent the first sessions listening, but near the end of the sessions I was a main speaker, talking and challenging a lot of the faculty members with questions.”

Mr. Baron channeled his new passion for antiracism and social justice into shaping the goals of ANSA. Fellow founding member Kimberley Hollingsworth, BSN ’21, believes that GW Nursing students want to understand racial biases, and a major goal of ANSA is to shed light on the issue and get more people involved.

“A lot of staff and faculty aren’t very aware of the racial biases that a lot of these [minority] students go through,” Mrs. Hollingsworth says. As an Afro-Latina, she experienced racism in her own work as a patient care technician, phlebotomist, and testing site coordinator. “Based on the color of my skin and being a woman, of course there’s a lot of racism,” Mrs. Hollingsworth says. “I was passed over for promotions just because—there wasn’t a valid reason given. But I see my white counterparts who haven’t had nearly the same [work] experience get moved on.”

Mrs. Hollingsworth has witnessed similar situations in the classroom setting. “I have seen white [students] get graded differently or have certain opportunities that were not awarded to minority students,” she adds. “Everyone should be treated fairly all across the board. I feel as minorities we have to work twice as hard just to succeed.”

Exhorting the school to acknowledge the racism that its own students experience was a driving force behind the interest of Mimi Bui, BSN ’21, in the group. “The nursing school needs to be much more cognizant of the challenges that their nonwhite students face every day—financial challenges, language barriers, all that kind of stuff,” Ms. Bui says.

“The nursing school needs to be much more cognizant of the challenges that their non-white students face every day—financial challenges, language barriers, all that kind of stuff.”

– Mimi Bui, BSN ’21

Addressing systemic racism at large educational institutions can be fraught. Even acknowledging racism as a cause of health disparities has not been widely embraced. When Mrs. Glover was pursuing her associate’s degree at a community college, she was dismayed when her nursing instructors discussed the various chronic conditions from which Black females are at a higher risk of dying. “They never talked about why—in some ways, it was kind of brushed off,” she recalls.

Mrs. Glover is pursuing a nursing degree because she felt discriminated against as a Black female patient. “I wanted to be part of the change I wanted to see in the world,” she explains.

In addition to the challenge of dismantling systemic racism, the students of ANSA struggle with simply finding the capacity to devote to the group on top of their coursework and personal obligations. The Accelerated B.S.N. program spans just 15 months, a short amount of time to meaningfully engage in an extracurricular organization.

The founding members are working with GW Nursing faculty and staff to help advance ANSA’s mission as students cycle in and out of the school. “Having people like myself and others on this board who can actually speak up about [antiracism], and be able to go out there and advocate, that’s what I hope GW Nursing will continue when I leave the school,” Ms. Hollingsworth says.

Founding Members

Watch video introductions directly from ANSA’s founding members to learn why they’re part of the Alliance.

Contact ANSA

Students interested in ANSA can email gwsonansa@gmail.com to learn about upcoming meetings and events

AUTHOR Meredith Lidard Kleeman

October 7, 2020June 9, 2021

GW Nursing is ‘Continuing the Conversation’ about structural racism in America

With COVID-19 as the backdrop for the world, the tragic murder of George Floyd and the killings of Breonna Taylor and Ahmaud Arbery brought to the forefront, once again, the issues of race, racism, and police brutality that have existed in America for decades in their modern forms. As a school of nursing, our hearts were heavy. We were outraged and dismayed. Some of us were tired and weary. The dean of GW Nursing, Dr. Pamela Jeffries and Dr. Sandra Davis, the school’s assistant dean for Diversity, Equity, and Inclusion, believed it was necessary to provide for the GW Nursing community time and a safe space to talk, share and listen, and to process systemic racism.

On June 2 and June 4, GW Nursing held a faculty and staff town hall and a student forum and wellness session. These sessions were moderated by Dr. Davis and invited panelists: Dr. Grace Henry, director of the School of Medicine and Health Sciences Office of Diversity and Inclusion; Natasha Kazeem, executive associate dean, Operations and Chair, Diversity and Inclusion Task Force Milken Institute School of Public Health; Jonathan M. Walker, assistant dean, Student Services, Diversity and Inclusion Elliott School of International Affairs and Kylie R. Stamm, diversity program manager, Elliott School of International Affairs.

The feedback from these meetings demonstrated the desire of students, faculty, and staff to learn more and do more to eliminate systemic racism in America. Accelerated Bachelor of Science in Nursing student Katherine Liwanag reached out to Dr. Davis to ask for more sessions. Ms. Liwanag said, “The insight, the pain, the hope, were all honest opinions and feelings that needed to be heard.” Mary Pearce, director of student services, asked what more we could do as a school. Continuing the Conversation was the direct result of faculty, staff and students wanting a safe space to address systemic racism in America. Dr. Davis said, “Race and racism have always been such taboo subjects. Through Continuing the Conversation, we are making the uncomfortable comfortable.” To make progress toward dismantling systemic racism, we need to first be able to talk to each other.

The feedback from the series has been encouraging, inspiring, hopeful and positive. Attendees have expressed appreciation and gratitude for the series. Attendees share books, movies, videos and webinars. They are reading, learning and sharing knowledge and resources with family and friends. They engage in ongoing learning and self-reflection after the sessions.

Accelerated Bachelor of Science in Nursing student Billy Baron has not missed a session in 12 weeks. He said he has grown tremendously, both personally and professionally. The sessions have empowered him to engage and feel comfortable in conversations about race.

Mary Pearce and Dr. Davis knew early on from positive responses that the series would not stop at the end of the fall semester. The respect and trust built among the attendees are a testament to a commitment to work for change at all levels of society. The next phase of the Continuing the Conversation series will be Unfinished Conversations, because we can never stop.

The impact of the series is already evident. What we have accomplished among a diverse and inclusive group of faculty, staff and students over 12 weeks is extraordinary. Change is occurring. Faculty are making adjustments to their pedagogy and courses. Faculty, staff and students are more cognizant of the ways that systemic racism operates on a daily basis. They are finding their voice to question and challenge policies, practices, attitudes and actions that once went unnoticed or were accepted as “just the way things are.” Attendees want to be a part of the solution and we’re equipping them with the tools to do so.

May 11, 2019October 12, 2020

Celebrating Diversity Efforts, HEED Award

Dean Jeffries speaking with GW Nursing leaders and grad students at Innovation Hall

Members of the GW Nursing community, university leaders and local leaders gathered in February in Innovation Hall on the Virginia Science and Technology Campus to formally recognize the school’s Health Professions Higher Education Excellence in Diversity (HEED) award from INSIGHT Into Diversity magazine. Dean Pamela Jeffries unveiled the school’s message of diversity and inclusion, and BSN students presented posters about the social determinants of health.

As a recipient of the annual Health Professions HEED Award — given to health schools and centers that demonstrate an outstanding commitment to diversity and inclusion — GW Nursing was featured in the December 2018 issue of INSIGHT Into Diversity magazine.

“Diversity plays an important role in the classroom, health workforce and society,” said Dean Jeffries. “It is an honor to be recognized with the HEED award as diversity initiatives are a strategic priority for GW Nursing.”

INSIGHT Into Diversity magazine selected GW Nursing for a number of factors, including:

Community Outreach

In collaboration with the Rodham Institute, Drs. Sandra Davis and Arlene Pericak created The Health and Community Engaged Passport — an interprofessional approach to teaching nurse practitioner students about the social determinants of health.

Innovative Diversity Education

Macy Faculty Scholar Dr. Ashley Darcy-Mahoney developed and launched “Pediatric Adversity and Early Childhood Development and Health,” a course for nursing and medical students to learn about social factors that shape health.

Health and Wellness

Through the school’s Well-Being Experience, a series of eight sessions, students develop the knowledge and skills to cope with stress and adversity in healthy, proactive ways. GW Nursing aims to educate a generation of nurses who can manage the stress and challenges of an ever-changing health care environment.

May 11, 2019October 12, 2020

Teaching Healthy Living to Middle Schoolers

Delivering high-quality health care requires knowing more than a patient’s blood pressure, heart rate and weight. Patients are more than these numbers; where they live, what they eat, whether they exercise also play a role in their health. GW Nursing’s Bachelor of Science in Nursing (BSN) students are learning this crucial lesson through a participatory action research project conducted in partnership with the AnBryce Foundation.

“During this project, our nursing students, along with the middle school students whom they taught, learned the importance of social determinants of health and how they can facilitate or impede the making of a heart-healthy community,” said Sandra Davis, the school’s assistant dean for diversity, equity and inclusion, and principal investigator on
this project funded by the NPHF/Astellas Foundation.

This project made such an impact on its community that it was on display in an exhibit at the Smithsonian’s National Museum of African American History and Culture through May 2019.

The middle schoolers learned by completing a PhotoVoice project in which they explored and documented their surroundings by taking photos, writing commentary on what was unhealthy and noting how their environment could be made healthier.

“Children get used to what they see at home,” said Iris Fountain, a parent who attended the Saturday Institute PhotoVoice Exhibit held at Thurgood Marshall Academy Public Charter High School in December. Ms. Fountain pointed out that neighborhoods in the D.C. area can have as many as three liquor stores on one block that open as early as 6 a.m. “If I notice, children notice it,” she said.

Indeed, one student wrote about the prevalence of alcohol.

“The picture on the left shows people drinking liquor and throwing it away in the streets. This shows that there are drunk people who hang out in the community, and that it is full of bottles of liquor,” one student wrote. “The photo can educate people in my community by showing what most people are hooked on, and telling them to cut down the amount of liquor they consume. The picture on the right is an example of how to improve the community. For every one liquor store you have there should be one organic store too.”

Through this project, area middle schoolers learned not only how to take care of themselves, but also how to advocate for and in their communities. GW Nursing BSN students guided the middle school students under instruction by Dr. Davis and her co-principal investigators, Assistant Professors Karen Dawn and Adriana Glenn, as part of the BSN program’s community health portion.

Social and environmental factors—such as education, housing, places to exercise and healthy places to eat—all matter when it comes to heart disease and risk factors for heart disease. Underrepresented groups, especially African Americans, suffer a disproportionate risk factor burden for heart disease. In addition to being one of the poorest cities in the United States, D.C. has one of the highest avoidable death rates from heart disease of all major U.S. cities.

Earlier this month, Ms. Fountain’s son wrote Maryland Gov. Larry Hogan encouraging him to create more community gardens in public areas. This was the Fountains’ first activity with GW Nursing and the AnBryce Foundation, but it will not be the son’s last as he hopes to attend Camp Dogwood, where BSN students provide first aid to campers, later this summer.

by ERIN JULIUS