Tag Archives: diversity in nursing

Nurses Know Bullying When They See It

The words in blue or underlined are hyperlinks, click on them and you will enjoy what you find. Also, please send this to ten other nurses, share as widely as you can!

Executive summary: This week we were treated to a display of bullying.

Bullying is defined as:

Bullying is the use of force or coercion to abuse or intimidate others. The behavior can be habitual and involve an imbalance of social or physical power. It can include verbal harassment or threat, physical assault or coercion and may be directed repeatedly towards particular victims, perhaps on grounds of race, religion, gender, sexuality, or ability.[2][3] The victim of bullying is sometimes referred to as a “target”.

Bullying is an issue in the nursing workplace.

yes, this is a shocking cartoon, but it indicates the degree to which the conservative movement, also known as the “Religious Right” disrespects persons of color. Every nurses needs to stand up for the dignity of persons, and to teach their children accordingly. If Romney gets elected President, America will be a meaner, tougher place.  That is not what I want. How about you?

Every nurse has experienced bullying in one form or another.  All you need to do is Google the term Nurse Bullying, and you will see that this has been a hot topic in 2012. It’s a hallmark of dysfunctional workplace culture, and I have written about it here.

Bullying and Big Bird

something that has totally shocked Wednesday was the casual reference made by Mitt Romney about firing Big Bird.  He made a joke out of it, but nurses should make no mistake: there is an agenda here at work. If you don’t believe me, watch this YouTube. In it, there is a guy who says that Elmo and Sesame Street are promoting a “gay agenda.”  ( this is astounding to me!). The guys in the YouTube video are against everything we teach to promote healthy growth and development among children.  Contrast the twit who wrote that book with Mister Rogers when he testified in front of congress.

From http://www.salon.com/2012/10/04/you_do_not_mess_with_big_bird/

What Romney, in his adorably out-of-touch way, failed to grasp with that statement is that practically every American under the age of 50 has a powerful childhood association with that goofy oversize lug. An entire generation can trace its first understanding of death to the moment that Big Bird let it sink in that “Mr. Hooper’s not coming back.” And another generation learned about loss and community and resilience after 9/11 when “Sesame Street” had Big Bird’s own nest destroyed in a storm. (The show aired Big Bird’s odyssey again after Katrina.) And I defy even a robotic millionaire to get through Big Bird’s choked-up rendition of “It’s Not Easy Being Green” at Jim Henson’s memorial service and not completely lose it when he says, “Thank you, Kermit.” […]

[D]espite coming out of the evening looking stronger than he has in weeks — Romney made the error of looking like a man who is not on the side of innocence, whimsy, learning or childhood. Nor did he seem to grasp that Big Bird is an integral part of a show that was created for and remains at its core about community and diversity, one that has for decades been an essential tool in helping low-income children prepare for school. Going after Big Bird is like putting down baseball and rainbows and YouTube videos of otter pups. You just don’t.

Primetime Propaganda

In 2011 I was in Nepal, so I missed the shooting star of a book titled “Primetime Propaganda”  (as an aside, it’s currently ranked a lot lower than my book; and also, you can buy used copies on Amazon for 81 cents).  The real reason Romney wants to defund PBS and Sesame Street has nothing to do with funding; it has everything to do with a backlash against teaching such things as tolerance, anti-bullying, respect, and dignity.

Personal story

Big Bird was originally designed to be the awkward teenager in all of us. He still is. Romney is not joking when he says he wants to fire Big Bird. Let’s stop this twisted agenda.

When my kids were little, we lived on an old run-down farm with eighty acres of land in rural Maine, down a gravel (i.e., unpaved) road. There were no other pre-school aged children within a mile. The only way they could play with other kids was to be driven somewhere else.  Maine Public Broadcasting  had Mister Rogers and Sesame Street on in the afternoons, right around the time we made dinner every day.  My wife and I grew up near Boston, in a diverse environment, going to public schools that were multiracial and playing on multiracial sports teams, and I wanted to make sure my kids kept the same outlook.  Sesame Street was one vehicle to promote that. Word is, cutting the PBS funding from Congress mainly will affect TV stations in rural areas.

Re-elect President Obama.

There are stories that Mitt Romney has been a bully all his life. He does not have a clue what it is like to be the victim of bullying. Romney does not know that the President is supposed to stand up for all Americans, not just the 1%. We need a grown up in the White House who knows what daily life is like for many of our citizens. That’s one more reason nurses need to vote for Obama.

and a suggestion:

If Mr. Obama wins re-election, I think that the Inauguration should include a guest appearance by Kermit the Frog. Singing his big break-out hit song. (from 1969???)

It’s Not Easy Being Green

Greetings, Kermit the Frog here And today I’d like to tell you a little bit about the color green Do you know what’s green Well I am for one thing You see frogs are green, and I’m a frog And that means that I’m green, you see

It’s not that easy being green Having to spend each day the color of the leaves When I think it could be nicer being red, or yellow, or gold Or something much more colorful like that

It’s not easy being green It seems you blend in with so many other ordinary things And people tend to pass you over ‘Cause you’re not standing out Like flashy sparkles in the water Or stars in the sky

But green’s the color of spring And green can be cool and friendly-like And green can be big like a mountain Or important like a river Or tall like a tree

When green is all there is to be It could make you wonder why But why wonder why wonder I am green, and it’ll do fine It’s beautiful, and I think it’s what I want to be

This is the message I want every kid in America, to hear.

For more background, go to this excellent blog.

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The Ultimate Multicultural icebreaker for nursing

Update August 17, 2015. This blog entry has had 1985 views. If you used this after finding it here, please post a comment to let us know how it went. inquiring minds want to know!

also: I have worked in many settings where I was the only outsider and there was a distinct cultural identity of the group, including trips to Nepal to teach nursing to batches of Nepali nursing students. To read about that experience go to Amazon and buy The Hospital at the End of the World, (my first book), or else buy one of my books. Browse my blogroll.

Honolulu Hawaii is the most minority-majority city in the US. Our classrooms in Honolulu reflect this.  You would think that inclusiveness and respect for multiculturalism is ingrained, but it is not… Even here, there is no guarantee that the subgroups within a class or cohort will mix unless we actively promote the idea. Frankly, we always have a subgroup of European descended students from Da Mainland, who start off by sticking to themselves. They need to get hip in a hurry. My goal has always been to prevent any group from forming cliques that don’t mix with the other subgroups. I’m pleased to report that by the end of the time here, these students have become culturally sophisticated. That’s what you want for a nurse!

And of course in nursing, you need to be comfortable with care delivery across a wide variety of ethnic and cultural backgrounds. It is not unusual for me to have a clinical group in which there are no “Howlies” or be caring for a patient group in which everybody is from one Asian culture or another. It’ s something I love about Hawaii.

What is an icebreaker?

It’s an exercise used when a group is forming their identity, designed to get them members to mingle and learn about people in the group they might otherwise not interact with. We do this particular icebreaker on Day One of nursing school.

Disclaimer: this one is best when there is a high number of English-as-Second-Language students in the group.

How I came up with this: it is probably not new to me. The first time I ever used it was in Maine. At a nursing school there, the population of faculty and students was mostly Mainers; but we also had a dozen or so RN-to-BSN students who were Korean nationals with limited English skills. They  did not mix and it was painful to watch. So we organized a “tea.” At the tea, the Americans sat on one side and the Koreans on the other, each uncomfortable as to how to get started.

It was like a Junior High Dance, all over again…..then…. I did this icebreaker. Magic happens.

Instructions

everyone  stands up and stretches.

then, those who only speak English are told to sit down.

Announce: “one of the great things about nursing is the opportunity to meet people from different cultures and to learn from each other. I love the idea of feeling at home no matter where you may be in the world”

“if you only speak English, you are at a cultural disadvantage, and we need to address that. Those who speak more than one language are waaaaay ahead of you.” ( usually people are surprised by this)

The multilingual persons are then dispersed around the room. The English-only students grab a pen and scrap paper, and divide up in to small groups, each led by one of the multi-lingual students. In Hawaii we usually have students that speak: Hawaiian, Ilokano, Tagalog, Mandarin, Cantonese, Japanese, Korean, Vietnamese, Samoan, and Thai. We also get a smattering of European languages as well. The more languages, the better this one works. One of the memorable ones was from South Africa who taught us something in Zulu. wicked cool!

Next, each group has five minutes in which the leader teaches a phrase in their language, to the English-only students. chosen by the multilingual person. doesn’t need to be long.

then the large group reconvenes and each group recites. we go around the room.

During the recitation, I am usually pretty theatrical, seeking ways to get the larger group engaged. I use all the skills I perfected back along when I was the front man for a polka band that played a lot of wedding receptions.

serendipity happens:

one time a German-speaker taught a beer-drinking song. I got the entire group to stand and wave their arm to-and-fro as if hoisting a mug.

a male  Ilokano-speaking student recited a love poem in Ilokano – the class was in stitches

we teach people the proper way to bow when with a Japanese person.

We teach about eye contact in Asian Cultures, using a specific game. students pair off, holding hands. if one of the pair looks away, smiles, or laughs, they must sit down. I once did this with Japanese students and they all sat down within five seconds; an American pair can last for two minutes.

If somebody writes using a foreign alphabet ( such as Japanese or Chinese) we ask them to write it on the board and everyone copies it.

We had a student who was fluent in signing for the deaf and taught the gestures to accompany the chosen phrase.

we did once get an Aussie student who taught some Aussie slang ( sort of cheating but it was funny).

There are an infinite number of variations. there are a million ways to use this; With an Italian speaker, for example, you can include hand gestures.

Success depends on the verbal quickness and eclecticism of the moderator. You can convey a sense of inclusion and fun.

Evaluations for this have been overwhelmingly positive, esp from among our English-as-a-Second-Language students. often, these persons get socially isolated due to language insecurity. Weeks or months later, some of these persons will take me aside and thank me for helping them by doing this.

in Maine? back to the original group in Maine – the Koreans and the Mainers.

All the Americans learned a phrase in Korean and found a way to remember the Koreans as people, not simply “Koreans.” I was instantly famous.

Here is a video of an icebreaker that was a dismal failure.

On the evaluations, I did have a person write “I have always disliked forced socialization exercises” – I think it was from a European-descended individual from a very reserved culture. There is always somebody at the back of the classroom who displays the haughty ennui of having done this too many times. Cut them some slack. You can’t please everybody, and obviously, the exercise was not designed for her.

This is my gift to you

Nowadays nursing schools everywhere are more likely to have students from diverse backgrounds that are breathtakingly representative of the whole world. If you teach in a multicultural classroom, you are invited to use this icebreaker. let me know how it works for you!

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part one: Guide to Hawaiian culture for the Travelling Nurse

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Exotic Hawaii?

I have a friend from the mainland who thinks Hawaii is really really exotic. and I suppose, compared to Indiana, it is. Then again, Indiana would be considered exotic in its own way if an anthropologist from some other country were to visit there. For me, having lived in Nepal, the answer would be – no. Pretty bland compared to Patan. We wonder why people think Americans ( the WASP kind) are arrogant? it’s because they(we?)  assume that the yardstick culture, the frame of reference by which everything is to be judged, is the one “they” grew up in. (whoever they may be….)  There’s a great poster from Syracuse Cultural Workers that applies, here.

Images from TV

Ask yourself what your image of Hawaii is. Chances are it’s from television.  Or maybe the movies. The Chamber of Commerce here is alway thinking of ways to promote Hawaii on the mainland. It’s no accident that the Pro Bowl is played here. (In January when everyone else is freezing.) What is Hawaii like from the inside?

For Travelling Nurses

Anyway, there has always been a subculture within nursing, of Travellers. Nurses with specialized skills who come to Hawaii for an exotic experience.  Now that I have been here seven years, I feel comfortable enough to compile a quick guide to cross-cultural nursing as applied to Hawaii. Particularly Honolulu.  Every nurse that goes to nursing school here already has learned these things.

The first question is, How did everyone get here? Honolulu is the most “majority-minority” city in the USA, the only state where European descendants have never been in the majority. You expect to find Hawaiians here, and 40% of all Hawaiians in the world, live on Oahu, as is fitting. but they are now a minority.

Yes, this is an issue.

Resources

IMHO, the best book on Hawaiian culture is Peoples and Cultures of Hawaii, written by two guys from the John A Burns School of Medicine. UPDATE: I am pleased to report that a new edition of this was released in 2011 –  There is only one review of the 1980 edition written on Amazon, but I think that reviewer knew what he was talking about,  it is incredibly insightful. The book is a classic, I will run down to the store and get the new one!

From a sociological or anthropological perspective, nurses absolutely need to learn about and respect the culture of which ever person they are caring for.  Frankly, that has always been something I loved about nursing. The variety of manifestations of the human spirit is what makes earth a great place.

Most nursing school nowadays require students to buy and use a reference book on this topic. Many of these books have a section on Hawaiian culture.  And also about Nisei, and about Pacific Islanders and Samoans.  All well and good. There is a gap in the professional literature. When we assign students to ask about the culture of a given client, they sometimes come back and say

“Well, he said he is part Pordagee, Hawaiian, Chinese, Filipino and Swedish. What do I put down on the assessment form? do I have to look up all of them?”

“Nah, just put down ‘local’

Local?

So then the question becomes, “Is there a distinct culture known as ‘Local’ around here, and if so, what is it?”

It’s a chapter waiting to be written in the edition of all those cultural atlases. Take note: whoever wishes to tackle this can become famous in a scholarly way. I do have to warn you: this is a minefield of political correctness. Be prepared to be flamed.

I don’t think I am the one to write it, but I will give suggestions to whomever is brave enough to assume this task.

Pidgin

First, language. There is a specific dialect of English spoken here, known as “Pidgin.”  And yes, you will hear it spoken, but only if you listen carefully. Pidgin, or “local talk” is also, a loaded political subject, since the colonialist Americans tried to eradicate it. You can find it on YouTube.  Because of the musical inflection of pidgin, it is not possible for a person from the mainland to fake it and pretend they are local; but if you are here you need to learn  how to enjoy it. I also highly recommend the book “Pidgin to Da Max” as a hysterically funny guide to the subject. There are examples on YouTube.

I suppose that Rule Number One rule for any person from Da Mainland would be, never assume that a person speaking pidgin lacks intelligence. ( a terrific link!)  Think of pidgin as a whole different language which just happens to contain elements of English. In fact, college students often are able to slip in and out between the King’s English and Pidgin just as if they were two different languages.  The decision to use one or the other is very sophisticated, situationally driven, and a conscious one. Because of historical active discrimination against pidgin-speakers, if a bilingual Pidgin/English speaker thinks you are condescending toward them because of it, you will find your job here much more difficult. Trust me.

A student of mine who was Asian, had studied on the mainland ( Nebraska!) for a year, and she said that one of the reasons that she came home was, she was tired of the fact that the Nebraska-based students assumed she didn’t speak English well. She said that prior to that experience, she never considered whether Asian-Americans could be the subject of racism. It had simply never occurred to her.

The former Saint Francis Hospital had a rule about language: The official language of the hospital was English, and employees were forbidden to speak any other language in the daily conduct of their work. Think about that one. The patient population was multicultural in a dazzling way, though, and if the patient initiated the conversation, it was okay. The staff there was capable of greeting them in the same multitude of languages. Actually, it was something I loved about working there.

Rule Two

Which leads to rule number two: learn about the culture of your coworkers, just as much as you learn about the culture of the patients. After all,they are probably one and the same. We had a new faculty person from New Orleans, Louisiana – a fascinating and wonderful American culture all of its own. One day at class break, I asked for volunteers to teach her how to fold a paper crane…. and ten students happily shared time to talk with her about origami and what it meant for them. Wicked cool.

Rule Three?

rule three is – “chill.” as in learn to chill.  (read every definition!) Be advised, this is also the most “Asian” City in the USA. Certainly the most polite of any city I have been in, and I have lived in a few. The most respectful and mellow. If you drive like you are in Boston or New York City, you will have a problem on the roads here. Here you will learn patience and how to enjoy a gentle sense of humor.

Food – sometimes only Zippy’s will do!

Next is food. there is a distinct Hawaiian cuisine, known as the plate lunch. You can get rice for Breakfast at McDonald’s.

I would be remiss if I omitted some of the great comic talents of Hawaii that are able to examine and poke fun at their own culture. Then of course, so much of cultural knowledge consists of little tidbits; discrete factoids that we would call “Pearls of Wisdom”

The North Shore is Going Off!

There is a distinct surf culture in Hawaii.  Subject of a whole nother blog.

Please share widely and feel free to comment.

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Filed under Honolulu, nursing education, nursing faculty jobs in Hawaii, Nursing in Hawaii