National Nurses United

Watching the effects of hospital closures and hospital administrations that emphasize the bottom line over patient care led Tidd to enroll in the Health Inequity and Care certificate program offered by American University's Anthropology Department and National Nurses United (NNU). Amy learned of the certificate through her patient advocacy work as an NNU member, and saw it as an opportunity to better advocate for her patients and for policies that serve the people. "I think it is really important for nurses to know and understand the outside forces that are acting on patients and some of the ways we can counteract those forces as advocates beyond the bedside," she says. With five core courses that address the root causes and features of health inequity, including neoliberal globalization, militarization, technological encroachment on healthcare providers' scope of prac- tice and more, the Health Inequity and Care certificate is designed for students interested in better understanding health and health- care injustice in order to more effectively advocate for health justice. The online class format provides a unique opportunity for experi- enced registered nurs- es and graduate and undergraduate Ameri- can University stu- dents to study together in virtual classrooms. Last semester Tidd took the Health Geographies course, in which students explore the ways that location impacts people's health and healthcare access. In discussing the roles that power and place play in health inequities, she provided an example from her experience as a nurse—the closure of Calais Regional Hospital's obstetrics and gynecology depart- ment. Quorum Health, the Ten- nessee-based for-profit management group that operates the hospital, decided to close the department in spite of strong community opposition because they no longer considered it to be profitable. The city of Calais is in the poorest county in Maine, and the closure of the department has left women in this area with no local access to OB-GYN care. The region served by the Calais Regional Hospital also includes the Passamaquoddy tribal reser- vation. Tidd explains that "not only does this closure mean that women in the region will have to travel almost 200 miles to the hospital where I work to receive any type of obstetric or gynecolog- ic care, this also means a drastic reduction in access to women's health services to an entire popu- lation of indigenous people." Tidd's advocacy work extends beyond her home state of Maine. In October she traveled to Puerto Rico with the Registered Nurse Response Network (RNRN), to help with the overwhelming need for humanitarian relief following Hurricanes Irma and Maria this year. While there, along with providing triage and medical care to the injured and ill, the team of RNRN nurses also worked to provide food to those in need and assist people in accessing clean drinking water. Since she returned, she has worked to educate the public, and to pres- sure elected officials to address the public health crisis she witnessed by expediting aid that Puerto Rico is entitled to and desperately needs. Now in her fifth and final course in the program, Tidd says what she has learned in these classes has helped her be more aware of the stark differences in the priorities of the healthcare industry and bed- side nurses like herself. She notes that as healthcare becomes increasingly commodified, nurses too often feel the pressure from above to generate revenue for their employers. "That's not really what we got into this for," Tidd says. "We're healthcare providers, not salespeople." Through her courses in the Health Inequity and Care certificate program, she says she is better able to focus on what her job truly is: protecting and advocating for her patients. Shannon Clark is a Ph.D. student in the anthropology program at American University. M A R C H | A P R I L 2 0 1 8 W W W . N A T I O N A L N U R S E S U N I T E D . O R G N A T I O N A L N U R S E 19 For more information about NNU's university programs, please visit www.nationalnursesunited.org/ certificate-programs. "When you start to explore the larger issues at hand, it becomes apparent that no matter how much work you do as a bedside nurse to advocate for your patients, if there are policies that create barriers for patients to get healthcare, our work is going to be futile."

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