Literature as a path towards cultural competence.

bookish tweetNurses know that cultural competence is an attribute that grows over the course of our careers and over the course of our lives.  Whether it is a skill or a certain ease – it grows incrementally through interactions with the people we come in contact with in our work place and in our communities.

Like a garden, our cultural sensitivity and our cultural competence needs to be tended and nurtured or it may wither or become stunted.

One of the best ways I’ve found to grow our cultural sensitivity is through reading – reading fiction, memoir, or non-fiction that deals with diverse populations and social issues.

Just this week I started You Don’t Have to Say You Love Me by Sherman Alexie.  The book is poignant, sweet, funny, heart-breaking.  Then just yesterday a wonder school nurse colleague recommended two books she had just read The Hate U Give by Angie Thomas and All American Boys by Jason Reynolds and Brendan Kiely.

Add these books to some of the books Our Kids and When the Spirit Catches You and You Fall Down that NASN leaders have shared in reading groups in the past, and we have a great multicultural reading list for book-loving #schoolnurses.

It’s Report Card Season for Wellness

wellness coachIt’s report card season and up and down the halls I hear teachers talking about make up tests and students saying things like, “My mom says if I don’t get my grades up she’ll…”.  School Nurses are glad we’re exempt from grade stress but we mustn’t forget that we have midterms looming as well.  June 30 will mark the midterm of this year’s round of New Year’s wellness resolutions and this year, for a change, I’m not dreading opening my wellness midterm reports card.

What makes this year different from past years where June would find me sheepishly making excuses about why, despite the best intentions, I had given up on my New Year’s resolutions to take steps to improve my wellness?  The difference is that I discovered the science and the magic of #tinyhabits.

tiny habitsI was lucky to be part of a cohort of School Nurses who were offered the opportunity to cross-train as Wellness Coaches through the Institute for Wellness Education.  Through Wellness Coach training we learned about the science of breaking complex health behaviors into their smallest building blocks called tiny habits.  We learned to build tiny habits, how to anchor tiny habits to a daily activity we’re not likely to skip, and how to reward ourselves when we complete our tiny habits.

Five months into my 2015 New Year’s resolution I just may get an A on my New Year’s resolution midterms.  By breaking down my resolution (to practice mindfulness meditation every day) into it’s tiniest components (get the mat out, sit on the mat for 30 seconds), by anchoring the tiny habits to a behavior I’m not likely to skip (after I shower), and by celebrating every time I complete the tiny habit I have seen this tiny habit sprout and send down roots.  I’m seeing the benefits of my new wellness habit at work and at home.

The tiny habits approach to personal wellness is simple and elegant but it is not necessarily easy.  It took many sessions with wellness coach trainers for me to learn to break those habits down to their tiniest components, to find stronger anchors to hitch them to, and to not skip celebrating success.  I even pulled out my 2014 New Year’s resolution (sketch in my art journal everyday) and gave it a #tinyhabits makeover that has given it new life.

Nurses across the country are discovering the benefits of cross-training as wellness coaches.  The coaching skills help us in our practice with our clients and in our personal wellness as well.  The first School Nurse as Wellness Coach cohort – Abigale Pelletier, Chris Tuck, Amy Wood and I invite you to learn more about this rewarding trend in wellness at our breakout session at the National Association of School Nurses (NASN) 47th Annual Conference in Philadelphia PA.  See you there!

wellness coach session

Now trending upwards: School Nurse blogs

trending upwardsLearn one.  Do one.  Teach one.  That model doesn’t only apply to catheterization and venipuncture skills – it now applies to technology and digital communication.

School nurses are sharing their skills and teaching other school nurses to explore the digital communication toolbox. That is the model of #TANTTT (Teach a Nurse to Tweet Tuesday).  That is the model of the NASN Twitter Mentors at #NASN2014 and #NASN2015.  That is the model of School Nurse Blogs like

Regina Wysocki  

Abby Pelletier      

Brenna Quinn      

me, Jessica Porter

Beth Mattey         

Michelle Sobande

Do you know the line in CPR when we point to the bystander and say, “You – call 911 and bring me the AED”?  Well, I’m pointing at you – Have you thought of blogging as a tool to share your school nurse story?  I would like nothing more that to add your name to this list of school nurse bloggers, of 21st century nurses.

Sometimes I’m tempted to skip to the comments.

NPR storyA recent NPR story highlights how people’s perceptions of what affects their health differ according to socioeconomic status.  I read the article but then I rushed to the comments.  Some comments come from the “pull yourself up by the boot straps” philosophy while other comments call for increased federal aid.

food is powerThe comments are all over the map politically and I realize I see my own conflicted attitudes reflected there.  I have seen inspiring success stories of students overcoming adversity but I also see the soul crushing effects of poor housing and unsafe neighborhoods.  I’ve seen struggling families make healthy choices and I’ve seen families give in to the limited choices available to them in a food desert.

The School Nursing community is beginning to address the health disparities we see every day in our practice.  We are learning to utilize community mapping and GIS technology to identify health disparities.  We seek to upgrade our cultural competency skills and our political advocacy skills to help decrease those disparities.

The NPR site reminds readers to “Please keep your community civil.”  The persistence of health disparities in this land of plenty is a call to action but at the same time, we need to engage families and health care providers in discussion of the root causes of these disparities.  As long as we “keep our community civil”, we don’t have to fear the comments section.

Can we talk about #culturalhealth?

My office is located on the sixth grade hall in a busy Middle School so in many ways I’m literally stuck in the sixth grade.  That’s not always a bad thing because sixth grade is a year full of exploration and learning.

When I sat down to explore why School Nurses need to start conversations about cultural competency, I reverted to one of our strategies on the sixth grade hall – the writing prompt.  Here is a sample of some writing prompts I see on the sixth grade hallway.  “You wake up and reach for your phone.  It’s not there because you just woke up in Rome, circa 100 C.E.  What will the rest of your day be like?”  Or how about, “Anacondas should be allowed to populate the Everglades if they can survive there.  Respond for or against and your scientific rationale.”

photo (11)The writing prompt I came up with to guide my personal assignment took me into some unexplored territory but not nearly as hair raising as Imperial Rome without a cell phone or wading through anaconda infested waters.  I searched for the terms cultural competency, health disparities, and health literacy on Twitter, on facebook, on Tumblr, and on Pinterest.  I found that many professionals are asking what does it take to be a culturally competent nurse or doctor or teacher.  Professionals are asking where they can find training resources to help them work towards cultural competency.

Parents and students too are posting about cultural sensitivity and disparities.  Over and over again parents and professionals are saying we have to find a way to start the vital conversations about disparities, about cultural sensitivity.

Professional conversations, modeling,  and sharing – that is the Nursing way of learning.  We invite you to start those conversations in your schools and with your school nurse colleagues.  The NASN2014 Cultural Competency work group and the NASN2014 Twitter Mentors will host a Twitter chat on the topic of Cultural Competency January 6 at 6 pm EST.  We hope you will take part in the conversation.

… and Dare I Say, Spiritual?


Mission San Jose, San Antonio TX


Lila Cockrell Theater, San Antonio TX


There is something deeply spiritual about being part of a large gathering of nurses who have devoted their careers to protecting and caring for “the least of them”, that is – the sick, the underserved, the students in our care.

This week more than 1200 School Nurses from all fifty states and many foreign countries are gathering in San Antonio for the annual National Association of School Nurses (NASN) Conference. Since most School Nurses are the only medical professional in their school, conference gatherings like this are an a critical way for School Nurses to recharge on several levels. At the level of the conference program the individual conference session titles may address professional development needs along the lines of clinical issues, case management issues, or advocacy issues.  But when you zoom out and look at the conference phenomenon as a whole, you will see how the gathering feeds the spiritual needs of the nurse as well.

The conference begins as a pilgrimage with nurses traveling in and documenting their journeys on facebook and Twitter.  The setting is stately with soaring ceilings.  Traditions of conference regalia such as ribbons and pins continue from year to year.

When I talk to School Nurses about what these annual conferences give them, they mention best practices, newest research, professional contacts but I’d like to offer one more thing only large, live conferences like this can offer: a spiritual strength and knowledge that –

You are part of a long tradition of professional carers.  You are part of something much larger than what goes on in your health room.  What you do makes a difference.