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Mourning and Moving On in Newtown: How can nursing influence policy change?, by Suzanne Campbell NP PhD

It was a normal Friday morning and having not yet weaned myself from “Good Morning America” after six months in B.C., I was checking in on the news.  I was shocked to hear of a shooting at Sandy Hook Elementary School in Newtown Connecticut, my home for the past twelve years until I moved to Vancouver last summer. Shock and disbelief followed, but the early reports did not sound too bad - one or two victims. By noon, my 18-year-old son, who is in university in Philadelphia, skyped me with more details - 28 were dead by the hand of a student who was a year ahead of him in high school.  And the shooter’s older brother, an early suspect who was not involved and has been cooperating in the investigation, graduated with my daughter. Another classmate, who is now a writer, eloquently described the loss of privacy, innocence, and anonymity and how the memories we shared have been destroyed.

http://www.theatlantic.com/health/archive/2012/12/did-this-really-happen-in-my-elementary-school/266317/

As a parent and a nurse, envisioning the impact on this small community has been unbearable. In an interfaith service in Newtown Sunday night, President Obama spoke of this tragedy having an effect nationally and internationally.

From a healthcare perspective, Suzanne Gordon’s recent blog discusses the moral distress of healthcare practitioners when public policy fails to create reasonable laws and the public lack the capacity to take sensible action.

http://suzannecgordon.com/health-care-professionals-should-stand-up-en-masse-for-gun-control/

Proof of the lack of sensible action and American’s “love affair” with guns (I might call it an obsession) are the 400 gun stores within a four county radius and 36 gun stores within 10 miles of the shooting. Statistics demonstrate that in the U.S., there are more gun retailers nationally than supermarkets or McDonalds. Some believe it is beyond the point of no return with over 200 million guns in circulation in the U.S., and the purchase of firearms increasing whenever there is a “threat” of changing policies. On “Black Friday” this year, the FBI processed 154,000 background checks for firearm purchases.  In November, with the anticipation of President Obama’s re-election, two million guns were purchased. Similarly, this weekend, after the tragedy in Connecticut, sales of automatic weapons, especially rifles, increased with the fear that they would soon be “off the shelves”.

Another issue is the ineffectiveness of background checks – because of the civil liberties act and privacy laws in the U.S., single men with psychiatric backgrounds may not be identified in the system.  In the Newtown attack the guns were not his but his mother’s and easily accessible in the house.  Shooters such as this are referred to as determined, psychotic, and suicidal.  And the way the media idolizes them and creates immediate celebrity status only encourages others, who might otherwise quietly commit suicide, to be attracted to this horrific method of killing so they too can go down in history. I think the Canadian approach of not naming the shooter and minimizing media exposure decreases the risk of the “copycat” scenarios that seem all too common in the U.S.

What about the effect of violent movies and video games?  Does the enhanced social interaction and realism make it difficult for young men who have mental health problems to differentiate between fantasy and reality? Most shooters are described as “angry, alienated, and disconnected” and yet an act like this tragedy involved pre-meditation and the use of assault weapons – automatic rifles which shoot the equivalent of 30 guns almost instantaneously and ammunition which causes utmost damage. These weapons should only be accessible to the military and law enforcement – why are they in the hands of civilians? Because as Donna Brazile, the ABC News Consultant said in an interview with George Stephanopoulos Sunday evening, “U.S. gun safety laws are broken.” It remains to be seen whether there will be any changes to the U.S. gun control laws, but in Canada, gun policy must be seen as a public safety issue.

Finally – the biggest elephant in the room – access to mental health care. In the U.S., access to mental health services is limited. The cost of care runs $13,000-$17,000/year with few beds and facilities open. In this case, the mother had expressed frustration with lack of support for managing her son’s mental health issues. In the Canadian system, we must maintain strong advocacy for an effective and publicly funded mental health system. Mental health services should never be considered a luxury for those who can afford it.

So as a nurse educator, practitioner, and grief counselor, how does this experience affect my view? My heart is with all involved, including the first responders (many of whom are volunteers who live in the community), the medical examiners, spiritual and grief counselors, doctors, nurses, teachers and parents.  This has touched everyone in one way or another and nothing can ever prepare one for this. Nurses can play a strong role working with politicians and policymakers to develop policies for better gun control and sufficient mental health care services, and we can support society to manage conflict in non-violent ways. We can monitor the media, including news reporters, movie-makers, and video-game creators, and hold them accountable. We can educate the public about mental health signs and symptoms and provide the support necessary in our schools, clinics, and medical offices, working closely with parents, teachers, counselors and the justice system to manage situations before they escalate to the extent of this tragedy. Finally, we can continue to educate staff and students on quick action in case of emergency, which certainly saved many lives in Newtown. Finally, we need to help all nurses be prepared to work with people who have been traumatized by their own tragedies. Teaching self-care and mutual support has never been so important.

I know the strength of this small town community. It was a major attraction when we moved there, and I know they will overcome this tragedy in time and be stronger for it. But it will be a long and painful process. Although I will be visiting Newtown for the holidays and will participate in the vigils and grieving, my new home is here in Vancouver, and some of the aspects of Canadian life that have drawn me here have been reinforced the past few days. There is much that B.C. nurses can do to speak out for sensible public policies, strong mental health services to all in need, and for creating a more caring and compassionate society.

Suzanne Hetzel CampbellABOUT SUZANNE CAMPBELL

Dr. Campbell is the Director of the University of British Columbia School of Nursing. She graduated with her BS and MS in Nursing from the University of Connecticut and her PhD in Nursing from the University of Rhode Island. She obtained her post-master’s certificate as a Women’s Health Nurse Practitioner from Boston College. Her clinical background of maternal-child health and lactation for the past 30 years has led to the support of families and the education of health care professionals in a variety of settings. She served as Director of Research and Special Projects to the Board of the International Lactation Consultant Association (ILCA) (Term 2006-2009) and presently sits on the Lactation Education Accreditation and Approval Review Committee (LEAARC) as the Higher Education Administration representative. Dr.  Campbell has consulted with the Connecticut State Women, Infants, and Children (WIC) Supplemental Nutrition Program. She was IT and curriculum expert for a grant which updated the Peer Counseling Program/Curriculum for WIC nationally. Dr. Campbell has published articles on lactation, nursing education, and is co-editor of a simulation book Simulation Scenarios for Nurse Educators: Making it Real. She was elected into the Nursing Academy of the National Academies of Practice and received the International Nurses Association of Clinical Simulation Learning (INACSL) Excellence in Academic Setting – Mentor Award. Dr. Campbell is committed to the education of all health care professionals, recognizing nursing’s role in an interprofessional setting and the continued need to develop knowledge, partnerships, and collaboration for the provision of excellent health care.

 

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