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This is the single best advice for any doctor at any stage: listen to nurses. In particular, listen to Black nurses

Also, protect nurses. In healthcare the terminology is “writing orders” - if that is not power imbalance, I don’t know what is

#MedTwitter
#NurseTwitter
#MedEd
One thing I have noticed on social media is: even at pre-med stage, the condescension & disrespect towards nurses sometimes is already there

Much of recent #MedTwitter drama I engaged in was because, though I knew it would be wise to “look away” could not

not if vs Black nurses
Across the board, regardless of race, when nurses, or anyone, is bullied within in clinical practice settings - setting that already have high rates of error

unsafe
on many levels

it is anti-#safety and #quality for patients & staff

#safetyculture

medcitynews.com/2015/04/nurses…
This story is heartbreaking and appalling on many levels. A loved one lost by suffocating after paralyzed. The family was not seeking to punish. Government chose to prosecute at individual level - but when 10 errors made, I question institution culture.

npr.org/sections/healt…
My thoughts on broken system that harms people within it, from patients & families to students & staff - experiencing a potentially fatal error as a patient really brought it home. Aunt also died from med error.

Yes, some ppl find me “harsh” on #safety

I am anti-silence & anti”#civility” that perpetuates & covers up appalling levels of harm

Research by @MartyMakary supports how prevalent error & harm is in #healthcare

But we must stop “looking away” or being “polite” about harm

wrong framing
death & disability r not “polite”
More from @MartyMakary on “unaccountable” culture in #healthcare & #medicine

propublica.org/article/qa-mar…

We cannot blindly trust anyone, not ourselves, not any exclusive group, not any individual. #safetyculture assumes errors will happen & transparency required #MedTwitter
It is the “code of silence” that drives harm in #healthcare per @MartyMakary & many others who address harm

Elitist, prestige-oriented culture assumes doctors know best
shuts out:
-nursing knowledge/ wisdom
-social work merit
-patient autonomy
etc, etc

cnn.com/2012/09/20/hea…
There are many on #NurseTwitter to follow. Please learn from those who must navigate complex realities on behalf of patients & selves without authority to “write orders.” #socialjustice nurses are especially under threat right now, personally and professionally. Support nurses
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#MedTwitter #NurseTwitter #MedEd #safety #quality #safetyculture #civility #healthcare #medicine #socialjustice

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Umbereen S. Nehal, MD, MPH
@usnehal
This, today, would be considered flat out torture

First, women’s health was not studied. Even when women’s health was studied, it was by harming black & indigenous women

When women talk of safe spaces I look at race

We know this has existed throughout history ...and now
In modern society, how does a woman with education and privilege seeking career success “lean in”?

She likely has someone else - often a low wage dark skinned woman - looking after her kids, cleaning bathrooms, cooking meals.

ethicalsystems.org/women-can-no-l…
What I have come to realize at midcareer & reading history more deeply

privileged women’s advancement requires exploitation of the disadvantaged, especially low income women

It is partly why election results in 2016 *was* voting for own interest in fact

vogue.com/article/white-…
Read 21 tweets
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Umbereen S. Nehal, MD, MPH
@usnehal
In recent years have started to question the traditional approach to #narrativemedicine. Who owns a story? What lens is applied? I get it is seen as important for “joy of practice” to tell these stories as doctors. Except, these are actual lives and bodies of human beings.
As in, I don’t know the right answer but I also don’t think we are asking enough questions of ourselves, our profession, our peers, our professors/attendings.

Ours is a profession that labels
>age 35 as “geriatric pregnancy” after all

My pinned tweet:
Or: #nyc writing class, read “The Laugh”
by Tea Obreht:had never been yet wrote story in Subsaharan Africa

Vivid descriptions of wild animals
Black male=passion

WOC in class had to point out to instructor: WOC characters were flat, one-dimensional, silent, passive
=White gaze
Read 18 tweets
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Umbereen S. Nehal, MD, MPH
@usnehal
In all places, particularly, in #Pakistan, extremely important for mothers, female role models & #HeforShe men to encourage young women and girls to be expressive, out of box, push boundaries, and never go silent.

Admire you on so many levels @ayesha_mian1
#womeninleadership
The only way to advocate for the voiceless and marginalized is to use any source of privilege one may have to create space, amplify others, and be willing to be told one is “too much” in myriad ways. What is the standard to measure too much, tho? If measure is status quo...
Who designed the metrics of “just right” vs “too much” and who defined “good” vs “bad”?

What gender, ethnicity/tribe, religion, etc wrote “the rules” - overt & unspoken?

What cultural triggers are there to invoke, anger, disgust, shame?

Who is in/out group?

Are others silent?
Read 11 tweets

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