It takes a special type of person to become a nurse. The job requires a combination of energy, empathy, clear mind, oftentimes a strong stomach, and a cheerful attitude. And while people typically think of nursing in a clinical setting, some nurses are driven to work with the people that feel forgotten by society.
Michelle Santizo is a street medicine nurse working in Los Angeles, California. For her, the field of street medicine requires providing lifesaving health services in unpredictable and sometimes uncomfortable environments, but is where she is most passionate about her work.
Nurse Santizo credits her parents for teaching her resilience, a necessary trait when providing care in places like tents, under bridges, in alleys, vehicles, at libraries, on the side of the freeway or even at a bus stop.
“Every corner of Los Angeles needs our services,” said Nurse Santizo. “It can be in a pristine, abandoned, trashed, or graffiti-filled neighborhood.”
Michelle | Heroes Behind the Masks presented by CeraVe www.youtube.com
Santizo prepares for the workday by loading her backpack with supplies before heading to a section of downtown L.A. known as “skid row” to care for her clients, who are typically people experiencing homelessness and living on the fringes of society without regular access to healthcare. As the child of immigrant parents, she experienced firsthand a lack of healthcare and basic necessities. Her mother fled from El Salvador as a young woman, arriving in the United States alone and without shelter.
“My mother told me that the only people that acknowledged her while sleeping outside on a bench [were the people going in and out of] the church that was across the street,” said Nurse Santizo. She said her mother instilled in her that there are many reasons why people are homeless and that each individual has their own story. “[She] taught me to never judge someone’s struggle … my mother’s inspiring upbringing taught me if you have the time to help the broken or disadvantaged, then take a moment to acknowledge or help in some positive way.”
Michelle and her mother on a beachCourtesy of Michelle Santizo
Growing up, Nurse Santizo watched her parents struggle to earn a living wage to keep up with the family’s needs. “My father worked nearly seven days of the week and my mother worked as much as she could in jobs like babysitting, cleaning homes or caregiving. Feeding our family was my parent’s main concern…healthcare and all the other important aspects of life became secondary or non-existent. My parents could barely make enough income to buy fresh fruit or vegetables,” she said.
The Santizo familyCourtesy of Michelle Santizo
That upbringing is what drove her to pursue a career in medicine, with the goal of giving back to underserved communities. “[Access to] medicine should not be determined based on your socioeconomic status. It should be a right for someone to seek healthcare when it is needed and important, especially for children and adolescents who will be the future of our generation,” said Nurse Santizo. She credits her lack of access to healthcare as a child for empowering her to keep pushing for change.
When the opportunity to practice street nursing arose, Santizo knew instinctively that it was the right fit. Every workday she has meaningful interactions, but one experience in particular had a lasting impression on her. She encountered a middle-aged man who had lost his job during the pandemic and was forced to live on the streets. Nurse Santizo approached, and he asked if she wouldn’t mind examining his feet. As she gently inspected the condition of his skin, she explained that he needed a thorough cleaning and a special ointment and offered to wash his feet and patch them up.
Courtesy of CeraVe
“This kind man stared right into my eyes and nearly cried, as he shared ‘no one has ever cared for me like this ever since I’ve been forced to live on the streets, nor has anyone ever acknowledged my existence,’” recalled Nurse Santizo. “I remember squatting on the side of the street while cars were driving by … my only mission was to devote that moment in time to servicing a person who needed my attention and love. As you can tell, I love what I do, and I could scrub feet for days when servicing the most vulnerable populations.”
According to the most recent report, approximately 580,466 people were experiencing homelessness in America in January 2020. Most were individuals (70%) and the rest were people living in families with children. The full effect of the pandemic on the homeless populations across the country have yet to become clear, and hard data will not be fully known until late 2022 or early 2023.
“Bringing medicine to people who are not able to seek medical assistance due to their inabilities whether it be homelessness, chronic illness, or mental health has always been my true calling … to serve the broken, the sick, the vulnerable and the ones who really need a second chance at life,” said Nurse Santizo, a reminder that no one knows what another human is battling.
To recognize the healthcare professionals that are so often giving to others before themselves, CeraVe seeks to spotlight those that go beyond the call of duty for their patients and communities. The brand is honoring nurses such as Santizo in the second iteration of a docuseries titled Heroes Behind the Masks Chapter 2: A Walk In Our Shoes.
Follow along in the coming days for more stories of heroism, kindness and love.
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Traveling without your baby for the first time can be tough. And if you're breastfeeding, it can be even tougher, as you have to pump milk every few hours to keep your body producing enough, to avoid an enormous amount of discomfort and to prevent risk of infection.
But for Emily Calandrelli, taking a recent work trip away from her 10-week-old son was far more challenging than it needed to be.
Calandrelli is a mom of two, an aerospace engineer and the host of the Netflix kids' science show "Emily's Wonder Lab." She was recently taking her first work trip since welcoming her second child, which included a five-hour flight from Los Angeles to Washington, D.C. Calandrelli is breastfeeding her son and had planned to pump just before boarding the plane. She brought ice packs to keep the milk from spoiling during the flight, but when she tried to go through airport security, the TSA agents refused to let her take some of her supplies.
Calendrelli shared the whole saga in a Twitter thread, which she initially deleted because she was embarrassed and anxious about the confrontation. She reshared the story in a new thread, saying, "They make too many mothers feel this way, so I'm going to talk about it bc this needs to stop."
She explained that she was going through LAX security with two freezer bags, one of which was frozen. She only needed one frozen bag for the departing trip, but would need both of them for her return when she'd have more milk to keep cold.
Here\u2019s what happened. Yesterday was my 1st trip away from my 10wk old son, who I\u2019m currently breastfeeding. I\u2019m going through security at LAX. I brought my pump and 2 ice packs - only 1 of which was cold (I won\u2019t need the other until I come home, when I\u2019ll have more milk).— Emily Calandrelli (@Emily Calandrelli) 1652181514
"Two male TSA agents told me I couldn't bring my ice packs through because they weren't frozen solid," she wrote. "I asked to speak to someone else and they had their boss come over and he told me the same thing." He said that if she had milk on her or the baby with her, it wouldn't be a problem. He also asked where the baby was multiple times.
I asked to speak to someone else & they had their boss come over & he told me the same.\n\nHe said \u201cif you had milk on you, this wouldn\u2019t be a problem.\u201d\n\nHe asked (*multiple times*) \u201cwell WHERE is the baby.\u201d He said if my child was with me, it wouldn\u2019t be an issue.— Emily Calandrelli (@Emily Calandrelli) 1652181666
Two things: 1) Why would she have breast milk with her on a departing flight when she had just left her baby? And 2) If the baby were with her, it likely wouldn't be an issue at all because she likely wouldn't have needed to pump in the first place.
Calendrelli said she asked multiple times to speak to a female agent and was refused. "They escorted me out of line and forced me to check my cold packs, meaning I couldn’t pump before my flight for fear it would spoil," she wrote.
Technically, she still could have pumped to relieve engorgement and keep her pumping schedule and just dumped out the milk rather than storing it. But throwing out breast milk isn't ideal, especially when you're trying to manage your supply with a baby's demand.
And as it turns out, the TSA agents were wrong. Passengers are allowed to have gel ice packs for medical purposes, and they do not have to be frozen.
But their understanding of the policy aside, the fact that they couldn't deduce the need for the packs based on the reality of pumping breast milk speaks to the need for a broader education about breastfeeding.
But guess what? They were wrong. TSA rules specifically state that you are allowed to have gel ice packs (regardless if they are fully frozen!!) for medically necessary purposes. And emptying my breasts on a regular schedule and providing food for my child IS medically necessary.pic.twitter.com/24Q44YzxOf— Emily Calandrelli (@Emily Calandrelli) 1652181768
Calandrelli shared that moms had flooded her inbox with their own TSA horror stories after she shared hers. "It is infuriatingly common to encounter @TSA agents who don't know their OWN rules around bringing breast milk/formula pumping equipment on planes," she wrote.
"Yesterday I was humiliated that I had to explain to three grown men that my breasts still produce milk when I’m not with my child," she added. "Yesterday I was embarrassed telling them about my fear of mastitis if I didn’t pump. Today I’m furious."
She also shared that the TSA agent treated her like "a petulant child, trying to sneak her toy through security" when he told her not to "try to sneak it back through another time."
"There's so much pressure to breastfeed, but @TSA makes it impossible," Calandrelli wrote. "It's yet another system in place that makes it harder for women to get back to work after they've started a family."
Indeed, there are so many ways in which our society is not supportive of motherhood, regardless of the lip service paid to it. According to the CDC, more than 80% of babies are breastfed as newborns and more than half are breastfeeding at six months. Not all of those babies are necessarily exclusively breastfed, but it is recommended—and not uncommon—for breast milk to be a baby's only food source for the first six months.
So we're talking about millions of breastfeeders at any given time, many of whom will travel at some point without their babies and need to pump. And yet we have so many people who are clueless about breastfeeding. Shouldn't the general population have a better understanding of how it works, considering that it's a basic biological function and common experience? Isn't this something we should be teaching in schools? It seems like it would be far more useful and valuable knowledge than much of what we force kids to learn and memorize.
If those agents had understood how breastfeeding and pumping work, there wouldn't have been an issue at all. Pumping is, indeed, a medical need when a breastfeeder is away from their baby for a length of time. The agents wouldn't have asked such bafflingly clueless questions or acted like this mom was doing something wrong.
If we really want to be a society that values families and supports babies, we need to make sure the basics of biology are understood and that systems don't make things harder on parents than they need to be.
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The energy in a hospital can sometimes feel overwhelming, whether you’re experiencing it as a patient, visitor or employee. However, there are a few one-of-a-kind individuals like Elaine Ahn, an operating room registered nurse in Diamond Bar, California, who thrive under this type of constant pressure.
Nurse Ahn felt drawn to a career in healthcare partially because she grew up watching medical dramas on TV with her mother. While the fast-paced level of excitement seen on TV is what initially caught her interest, she quickly found out that real-life nursing is quite different from how it was portrayed on her favorite shows.
Courtesy of Elaine Ahn
The most striking difference, according to Ahn, is the level of involvement that nurses have with their patients during each 12-hour shift. Nurses are often the first to catch subtle signs and symptoms that provide insight into how a patient is doing emotionally as well as physically. Science tells us that emotional health and our overall attitudes have a direct impact on physical health and healing, and Nurse Ahn noticed early on that she could make a huge difference in her patient’s recovery, just by taking the time to sit down for a chat.
California is the only state in the country to require by law a specific number of nurses to patients in every hospital unit. It requires hospitals to provide one nurse for every two patients in intensive care and one nurse for every four patients in emergency rooms, for example. This regulation was created to increase positive outcomes for patients and prevent employee burnout. Even though she never has more than five patients to care for during a shift, Nurse Ahn, like many nurses,still feels stretched thin coping with the needs and demands of the day.
“Sometimes people just need to be heard. In the busy world of acute care, time can really be a luxury. With the number of tasks to perform and numerous alarms pulling nurses and aides in various directions, stretching us thin like pizza dough, it’s upsetting because it can get difficult to be able to spend as much time as we would like with our patients,” said Ahn.
“I remember one day having a patient and his family member being anxious and frustrated. In that moment, I found that drawing up a chair to sit at their eye level and giving them my full, undivided attention for however long I could truly went a long way. They later told me that it was the first time during their hospital stay that they felt heard without being rushed, and this experience led me to adopt this as a part of my practice,” said Ahn.
Nurse Ahn was assigned to a patient with terminal lung cancer, referred to in this series as “Grumpy Man.” Grumpy Man was dying, in constant pain and didn’t have any visitors. He was lonely and without hope, and it tugged at the nurse’s heartstrings.
Elaine | Heroes Behind the Masks presented by CeraVe www.youtube.com
She credits two of her mentors, Josh and Jess, with the idea of providing this patient with more TLC and this inspired her to implement the routine of having daily 15-minute chats with him.
“Especially upon learning that he had no friends or family members to visit or call him, I really wanted to be someone who was present with him in this very difficult time of his life. I wanted him to be able to have another human present and be engaged with him and for him to feel heard and cared for,” said Ahn.
Courtesy of Elaine Ahn
It’s no secret that nurses often put their own patients well-being above their own. That level of caring is what makes them so good at what they do, but it can also lead to exhaustion. Even though she thrives on the rush of being busy, caring for patients like Grumpy Man taught Nurse Ahn the importance of taking a moment to pause, center herself and prioritize taking care of herself first, so she has the energy to devote her undivided care and attention to her patients.
“It’s so easy to get caught up in the momentum of busy-ness, but I make the point to not rush myself and take things one thing at a time. To my delight, taking things one step at a time helped me complete things faster than rushing,” said Ahn.
To help care for the healthcare professionals that are so often giving to others before themselves, CeraVe seeks to spotlight those that go beyond the call of duty for their patients and communities in the Heroes Behind the Masks Chapter 2: A Walk In Our Shoes campaign. The goal of this year’s campaign is to showcase incredible nurses such as Nurse Ahn and celebrate the nursing community as a whole, recognizing the trials, emotional and physical toll the profession has while aiming to inspire and encourage them.
Follow along in the next few days for more stories of heroism here.
Not everyone breastfed before formula was invented.
As if the past handful of years weren't challenging enough, the U.S. is currently dealing with a baby formula crisis.
Due to a perfect storm of supply chain issues, product recalls, labor shortages and inflation, manufacturers are struggling to keep up with formula demand and retailers are rationing supplies. As a result, families that rely on formula are scrambling to ensure that their babies get the food they need.
Naturally, people are weighing in on the crisis, with some throwing out simplistic advice like, "Why don't you just do what people did before baby formula was invented and just breastfeed?"
That might seem logical, unless you understand how breastfeeding works and know a bit about infant mortality throughout human history.
Rutgers University historian Carla Cevasco, Ph.D. shared some of the history of infant feeding in a viral Twitter thread to set the record straight. (Note: Cevasco provided sources for her facts, which can be viewed at the end of her thread on Twitter.)
"You may be hearing the argument that before the rise of modern commercial infant formula, babies all ate breastmilk and everything was great," she wrote. "As a historian of infant feeding, let me tell you why that’s not true."
First of all, throughout history, people have at times needed to feed infants using foods other than breastmilk. For many reasons:— Carla Cevasco, PhD (@Carla Cevasco, PhD) 1652312444
Cevasco explained that, throughout history, people have had to feed infants food other than breastmilk for a variety of reasons.
"Sometimes the birthing parent was unable to breastfeed," she wrote, "Because: death in childbirth, or physical/mental health concerns, or need to return to work outside the home right after childbirth, OR their partner or enslaver forced them not to breastfeed so that they could return to fertility ASAP after giving birth.
"Sometimes baby was unable to breastfeed. Because: poor latch, prematurity, cleft palate, other health or disability reasons, etc.
"Sometimes baby was being cared for by carers other than birthing parent, including adoptive parents."
So, feeding baby other people\u2019s breastmilk wasn\u2019t necessarily an ideal situation either, given the power dynamics of race, class, and gender in the past.— Carla Cevasco, PhD (@Carla Cevasco, PhD) 1652312706
Cevasco went on to explain what babies ate instead of a parent's breast milk in those situations.
"Sometimes someone else would breastfeed the child," she wrote. "This might have been a relative or neighbor doing it for free. Or it might have been a paid or unpaid servant or enslaved person doing it at the expense of their own nursing infant, who might starve to death as a result."
She also explained that some babies thrived on alternative diets, which are not recommended today due to concerns about safety and nutrition.
"Wabanaki women in the 18th century sometimes fed infants a mixture of boiled walnuts, cornmeal, and water; an English colonist, Elizabeth Hanson, reported that her baby thrived on this diet," she wrote. "In early modern Europe, babies often ate pap or panada, mixtures of animal milk or water, bread crumbs or flour. Sometimes these were boiled, sometimes they weren’t."
However, she explained, those milk substitutes weren't always safe or nutritionally complete.
"So before the advent of modern commercial formula (in the 1950s), a lot of babies died of illness or starvation because they couldn’t breastfeed and the alternative foods were not safe or adequate," she wrote. "Let me repeat that: in the absence of modern formula, A LOT OF BABIES DIED OF ILLNESS OR STARVATION DUE TO LACK OF SAFE OR ADEQUATE FOOD."
As Cevasco illustrates, the idea that the pre-formula days were a bastion of infant health due to widespread breastfeeding is simply incorrect. Cevasco explained that better supports such as paid parental leave, free lactation consultation and education, better access to places to pump and so on, would go a long way toward increasing breastfeeding rates. She also pointed out that the greed of the corporate formula industry created the formula shortage crisis.
"But! Let’s not demonize formula because of an imagined past in which everyone breastfed," she wrote. "In the ACTUAL past, babies fucking starved and died of disease. Babies who would have survived today, because they would have had access to safe, nutritionally complete formula. Access that is now, horrifyingly and unjustly, under threat for many babies and their caregivers."
There will ALWAYS be people who need formula for a whole hosts of reasons.— Carla Cevasco, PhD (@Carla Cevasco, PhD) 1652313204
Cevasco pointed out that there are multiple safe and nutritionally complete ways to feed a baby, and making sure babies don't go hungry should be our main goal.
So many misinformed comments could be avoided with a basic understanding of what infant feeding looked like in the past, as well as a basic understanding of how breastfeeding works both physically and logistically. Let's spend more time informing ourselves and sharing facts from experts rather than continuing to perpetuate unhelpful and harmful myths about both breastfeeding and formula feeding.
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While every person with autism spectrum disorder (ASD) is different, there are some common communication traits that everyone should understand. Many with ASD process language literally and have a hard time understanding body language, social cues, exaggeration and cultural cues.
This can lead to misunderstandings that result in people with ASD appearing to be rude when it wasn't their intent. If more neurotypical people (those without ASD) better understood these communication differences, it’d be much easier for everyone to get along.
A perfect example of this problem and how to fix it was shared by Yuri, a transmasc person who goes by he/they, who posts on TikTok about having ADHD and ASD. In a post that has more than 2.3 million views, Yuri claims he was “booked for a disciplinary meeting for being a bad communicator.”
Obviously, his manager needs to learn a little more about working with people with ASD.
To help his co-workers better understand his unique communication style, Yuri posted a note on his office door so there wouldn't be any more misunderstandings.
I prefer direct, literal and detailed communication
If I am:
Not making eye contact
Not greeting you back
Not understanding your social cues, etc.
There is no malicious intent. It is the autism.
Thank you for understanding.
I made an autism sign at work bc i got booked for disciplinary meeting for being a bad communicator.
The post inspired some great responses from people who totally understand what Yuri is going through.
"This should be the norm tbh!! very proud of you for stating your boundaries and needs clearly," Alastar wrote. "I wish everyone had signs telling me how to communicate tbh," Bro added.
"How is it that we prefer direct, literal, and detailed communication, but somehow WE'RE the ones with a communication issue???" Reading cosmere! wrote.
In a follow-up video, Yuri addressed some of the commenters who didn’t know if he was diagnosed by a doctor.
“The funniest thing about the comment section of my autism sign video is the people who are asking me, ‘Are you self-diagnosed? Are you formally diagnosed?'” he said in the video. “Do you think neurotypical people would make a sign like that? Do you think that would happen? Do you think a neurotypical person would do that?”
Autism is a misunderstood disorder so it was a brave move by Yuri to come out about being on the spectrum and share how he prefers to communicate. It’s also a reminder for all of us that we all have the right to show others how we wish to communicate.
This story is also a great lesson for anyone who works with people who have ASD to learn more about their unique communication styles so we can all understand one another. It could be the difference between a hostile work environment and one where everyone can thrive and feel safe.
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