DiversityNursing Blog

by Jennifer Etienne and Anna Diane
Boston College William F. Connell School of Nursing

Our names are Jennifer Etienne and Anna Diane, and we are currently senior nursing students at Boston College. This past January, Boston College’s Connell School of Nursing sponsored a nursing service trip to Leogane, Haiti as a part of the community health clinical requirement. This service trip included Boston College (BC) nursing students, nurse practitioners and registered nurses. We held mobile clinics for ten days and saw over 1100 patients. Over the course of our trip, we encountered many patients who we will never forget.

We were amazed by the beauty and kindness of the Haitian people despite all the myriad challenges of their daily lives. We saw many of the common medical conditions that we see in the U.S., such as hypertension, GERD, and diabetes. Due to the area’s extreme poverty, most of our patients had not received health care in years- if at all. A typical day consisted of waking up at 6 a.m., eating breakfast, and packing up a truck with all of the medications and supplies that we had restocked and repacked the night before. We worked with the resources that were available in the community. We set up the clinic with a triage station, consultation, and pharmacy that were situated in the home of one of the individuals within the community. We were fortunate to have a Haitian dentist participate in our clinic as well. Generous neighbors were kind enough to donate chairs and tables for use in our clinics. The women’s privacy room for pelvic exams was constructed from two sheets and a cement wall on a slab of pavement, and the dentist did his work in a reclining lawn chair. In spite of these challenging conditions, our clinics were very successful with the individuals within the community, as exemplified by their gratitude.

The truth is that the people in Haiti receive little healthcare and basic problems often become major health concerns, which is very frustrating to us as future health care providers. This experience illustrated the importance of preventative health care measures. Preventative health care measures, such as providing health education, not only empowered the people, but also gave us a chance to interact with our patients. For example, we crafted and brought cycle beads, which we handed out to the women who we saw in our clinics. These beads help women with family planning as an alternative to birth control contraceptives because many Haitian women do not have the choice to take birth control or access to contraceptives.
It was clear that education was the most important aspect of health promotion and health prevention in Haiti, because it gave the Haitian people a sense of autonomy. For example, simple measures such as demonstrating to Haitians how to properly carry a bucket of water by evenly distributing their weight could help prevent future back problems. We realized, however, that in order to educate the Haitian people on preventative measures, we had to consider what resources were available to them. For instance, teaching a group of Haitian families how to reduce their risk of hypertension would be difficult since measuring cups and nutritional labels are not always available to them. However we could overcome the issue by demonstrating the healthy amount of salt used to prepare meals by using the tip of one’s pinky as an alternative measuring device. Such measures could help to reduce the risk of hypertension in Haitian families and significantly improve overall health. We believe that the use of primary prevention can help to prevent illness in Haiti and empower the people to make their own healthy choices.
Even though we treated more than eleven hundred patients, the realization that the majority of Haitians still lack access to basic health resources was overwhelming. Despite this sad reality, the people we met and the patients we treated assured us that our work was appreciated and worthwhile. Treating this population was an extremely moving experience. We were able to immediately see the difference that we were making, whether it be through treating a baby with scabies or rehydrating a child, the patients were enormously appreciative. This trip has forever changed how we view the care that we will provide as future nurses. We are more aware of the issues that affect Haitians, such as a pervasive lack of health education and the need for more culturally sensitive health care providers. This experience has further motivated us, because as minorities, we recognize our important role in communicating, advocating, and initiating preventative programs to help improve the care and quality of health of minorities. We hope to apply our nursing skills, education, and experiences to help decrease health disparities both within the U.S. and other countries.

Thank you for allowing us to share about our experience in Haiti. We strongly encourage others to consider doing nursing work abroad. In addition to helping those in need of care, such trips endow nurses with truly invaluable perspective into the issues that face the world of health care. With hope, the insights that nurses gain through these types of trips will benefit their patients for years to come.

Originally published by the University of Phoenix

1. Join a nursing society.

"Nursing societies provide a wide variety of ways to stay on the cutting edge of our profession," says Kerrie Downing, RN, MSN, campus college chair of the nursing program at the University of Phoenix Minneapolis/St. Paul Campus. Nursing societies can be large and national in scope, such as the American Nurses Association, or small, as regional associations and specialty societies are. These organizations often offer their members access to publications, online discussion boards and a host of other services, which can include career advice, conferences, conflict resolution, even political advocacy.

"It's always great to have someone else within the profession to connect with, and not just be limited by the people in your workplace," Downing says.

2. Volunteer in your profession.

"I advise nurses to get involved in their [profession's] self-governance," says Juanito C. Torres Jr., MSN, a registered nurse who manages the nursing simulation lab at the University of Phoenix Hawaii Campus. This can include unit practice councils at the hospitals where nurses work, or research committees sponsored by nursing societies, among other opportunities. "Nurses need to get involved in these types of committees to be aware of the latest developments and promote best practices," Torres says. Nurses can even get involved in political action; changes in national policy on seat belt laws and public smoking bans, for instance, owe their enactment in large part to nurses.

3. Attend conferences often.

Conferences offer plenty of opportunities to stay current, whether it's an opportunity to network or hear lectures by leading voices in the profession. "If you've been working in the same area for more than two to three years, your skills are probably stale and you need to get up to speed," says Margi Schultz, RN, PhD, who obtained her BSN and MSN degrees from University of Phoenix and is currently a nurse educator. "Conferences offer you a way to get the latest information so you can keep your nursing practice based on the best available evidence."

4. Read nursing journals.

Torres says that top nursing journals such as American Journal of Nursing and Evidence-Based Nursing publish the latest research. Many hospitals subscribe to these and other journals, and societies frequently make them available at a discount to their members.

5. Step out of your comfort zone.

Shultz recommends that nurses shake up their routines a bit in order to gain new skills. "Go to classes, obtain advanced certifications, maybe shadow a nurse in another specialty," she says. "There's no reason to get bored with the same old thing."

New CDC Campaign Aims to Stem HIV Crisis among Black Women

To combat the high toll of HIV and AIDS among black women in the United States, the Centers for Disease Control and Prevention today launched Take Charge. Take the Test., a new campaign to increase HIV testing and awareness among African-American women. The campaign – which features advertising, a website and community outreach – is being launched in conjunction with National Women and Girls HIV/AIDS Awareness Day in 10 cities where black women are especially hard-hit by the disease.

“At current rates, nearly 1 in 30 African-American women will be diagnosed with HIV in their lifetimes,” said Kevin Fenton, M.D., director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention. “To help reduce this toll we are working to remind black women that they have the power to learn their HIV status, protect themselves from this disease, and take charge of their health.”

The program is being launched in Atlanta; Chicago; Detroit; Fort Lauderdale, Fla.; Houston; Memphis, Tenn.; Newark, N.J.; New Orleans; Hyattsville, Md.; and St. Louis.

Take Charge. Take the Test. is part of CDC’s commitment to address the urgent HIV prevention needs of African-American women, who are far more heavily affected by HIV and AIDS than women of any other race or ethnicity in the United States. African-American women account for nearly 60 percent of all new HIV infections among women (and 13 percent of new infections overall). The rate of new infections among black women is 15 times higher than among white women.

The campaign emphasizes the importance of HIV testing as a gateway to peace of mind and better health. Campaign messages will reach black women through a variety of highly visible channels, including outdoor and transit advertising; radio ads; posters and handouts distributed in salons, stores, community organizations, and other venues; campaign ads and materials on health department and partner websites; and a dedicated campaign website,http://hivtest.org/takecharge, where women can find HIV testing locations in their communities.

In addition to promoting HIV testing, the campaign encourages African-American women to talk openly with their partners about HIV and insist on safe sex, and to bring these same messages to other women in social settings, workplaces, living rooms, and religious congregations.

Take Charge. Take the Test. reflects a strong partnership between CDC, health departments, and local organizations in the 10 participating cities, which worked together to develop local campaigns for the communities they serve. The campaign was initially piloted in Cleveland and Philadelphia, where Take Charge. Take the Test. community events were attended by nearly 10,000 women, and campaign messages were seen more than 100 million times.

“We hope to extend the reach of this campaign to multiple cities throughout the nation, help empower many more women to take control of their health, and help break the silence about HIV in their communities,” said Jonathan Mermin, M.D., director of CDC’s Division of HIV/AIDS Prevention (DHAP).

Research shows that black women are no more likely than women of other races to engage in risky behaviors. But a range of social and environmental factors put them at greater risk for HIV infection. These include higher prevalence of HIV and other sexually transmitted infections in some black communities, which increase the likelihood of infection with each sexual encounter. Limited access to health care can prevent women from getting HIV tested. Research also shows that financial dependence on male partners may limit some women’s ability to negotiate safe sex. HIV stigma, far too prevalent in all communities, may also discourage black women from seeking HIV testing.

“This campaign is just one part of the solution,” said Donna Hubbard McCree, Ph.D., associate director for health equity at DHAP. “All of us have a role to play in stopping the spread of HIV among black women – by talking to our sisters, daughters, husbands, and boyfriends about how to protect ourselves against HIV and the importance of getting tested; by speaking out against stigma; and by tackling the social inequities that place so many of us at risk for HIV.”

Take Charge. Take the Test. is the latest campaign of CDC’s Act Against AIDS initiative (http://actagainstaids.org) a five-year, $45 million national communication campaign to combat complacency about the HIV/AIDS crisis in the United States. The campaign also directly addresses the goals of the National HIV/AIDS Strategy, which calls for reducing new infections, intensifying HIV prevention efforts in communities in which HIV is most heavily concentrated, and reducing HIV-related deaths in communities at high risk for HIV infection. Other Act Against AIDS campaigns include those targeting high-risk populations such as gay and bisexual men, as well as efforts to reach health care providers and the general public.

from The CDC   

What do you think? How will the CDC Campaign work? Will it be effective? Shoot off in the comments!

1. Communication Skills

Solid communication skills are a basic foundation for any career. But for nurses, it’s one of the most important aspects of the job. A great nurse has excellent communication skills, especially when it comes to speaking and listening. Based on team and patient feedback, they are able to problem-solve and effectively  communicate with patients and families.

Nurses always need to be on top of their game and make sure that their patients are clearly understood by everyone else. A truly stellar nurse is able to advocate for her patients and anticipate their needs.

2. Emotional Stability

Nursing is a stressful job where traumatic situations are common. The ability to accept suffering and death without letting it get personal is crucial. Some days can seem like non-stop gloom and doom.

That’s not to say that there aren’t heartwarming moments in nursing. Helping a patient recover, reuniting families, or bonding with fellow nurses are special benefits of the job. A great nurse is able to manage the stress of sad situations, but also draws strength from the wonderful outcomes that can and do happen.

3. Empathy

Great nurses have empathy for the pain and suffering of patients. They are able to feel compassion and provide comfort. But be prepared for the occasional bout of compassion fatigue; it happens to the greatest of nurses. Learn how to recognize the symptoms and deal with it efficiently.

Patients look to nurses as their advocates — the softer side of hospital bureaucracy. Being sympathetic to the patient’s hospital experience can go a long way in terms of improving patient care. Sometimes, an empathetic nurse is all patients have to look forward to.

4. Flexibility

Being flexible and rolling with the punches is a staple of any career, but it’s especially important for nurses. A great nurse is flexible with regards to working hours and responsibilities. Nurses, like doctors, are often required to work long periods of overtime, late or overnight shifts, and weekends.

Know that it comes with the territory. The upside is that a fluctuating schedule often means you’re skipping the 9 to 5, cubicle treadmill. Sounds perfect, right? Run errands, go to the movies, or spend time with the family — all while the sun still shines!

5. Attention to Detail

Every step in the medical field is one that can have far-reaching consequences. A great nurse pays excellent attention to detail and is careful not to skip steps or make errors.

From reading a patient’s chart correctly to remembering the nuances of a delicate case, there’ s nothing that should be left to chance in nursing. When a simple mistake can spell tragedy for another’s life, attention to detail can literally be the difference between life and death.

6. Interpersonal Skills

Nurses are the link between doctors and patients. A great nurse has excellent interpersonal skills and works well in a variety of situations with different people. They work well with other nurses, doctors, and other members of the staff.

Nurses are the glue that holds the hospital together. Patients see nurses as a friendly face and doctors depend on nurses to keep them on their toes. A great nurse balances the needs of patient and doctor as seamlessly as possible.

7. Physical Endurance

Frequent physical tasks, standing for long periods of time, lifting heavy objects (or people), and performing a number of taxing maneuvers on a daily basis are staples of nursing life. It’s definitely not a desk job.

Always on the go, a great nurse maintains her energy throughout her shift, whether she’s in a surgery or checking in on a patient. Staying strong, eating right, and having a healthy lifestyle outside of nursing is important too!

8. Problem Solving Skills

A great nurse can think quickly and address problems as — or before — they arise.

With sick patients, trauma cases, and emergencies, nurses always need to be on hand to solve a tricky situation. Whether it’s handling the family, soothing a patient, dealing with a doctor, or managing the staff, having good problem solving skills is a top quality of a great nurse.

9. Quick Response

Nurses need to be ready to respond quickly to emergencies and other situations that arise. Quite often, health care work is simply the response to sudden incidences, and nurses must always be prepared for the unexpected.

Staying on their feet, keeping their head cool in a crisis, and a calm attitude are great qualities in a nurse.

10. Respect

Respect goes a long way. Great nurses respect people and rules. They remain impartial at all times and are mindful of confidentiality requirements and different cultures and traditions. Above all, they respect the wishes of the patient him- or herself.

Great nurses respect the hospital staff and each other, understanding that the patient comes first. And nurses who respect others are highly respected in return.

Student at the UCLA School of Nursing start their nursing career with a high tech boost. As part of their ceremony to receive their white coats, this year they were also give iPod Touch devices preloaded with Medication and Diagnosis guides as well as a Spanish language dictionary and translation assistance. UCLA is determined to offer new grad nurses that are ready for "High Touch" care but within a "High Tech" environment.

 Nursing Reimagined. Nursing Redefined.

Want to Learn More?

• Civil Rights Memorial Center Located in historic Montgomery, Ala., across the street from Southern Poverty Law Center, the center offers images of iconic civil-rights leaders, a 56-seat theater and the Wall of Tolerance, where visitors pledge to take a stand against hate by entering their names on an interactive wall.
• DuSable Museum of African American History This Chicago museum has been dedicated to the collection, preservation, interpretation and dissemination of the history and culture of Africans and Black Americans for more than 46 years.
• Hampton University Museum & Archives Located on the grounds of Hampton University campus, the museum, which was founded in 1868, is one of the oldest in Virginia. It features more than 9,000 objects, including African American fine arts, traditional African, Native American, Native Hawaiian, Pacific Island, and Asian art.
• Idaho Black History Museum Housed in St. Paul Baptist Church in Boise, one of the oldest buildings constructed by Idaho Blacks, the museum presents exhibits and educational outreach, including workshops, literacy programs and music.
• International Civil Rights Center & Museum This newly opened exhibit and teaching facility, located in the historic F.W. Woolworth building in Greensboro, N.C., where four N.C. A&T freshmen set off a nonviolent sit-in 50 years ago, is a recreation of what the segregated South was like during the civil-rights movement. 
• Museum of African American History in Boston Based in an African Meeting House, the oldest U.S. church built by free Blacks in 1806 has recently been restored, thanks largely to sponsorship from Walmart Foundation. It features stories of Blacks from 1638 through the Civil War.
• NAACP Interactive Historical Timeline Funded through a $500,000 grant from the Verizon Foundation, this newly launched online learning tool from the NAACP offers major milestones in Black history, biographies of legendary leaders in Black history and other educational resources. Verizon Communications is No. 22 in the 2011 DiversityInc Top 50.
• Smithsonian National Museum of African American History & Culture Although the museum is currently being built on the National Mall in the District of Columbia, not far from what were once slave markets called “Robey’s Den,” a gallery can be found on the second floor of the National Museum of American History. And thanks to a $1-million grant of technology and expertise from IBM (No. 7), you can take a virtual tour at nmaahc.si.edu.

VIDEOS

1. DiversityInc CEO Luke Visconti and National Civil Rights Museum President Beverly Robertson
2. Charles H. Wright Museum of African American History
3. African American History Museum in Boston
4. Smithsonian National Museum of African American History series
5. National Underground Railroad Freedom Center

COLLATERAL MATERIAL

• PricewaterhouseCoopers: 10 Minutes on Managing Diversity
• PricewaterhouseCoopers: Confronting the Issue brochure
• PricewaterhouseCoopers: Impact fact sheet
• PricewaterhouseCoopers: Why Diversity Why Now
• WellPoint’s Black History Month poster

In addition to being a Career Job Board for student Nurses up to CNO's, we are an Information Resource. We hope you find this "Focus on Diversity" story particularly interesting...

Pat Magrath, National Sales Director at DiversityNursing.com recently sat down with Dr. Earlene Avalon, PhD, MPH, Director of Nursing Diversity Initiatives; and Eva Gómez, MSN, RN, CPN, Staff Development Specialist at Children's Hospital Boston to discuss the Nursing Career Lattice Program, Diversity and Cultural Competence, and their roles at Children's Hospital Boston.

Dr. Avalon has overseen The Nursing Career Lattice Program (NCLP) at Children's Hospital Boston since the Program started in 2009. The NCLP is an initiative designed to increase the racial and ethnic diversity of Children's nursing staff. Through a generous grant, the NCLP was designed to "address the local shortage of nurses of color as well as to create a workforce that better reflects our patient population's multi-ethnic and multi-racial makeup. The Lattice Program looks for potential nursing students among our current employees-including Clinical Assistants, Surgical Technicians, Administrative Assistants and Food Service staff." The NCLP provides the services and support employees need to complete their education in various nursing schools throughout the Boston area.  

Dr. Avalon states, "It is important to note that I am not a nurse by training. My training is in public health and workforce development in healthcare. I have always been interested in ways that we can increase diversity at the provider level (e.g. nursing) and how that impacts patient satisfaction and outcomes."   

Dr. Avalon suggests "workforce development programs are a win-win for both the employee and the hospital. In particular, given the significant impact that nurses have on the lives of our patients and their families, we are committed to continuously growing a nursing workforce that is able to successfully meet the needs of our changing patient population."

"Our work focuses on looking within our own four walls and developing our employees to their fullest potential," says Dr. Avalon. "One of my responsibilities, and truly one of the best aspects of my job, is the opportunity to sit down with an employee and discuss their aspirations and any challenges they face in pursuit of a career in nursing.  For many, they were forced to put their dream of becoming a nurse on hold.  Oftentimes, employees express that they are the first in their family to attempt college-level courses and they do not have support systems at home. As a result, they often do not know what questions to ask or where to begin and this can negatively impact their success in college. NCLP offers support to our employees that allows them to realize that they are not alone in this process."  

The program provides employees with one-on-one mentoring, professional development, academic counseling and the financial support needed to successfully complete nursing school. "My team helps employees to create a semester-by-semester plan that will enable them to pursue their dream of becoming a nurse - even if it is on a part-time basis." Dr. Avalon continues "We also support our employees by providing them with an experienced nurse as a mentor and the opportunity to shadow a nurse in order to have a better understanding of the profession."

NCLP is not just an academic resource; they help each employee with tutoring, selecting pre-nursing coursework as well as creating a plan to help balance the demands associated with school, transportation, family and work. NCLP enables Children's Hospital Boston to create a strong multicultural workforce that provides the best family-centered care to their patients and community.

Five years ago Ms. Gomez came on board as a Staff Development Specialist to focus the work on Cultural Competence and Diversity. She states, "Among my many roles, I lead the Multi-Cultural Nurses' Forum, the Student Career Opportunities Outreach Program and I provide Cultural Diversity Awareness training to staff throughout the hospital."

I asked Ms. Gomez why Healthcare Institutions should have someone like her on their staff. She responded, "Cultural competence and diversity are two essential ingredients in delivering care for all patients and should be assets that are recognized, valued and embraced at every level of any hospital or healthcare institution. Awareness, advocacy and education are essential components of successful diversity and cultural competence initiatives. Having someone in this role can help hospitals remain on track by carrying out the activities that drive these initiatives. This effort will ultimately lead us into providing care for all of our patients in a culturally appropriate and meaningful way."

She also states, "The work of diversity is ongoing and evolving. In 5-10 years, we will probably have grown and improved the diversity within the nursing profession. However, I expect we will continue to work so our efforts don't become stagnant and we need to sustain the positive changes achieved thus far. The future is hopeful, but it will require time, dedication and work from all of us."

Working together with other Children's Hospital Boston employees, Dr. Avalon and Ms. Gomez have:

• Organized and coordinated The Multi-Cultural Nurses' Forum, which included their first-ever night session. This session was held at 2am in order to better meet the needs of their night nurses. The hospital's CNO and Senior Vice President, Eileen Sporing attended the meeting in order to have a one-on-one conversation with the night time nursing staff who are part of the forum.
• Brought diverse high school students into the nursing profession through their Student Career Opportunities Outreach Program.
• Created a successful nursing mentoring program.

The Peer Advisor Program, which pairs upper-class students with first-year students to help them get acclimated to and thrive at U.Va., became her extended family. Students in the program came to rely on her like a mother away from home.

On the occasion of her retirement, Terry sat down for an interview with UVa Today's Anne Bromley and talked about the philosophy behind the Peer Advisor Program and her roles at the University.

…

UVa Today: Did you feel like you were creating something new here at U.Va., changing its history?

Terry: I didn’t think of it so consciously at that time. I thought of it more as exposing more people, more children, more students about possibilities about college. 

The great thing about those sessions is that not only were we talking with high school juniors and seniors, but the families were there. I remember creating a series of leaflets for children. We called it "Steps to College." In it we were suggesting things for them to think about for that particular year. 

It makes me feel very proud, being in the Office of Admission for almost 10 years, from 1980 to 1989, and seeing the numbers of black students increase. When I look at the alumni who come back, many of them were students in high school when I met them. That makes me feel older, but it also makes me feel proud because of the things that they are doing. 

Those days at admissions laid the foundation in terms of this work for the Peer Advisor Program. 

I often tell the story of my second year in admissions when the vice president for student affairs, Ernie Ern, invited me and others to a meeting he was holding of black students. The thing that touched me the most was a young man, and I remember his words: "U.Va. has done everything to get me here, but now that I’m here, nobody seems to care." I never forgot that, because here was a student who had been recruited and who had come, but who was experiencing what I’ll call disappointment, experiencing isolation.

When I left that meeting, I went back to my office and I sat down and I looked at the black student admissions committee that I had organized. One of the things I immediately thought is, I'm going to add a subcommittee to check on students we had had contact with. I assigned members of the committee to the different residence halls, and they picked up where we left off – after two or three weeks, we were gone – but the students were there to check on the welfare of other students, and that was one of the forerunners of the Peer Advisor Program.

I found, probably about a year or two ago, a note that I had written Jean Rayburn, who at the time was dean of admission. She had sent out a note to the staff to ask if any of us had any ideas about ways of retaining students. I actually wrote – and I have it hand-written because we didn't have the computers then – several things, and one of them was what I called a "Big Brother, Big Sister program." I smiled when I read it because number one, I had forgotten about it; number two, when I read it, it was exactly the kinds of things I have done with the Peer Advisor Program. 

UVa Today: How did you come over to the Office of African-American Affairs?

Terry: I applied for the position because I wanted to have more time with my children. Did that happen? No. Looking at this office and that it had developed this program that I'd actually proposed, this was something I was excited about. It was the program that attracted me. 

Everybody makes sacrifices, and when I look at U.Va. and some of the sacrifices, it's not just been me, it's been my family. 

Shawna, when she was real little, she thought every person who was a teenager or a young adult was a peer adviser. I remember being in church one Sunday and U.Va. students talking to me. Shawna got antsy because she'd been good, she had sat through service, and she beckoned me and said, "Mommy, Mommy, can't we go home? Can't you stop talking to all these peer advisers?" 

I think in our household, it almost has been that I have three children as opposed to two – the Peer Advisor Program is actually the same age as my son, 24. So they have grown up around peer advisers. I'd have peer advisers over for dinner, we would do things together, so it's just been that other presence in our house.

…

UVa Today: Have people asked you, "Shouldn't every first-year student have this kind of program?" Are there things that are specific issues or challenges to black students, or has that changed over time?

Terry: The latter part hasn't changed. I have peer advisers do mid-year interviews. We have questions about the disappointments you have experienced, the joys you've had; what is the best academic experience you've had, what is the worst? I do find that students still talk about, sadly, some racial insensitivity. If one asks, "Is this program still needed?", it is still needed, though this program is not about separating, it's about providing support. 

Should every student have a peer adviser? I think every student should. The way I have always seen it is every student has a peer adviser through the role of residence life. I think the difference is peer advisers don't have to manage an environment within a dorm setting, so I know peer advisers don't have to enforce rules. With [resident advisers], there are certain rules they have to enforce. RAs are on call 24 hours; so, too, are peer advisers. 

Where I see the difference is, if there is some racial insensitivity – it's not to say that an RA cannot address that at all, an RA can – I have additional support here. If I have experienced something, then I can be of more assistance, perhaps, than someone who may not have experienced it. 

… 

— By Anne Bromley