Category Archives: Home health care

Jul 30 2012

Home Mental Health Care for Gunshot Victims

By Jooyoung Lee, PhD, assistant professor of sociology at the University of Toronto and a 2009 – 2011 Robert Wood Johnson Foundation Health & Society Scholar at the University of Pennsylvania


Ervin is a black Rastafarian. He has a calm and easy-going demeanor, something that he attributes to growing up in a small Jamaican village near Kingston.  On most days, Ervin rolls his long set of locks into a beehive that he conceals beneath brightly colored turbans.

He was one of the first gunshot victims that I met while conducting ethnographic research in Philadelphia.  On a chilly Friday in January, Ervin hobbled into the trauma clinic at The University of Pennsylvania.  His work boots were covered with tufts of snow and his puffy winter jacket hid a lean and muscular 35-year old body. 

When I first introduced myself and the purpose of my study, Ervin smiled from ear-to-ear.  He was anxious to tell his story and gave me a detailed play-by-play of how he had been shot twice in the legs—both 9mm bullets had been retained and were causing him great discomfort and pain.

Although he was nearly a year removed from his shooting, Ervin spoke openly about recurrent nightmares, trouble sleeping at night, and described feeling frightened by loud noises in his neighborhood—some of which were “false alarms” and others which were gunshots fired near his home.  Although I am a sociologist by training and have never been trained in counseling or psychotherapy, my gut told me that Ervin was suffering from post-traumatic stress symptoms. 

A couple weeks later, I visited Ervin at his home.  During my visit, I asked Ervin if he had ever spoken to a mental health professional about his trauma.  He shook his head and explained that he knew of free mental health services in Philadelphia, but could not afford to go.  As a day laborer, Ervin relied on landscaping, construction, and other manual labor that often required him to be ready for work at a moment’s notice.  He explained, “If they call me and I’m at some office, I might lose a job that could be the only one I get for a few weeks.”

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Jan 16 2012

Living the Dream: How We Care Matters

Debra A. Toney, PhD, RN, FAAN, is founder of TLC Health Care Services of Las Vegas, and the immediate past president of the National Black Nurses Association. She is an alumna of the Robert Wood Johnson Foundation Executive Nurse Fellows program. Toney is the keynote speaker at Vanderbilt University Medical Center’s annual Martin Luther King Jr. lecture on Monday.


Today, on this national day of service, people across the country are honoring the legacy of Dr. Martin Luther King, Jr. by making a difference in their communities. They’re picking up trash, making meals at food banks, cleaning up parks and caring for the less fortunate. But this shouldn’t be a once a year occurrence; it is my dream that a sense of caring and greater purpose will someday be ingrained into our everyday lives. As a health care professional, I try to carry this calling with me every day.

Health care is becoming increasingly complex. Our population is aging and becoming more diverse. Patients come to us with multiple chronic diseases and a bag full of medications for refills, often not knowing why they are taking them. The waiting room is packed and everyone wants to be seen now. And the health professional is wondering how to get through the day.

All of this comes with a cost. Not a monetary cost but a human caring cost – the lack of touch, caring and compassion. We call patients by their disease; “the gallbladder in room 232” or “the COPDer in 476.” We order test, tests, and more tests to avoid lawsuits, a form of defensive medicine. Health care costs are out of control and millions of people are without health insurance. Access to quality health care is lacking. Provider salaries are on the decline.

These are the real challenges of health care today. Yet amidst these many challenges, we must not lose sight of patients, who literally put their lives in our hands. Patients look to us to provide them with quality health care. We must continue to provide personalized care and teach the next generation of health professionals how to do so.

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