TOPIC: IN SUPPORT OF ADVOCATING FOR THE MENTAL HEALTH AND GENERAL SAFETY OF

CHILDREN AND ADOLESCENTS SEPERATED FROM THEIR PARENTS AT THE U.S.-MEXICO

BORDER

SUBMITTED BY: Florida Nursing Students Association Executive Board

AUTHORS: Kiara Bradley, Caitlin Cox, Abbygail Lapinski, Samuel Apostol

WHEREAS, Attorney General Jeff Sessions issued a “zero-tolerance policy” that mandated
intensified prosecution of illegal entry into the United States of America through the
Southern U.S. border by an alien citizen (Sessions, 2018); and
WHEREAS, this policy prompted the separation of approximately more than 2000 children from
their parents. South Florida shelters for migrant children housed approximately 1000
children, ranging from ages 4-17 years old; U.S. Florida State Senator Bill Nelson claimed
that about 174 of these children were being held as a direct result of Jeff Sessions policy
(Swisher, 2018); and
WHEREAS, a study done by the United Nations Refugee Agency revealed that the causative agents
for the migration of these children to the U.S. are “violence in society, abuse in the
home, deprivation and social inclusion, family reunification or better
opportunity”(UNHCR, n.d.); and
WHEREAS, the Trump Administration’s cessation of separating families at the border on June 20th,
2018, does not account for the trauma endured by the children and the potential long-
term effects of such trauma (Wan, 2018); and
WHEREAS, parental separation is considered a “toxic stressor,” an experience that engages strong
and prolonged activation of the body’s stress management system, which can result in
both psychological and physiological consequences (Kraft, 2018); and
WHEREAS, this toxic stress can have a long-term effect by changing how the body responds to
stress. It disrupts higher-order cognitive processes and can negatively impact brain
structure and function, which puts children at greater risk for negative effects such as
anxiety, depression, post-traumatic stress disorder, decreased IQ ,obesity, impaired
immunological response, ADHD, delayed physical growth, cancer, heart and lung
disease, stroke, and morbidity (SRCD, 2018); therefore be it

RESOLVED, that the Florida Nurses Student Association encourage its constituents to advocate and

raise awareness for the mental and physical health and development of this vulnerable

population; and be it further

RESOLVED, that the FNSA and its constituents contact their local representatives and lead a call for

action regarding the recognition of the international protection needs of these children;

and be it further

RESOLVED, that the FNSA publish an article in the FNSA HOTLINE on this topic; and be it further
RESOLVED, that the FNSA send a copy of this resolution to the Florida Nurses Association, Florida

League for Nursing, Florida Department of Minority Health and Health Equity, and all

other deemed appropriate by the FNSA Board of Directors.

TOPIC: IN SUPPORT OF INCREASING AWARENESS OF RISK FACTORS ASSOCIATED WITH
SUICIDE IN PATIENTS WHO HAVE SCHIZOPHRENIA

SUBMITTED BY: Florida Atlantic University Student Nurses Association

AUTHORS: Kiara Bradley, Anthony Goldberg, and Nigam Reddy

WHEREAS, schizophrenia is a chronic brain disorder characterized by the presence of of the

following symptoms: delusions, hallucinations, disorder of thought, lack of emotional
expression, and other negative symptoms. (National Institute of Mental Health, 2015);
and
WHEREAS, approximately 3.5 million people in the United States of America are diagnosed with the
condition (Schizophrenia and Related Disorders Alliance of America, 2015); and
WHEREAS, it is estimated that amongst those who suffer from schizophrenia, between 40-79%
report suicidal ideations, 20-40% of patients attempt suicide, and 4-5% of patients die
by suicide (Sanchez et al.); and
WHEREAS, risk factors associated with suicide attempts in patients with schizophrenia include
depressive disorders, history of past suicide attempts, number of past psychiatric
admissions, feelings of hopelessness, young age or older age at onset, being of the male
sex, and substance misuse (Carlborg et al., 2010); and
WHEREAS, the identification of these risk factors is critical in the strategic planning of prevention in
various clinical settings (Carlborg et al., 2010); therefore be it

RESOLVED, that the Florida Nursing Students Association will encourage nursing students to pursue

further education related to the topic; and be it further

RESOLVED, that the FNSA will encourage advocacy to increase awareness of risk factors associated

with suicide in patients who have schizophrenia; and be it further

RESOLVED, that the FNSA will publish an article in the FNSA HOTLINE related to this topic; and be it

further

RESOLVED, that FNSA will send a copy of this resolution to Florida Nurses Association,

American Nurses Association, National League for Nursing, Florida Board of

Nursing, National Student Nursing Association, National Institute of Nursing

Research, and all others deemed appropriate by the FNSA Board of Directors.
TOPIC: IN SUPPORT OF INCREASING THE AWARENESS AND PREVENTION OF UNINTENTIONAL
DROWNING RELATED INJURIES IN AT RISK POPULATIONS

SUBMITTED BY: Student Nurses Association at the University of Central Florida Orlando
City/State: Orlando, Florida

AUTHORS: Buschbom, Allison, Coisnard, Amy, Evans, Rachel, & Lucas, Kimberley

WHEREAS, drowning is defined as, the process of experiencing respiratory impairment from
submersion or immersion in a liquid, (Webber, Schmidt & Sempsrott, 2017, p. 1); and
WHEREAS, drowning is the leading cause of unintentional injury deaths in children four [years old]
and younger and the second leading cause of unintentional injury deaths in children
ages five to fourteen (Brennan, Hong, & Wang, 2018, p. 1); and
WHEREAS, drowning is also a significant cause of death of persons over the age of 65 with a
medical ailment that affect his or her balance, vision or judgment (Residential Swimming
Pool Safety Act of 2018, p. 1); and
WHEREAS, [in 2014], 3,796 pediatric patients were hospitalized [in the United States] with an
average admission cost of $31,137; the total healthcare dollars spent on drowning
admissions that year was $118,204,000 (Brennan, Hong, & Wang, 2017, p. 1); and
WHEREAS, 85% of cases of drowning cases can be prevented by supervision, swimming instruction,
technology and regulations needed and in place (Macintosh & Austin, 2017, p. 1); and
WHEREAS, efforts aimed at drowning prevention and providing early, on-scene, bystander
resuscitation have likely contributed to the substantial decreases in mortality secondary
to drowning events in the past decade (Brennan, Hong, & Wang, 2017, p. 1); and
WHEREAS, nursing has been voted the most trusted profession for the 16th consecutive year in the
United States (Brenan, 2017, p. 1); and
WHEREAS, health promotion is an important aspect of nursing that is defined by “the process of
advocating health in order to enhance the personal, private, and public support of
positive health practices” (Greiner, 2014, p. 1); and
WHEREAS, community awareness is an essential component of preventive healthcare which is a
critical elements of community health as a whole (Fooladi, 2015, p. 2); and
WHEREAS, nurses are found at the foundation of any successful effort in improving the health and
wellbeing of a society as a whole (Fooladi, 2015, p. 2); therefore be it

RESOLVED, that that the Florida Student Nurses Association (FNSA) encourage its constituents to

educate nursing students, health care professionals, community organizations, schools,

and colleges to promote education regarding drowning prevention, accidental drowning

interventions and pool safety if feasible; and be it further

RESOLVED, that FNSA will encourage its constituents to include environmental safety questions

related to pool safety when assessing the pediatric and geriatric populations; and be it

further
RESOLVED, that that the FNSA demonstrate a commitment to health promotion by providing

education on pool safety and accidental drowning interventions and awareness through

seminars at State Convention each year, if feasible; and be it further

RESOLVED, that that the FNSA publish an article in Hotline on this topic, if feasible; and be it further

RESOLVED, that the NSNA send a copy of this resolution to the Florida Nurses Association, the

Florida Division of Emergency Management, Florida Public Health Association, and all

others deemed appropriate by the NSNA Board of Directors.

TOPIC: IN SUPPORT OF IMPLEMENTING LGBT INCLUSIVE OPTIONS ON MEDICAL
INTAKE FORMS TO PROVIDE COMPREHENSIVE HEALTH SERVICES FOR SEXUAL
AND GENDER MINORITIES

SUBMITTED Student Nurses Association at the University of Central Florida Orlando

BY:
AUTHORS: Harrison, Bryce

WHEREAS, the portion of American adults identifying as lesbian, gay, bisexual or

transgender (LGBT) increased to 4.1% in 2016 from 3.5% in 2012 (Gallup Inc,
2017); and

WHEREAS, Queer-identifying [LGBT] individuals have historically been subject to

discrimination, social stigmatization, harassment, and violence, and continue to
confront these barriers today (Lee & Kanji, 2017); and

WHEREAS, the LGBT community has unique health concerns and is at higher risk for mental
health conditions, substance use, and suicide; these health disparities have been
associated with social discrimination, ignorance, and assumptions made about
gender, sex, and sexuality (Lee & Kanji,
2017); and

WHEREAS, gay and bisexual men have the largest number of new [HIV] diagnoses in the
United States (U.S. Department of Health & Human Services, 2018); and
WHEREAS, lesbians and bisexual women are at an increased risk of breast, ovarian, and
endometrial cancers due to fewer full-term pregnancies, fewer mammograms,
and obesity (Hafeez, 2017); and

WHEREAS, observational studies have identified higher risks of thrombosis in transwomen

with at least one of the following risk factors: smoking, genetic predisposition,
prolonged immobility, or use of ethinyl estradiol or conjugated estrogens
(Chipkin & Kim, 2017); and

WHEREAS, medical concerns before initiating testosterone therapy for transmen should
follow those for genetic men receiving replacement testosterone therapy
(Chipkin & Kim, 2017); and

WHEREAS, transwomen [transgender women- male to female] who have not had gender-
affirming surgery can have abnormalities of the penis, scrotum, testicles, and
prostate; transmen [transgender men- female to male] receiving testosterone
who have not had gender-affirming surgery can still have breast masses and
abnormalities of the vagina, cervix, uterus, and ovaries (Chipkin & Kim, 2017);
and

WHEREAS, if routine sexual orientation questioning is incentivized or otherwise encouraged,

it will be essential to provide widespread patient education and empowerment
 activities, to require facilities to have meaningful nondiscrimination policies and
staff training in place, and to teach health care providers in a systematic way
how to discuss sexual orientation sensitively with patients (Alper, Feit, &
Sanders, 2013); and

WHEREAS, transgender people are more likely to want to self-identify as such in an EHR
(Electronic Health Record) than are lesbian, gay, or bisexual people. It is
important, then, to consider these differing sensitivities when designing and
implementing questions for use in a patient portal or EHR (Alper, Feit, & Sanders,
2013); and

WHEREAS, a majority of studies indicated patients’ willingness to respond to, and a

perceived importance of, questions about sexual orientation and gender identity
(Bjarnadottir, Bockting, & Dowding, 2017); and

WHEREAS, health promotion is an important aspect of nursing that is defined by “the

process of advocating health in order to enhance the personal, private, and
public support of positive health practices” (Greiner, 2014, p. 11); and

WHEREAS, stated in the American Nurses Association’s Code of Ethics, “the nurse, in all
professional relationships, practices with compassion and respect for the
inherent dignity, worth, and uniqueness of every individual, unrestricted by
considerations of social or economic status, personal attributes, or the nature of
health problems,” (American Nurses Association, 2015); therefore be it

RESOLVED, that the Florida Student Nurses Association (FNSA) encourages its constituents
to modify their medical intake forms to include: segregating ‘biological sex’ and
‘gender identity’ into two separate questions, acknowledging the transgender
identity in the ‘gender identity’ section, and providing a ‘sexuality’ section; and
be it further

RESOLVED, that the FNSA encourage its constituents to educate nursing students, health
care professionals, community organizations, schools, and colleges to promote
education regarding physical and mental health risks for the LGBT population;
and be it further

RESOLVED, that the FNSA will reach out to to the Gay and Lesbian Medical Association
(GLMA) in order to collaborate about providing their “Guidelines for Care of
Lesbian, Gay, Bisexual, and Transgender Patients” to its constituents; and be it
further

RESOLVED, that the FNSA demonstrate a commitment to health promotion by providing

education on provisions to provide an inclusive environment for the LGBT
patient through seminars at State Convention each year, if feasible; and be it
further
RESOLVED, that the FNSA publish an article in Hotline on this topic, if feasible; and be it
further

RESOLVED, that the FNSA send a copy of this resolution to the Florida Nurses Association,
the Florida Division of Minority Health and Health Equity, Florida Public Health
Association, and any others deemed appropriate by the FNSA board of directors;
and be it further

RESOLVED, that the FNSA send a copy of this resolution to the National Student Nurses'
Association (NSNA) House of Delegates for considering implementing the
resolution into their policies and actions.
TOPIC: IN SUPPORT OF THE INCREASE AND CORRECT USE OF MEDICAL INTERPRETERS FOR
LIMITED ENGLISH PROFICIENCY (LEP) PATIENTS

SUBMITTED BY: Florida Atlantic University

AUTHORS: Fabienne Joseph, Stephanie Garcia, Brandy Gaustad

WHEREAS, there has been a vast influx of Americans with Limited English Proficiency (LEP) skills,
“more than 25 million Americans speak English “less than very well,” according to the
U.S. Census Bureau.” This calls for a great need in the use of qualified medical
interpreters in order to provide efficient care for these patients. Although mandated on
a federal level, proper interpretation services are not provided for LEP patients due to
various reasons, a main one being cost of such a service. (Garlack, 2016, p. 201); and
WHEREAS, being there are currently only 15 states in which the cost of the interpreter is covered
by Medicaid and reimbursement is provided to the healthcare facility. Thirty-five states
however, are not rewarded the federal financial assistance from the Department of
Health and Human Services. (Youdelman, 2017, p. 1); and
WHEREAS, often Ad Hoc nonprofessional medical interpreters usually family, are used leading to
misinterpretation or omission of pertinent clinical information. (Juckett & Unger, 2014,
p. 478); and
WHEREAS, if an interpreter is used, more often than not they are used incorrectly. (Juckett &
Unger, 2014, p. 478); and
WHEREAS, individual states are not required by Medicaid to reimburse providers for language
services, leading to a circumstance in which “roughly one-third of U.S hospitals are not
providing language services at all.” (United Language Group, 2016, p. 6); and
WHEREAS, In the long term, the cost of insufficient care exceeds the cost of interpretation services.
Patients receiving interpretation services are less likely to be readmitted to the hospital
within 30 days. (Lindholm M, Hargraves JL, Ferguson WJ, Reed G., 2012); and
WHEREAS, Persons that are not proficient in English may be more likely to seek healthcare services
if they are aware of interpretation services that are available to them. Treating these
people before their condition worsens may further decrease healthcare service costs,
increase healthcare efficiency, and prolong length and quality of life. (Lindholm M,
Hargraves JL, Ferguson WJ, Reed G., 2012); and
WHEREAS, Transcultural issues arise when nurses, patients, and families, are guided by different
moral paradigms and hold differing views of what is important or necessary regarding
health recovery illness, or the dying process. (Dossey & Keegan, 2016, p. 132); and
WHEREAS, Ethical or legal dilemmas may arise from lack of understanding of language, procedures,
expectations, and other elements of the culture that lead to miscommunication, unclear
decisions, and a sense of powerlessness or lack of control (Dossey & Keegan, 2016, p.
132); therefore be it

RESOLVED, that the National Student Nurses’ Association urge for the implementation of nationally

accepted set of medical interpretation standards that must be followed by all federally

funded healthcare facilities by submitting a plan to the Patient Safety Advisory Group of

The Joint of Commission to establish national patient safety goals; and be it further
RESOLVED, that FNSA and its’ members urge for the lobbying for some level of provider

reimbursement for language services in the state of Florida; and be it further

RESOLVED, that FNSA let existing states’ language services programs serve as exemplary for the

state of Florida in order to obtain federal funds to support a possible language services

program; and be it further

RESOLVED, that the NSNA posts efficient ways in utilizing properly trained and qualified medical

interpreters on their website; and be it further

RESOLVED, that the NSNA send a copy of this resolution to Florida Nurses Association, National

Health Law Program, American Hospital Association, National League for Nursing,

Florida Health Department, and all others deemed appropriate by the NSNA Board of

Directors.
TOPIC: IN SUPPORT OF INCREASING AWARENESS REGARDING AUTISM SPECTRUM DISORDER
IN THE HEALTH CARE SETTING

SUBMITTED BY: University of Florida Student Nurses Association, Gainesville, FL

AUTHORS: Raquel Mannino, Alec Gordon

WHEREAS, the Centers for Disease Control and Prevention (CDC) estimates ASD prevalence to be 1
in 59 in children aged 8 as of 2014, up roughly 150% since 2000. (Baio et al., 2018, p.
14); and
WHEREAS, youth with ASD have higher utilization of primary care, specialty care, and acute care
than non-ASD youth (Cummings et al., 2016, p. 2); and
WHEREAS, in an online survey of 209 autistic adults and 228 non-autistic adults, autistic
participants previously reported significantly greater unmet healthcare needs, greater
emergency department use, lower use of preventive services such as Papanicolaou
smears, lower healthcare self-efficacy, and lower satisfaction with patient-provider
communication (Nicolaidis et al. 2015, p. 2); and
WHEREAS, individuals with Autism have reported that their provider’s uneven skills led them to
make false assumptions about the autistic individual’s abilities to understand health
care issues, communicate, or navigate the health care system (Nicolaidis, Kripke, &
Raymaker, 2014, p. 8); and
WHEREAS, adults with ASD have higher prevalence of chronic medical conditions such as
autoimmune and allergy conditions, allergy, GI and sleep disorders, and seizure,
dyslipidemia, hypertension, diabetes, obesity, and thyroid disease (Croen et al., 2015, p.
4); and
WHEREAS, co-morbid psychiatric conditions are increased in ASD compared to the general
population, with adults having nearly triple the rate of depression, quadruple the rate of
dementia, and five times the rate of suicidal attempts (Croen et al., 2015); and
WHEREAS, with an Autism “toolkit”, significant improvements in care for patients with Autism were
reported by parents and by staff from various wards and departments in a hospital
setting (Kennedy et al., 2016, p. 11); therefore be it

RESOLVED, that the Florida Nursing Students Association (FNSA) advocate for improving awareness

regarding patient’s with Autism spectrum disorder; and be it further

RESOLVED, that all staff working in health care settings in Florida, if feasible, become further

educated and aware of the needs of patients with Autism spectrum disorder; and be it

further

RESOLVED, that FSNA send a copy of this resolution to the Florida Nurse’s Association, the Florida

League of Nursing and all others deemed appropriate by the FNSA Board of Directors,

and all others deemed appropriate by the NSNA Board of Directors.

TOPIC: IN SUPPORT OF INCREASED NURSING EDUCATION REGARDING HUMAN
TRAFFICKING

SUBMITTED BY: Adventist University of Health Sciences Student Nurses’ Association

Orlando, FL
AUTHORS: Paige Christine Piggee

WHEREAS, Human trafficking is a public health emergency affecting an estimated 12 to

30 million people globally (Speck, Mitchell, Ekross, Sanchez, & Hilfinger-
Messias, 2018); and
WHEREAS, Human Trafficking generates $150 billion dollars of revenue globally. Two
thirds of total profits are derived from sexual exploitation, the remainder
from forced economic exploitation, including domestic work, agriculture and
other economic activities (Abudu, 2018); and
WHEREAS, “Healthcare professionals specifically Nurses may be the initial contact that
these victims make outside the world of trafficking. Nurses are key agents in
the identification of human trafficking, which is essential to eliminating this
public health problem. Failure to detect results in missed opportunities to
assist victims.” (Scannell, MacDonald, Berger, & Boyer, 2018); and
WHEREAS, “85% of trafficked victims have contact with health care providers in any
year, nurses are critical to the identification of trafficked persons; effective
promotion of their physical, mental, and cognitive health.” (Speck et al.,
2018); and
WHEREAS, Healthcare professionals have not been successful in recognizing or rescuing
victims of human trafficking due to inadequate education on Human
Trafficking statistics, impact, risk factors, warning signs, community
resources, and systems (Egyud, Stephens, Swanson-Bierman, DiCuccio, &
Whiteman, 2017); and
WHEREAS, The Florida Board of Nursing as of 2017 requires a 2-hour continuing
education course in human trafficking utilizing objectives to familiarize
healthcare professional with the issues of human trafficking, including
recognition of potential victims, and identification of support services for
victims (Florida Board of Nursing, 2017).; and
WHEREAS, Integrating human trafficking education into nursing curriculum increases the number of
healthcare providers who can accurately and successfully identify, treat, and assist
trafficking victims (Lutz, 2018); therefore, be it

RESOLVED, that Florida Nursing Student Association (FNSA) encourage its members to

advocate for the incorporation of Human Trafficking awareness into nursing

curricula; and be it further

RESOLVED, FNSA will provide an educational workshop on Human Trafficking including

discussion on populations at risk, identification of victims, therapeutic

communication for survivors; and be it further

RESOLVED, Local SNA chapters will host workshops to promote identification of

potential Human Trafficking victims within the healthcare delivery system

and in the community; and be it further

RESOLVED, that the FNSA send a copy of this resolution to the American Nurses,

Association, National League for Nursing, American Organization for Nurse

Executives, Association of Community Health Nursing Educators, American

Association of Colleges of Nursing, Organization for Associate Degree

Nursing, National Council of State Boards of Nursing, Accreditation

Commission for Education, and all others deemed appropriate by the FNSA

Board of Directors.
TOPIC: IN SUPPORT OF INCREASED EDUCATION ABOUT HEALTH DISPARITIES AMONG LGBTQ+

POPULATIONS WITHIN THE NURSING CURRICULUM

SUBMITTED BY: University of Central Florida Student Nurses’ Association, Daytona, Florida

AUTHORS: Shayna Solomon, Joshua Crawhorn

WHEREAS, recent data collection shows that approximately 10 million Americans identify as
lesbian, gay, bisexual, or transgender (LGBT): comparably 4.1% of the adult American
population. (Gates, 2017); and
WHEREAS, the American Nurses association issued a position statement in 2018 demanding a need
for nurse advocacy for LGBTQ+ populations. Lack of education and awareness of the
health disparities faced by this population contribute to the poor health outcomes the
LGBTQ+ community will face in their lifetime. (ANA Center for Ethics and Human Rights,
2018); and
WHEREAS, research studies have shown evidence that LGBTQ+ populations experience higher
incident rates of mental health disorders, including (but not limited to) depression and
anxiety. Nearly one third (29%) of LGB youth attempted suicide in 2017. LGBTQ+ men
and women are more likely to report moderate to severe psychological distress than the
heterosexual population. (Gonzales, Przedworski, & Henning-Smith, 2016); and
WHEREAS, prior evidence shows that older LGB adults are at a higher risk for chronic health
conditions, including (but not limited to) cardiovascular disease, obesity, arthritis,
cancer, and hepatitis. (Ward, Joestl, Galinsky, & Dahlhamer,2015); and
WHEREAS, findings from research studies show evidence that the LGBT populations are currently
more at risk for substance abuse including drug, alcohol, and tobacco abuse. Recent
studies show that sexual minorities are more than twice as likely to use an illicit drug
than those identifying as heterosexual. Adolescent LGB are 90% more likely to abuse
substances than the heterosexual adolescent. (National Institute on Drug Abuse, 2017);
and
WHEREAS, LGBTQ+ individuals are at risk for an overall shortened life expectancy. This gap is
related to (but not limited to) LGBT homeless youth, LGBT individual’s lack of health
insurance, lack of culturally competent providers and isolation barriers that exist within
the elderly LGBT population, and lack of representative data on LGBT Americans.
(Healthy People, 2018) and

RESOLVED, that the National Student Nurses’ Association (NSNA) Florida Nursing Students

Association (FNSA) encourage its constituents to enhance education regarding LGBTQ+

health disparities; and be it further

RESOLVED, that the NSNA FNSA encourage its constituents to educate themselves on the American

Nurses’ Association’s (ANA) position on nursing advocacy for LGBTQ+ populations; and

be it further
RESOLVED, that the NSNA FNSA provide educational opportunities at the Annual and State

Conventions through break-out sessions related to this topic, if feasible; and be it

further

RESOLVED, that the NSNA FNSA provide information on the NSNA FNSA website as well as publish

an article in Imprint the FNSA Hotline to increase awareness on the importance of

knowledge of LGBTQ+ health disparities, if feasible; and be it further

RESOLVED, that the NSNA FNSA send a copy of this resolution to the American Nurses Association,

American Association of Colleges of Nursing, National Council of State Boards of

Nursing, National League for Nursing, American Public Health Association, American

Journal of Nursing, Organization for Associate Degree Nursing, American Organization of

Nurse Executives, American Civil Liberty Union, Human Rights Campaign, and all others

deemed appropriate by the NSNA FNSA Board of Directors.