The drug middlemen lobby has had a busy week. It’s the second major lawsuit the PCMA has filed against a state law reforming the PBM industry since Monday.
]]>The drug middlemen lobby has had a busy week. It’s the second major lawsuit the PCMA has filed against a state law reforming the PBM industry since Monday.
]]>No one makes these demands of me, and yet, I feel burdened by them anyway — by the opaque feeling of obligation on a day my birthright says I should have none. The older I get, the less persistent these emotions are. But when they hit, and they always do, it’s a psychic whallop. For a brief moment in time, I’m questioning everything tangentially related to my dual identities (gay guy and June-born person), which can be an exhausting emotional shift when you spend 11 out of 12 months of the year blissfully ignorant of what others in your community might perceive as shortcomings.
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Why is it that I have few close friends who are gay men, but I can’t seem to stop pulling women of all kinds into my orbit? Do I not make enough of an effort to keep in touch with my fellow gay men, and if so, why? Why aren’t my 30s making me more wistful toward the community I was born into? Am I being wilfully ignorant of some broader complex I have about my sexuality, or am I just growing further into my own self, and thus, less inclined to align with whatever picture of gayness I perceive “Pride” to be for? I can picture myself prattling on about this to the straight woman I bring to the gay bar — a crime that is, to many of my kind, punishable by stoning in the lobby of a Barry’s Bootcamp — and having an old, strict gay man interrupt us: “So who, pray tell, is Pride for and not for?”
Pride is a feeling, not a fixed state. You can’t name it or force it into a box, and if you do, the result will always read as disingenuous.
That’s just the thing: I’m not sure, and I think it’s become difficult for many queer people to understand. Is Pride still a protest, or is it a product? One might argue that there’s some reality where Pride can be both of these things — where those who see it as an active demonstration of queer visibility can mingle with the people looking to wear cutoff jean shorts and get day drunk. But it’s especially difficult to ignore the fact that protest and product are inherently at war when the rainbow-patterned Lockheed Martin float comes cascading down the parade route. I don’t care if Chase Bank slaps a Pride flag on their logo, or even if they make the logo look like a sphincter. Any publicly traded company truly interested in celebrating the queer community should make a sizable contribution to a charity, put out a press release, and stay the hell away from any social events.
As much as I think most queer people wish they could distance themselves from Pride’s commodification, the increased corporatization of our month is impossible to ignore. Pride is intended to be a celebration of whatever queerness means to the individual. But such heavy commercial appeal erodes all that singularity, leaving queer people to fend for themselves in defining and celebrating their identities, apart from the pinkwashing. But those interpretations don’t always come easily. Sometimes, being part of a community can be an extremely isolating, lonely experience.
When expressing some version of these feelings to a new acquaintance I’d met at a friend’s joint Pride-birthday party a couple of years back, he asked if I’d ever been to Fire Island. When I replied that I hadn’t, his face turned white — almost as white as the island’s predominant guests. “You have to go,” he said, grabbing my shoulder, as if he were trying to communicate the desire through physical transference. “It’s gay Mecca. And so rich in history! Fire Island is like traveling back in time, before Pride became a corporate event. Everything there is still just as it was in the ’70s and ’80s.” A wisecrack about the real estate prices popped into my head, but I held my tongue. However, I can’t say that the steep cost of a Fire Island weekend hasn’t been one of the primary factors keeping me from boarding the ferry and sloshing around the Long Island Sound. Lodging is one thing, the cost of food and drink is another entirely. (Maybe if Chase Bank really wants to make a difference, they’ll buy the entire island and subsidize it for queer people! Kidding.)
After the party died down and I boarded the subway back to my apartment, I spotted people headed home from Pride celebrations of their own, or perhaps just heading out for the night. Everyone seemed jovial, leaving me to glare at my reflection in the dark train window, between stations, wondering what exactly my deal was. Why does the idea of Fire Island or any of its equally gay attractions fail to spark any interest in me? I can’t, at the very least, muster a curiosity for its storied past as a haven for gay men pre-AIDS crisis? I burst into tears whenever I see a vintage photo strip of gay men, kissing or looking lovingly at one another in the privacy of a photobooth. These small yet radical acts of love overwhelm me with emotion. Yet, Fire Island as a concept produces nothing more than a toy monkey clanging its cymbals in my brain. “You just have to go to really get it,” friends still tell me. I look in their eyes, and I believe it’s true for them. For myself, I remain unconvinced.
Pondering these things at all is its own exhausting experience, filled with more questions. Am I so cruelly esoteric that mainstream ideas of gayness do nothing for me? Is there a stick planted firmly in my ass that should be removed and replaced with something that aligns more with my sexuality? Does acting this way make me feel special or better than those who can be more readily free of such hangups? If a non-insignificant portion of my writing is dedicated to the importance of community and the places we find it, why is it that, when surrounded by gay people, I never feel more alone? Am I an imposter, a fraud, jealous or just a jerk?
In all of my years of self-examination — and in writing this very piece — I’ve come to determine that I’m resistant to anyone projecting their definitions or ideas of gayness onto me. This, I believe, is the product of growing up a digital native. We were encouraged to be ourselves on social media, to curate Tumblr blogs, click-clack the afternoon away in LiveJournal diaries, or design MySpace pages just the way we wanted them, hacking the code to make everything appear just so. When the founders of social media platforms and their VC backers realized self-expression could be commodified, the ad-driven, data-based new experiences were a betrayal. “Our algorithm has determined that you’re a giant f*g. Would you like to see more fierce slayage?”
Maybe! But maybe not, too. Can anyone be allowed to choose their own experiences anymore, to pursue the things that make them feel most like themselves, without having their personality computed into ones and zeroes, or turned into marketing fodder for a brand that doesn’t actually care if they live or die? I realize I’m posing a lot of queries here and not following them up with any concrete answers, but that’s because I don’t really have the answers myself. I don’t know what Pride looks like to me; I only know what it feels like.
I’ve spent my life feeling that the way I express my queerness doesn’t align with what so many people think it should be. As many strides as we’ve made toward progress, sometimes people still can’t register gayness unless you drop that hip and loosen that wrist, metaphorically or otherwise.
The contours of Pride appear in my mind whenever I’m watching a movie that I feel speaks to my own uniquely homosexual sensibilities, which frequently change. Sometimes, I feel most gay when I’m strolling outside feeling the breeze against my skin, like I’m experiencing the joy in a way that only I can, balanced with my own unique burdens and comforts. And I will also occasionally feel my cells inside my big gay body start to strobe with rainbow color when I chow down on gay junk food, like this Demi Lovato dance track that became my most-played song of last August.
But what I do think most queer people can agree on is that Pride is a feeling, not a fixed state. You can’t name it or force it into a box, and if you do, the result will always read as disingenuous. Four years ago, before I came to Salon, I wrote about Beyoncé’s “Break My Soul” in what I thought was a voicey, measured analysis of the song’s immediate danceability. That Beyoncé had released her highly anticipated house single during Pride Month was, naturally, referenced in the article, but it was far from the crux of the piece. I was glad that the writing avoided sounding like a parody of a tweet. (Or this abhorrent, gay-pandering Meghan Trainor press release I’ll reference any chance I get.) But when the piece was published, I shuddered at the headline: “Beyonce’s ‘Break My Soul’ just broke the internet and — hell yeah — is a Pride Month dance bop.”
The headline, which I admittedly should’ve pushed back against, sounded so completely unlike me that I was embarrassed to post it anywhere, choosing instead to trade mortified texts with my friends who understood the sentence to be about as far from Coleman as you could get. I’d filed the piece with a suggested headline saying the song was “a sledgehammering return to the dance floor,” a phrase that, you know, actually indicated how the song sounds.
But maybe that was simply too normal, too accurately descriptive to be written by a gay guy. I’ve spent my life feeling that the way I express my queerness — something that, explicit in the text or not, informs every piece of writing I’ve ever produced — doesn’t align with what so many people think it should be. As many strides as we’ve made toward progress, sometimes people still can’t register gayness unless you drop that hip and loosen that wrist, metaphorically or otherwise.
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In my days as a baby gay, the go-to platitude around being queer was that our differences are what make us special. When I was a teenager struggling to understand exactly who I am, I took that to heart. And I still believe it. But humanity’s many variations don’t sell ads. They don’t drive clicks. And they don’t make money. The discrepancies between gay and straight are far more marketable when they’re blasted into a blaze of word salad headline glory.
And you know what? Good. Let’s keep it that way. Pride isn’t homogeneous, and no brand should be able to make more money because of it. Pride Month shouldn’t be a means to an end. The goal of Pride is not to make queer people equal — or even palatable — to their straight counterparts. I understand this rubs some people the wrong way, but Pride shouldn’t be about normalization; that’s just the happy byproduct. Pride is as much a celebration of personality as it is identity. Those two things may be symbiotically and inextricably linked. But it’s personality that shapes who we are, and provides us with the qualities that set us apart from others, making us truly exceptional. Pride is a state of mind, an interest, a wig, a favorite group of friends, a pair of sunglasses, a movie you love or a song you can’t stop playing. It’s the joy you feel from living authentically.
Right now, for me, Pride feels like being moved by the unexpectedly poignant lyric in the random afrohouse song Rihanna recorded for last year’s “Smurfs” movie soundtrack: “How can so familiar be so brand new? Just met you tonight, but you feel like a friend of mine.” I’ve tried for a year to get some of my closest acquaintances to understand why this song is so great, why I find it so bizarrely beautiful, but few do. And that’s OK, too. Because sometimes, when it comes on shuffle while I’m out for a walk, it makes me smile and shed a tear, thankful that I am whatever kind of gay I am that I get to love something so strange, so much. I don’t think that makes me special, or different, or better, but I do think it makes me who I am: me.
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]]>According to a draft of the agreement read aloud to White House reporters on Wednesday, the agreement would also somehow bring an end to Israel’s war in Lebanon, create a reconstruction fund of $300 billion for Iran, lift all sanctions on Iranian oil and push discussion of its nuclear program into future negotiations. Some Republican senators have already expressed misgivings, and Israeli Prime Minister Benjamin Netanyahu says he won’t be bound by this agreement, so it’s very hard to tell what this actually means.
Trump really looks worn out. On Tuesday, he appeared to have forgotten his usual bronze makeup, which was a startling sight. His energy is notably low, especially for a gathering like this one; meetings with Europeans usually turn him combative and hostile. Back in 2017, he announced his presence on the world stage by lecturing European leaders about their failure to “pay their dues” to NATO and accusing them of unfair trade practices. In other first-term trips, he was generous and gracious to the presidents of Russia and China, making it abundantly clear who he respected and who he didn’t.
At the G7 meeting in Quebec in 2018, Trump demanded that Russia be allowed to rejoin the group. (Vladimir Putin had been 86’d after the invasion of Crimea in 2014.) After being rebuffed on that front, Trump stormed off to canoodle with another favorite world leader, North Korea’s Kim Jong-un, with whom he announced he had fallen in love. The following year, 2019, was uneventful by comparison because the Europeans showered him with flattery. That was when he announced that a committee had looked at venues for the next year’s meeting in the U.S., and had — imagine this! —decided that the best possible option was his Doral golf resort in Florida. That act of self-dealing was so blatant he was actually forced to walk it back and schedule the meeting at Camp David instead. Perhaps fortunately, the pandemic forced the entire G7 event to be canceled in 2020.
Last year’s return to the world stage was very bad indeed. Trump stormed into Canada high on his “landslide” victory (with 49.8% of the vote) and insulted everyone, hurling threats of tariffs and otherwise making clear that he had no use for any of America’s so-called allies. Once again, he bailed out early, supposedly to devote his magic dealmaking skills to ending the fighting between Israel and Iran. That clearly did not happen.
It’s abundantly clear that Trump is still smarting from Western leaders’ collective refusal to follow him into that misbegotten war. If he weren’t so visibly exhausted, he’d probably be a lot more belligerent.
Since then, several more events have soured the relationship between the U.S. and its allies to the point where they are scarcely allies at all. Trump’s outrageous “Independence Day” tariffs, his abandonment of Ukraine and his crude, dismissive treatment of Volodymyr Zelenskyy in the Oval Office, his outrageous U.N. speech and his threats to seize Greenland by force have finally moved the Europeans to realize that America is unstable and they need to look after themselves. That understanding was validated just a couple of weeks ago when Defense Secretary Pete Hegseth went to Normandy and proceeded to stomp all over the alliance’s finest moment by insulting Europe on D-Day and then announcing that the U.S. will pull thousands more troops off the continent.
The biggest issue facing the summit this year is the economic upheaval caused by the war in Iran, which will continue far into the future whether or not the war itself is over. Like it or not, that illustrates how interconnected the world still is. All the G7 leaders were relieved that something has been agreed upon that may mean ships can once again pass safely through the Strait of Hormuz. It’s abundantly clear that Trump is still smarting from Western leaders’ collective refusal to follow him into that misbegotten war. If he weren’t so visibly exhausted, he’d probably be a lot more belligerent. As it is, he’s spending his time hyping this deal as the conclusion of a narrative that casts him as a big hero. But between his diminished energy and the obvious fact that he lost the war and is desperate to get out of it, none of that is working.
The other issue on the table is the war in Ukraine. After promising to make a peace deal on his first day in office, Trump has pretty much abandoned it, only reluctantly agreeing to sell the Ukrainians more weapons. The EU and Britain have stepped up, and Ukraine has shown itself to be an immensely resilient country with impressive military cunning, pushing Russia’s mighty military to unsustainable casualties. Trump has made it clear that he’s out, telling the press, “We have nothing to do with it; we sell weapons to them. It has no impact on us. … We’re thousands of miles away.” So says the man who has spent the last three months waging a pointless war in the Middle East.
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Trump has agreed to restore the sanctions on Russian oil and proclaimed that he hates to see all the dying and will do whatever he can to get Russia to the negotiating table. His heart’s not in it. He appears to have accepted that he’s never going to get his coveted Nobel Peace Prize, so what’s the point?
There is one bright spot for the weary, spent octogenarian. While German Chancellor Friedrich Merz disappointed him with nothing better than a World Cup soccer jersey with Trump’s name and the number 47 on the back, French President Emmanuel Macron came through with a gift so perfect, Trump actually extended his stay.
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Macron invited him to a formal dinner to be held at the one place Trump admires most in the world, other than Mar-a-Lago and Trump Tower: the Palace of Versailles. Trump said, “I was leaving in the afternoon and then the French president, who happens to be a very nice man, invited me to dinner at Versailles. Versailles is not a gold leaf. Versailles is the real deal.” The real deal!
For just a moment, he was in his happy place, contemplating his ballroom and thinking about how he might compare to Louis XIV, the monarch he might most admire if he knew anything about him. After that dinner, he will fly back to the United States filled with inspiration and will no doubt begin revising his plans for the new White House ballroom by adding something he should have thought of a long time ago: a hall of mirrors. What better tribute to a narcissistic would-be king could there possibly be?
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]]>Two cases, Little v. Hecox and West Virginia v. BPJ, task the justices with determining, in different ways, the constitutionality under the 14th Amendment of state bans on school sports participation based on sex assigned at birth. The Supreme Court held oral argument for both cases in mid-January, and the justices are expected to hand down a ruling at the end of June or early July.
Beyond defining the future of transgender athletes’ ability to participate in public school and collegiate-level sports, the cases test the strength of the 14th Amendment, adopted in 1868, which could have far-reaching consequences on every American’s rights under the equal protection clause.
Little v. Hecox challenges Idaho’s 2020 “Fairness in Women’s Sports Act,” which barred transgender women and girls from playing on female sports teams in public schools and colleges and allowed any person to question a student athlete’s gender, subjecting her to a medical verification process. Stemming from a lawsuit filed by a trans student who had undergone hormone therapy and wanted to join Boise State University’s cross-country team, the case questions whether a state, so long as it remains consistent with the 14th Amendment’s equal protection clause, can require sports participation based on biological sex.
West Virginia v. BPJ features a similar challenge against the state’s 2021 “Save Women’s Sports Act,” which required public schools and colleges to designate sports teams based on “biological sex” and prohibits students assigned male at birth from participating on women’s teams. It hinged on the experience of a trans girl who took puberty blockers for treatment of gender dysphoria at the onset of puberty and sought to continue participating on girls’ teams, and asks the court to consider whether Title IX or the 14th Amendment bars a state from assigning students to sports teams based on their birth-assigned sexes.
As these cases question transgender Americans’ — particularly trans youths’ — access to equal protections under the Constitution, they could also weaken that very protection under the 14th Amendment for all Americans.
The Supreme Court decisions in these consolidated cases will come on the heels of a suite of pivotal transgender rights cases that have made their way to the court. Last summer, the court ruled narrowly in favor of a Tennessee ban on gender-affirming care in U.S. v. Skrmetti, while it allowed the Trump administration’s executive orders banning transgender people from enlisting and serving in the military, and requiring passports to display holders’ sex assigned at birth to take effect pending litigation in U.S. v. Shilling and Trump v. Orr, respectively. Given those outcomes, the odds that the court will rule in the transgender respondents’ favor aren’t high — and that should concern all Americans.
For one, the petitioners argue that these bans on transgender athletes’ participation in sports, should they be upheld, will protect women from injury, allow for competitive fairness and preserve women and girls’ equal opportunity. Countless trans rights advocates and women’s rights organizations have highlighted, however, how such bans ostensibly open cisgender women and girls, particularly those perceived as more masculine for one reason or another, up to invasive body examinations and discrimination.
See, for example: the contention over Algerian Olympic boxer Imane Khelif’s eligibility in 2024, the recent parroting of false, anti-Black claims that former First Lady Michelle Obama is “a man” and Candace Owens’ baseless conspiracy theory questioning French First Lady Brigitte Macron’s gender identity.
Second, and most critically, are the cases’ tests of the 14th Amendment’s equal protection clause, which protects against discrimination. As these cases question transgender Americans’ — particularly trans youths’ — access to equal protections under the Constitution, they could also weaken that very protection under the 14th Amendment for all Americans.
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If the Supreme Court is willing to deny key freedoms to some of the nation’s most vulnerable by narrowing its interpretation of whom the Constitution applies to and, more importantly, protects, it stands to reason that it can narrow it further for others, opening the door for greater discrimination and reshaping interpretations of the founding document around the whims of the nation’s politics rather than refining the nation through its principles.
Justice Ketanji Brown Jackson’s questioning in oral argument for Little v. Hecox alluded to this concern while questioning deputy solicitor general Hashim Mooppan, who represented the Department of Justice in support of the petitioners, over the number of people that the sports participation law was tailored to cover or exclude.
“I understand that you’re saying that if the law has such a broad sweep of constitutionality, then we’re not going to strike this thing down just because we can identify one person for whom it doesn’t apply,” Jackson said. “But, if you are that one person and you can show that this is unconstitutional as applied to you, I guess I don’t understand why it matters that it’s constitutional as applied to 99.9 percent of the other people?”
Justice Sonia Sotomayor further questioned during that oral argument what percentage of the population a subclass accounts for would make it meaningful.
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“Is it 1 percent, 5 percent, 30 percent, 15 percent? One is not enough for you, but why?” she asked. “The numbers don’t talk about the human beings.”
This ripple effect of such constitutional arguments also came to light in U.S. v. Skrmetti as the justices deliberated whether Tennessee’s prohibition of access to hormone therapy and puberty blockers based on whether a young patient sought the treatment to transition or for precocious puberty constituted a sex-based classification. As Justice Ketanji Brown Jackson stressed during oral argument, if such a distinction doesn’t base access to treatment on sex as Tennessee argued, the race-based access to marriage that justices found in Loving v. Virginia, which sought to overturn a miscegenation law, shouldn’t be valid either.
The ruling allowing Trump’s executive order on displaying birth-assigned sex in passports in Trump v. Orr provides yet another example. The majority opinion holds that the transgender respondents “failed to establish that the government’s choice to display biological sex ‘lack[s] any other purpose other than a bare … desire to harm a politically unpopular group,” citing language from the 2018 Trump v. Hawaii ruling that denied that the first Trump administration’s travel ban violated the First Amendment’s establishment clause by restricting refugees from majority-Muslim countries.
Add to these risks that a broader ruling from the Supreme Court in West Virginia v. BPJ regarding the assignment of public school activities based on sex lends itself to more bathroom restrictions in public spaces. A recently viral video of a father taking his daughters to the women’s restroom and having the police called on him by another customer demonstrates how all Americans would face harm under these pending rulings.
It’s no mistake that such cases reach the nation’s highest court in a post-Roe v. Wade U.S., one that exists shakily in economic uncertainty and a cultural moment where ultrapolarized politics beget increased political violence and ultraconservative government officials seek to curtail funding for public services like SNAP and Medicaid in favor of expanding funding for Immigration and Customs Enforcement through the end of President Donald Trump’s term.
Restrictions on Americans’ ability to live freely arise slowly and in many forms, and the suite of transgender rights cases before the Supreme Court and pending below it serve as a reminder of what’s at stake.
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]]>SNAP reforms would “restore integrity” to the program and ensure it works for the “most vulnerable among us, including children,” said Rep. Glenn “GT” Thompson, a Pennsylvania Republican and chair of the House Agriculture Committee.
Passing the bill would be a “historic accomplishment” that will ensure “those in need can continue to receive the assistance they need,” said Rep. John Rose, a Republican from Tennessee.
And Rep. Dusty Johnson, a South Dakota Republican, said the bill would focus resources on the “neediest” Americans. “If you are a pregnant woman, your benefits are unaffected. If you have young children at home, your benefits are unaffected by this bill. If you are disabled, your benefits are unaffected by this bill.”
But nearly a year after the measure was signed into law, the number of children receiving food assistance has plummeted by at least 776,000, according to a ProPublica analysis. At least 12 states break down program participation by age, and of the 1,670,011 people who are no longer receiving benefits in those states, 776,134, or 46%, were children.
Another analysis reached the same conclusion: Just last month, the nonpartisan Center on Budget and Policy Priorities found there were 700,000 fewer children receiving food assistance.
Arizona has seen the nation’s largest percentage decline in SNAP participants; 205,223 children are no longer receiving the benefit since July 2025, a 55% drop. Louisiana had the second largest percent decline among children, 22%.
The U.S. Department of Agriculture, which oversees SNAP, hasn’t detailed the impact on children aided by the program, but initial figures show that compared to February 2025, 4.3 million fewer people received SNAP nationwide in February 2026, leaving 37.8 million participants.
Although children weren’t the intended targets of the legislation’s changes, they’re increasingly “collateral damage,” said Katie Bergh, a senior policy analyst at the Center on Budget and Policy Priorities.
If states are trying to comply with the law’s changes to SNAP, they’re likely not focusing on making the program accessible, Bergh said. Other experts said that people may be pushed off the program because of increased paperwork requirements to remain eligible.
States are required to impose work requirements for most adult recipients, while preparing for two major cost shifts. In October, states will begin covering 75% of the program’s administrative costs. States have been paying 50% of those costs.
In addition, states will have to pay a larger share of SNAP benefits starting in October 2027, based on their error rate. Error rates reflect overpayments or underpayments of SNAP benefits. While sometimes characterized as fraud, such errors are usually the fault of the state agency or the SNAP recipient, according to USDA, which describes them as “largely unintentional.”
If a state agency is facing staffing shortages and struggling to comply with new regulations, it will be harder for low-income families to access the benefits, Bergh said. “Families are falling through the cracks.”
In Massachusetts, for example, the share of SNAP applicants who called an assistance line and couldn’t reach a worker rose from 61% in November to nearly 81% in March, according to the Department of Transitional Assistance, which administers SNAP in the state. The state agency did not respond to a request for comment.
A USDA spokesperson did not address ProPublica’s questions about the number of children who have lost access to SNAP. “There is no shortage of resources for the most vulnerable among us, including children,” the spokesperson said.
The three members of the House Agriculture Committee who defended last year’s bill before its passage — Rose, Thompson and Johnson — did not respond to ProPublica’s questions about their statements now that many children no longer receive SNAP benefits.
Rep. Jim McGovern, a Massachusetts Democrat, asked Secretary of Agriculture Brooke Rollins about her recent comments that it was “good news” that millions of people no longer receive SNAP. If more than 700,000 children have been dropped in the 12 states that report those figures, “that number’s going to be into the millions” when other states are included, he said.
Rollins responded, “The 700,000 number of children is not correct,” contending that most people who were kicked off SNAP were “fraudulent.”
“That is not a nonpartisan group that gave you that number,” she said. (ProPublica independently verified the figures reported by the Center on Budget and Policy Priorities.)
McGovern said he has talked to people who have lost food assistance. “These are people who actually need and rely on this food assistance to provide basic nutrition for their families,” he said.
Pressure to lower error rates “creates a temptation for the states to bump off working families,” said Parke Wilde, a food economist at Tufts University. Working families may have more volatile incomes, making it harder for state agencies to assess benefits accurately.
“When they say we want to preserve SNAP for those with the greatest need, they’re sort of acknowledging that they want the scale of the SNAP program to be smaller,” he said.
Mariana Chilton, an expert in child hunger at University of Massachusetts, Amherst, said a smaller program won’t save money in the long run. Research shows that children who receive SNAP benefits are healthier, have better academic outcomes, use hospitals less often and have better mental health as teenagers.
She called the situation a “public health crisis” in the making. “When children are not healthy, this affects children today and it affects them throughout their lifetimes,” she said, likening hunger during early childhood to a brain injury.
As Arizona’s SNAP participation drops, nonprofits are feeling the effects. St. Mary’s Food Bank, the largest in the state, has seen a 15% increase in need this year, which translates into 300,000 more visits from people in search of food, said Milt Liu, the chief executive officer.
“It’s important for everyone to realize that policies have implications for people on the edge, and we’re seeing that in our line every day,” he said.
On a recent morning, Ana Alvarez waited in a line of vehicles at a St. Mary’s food bank in Phoenix. Alvarez, a single mother of five who works at a restaurant, started coming to St. Mary’s after she lost her SNAP benefits in September.
She reapplied for SNAP with the Arizona Department of Economic Security in December, but the application is still pending. The department did not respond to questions about its backlog.
She clips coupons and has cut out trips to the zoo and restaurants with her children. The slow season at the restaurant where she works is about to hit. And as summer temperatures rise, Alvarez wonders how she will afford her electric bill, her rent and her car payment.
At least once a week she contacts the agency about her application. The last time she called, a worker told her what others have in the past: She will have to keep waiting.
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Last month, we recognized National Nurses Week, a meaningful time each year when we pause to reflect on and celebrate the extraordinary impact nurses have on individuals, families, and communities.
Nurses Week is anchored on May 12, the birthday of Florence Nightingale, whose work forever transformed healthcare and shaped the direction of nursing. Nightingale’s legacy is not simply historical—it is deeply relevant today. She saw what others overlooked. She questioned assumptions when suffering was accepted as inevitable. She believed that environment, dignity, and careful observation could change outcomes and save lives.
Perhaps most enduring, she modeled the courage to speak up and challenge “the way things have always been.” That spirit continues to live in each of you.
When I reflect on what it means to be a nurse, I think of what I see every day in our profession.
I see nurses who remain present with patients and families during moments of uncertainty.
Nurses who take the time to explain—again and again—because understanding matters.
Nurses who notice subtle changes others might miss.
Nurses who hold space for grief and quietly celebrate healing.
I see nurses who stand steady in moments of fear, who stay at the bedside long after charting is complete, and who carry the stories of their patients long after a shift has ended. I see nurses who show up—on nights, weekends, holidays, and on ordinary days that become extraordinary because someone needed their care.
I see nurses who advocate—who speak up when it matters most. Nurses who recognize that a patient is never just a diagnosis, but a person with a story: a mother, father, sister, brother, son, or daughter. Nurses who understand that each individual brings a unique lived experience that deserves respect and compassion.
This is the essence of nursing.
Nursing is both a science and an art. It is evidence-based practice grounded in human connection. It requires critical thinking and compassion in equal measure.
Nurses are not optional. Nurses are essential.
We are advocates, healers, listeners, and educators. We are protectors of dignity and champions for those in our care.
Each time I witness your work, I am reminded why I was called to this profession—and why, after more than four decades, I remain deeply proud to be a nurse.
As we reflect on Nurses Week, I encourage each of you to recognize the legacy you carry forward: a legacy of trust, service, and humanity. It is reflected not only in the moments that are seen and celebrated, but also in the quiet, often unseen acts of care that define our profession.
Thank you for choosing nursing. Thank you for your continued commitment to growth, to advocacy, and to excellence in care.
Never underestimate the difference you make or the impact you are capable of achieving.
It is truly an honor and a privilege to serve alongside you.
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As we move through the second quarter of the year, one message continues to guide our work at the Iowa Nurses Association: we hear you.
Across conversations with members, committee work, events, and day-to-day interactions, we continue hearing a common theme—our members want meaningful connection, greater visibility, stronger engagement opportunities, and a more active nursing community. I want you to know that your feedback is not only being heard—it is shaping our priorities and driving our work.
One of the ways we are strengthening engagement is through our Beyond the Bedside podcast, which continues to grow as a platform to highlight the many ways nurses are influencing healthcare beyond traditional roles. Through stories of leadership, innovation, advocacy, education, and career growth, we hope to create additional opportunities for members to connect with one another and with the profession. We are excited about the momentum surrounding the podcast and encourage members to continue sharing ideas for future topics and guests as we expand this initiative.
We are also preparing for our Fall Conference in Ames with the theme Stronger Together. The theme reflects what we believe at INA: nursing is at its best when we learn from one another, support one another, and work together toward common goals. We are excited to create opportunities for networking, learning, and collaboration that strengthen our nursing community across Iowa.
I also want to recognize and thank the members of the Education Committee for their tremendous efforts in planning this robust event. Dawn Bowker, Misty Brooks, Ginny Wangerin, and Bonnie Davidson have been working diligently behind the scenes to develop a meaningful and engaging conference experience for attendees. Their commitment, leadership, and dedication are helping bring this vision to life, and we are grateful for the time and energy they continue to invest on behalf of INA and our members.
Your voice also remains essential in helping determine where we go next. During the month of June, INA will launch a membership engagement survey developed at the direction of the Board of Directors and formulated by the Nursing Practice Committee. This initiative reflects our commitment to listening intentionally and understanding how INA can better meet the needs of nurses across practice settings and career stages. We encourage all members to participate and provide honest feedback. Your insights will help guide future initiatives, strengthen member value, and inform our continued efforts to elevate engagement and expand INA’s presence throughout Iowa.
Building stronger connections also means showing up consistently and strengthening our partnerships across nursing organizations throughout the state. To help enhance communication and visibility, Greg now has a standing agenda item with the Iowa Organization for Nursing Leadership (IONL) Board each quarter. He will also be attending the upcoming IONL District A meeting in Jefferson to share INA initiatives and engage directly with nursing leaders across that district. These intentional opportunities allow us to increase awareness of INA’s work and strengthen collaboration across Iowa nursing communities.
Advocacy remains central to our mission as well. On Tuesday, May 19, I had the privilege of joining Sam Wu, Chair of INA’s Public Policy Committee, at the Iowa State Capitol for the signing of SAFE Center legislation. Moments like these serve as a powerful reminder that nursing voices matter and that meaningful change happens when advocacy is paired with action. We are proud to continue supporting initiatives that strengthen healthcare and improve outcomes across Iowa communities.
There is still work ahead, but I want you to know that we are committed to heightening engagement, increasing visibility, strengthening partnerships, and ensuring INA remains responsive to the needs of its members. We are listening. We are showing up. We are building stronger connections and creating more opportunities for nurses to engage with INA in meaningful ways. We are working hard to elevate the presence of INA throughout Iowa—and every step forward begins with hearing and responding to the voices of our members.
Thank you for your continued support, your engagement, and your commitment to nursing. We are stronger together.
]]>Although I maintain an optimistic view of nursing, most of us have sat through our share of meetings populated by the proverbial Negative Neds and Debbie Downers. Cynicism has a quiet way of entering the profession. It doesn’t arrive dramatically; it seeps in, through chronic understaffing, relentless documentation, broken systems, moral distress, and the slow erosion of trust. For nurses in clinical practice and academia alike, cynicism can feel protective. It becomes an emotional buffer against disappointment. Yet what begins as self-protection may, over time, hollow out the very heart of nursing.
Cynicism is more than skepticism. Skepticism asks questions; cynicism assumes the worst. Cynicism is the habitual distrust of motives, and the belief that people act primarily out of self-interest. It’s marked by sarcasm, pessimism, and emotional withdrawal. In professional life it shows up as disengagement, eye-rolling at new initiatives, dismissiveness toward colleagues or students, and the quiet assumption that nothing will truly improve. Cynicism is rarely loud. More often it’s a shrug.
Nursing is sustained by meaning. It’s animated by connection, purpose, and social reciprocity. Cynicism erodes meaning by reframing every effort as futile and every intention as suspect. It dulls empathy. It narrows perspective. It replaces curiosity with contempt. The nurse who once lingered to teach a family now counts minutes. The faculty member who once delighted in mentoring now scans for plagiarism. Cynicism whispers that generosity is naïve. Over time, this inner narrative can suffocate the nursing vocation.
Cynicism isn’t only a professional hazard; it’s a health risk. Research has linked chronic hostility and cynical attitudes with increased stress hormone levels, hypertension, cardiovascular disease, and impaired immune function. Persistent negativity sustains the body in a low-grade fight-or-flight state. Sleep suffers. Recovery diminishes. Emotional exhaustion deepens. Psychologically, cynicism correlates with burnout, depression, social isolation, and decreased life satisfaction. When one’s worldview is dominated by pessimism, even positive events are filtered through skepticism. The body and mind are built for connection, not chronic antagonism.
The good news: cynicism isn’t inevitable. It can be tempered by small, deliberate practices that cultivate positivity in everyday nursing life:
Celebrate the nurse who advocated for a patient, the student who demonstrated integrity, the colleague who went the extra mile. Speaking well of others in their absence is culture-building. Good gossip elevates everyone and it brings out the best in all of us.
Gratitude need not be grand. Notice small things: a patient getting better, a smooth handoff, a colleague stepping in, a student asking a thoughtful question. A brief daily acknowledgment shifts attention from scarcity to sufficiency. Gratitude doesn’t deny systemic problems; it simply refuses to let them dominate the narrative.
Language shapes perception. The reflexive “How are you?” frequently functions as social filler; it rarely invites authentic response. Saying “Good morning” subtly assumes goodness is already present. It’s declarative, not interrogative. Try saying it with intention.
Personal agency resides in small acts: giving a patient one minute of undivided attention, explaining a treatment clearly, writing meaningful feedback to a student, advocating for one practical improvement on the unit or in the syllabus. Culture rarely changes through grand gestures; it changes through the accumulation of small acts.
Joy in nursing frequently manifests in moments easily overlook: a patient’s relief from pain, a student’s volunteerism, a colleague’s DAISY award, a productive staff meeting. Naming these moments aloud counters the cognitive bias toward negativity.
Tempering cynicism doesn’t mean naïve positivity. Nurses can advocate for excellence and challenge broken systems without surrendering to contempt. Realism acknowledges difficulty; cynicism assumes futility. Nursing has always been sustained not merely by skill, but also by spirit. Guarding that spirit against cynicism isn’t sentimental; it’s our affirmation that we haven’t abandoned hope.
Fidelindo Lim, DNP, CCRN, FAAN is a Clinical Associate Professor at New York University Meyers College of Nursing
]]>The baseline data showed an opportunity to offer patients more resources to help manage their postprocedure pain and reduce the gap between current pain levels and acceptable pain levels. Patient perception is subjective, as is pain experienced after a surgical procedure. This quality improvement initiative enabled a nurse-driven, evidence-based process offering patients an alternative, complementary approach to addressing pain outside of traditional oral pain medication, which, according to Önal Alkan, can have a synergistic effect. Patients’ overall satisfaction with their care experience is tied to reimbursement for many facilities, and facility rankings are often posted online for public viewing.
A review of available research across multiple databases yielded information organized into themes as part of the project’s literature synthesis. The four main themes noted in the articles, synthesized and used to support foundational concepts of intervention implementation, included music therapy with patient input, music therapy without patient input, surgical procedure-related pain, and surgical procedure-related pain-related anxiety. Many of the articles in the literature synthesis, including by Suarez and colleagues, discussed nurse-driven initiatives that used nonpharmacological pain management in conjunction with other treatment modalities to produce a complementary effect, thereby modifying patients’ perception of acute pain postprocedure.
The final group of scholarly journal articles were synthesized into a cohesive group to support the project, creating a framework for an evidence-based, nursing-driven, literature-supported implementation plan.
This quality improvement initiative followed a continuous cycle of process improvement, using the plan-do-study-act (PDSA) format. After training, the pre-op clinic nurse educator added an insert to the pre-op clinic patient instructions to reinforce listening to music therapy at home between the pre-op visit and surgery day.
For scheduled surgeries requiring a minimum 24-hour post-procedure stay and “floor status” patients, the primary nurse admitted the patient and documented per facility policy. A unit staff nurse then provided a handout on accessing streaming music services on Smart TVs in patient rooms as part of the admission process.
Frontline nursing staff completed a patient pain assessment every 12 hours per facility standards, which are part of the electronic health record (EHR). Postdischarge, a project team member collected data from the EHR for all patients who received the nurse-driven intervention. Over 7 weeks, pre- and postintervention data were compiled and compared once the sample size matched the baseline.
The pain scores were extracted from the patient’s EHR and the nursing shift assessment standard national health system note. The project leader recorded pain score data extracted from the patient’s chart on a password-protected Excel spreadsheet, with the two pain score categories averaged over 48 hours postprocedure. The leader then compared the two groups: patients with a current pain score average at or below their average acceptable pain score, and those with an average current pain score greater than their average acceptable pain score. The project team completed this process for 70 patients before intervention implementation and for 73 patients after.
Stakeholders and leadership interpreted the improved patient experience reflected in the data as a clinically significant change. Baseline data showed that of the 70 patients, 84% (59 out of 70) had average current pain scores greater than their average acceptable pain score, with a project goal to reduce this to 25% or less postintervention implementation over the planned period. The final data showed a change to 56% (41 out of 73), which wasn’t as low as the project target but still reflects a shift toward improved patient experiences. The clinical significance of the results relates to patient experience, which improved as the patient-reported pain score (when averaged) showed that more patients’ acute pain scores were at or below their acceptable pain scores.
Note: Pre-Implementation Cohort: 70 patients, Post-Implementation Cohort: 73 patients
One of the advantages of this kind of project is the ability to harness existing technology resources, which means minimal financial impact on any facility attempting to reproduce results when similar technology is already available in-house. The patient interaction with the preop nurse educator and the staff nurse upon admission would have occurred regardless of the intervention, and the added time to each role’s workflow was 5 to 10 minutes per patient per shift.
The streaming music services were already available on the Smart TV in each patient room but were cumbersome to navigate and traditionally underused. By providing the patient with written instructions for the Smart TV streaming music service and reinforcing them with nursing staff, it became an accessible resource that improved the patient experience.
The patient’s perception of postprocedure pain is subjective and self-reported, which can potentially make it challenging to move this metric. This project had the advantage of an existing requirement that nurses assess and document patients’ self-reported current and acceptable pain score every 12 hours. This allowed the project team to use the pain scores charted in the nursing assessment as a metric without changing nursing workflow or documentation. Implementing the intervention would have been more challenging if it had required a significant change to nursing workflow or charting.
The project leader already had a collaborative relationship with the surgical unit staff and the preop nurse educator, which allowed for dissemination of information along existing communication channels. The preop nurse educator (who meets with patients 1:1) had the advantage of unvarnished patient responses, which were then communicated to the project leader. These responses showed excitement and engagement when patients were given the option to choose parts of their postprocedure care plan.
This project provided a great opportunity to harness existing technology in a way that requires minimal cost to the facility and maximum impact on the patient experience, as reported by the patients themselves. Patients asked whether they could bring their own musical instruments to play after surgery, recorded their worship services before surgery, and even made playlists they shared on streaming music services. The available literature on complementary pain management can be used by nursing staff at any facility to harness existing technology to enhance the patient experience.
Sarah Wright DNP, RN, is a Nurse Manager at Harry S Truman Veterans Memorial Hospital in Columbia, MO.
References
Önal Alkan A, Uslu Y, Karabacak U, Adigüzel Akbaba M. Effect of music therapy on dressing pain in intensive care patients with pressure injury. Adv Skin Wound Care. 2025;38(8):419-25. doi:10.1097/asw.0000000000000336
Suarez A, Delgado Y, Servais A, et al. Effects of combining music therapy, light therapy, and chromotherapy in the treatment of chronic pain patients: A pilot study. Evid Based Complement Alternat Med.2024:3006352. doi:10.1155/2024/3006352
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Harassment and bullying within the workplace continue to cause problems for nurses and organizations across the globe (Smith et al., 2020). Workplace harassment and bullying include treatment from individuals who knowingly use their power or position to hurt and cause others to feel inferior or powerless (Tight, 2023). The perpetrator uses abusive behavior to make victims conform to their wishes. Not only do workplace harassment, bullying, and violence affect the lives of nurses in direct patient care settings, but in every area of nursing practice, including academia. Nurse educators encounter ill treatment from students, peers, and those in leadership roles. Although researchers have studied the atrocious and adverse treatment of faculties in educational institutions for decades, little has changed (Tauber et al., 2022). In essence, facilities may have policies in place but fail to implement them, leaving abusers unscathed and victims suffering even after reporting incidents to no avail (Tauber et al., 2022). The Department of Education, governing and accrediting bodies, and the leadership of institutions of higher education must be aware that harassment, bullying, and violence exist in the workplace, including academia. These entities must be cognizant of the abusive behavior and the impact of such treatment on educators and refuse to tolerate it in covered organizations. Nursing faculties must be taught how to identify abuse and harassment, measures to take, and how to cope even if the perpetrator is allowed to continue with their behavior. (Edmonson & Zelonka, 2019).
The culture of harassment and bullying may be evident as one or more individuals in the environment cause distress and discomfort for others. The treatment may be obvious or underlying and subtle, but it causes those targeted and individuals close to them to feel violated and undervalued. Blatant attacks may include negative comments about the person or their performance, micromanaging, or not allowing the individual to practice independently (Edmonson & Zelonka, 2019). The perpetrator often implies that every task has to be completed and that any other way is inferior to theirs. They may criticize, blame, or belittle others while trying to intimidate them. The individuals’ attacks may be less noticeable when they sabotage another’s efforts by giving them a difficult or impossible assignment or work schedule, failing to disclose important information, or spreading rumors about them (Edmonson & Zelonka, 2019). Researchers find that victims of bullying and harassment tend to be less experienced nurses within an organization. However, it can happen to anyone the perpetrator finds threatening or whom they envy (Smith et al., 2020). Feeg et al. (2021) found that the mistreatment may be considered an initiation process but can cause individuals to leave the faculty role, an area dealing with a national shortage. The organization’s education quality may also be compromised (Edmonson & Zelonka, 2019).
Anusiewicz et al. (2019) give credence to the lack of workplace resources and support, organizational climate, and leadership styles as precipitating factors for harassment and bullying. Having adequate staffing and other resources to perform one’s job and being supported by all levels of management decrease stressors within the workplace. Anusiewicz et al. (2019) compare organizations that permit harassment and bullying to colleges that allow hazing. If an institution tolerates one incident of bullying and harassment, it will become a “cultural norm,” and those within the organization will think the practice is acceptable (Anusiewicz et al., 2019, p. 256; Keashly, 2023). As a result, numerous people would suffer from this maltreatment of faculty. If perpetrators are allowed to continue their practice and move higher in an institution, the product of the facility could be impacted tremendously.
Leaders who lead with intimidation cause fear and increased stress for employees and affect how they engage with subordinates, peers, and students. Psychological stress often leads to physical illnesses that can interfere with work performance and academic performance (Clark et al., 2013). Clark et al. (2013) reported that approximately thirty-two percent of faculty teaching in healthcare programs admitted to experiencing incivility in their teaching role. A faculty’s perception of the problem, their supervisor’s reaction, and the organization’s support and response to workplace harassment, bullying, and incivility would determine if the mistreatment gets reported. When students are uncivil toward faculty, the educator may not report the incident for fear of negative evaluations and being fired. Incivility in the classroom may involve students disturbing the classroom by entering or leaving the classroom outside of the start and end of the session, talking during class, and challenging the instructor’s knowledge (Small et al., 2024). Small et al. (2024) identified that other uncivil behaviors by nursing students include inappropriate emails, arguing about grades, and demeaning comments about faculty on surveys or evaluations. When students blame educators for poor grades and are not accountable for their learning, this is considered uncivil behavior. Many of these actions are exhibited by learners, but few learning institutions address them. Nurse educators experiencing hostile treatment often deal with poor self-efficacy, anxiety, insecurity, and low job satisfaction. Without the institution’s support, many faculty members decide to leave the teaching role.
It is up to institutions of higher learning to support their faculty and ensure that uncivil behavior is addressed. If systems are in place to support faculty and work with students to change offensive behavior, faculty and students benefit. Nursing programs also benefit by having higher morale among the faculty, fewer sick leave days used, and a lower rate of resignations and onboarding of new educators. With the current shortage of nurse educators, these programs should deter any negative behavior or actions from impacting their current nursing faculties.
As healthcare organizations work to stifle all forms of workplace violence, every work environment must be proactive in facilitating awareness of incivility, harassment, and bullying through training (TJC, 2021). This training should be required for all staff and faculty to promote teamwork, collaboration, and professional behavior while discouraging disruptive actions. In addition, the Joint Commission (2021) recommends training on conflict resolution. Policies and procedures surrounding incivility should be adopted. Not only should organizations have these policies, but they should also be vigilant in taking action as needed.
Therefore, a zero-tolerance policy should be implemented with a non-intimidating reporting system (TJC, 2021). Nurse educators who report bullying and harassment should not fear retaliation from perpetrators.
Meanwhile, nurse educators confronted with uncivil treatment must commit to self-care and ask for help by following their agency reporting system. Support through an Employee Assistance Program (EAP) may be needed for psychological and emotional care. Self-care measures such as adequate sleep, diet, and exercise should be followed. Deep breathing, mindfulness, and guided imagery can be helpful during stressful times. Trusted support persons inside and outside the workplace may also be needed.
Victims should document occurrences to keep a record of the dates, times, and situations. If nothing is done when reports are made and the bullying and harassment continue or escalate, the victim may succumb to physical and psychological distress. In that case, they must decide to continue in the role or leave the position. Most importantly, the nurse educator should recognize their value and never let anyone else define them and their worth.
Anusiewicz, C., Shirey, M. & Patrician, P. (2019). Workplace bullying and newly Licensed registered nurses: An evolutionary concept analysis. Workplace, Health and Safety, 67(5), Retrieved from https://doi.org/10.1177/2165079919827046
Clark, C., Olender, L., Kenski, D. & Cardoni, C. (2013). Exploring and addressing faculty-to-faculty incivility: A national perspective and literature review. Journal of Nursing Education, 52(4), 211-218. Retrieved from https:// doi.org/10.3928/01484834-20130319-01
Edmonson, C. & Zelonda, C. (2019). Our own worst enemies. Nursing Administration Quarterly, 43(3), 274-279. Retrieved from https://doi: 10.1097/NAQ.0000000000000353
Feeg, V. D., Buonaguro, R. & Mancino, D. (2021). Nurse faculty bullied before COVID: A continuation of the “Same Old, Same Old” or more?
Dean’s Notes, 42(30). Retrieved from https://www.ajj.com/sites/default/deansnotes/2021/winter2021.pdf
Keashy, L. (2023). When faculty are bullied: The unacceptable cost of doing our job and what universities can and should do. FEBS Letters, 597(3), 339-343. Retrieved from https://doi.org/10.1002/1873-3468.14564
Small, S., Cashin, G., English, D. & Moran, G. (2024). “It is essentially about treating each other well”: Insights from faculty on incivility in nursing education. Canadian Journal of Nursing Research, 56(1), 81-94. Retrieved from https:// doi: 10.1177/08445621231204985
Smith, C., Palazzo, S., Grubb, P. & Gillespie, G. (2020). Standing up against Workplace bullying behavior: Recommendations from newly licensed Nurses. Journal of Nursing Education and Practice, 10(7), 35. Retrieved from https://doi: 10.5430/jnep.v10n7p35
Tight , M. (2023). Bullying in higher education: An endemic problem? Tertiary Education and Management, 29, 123–137. Retrieved from https://doi.org/10.1007/s11233-023-09124-z
The Joint Commission. (2021, June). Quick safety 24: Bullying has no place in health care. Retrieved from https://www.jointcommission.org/resources/news-and-multimedia/newsletters/newsletters/quick-safety/quick-safety-issue-24-bullying-has-no-place-in-health-care/bullying-has-no-place-in-health-care/v
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