As we move into the final months of 2026, I am reminded that the strength of the Iowa Nurses Association comes from our collective voice, shared purpose, and commitment to advancing nursing across our state. This spirit is reflected in the theme of this year’s annual conference: Stronger Together.

I invite you to join us at the Gateway Hotel & Conference Center in Ames for two important days of recognition, connection, and professional growth. Our Awards Ceremony will be held on the evening of Tuesday, October 27, as we celebrate the nurses and healthcare partners whose leadership and service are making a meaningful difference throughout Iowa. We also will include some lighthearted fun with trivia and networking Tuesday evening. The INA Annual Conference will follow on Wednesday, October 28, bringing nurses together to learn, exchange ideas, strengthen relationships, and consider how we can collectively shape the future of our profession.

In addition to the conference, important organizational work is underway. Proposed changes to the INA Bylaws will be shared with members for consideration. A bylaws hearing will be included as part of our virtual Membership Assembly on Friday, December 11, at 12:00 p.m. via Zoom. This meeting will provide members with an opportunity to learn more about the proposed changes, ask questions, and participate in the governance of the association. Additional information about the proposed amendments and how to join the Membership Assembly will be shared in advance.

I am also grateful for the members serving on our Membership Engagement Task Force. This group is reviewing the results of the recent Membership Engagement Survey and using your feedback to identify meaningful opportunities to strengthen the member experience. Their work will culminate in recommendations to the INA Board of Directors for an action plan to guide membership engagement in 2027 and beyond. Thank you to everyone who completed the survey and shared candid feedback. Your perspectives are essential as we work to ensure INA remains responsive, relevant, and valuable to Iowa’s nurses.

Whether we are gathering at the annual conference, recognizing excellence within our profession, thoughtfully reviewing our governing documents, or developing new ways to engage our members, each of these efforts reflects the same belief: we accomplish more when we work together.

I look forward to seeing many of you in Ames this October and online for our Membership Assembly in December. Thank you for your continued membership, leadership, and commitment to nursing in Iowa.

Stronger together,

Greg Opseth
Executive Director
Iowa Nurses Association

These are some of the factors that have likely contributed to the heightened attention to correctional health nurse liability. Claims against nurses in this specialty have increased in recent years, according to a 2026 report from NSO and CNA. The percentage of correctional facilities involved in closed claims rose from 4.4% in 2020 to 6.2% in 2025. Over the same time, the average total cost incurred for closed claims increased from $219,924 to $262,272. Areas at particular risk of liability include failure to treat, delayed urgent care, and failure to respond to mental health issues, such as the risk of suicide.

Fortunately, correctional health nurses can reduce their risk. This effort requires understanding key concepts of incarceration and healthcare delivery, the impact of documentation gaps on legal defense, and the nature of the correctional health practice environment. Once nurses have a firm grasp of these areas, they can take steps to protect themselves.

Incarceration concepts

An incarcerated person’s right to quality care is embedded in the U.S. Constitution: The Eighth Amendment forbids “cruel and unusual punishment.” As noted by the Legal Information Institute, 42 U.S. Code § 1983 allows U.S. citizens to sue any state and local government official who violates their constitutional or legal rights. Correctional health nurses are frequently government employees.

A common issue in correctional health liability is “deliberate indifference,” which in the context of healthcare refers to a person’s conscious disregard for a prisoner’s known medical condition. In the 1976 landmark case of Estelle v. Gamble, the U.S. Supreme Court noted that deliberate indifference violates the Eighth Amendment. 

Attorney Taylor D. Brewer writes that although the definition of deliberate indifference can vary by state, it generally requires proof that the defendant was aware of the plaintiff’s serious medical need, knew there was a substantial risk of harm if it was not addressed, but failed to act.

Incarcerated patients have privacy rights under HIPAA, although provisions related to correctional health settings exist, as outlined in 45 CFR 164.512. The provisions cover situations where disclosure to an administrator or correctional officer is permitted, such as when the patient’s health status could affect the health of others. For example, a patient who has a respiratory infection needs to wear a mask. Other situations include potential safety risks to others, including officers and other incarcerated people. In these cases, it is important only to share essential information. 

A common problem in correctional health is provider bias. Examples of bias include routinely believing patients to be untruthful and misinterpreting health-seeking behavior for attention-seeking behavior. These biases can lead to poor care, patient harm, and legal liability.

Vital role of documentation

Consider this scenario: A correctional health nurse knows her patient, who has been taking a prescribed antipsychotic medicine, is on a suicide watch. One day, the nurse does not administer the medication, and the patient subsequently dies by suicide. Unfortunately, the review of documentation in the electronic health record does not show why the nurse omitted the drug. There could have been valid reasons (e.g., patient refusal, a serious adverse effect), but without documentation, the nurse has little defense in court. 

This case illustrates the crucial role of documentation in mounting a legal defense. Adverse outcomes alone do not establish negligence. Rather, four elements must be present: the provider had a duty to care for the patient, the provider breached the standard of care, the breach caused the injury, and the patient suffered harm as a result. Proper documentation helps establish that the provider followed the standard of care. In addition, if a patient claims injury, but the record shows none occurred, the provider’s case is strengthened.

Good practices for proper documentation by nurses include basing entries on objective data (not subjective opinions); recording all assessments, administered drugs, and immunizations; detailing patient progress towards treatment goals; and making timely entries. Timestamped access, a hallmark of electronic health records, enables a clear view of who documented what and when. Nurses should document the rationale for situations such as treatment delays, deviations from standard treatment, and clinical decision-making.

Practice environment

Few nurses experience correctional health during school, so those entering the specialty require significant education about the role and its responsibilities. Too often, however, short staffing leads to short orientation. 

Once on the job, correctional health nurses have few nurse colleagues to work alongside. This, along with the nature of the incarceration setting with locked doors and limited access, can cause feelings of isolation and stress. Pressure from officers or administrators about how patients are managed can add to stress levels. In addition, nurses may be practicing in an aging facility with aging equipment while they care for a complex patient population. Finally, nurses may feel anxious about their personal safety.

Reducing liability

The following actions can help reduce a correctional health nurse’s liability risk. 

• Practice within your state’s scope of practice and follow the facility’s policies and procedures. Ensure that standard protocols and orders are current. Policies, procedures, standard protocols, and standard orders should be reviewed on a regular basis, usually at least annually. 
• Follow general nursing standards of care from the American Nurses Association. 
• Follow standards of care related to the correctional setting, such as those from the National Commission on Correctional Health Care, which has standards for jails, prisons, juvenile facilities, mental health services, and opioid treatment programs. It also has guidance for specific situations such as the medical treatment of substance use disorders and many position statements addressing specific situations such as breastfeeding, adolescent sleep hygiene, and the diagnosis and management of hepatitis C. The organization publishes a journal and offers education resources. 
• Be aware of potential biases that could cause you not to provide appropriate care (e.g., stereotyping those with substance use disorders as being untruthful about pain)(See sidebar).
• Provide education to patients at the appropriate education level and in the preferred language. Document education was provided, and the patient’s understanding.
• Ensure privacy. Follow HIPAA guidance related to correctional settings. For example, share patient information with guards only on a need-to-know basis (e.g., suicide risk, infectious disease precautions, physical accommodations, dietary restrictions). Avoid sharing why these things are needed, for example, diagnoses or specific conditions. 
• Maintain professional boundaries with incarcerated people and correctional officers. 
• Check that emergency equipment is available and in good working order. 
• Ensure that medications, especially controlled medications, are properly stored and that access is restricted to authorized personnel to reduce the risk of diversion.
• Ensure that patients at risk for suicide are closely monitored. 
• Document assessments and care. If the patient’s condition worsens, notify the appropriate provider and document this notification. Documentation should include your findings, the person contacted, the method of communication (e.g., phone, email), and the resulting plan of action. Escalate to the next level if the response is insufficient. 
• Engage in continuing education in key areas such as infection prevention, emergency response, substance use disorder, and suicide prevention. It may be helpful to become certified as a correctional health nurse through NCCHC. A useful education and networking resource is the American Correctional Nurses Association. 
• Maintain malpractice and professional liability insurance. 
• Advocate for patients and system change as needed. For example, ensure that older adults are screened for cognitive impairment and receive regular health assessments for sensory deficits and fall risk. This patient population may also be victims of elder abuse. 
• Remember that your first responsibility is to the patient, not to administrators of the facility.
• Protect your mental health. Correctional nursing can be a particularly stressful setting. Take steps to reduce stress, which could lead to errors as a result of psychological distress. Network with other nurses in the specialty.
• Above all, be proactive in taking steps to reduce your risk. This will also help patients receive better care.

Serving patients while
protecting oneself

All incarcerated patients deserve quality healthcare, yet caring for them can be challenging. Correctional health nurses can help these patients, who often have significant physiologic and psychosocial issues predating incarceration, receive the best possible care. At the same time, nurses can implement measures in this article to protect themselves from legal action. 

Avoiding cognitive bias

Incarcerated people are often victims of cognitive bias, which is the inherent tendency of people to interpret events and other people based on their own beliefs, perceptions, and experiences, which can lead to inaccurate conclusions. Cognitive bias can negatively affect patient care. For instance, it might cause a correctional health nurse to discount a patient’s pain, incorrectly attributing it to drug-seeking behavior rather than an undiagnosed medical condition.

In an article, Rollings-Mazza and Williams list 11 forms of cognitive bias. For example, confirmation bias refers to valuing information that supports our existing ideas and ignoring information that does not. Anchoring bias refers to the tendency to rely too much on the first information we receive, and the bandwagon effect occurs when we adopt behaviors or beliefs because we believe they are pervasive (“everybody’s doing it).

Among the tactics the authors provide for overcoming cognitive bias are:

• Be aware that biases are more likely to distort decision-making when you are rushed, multitasking, or tired;
• Play “devil’s advocate” with your own beliefs or suppositions; question yourself;
• Acknowledge the possibility that you might not be right; be aware of your own limitations; and
• Consider data from all positions, weighing them equally.

Refer to the article for the entire list.

Source: Rollings-Mazza P, Williams T. Beware the dangers of cognitive bias. CorrectCare. 2023;37(2):12-13.

This article does not constitute legal advice.

References

American Nurses Association. Nursing: Scope and Standards of Practice, 4th Ed. 2021.

Bieber C. Medical negligence: Legal definition & examples. Forbes. 2022.  https://www.forbes.com/advisor/legal/medical-malpractice/medical-negligence/

Brewer TD. The evolving test for deliberate indifference in correctional healthcare. 

Code of Federal Regulations. § 164.512 Uses and disclosures for which an authorization or opportunity to agree or object is not required. https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-164/subpart-E/section-164.512

Legal Dictionary. Estelle v. Gamble. 2019. https://legaldictionary.net/estelle-v-gamble/

Moran Reeves & Conn PC. 2024. https://moranreevesconn.com/news/the-evolving-test-for-deliberate-indifference-in-correctional-healthcare/

CNA, NSO. Nurse Professional Liability Claim Report, 5th Ed. 2026.

Legal Information Institute. 42 U.S. Code § 1983 – Civil action for deprivation of rights. n.d. https://www.law.cornell.edu/uscode/text/42/1983

Legal Information Institute. § 164.512 – Uses and disclosures for which an authorization or opportunity to agree or object is not required. n.d. https://www.law.cornell.edu/cfr/text/45/164.512

National Commission on Correctional Health Care. Care for aging patients in the correctional setting. 2024. https://ncchc.org/position-statements/care-for-aging-patients-in-the-correctional-setting/

National Commission on Correctional Health Care. Jail guidelines for the medical treatment of substance use disorders. 2025. https://www.ncchc.org/wp-content/uploads/2025-MAT-Guidelines-for-Substance-Use-Disorders-3-6-25.pdf

National Commission on Correctional Health Care. Professional certification. n.d. https://ncchc.org/professional-certification/

National Commission on Correctional Health Care. Standards: a framework for quality. n.d. https://ncchc.org/standards/

Rollings-Mazza P, Williams T. Beware the dangers of cognitive bias. CorrectCare. 2023;37(2):12-13.

Disclaimer: The information offered within this article reflects general principles only and does not constitute legal advice by Nurses Service Organization (NSO) or establish appropriate or acceptable standards of professional conduct. Readers should consult with an attorney if they have specific concerns. Neither Affinity Insurance Services, Inc. nor NSO assumes any liability for how this information is applied in practice or for the accuracy of this information. Please note that Internet hyperlinks cited herein are active as of the date of publication but may be subject to change or discontinuation.

This risk management information was provided by Nurses Service Organization (NSO), the nation’s largest provider of nurses’ professional liability insurance coverage for over 550,000 nurses since 1976. The individual professional liability insurance policy administered through NSO is underwritten by American Casualty Company of Reading, Pennsylvania, a CNA company. Reproduction without permission of the publisher is prohibited. For questions, send an e-mail to service@nso.com or call 1-800-247-1500. www.nso.com.

Reprinted with permission from Nurses
Service Organization (NSO).

A State Board of Nursing (SBON) complaint may be filed against a Nurse Practitioner (NP) by a patient, a patient’s family member, colleague, employer, and/or other regulatory agency, such as the Department of Health. Complaints are subsequently investigated by the SBON to ensure that licensed nursing professionals are practicing safely, professionally, and ethically. SBON investigations may lead to outcomes ranging from no action against the NP to revocation of the NP’s license to practice. Therefore, when a complaint is asserted against a NP to the SBON, the NP must be equipped with the resources to adequately defend the matter. Being unprepared may represent the difference between a NP retaining or losing their license. This case study involves a registered NP who had been a NP for over 20 years and was currently working in an outpatient clinic setting.

Background

The NP was contacted by an SBON investigator informing him that a complaint had been filed against him. The subject of the complaint was posts and re-posts on the NP’s personal social media account regarding multiple political matters. The investigator confirmed that the complaint alleged improper conduct connected to social media activity rather than patient care, clinical practice, substance use, fraud, or criminal activity.

The investigator informed the NP that he would soon receive a formalized SBON notice detailing the complaint information as well as a date for the hearing.

A few days later, the NP received the documents from the SBON. The NP notified the insurance carrier who retained the assistance of an attorney experienced in defending complaints filed with the licensing board. The NP provided the attorney with the documents he received from the SBON. The attorney reached out to the SBON investigator on behalf of the NP. Both agreed to delay the formal hearing so that the attorney could review the allegations of the complaint and provide a response to the SBON on the NP’s behalf.

The attorney noted that the NP established his social media account approximately eight years prior to the complaint as well as the following:

• The account was made using a nickname that his friends and family knew him by and not the formal name he used in practice.
• His profession as an NP was not identified.
• No patients or patients’ information was ever mentioned.
• No patients were tagged in any of his posts.
• All postings occurred outside any professional setting.

While reviewing the specific information on the NP’s social media account, the attorney noted that there were only five instances in which the NP reposted news articles and images that were already available online and minimal original commentary.

During the timeframe in which the attorney was reviewing the complaint and information on the NP’s social media account, the NP experienced targeted attacks both personally and financially. The individuals opposed to the social media content contacted the NP’s employer, licensing authorities, and others. The NP deleted all posts referenced in the complaint, and, when his employer continued to receive complaints, he deleted his social media account. Despite creating a new account using an alias and avoiding any political comments, the NP and his employer continued to receive complaints.

In the attorney’s response to the SBON, she described the organized online effort targeting people who publicly expressed support for political matters. She claimed that the NP’s employer had difficulty including his information on its website because renewed complaints or communications would occur after publication. In her letter to the SBON, the attorney argued that the investigation against the NP should be dismissed. The attorney stated:

• The SBON lacked authority to regulate or discipline a licensee for personal political activity unrelated to professional practice and that continuing the investigation would extend beyond the SBON’s intended regulatory authority.
• The conduct involved protected personal expression and did not contain any information regarding the
• NP’s profession, patients, his employer, or the name he used professionally.
• Because the content was shared privately and outside the professional context, constitutional analysis further supported dismissal of the case.

SBON’s Response and Resolution

The SBON responded that they had closed their investigation but noted that confidentiality laws prevented disclosure of the exact reason for closure. The response letter explained that routinely cases are closed for a variety of reasons, which may include:

• Insufficient evidence.
• Allegations that do not constitute a violation even if true.
• Unfounded allegations.
• Expiration of the statute of limitations.
• A non-public action by the SBON.

Importantly, the closure letter did not specify which of these reasons applied in this case. It simply confirmed that the investigation was closed and that the file remained confidential. The SBON also stated that if additional information was received, they could reopen their investigation into the NP.

This case exemplifies the importance of notifying your insurance carrier and retaining an attorney familiar with professional licensing board matters, as the outcome may have been different with a less experienced attorney or if the NP had tried to communicate a resolution with the board on his own. While the SBON matter resolved positively for the NP, he suffered both personally and professionally. The expenses incurred to defend the insured in this matter exceeded $4,000.

This matter demonstrates how personal social media activity can trigger licensing complaints even when the conduct is not directly tied to patient care, and how licensure defense expenses coverage may be used to obtain legal representation during a board investigation.

Risk Management Recommendations

Below are risk recommendations that may help mitigate a licensing board investigation being conducted against an individual based on their personal social media presence.

Practical risk management recommendations include a simple test prior to posting on social media – “Would I be comfortable seeing this post displayed on a licensing board complaint, malpractice case exhibit, employer HR file, or newspaper front page”? If the answer is no—or even maybe—don’t post it.

Never post any information that could identify a patient. The single greatest social media risk is disclosure of protected health information (PHI). Even a de-identified story may violate privacy requirements if enough details exist for someone to identify the patient. Examples that could identify a patient include:

• Patient photographs or videos
• Names, initials, room numbers, or dates
• Clinical details that could identify a patient
• Stories that allow others to recognize a patient, even if the name is omitted
• Screenshots from electronic medical records
• Images that inadvertently include patient information in the background
• Assume everything you post is public and permanent.

Separate personal opinions from professional identity. This matter illustrates how personal posts can still generate licensing board complaints even when they are unrelated to patient care. Consider:

• Whether your profile identifies you as a NP, physician, therapist, pharmacist, or other healthcare professional.
• Whether your employer can be identified.
• Whether controversial content could be perceived as unprofessional conduct.

Verify health information before sharing. Healthcare professionals may face criticism, complaints, or liability if they share inaccurate healthcare information. Before posting:

• Verify information from reputable scientific sources.
• Avoid spreading unverified claims.
• Distinguish facts from personal opinion.
• Consider whether a reasonable patient might rely on the information.Understand employer and SBON policies. Healthcare professionals should know:
• Employer social media policies
• HIPAA requirements
• SBON regulations
• Professional association ethical standardsMany SBON consider online conduct when evaluating allegations of:
• Unprofessional conduct
• Boundary violations
• Harassment or discrimination
• Patient confidentiality breaches
• Never post while performing patient care. Social media activity during patient care can become problematic in malpractice litigation.

Review online privacy settings regularly. Privacy settings reduce risk but do not eliminate it. At a minimum:

• Restrict public access where appropriate.
• Review tagged photos.
• Limit who can view personal information.
• Be cautious about location-sharing and geotagging.
  Seek early assistance if a complaint is filed. Immediately contact your carrier if contacted by:
• A licensing board
• An employer investigator
• A professional association
• A plaintiff attorney 

Disclaimer: The information, examples and suggestions presented in this material have been developed from sources believed to be reliable as of the date they are cited, but they should not be construed as legal or other professional advice. CNA, Aon, Affinity Insurance Services, Inc., NSO, or HPSO accepts no responsibility for the accuracy or completeness of this material and recommends the consultation with competent legal counsel and/or other professional advisors before applying this material in any particular factual situations. This material is for illustrative purposes and is not intended to constitute a contract. Please remember that only the relevant insurance policy can provide the actual terms, coverages, amounts, conditions and exclusions for an insured. All products and services may not be available in all states and may be subject to change without notice. Certain coverages may be provided by a surplus lines insurer. Surplus lines insurers do not generally participate in state guaranty funds, and insureds are therefore not protected by such funds. The claims examples are hypothetical situations based on actual matters. Settlement amounts are approximations. Certain facts and identifying characteristics were changed to protect confidentiality and privacy. Any references to non-CNA, non-Aon, AIS, NSO, and HPSO websites are provided solely for convenience, and CNA, Aon, AIS, NSO and HPSO disclaim any responsibility with respect to such websites. “CNA” is a registered trademark of CNA Financial Corporation.

Certain CNA Financial Corporation subsidiaries use the “CNA” trademark in connection with insurance underwriting and claims activities. This material is not for further distribution without the express consent of CNA. Copyright © 2026 CNA. All rights reserved.

Healthcare Providers Service Organization is a registered trade name of Affinity Insurance Services, Inc., a licensed producer in all states (TX 13695); (AR 100106022); in CA, MN, AIS Affinity Insurance Agency, Inc. (CA 0795465); in OK, AIS Affinity Insurance Services, Inc.; in CA, Aon Affinity Insurance Services, Inc., (CA 0G94493), Aon Direct Insurance Administrators and Berkely Insurance Agency and in NY, AIS Affinity Insurance Agency.

Reprinted with permission from Nurses
Service Organization (NSO).

Donald Trump then sped off in the presidential limo known as the Beast — at nearly 100 mph, according to pool reports — and headed for an event in Oklahoma. Republicans gazed in mock wild wonder, palms outstretched, claiming they have no idea why they’re staring at potentially historic losses in the midterm elections next month. 

Afterwards a MAGA supporter told me that Trump’s performance was just “presidential humor.” And fair enough. Donald Trump has spent a lifetime being, in effect, the Wednesday night open-mic comic at a backroom bar in some college town in Missouri. 

Neither capable of growth nor understanding, he’s that guy with just one punchline. He’s a one-trick pony: “Sir, she said. Sir.” He’s the most talentless man ever caught in the bright glare of the light he demanded from the world.

But he is persistent. That’s his superpower. The grift? Oh, that part he learned from experience. But he’s naturally persistent, and out of that grew the corruption, fearmongering and boundless anger — all driven by his superpower. He learned to be transactional. Every failure is fuel for the next fiasco.  

The first Trump administration was an accident, largely brought about by the split I witnessed firsthand between Hillary Clinton’s and Bernie Sanders’ supporters at the Democratic convention in Philadelphia during the last week of July 2016. What a shock: The Democrats destroyed their chances through infighting. Who knew?

Trump never thought he’d win that election. Some Republicans, who later fled the party, never accepted him as a legitimate heir to the GOP’s legacy when he did. Now, critics and fans alike have pointed out that there’s no doubt he’s the rightful heir to the Republican Party of Richard Nixon, Ronald Reagan and George W. Bush; more corrupt than Nixon, a happy practitioner of Reagan’s economics and more of a mean-spirited-wimp than Hunter S. Thompson ever thought Bush could be. 

Trump’s refusal to bust up monopolies while cutting staff to the National Park Service and selling off public lands has removed any illusions that he might be a Teddy Roosevelt Republican. His lack of military service takes him out of the realm of being a Dwight Eisenhower Republican. As for Abraham Lincoln, Trump has tried his best to divide a nation, not unite one. 

Since Trump never thought he’d win in 2016, he never really planned anything; he let the Republican establishment run things until he got comfortable sleeping in the big chair in the Oval Office and declaring each week “infrastructure week” while doing nothing about it. 

Then came COVID, and in 2021 Trump found himself out of power after, of course, refusing to concede the election and inciting a failed insurrection. That failure fueled his persistence and led to his 2024 re-election. The failure also fueled his anger. His subsequent 34 felony convictions in New York and the federal investigations into his actions became motives for Trump to seek and destroy all who tried to bring him to justice.

His persistent greed, anger and need for revenge empowered him during his first 100 days back in office in 2025, leading to sweeping, Nazi-esque changes sold to the public by discrediting or co-opting the media. 

Meanwhile, the former East Room of the White House looks like Dresden during postwar reconstruction; the Kennedy Center is starting to resemble a Greek ruin; the Lincoln Memorial Reflecting Pool is empty and broken, and for some reason that can only be understood under the influence of hallucinogens and Red Bull, he now wants to build a triumphal arch and stuff it with weapons.

We have no idea why we’re at war with Iran and no idea how to negotiate a peace. Trump’s latest attempt at that answer came in the Oval Office on Wednesday when he said, for what must be the fifth or sixth time, that he could just blow Iran up. 

At least 58 people have died after being remanded to ICE facilities. Homeland Security chief Markwayne Mullin shrugs that off and says nothing ICE does is controversial and he’s not running “Holiday Inns — these people broke the law.” His superpower seems to be life-ending, militant ignorance.

Then there’s Russia, Ukraine, China and a host of other scandals. Those include but aren’t limited to spending taxpayer money on political ads, the price of diesel fuel, the slaughter of Palestinians in Gaza, antisemitism, misogyny and the L.A. mayor’s race. 

While covering Trump is always a challenge, covering his minions is another story. Sen. Eric Schmitt of Missouri, who made his bones trying to kill the Affordable Care Act and challenging the results of the 2020 election, made a complete fool of himself this week in the Senate while attacking former special counsel Jack Smith. 

Schmitt’s superpower is apparently making an ass of himself in public. By misrepresenting nonsensical evidence, he accused Smith of perjury. When called out for his sophomoric display, he then went on right-wing media and lied some more.

Smith, who still reminds me of Coach Beard in “Ted Lasso,” explained that his prosecution wasn’t politically inspired. It was driven by facts. “My service has spanned both Republican and Democratic administrations. I am not a politician, and I have no partisan loyalties,” he said. “My career has been dedicated to serving our country by upholding the rule of law and the core principles on which our country was founded,” Being driven by facts and principles is a pretty decent superpower and should describe most people, including reporters, lawyers, scientists, politicians and clerics. 

“The charges against President Trump were the result of the evidence,” Smith said. “Grand juries in two separate districts reached this conclusion based on his actions. Rather than accept his defeat in the 2020 presidential election, President Trump engaged in a criminal scheme to overturn the results and prevent the lawful transfer of power.”

That conclusion shouldn’t come as a surprise to anyone after all this time. Trump told me in the Brady Briefing Room, six weeks before the 2020 election, that “If you stop counting the votes” there wouldn’t need to be a peaceful transfer of power. He’d just stay on indefinitely.

Trump thus teaches us that persistence pays off even if the proposition is criminal and the facts aren’t in your favor. That’s why he currently commands the center ring of the circus.

Meanwhile, down in Texas, we have the aforementioned Sideshow Ken Paxton, one of the most loathsome individuals ever to climb out of the primordial ooze and declare himself a human being. This is a man so vile that even Trump hates him, and so do the Trump-happy Texas Republicans who have been known to embrace faith healers and hunt snakes in shorts and cowboy boots. They tried to rid themselves of Paxton, but he somehow slipped away.

Paxton’s superpower is his lack of spine and his greasy nature. That, combined with Trump’s (ahem) support, is the reason Paxton isn’t in prison. 

But time has its way with everyone. After more than a decade of deploying his superpower, Trump is noticeably faltering, even conceding from the Oval Office this week that his party may lose the midterms. The man who has traded on fear, corruption and grift for so long that he looks like a cartoon Tasmanian devil without the charm has now come to resemble Otis, the sleepy town drunk in “The Andy Griffith Show” (look it up, for heaven’s sake). 

Waiting in the wings is “Hillbilly Elegy” JD Vance, worming his way through the crowd. That’s his superpower: He’s a bearded human worm. If you don’t like him, you might place a bet on Marco “The Juggler” Rubio. His superpower is handling a variety of tasks without the loud explosive thud of total failure often seen from Trump, Vance and Pete Hegseth, who’s more like the the secretary of fashion than the “secretary of war.” That makes “Li’l Marco” a bright star in Trump’s dark firmament, even if it’s evident nobody likes him.  

Hegseth, on the other hand, is among the dimmest. His superpower seems to be the ability to cosplay a vain summer camp counselor in the Adirondacks from a bad Hallmark comedy.  

For the comic book fans out there, the Republicans are led by a Yellow Lantern with fading powers, delusional in his beliefs and actions, too fearful to change and faced with the overpowering realization that his time in power is quickly coming to an end. 

He even sent an email to supporters Thursday claiming “This could be my final four weeks as president.” Sure, it was another grift, as well as fatalistic and totally disingenuous. 

They may have to pry Trump out of the Oval Office with a crowbar and a handful of sedatives in 2029, if he lasts that long. But next month’s midterm elections, should they go as badly as Trump obviously fears, will mean the effective end of his presidency. What comes after that could be chaos. Don’t expect mature or professional behavior from a party that can’t tell the difference between an NBA game in Atlanta and a women’s college basketball game in Silver Spring. Just realize it’s the same party that wants to punish transgender Americans while rewarding the ultra-rich. 

The only question that matters is this; Does Trump have enough juice left in his Yellow Lantern ring for one last fearful victory? At his mini-convention in Dallas he told his followers to “cheat like hell.” At the same time Trump asked everyone to vote as if he were on the ballot; unfortunately for the Republicans, many will do just that. At this point, it’s almost as if Trump is campaigning for the Democrats. 

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Seems appropriate. Most of the Democrats are counting on winning by simply saying, “I’m not Trump.”

Folks, they’re not putting Vance out in the field for the Donald’s sake. He’s there for the same reason: Because he’s not Trump. Soon enough, JD could graduate from the sideshow to the center ring.

Should Trump and the Republicans suffer the historic midterm blowout everyone sees coming — barring armed confiscation of ballot boxes — the president will play the victim, a martyred hero who will claim the elections were rigged and blame Joe Biden, China, Canada, our NATO allies and Iran. If he somehow finds a miraculous recharge for his ring, he will use his superpower to foment further revenge and retribution. Every failure is fuel for the next fiasco.

I’ve been told that everyone has a superpower. If so, I’ll defer to what my father told me was mine: asking annoying questions. I still have a few for you, Mr. President.

The post Trump’s superpower is fading. Can he recharge before the midterms? appeared first on Salon.com.

​These unique circumstances likely help explain why liability closed claims involving home health nurses comprise the largest proportion of claims by specialty (21.7%), according to a 2026 report from NSO and CNA. The same report found that the average total incurred cost for home health claims increased by 39.3% from 2020 to 2025 (from $210,325 to $277,503). 

Fortunately, home health nurses can mitigate their liability risk. It starts with understanding potential areas of liability and then implementing preventative measures for each.

Liability risks

Several areas can pose liability risks for home health nurses.

Scope of practice and role clarity. Liability risk increases when home health nurses take on tasks and responsibilities beyond their licensure and expertise. In addition, nurses may not fully understand requirements related to home care found in state nurse practice acts, state law, and federal regulations that may impact them and the agency they work for. For instance, nurses need to be aware of who can order home care and the guidelines concerning the use of verbal orders. In South Carolina, for example, verbal orders have to be authorized no later than 72 hours after the order is given.

Patient assessment and monitoring. Home health nurses often face daunting challenges when performing assessments. They may be working in cluttered, noisy environments, with distractions such as family members and pets. These conditions can make it easy to miss findings, a situation that can affect the plan of care and identification of the need for immediate follow-up. For example, the nurse may fail to recognize and promptly report a patient’s deteriorating condition, which can lead to delayed treatment and adverse outcomes.

Medication management. Patients in the home frequently have complex medication regimens, which increases the risk of errors related to administration, reconciliation, and patient adherence. Liability risks are compounded when a nurse fails to provide sufficient education (or fails to document that education was provided) to patients and caregivers.

Documentation and communication. Documentation can be challenging for home health nurses because of space constraints in the home, the desire to limit time spent in a potentially dangerous situation or hazardous environment (for example, pest infestation), and the need to complete the shift’s assignments. Another consideration is that the nurse is the only one who can document what occurred in the event of an issue or incident: there are no coworkers to serve as witnesses. Both written and verbal communication can be disrupted: Breakdowns in communication with physicians, agencies, or caregivers often contribute to home health claims.

Environment and safety. As they focus on delivering care to the patient, home health nurses may neglect to assess the environment, checking for unsafe living conditions, areas that could impact infection control (e.g., insulin stored in a dirty refrigerator), and fall hazards such as throw rugs. This can cause failure to address issues, raising the risk of liability. Home health nurses also may encounter evidence of criminal activity, such as theft; physical, sexual, and verbal abuse; and destruction of property. Failure to report per guidelines can lead to charges of negligence. An additional problem area is the potential for a motor vehicle accident when a nurse inappropriately takes a patient to a store, misguidedly seeking to be of assistance.

Delegation and caregivers. Delegate appropriately to any caregivers; use the nurse practice act, nursing standards, and agency policies as a guide. Provide education and determine that the caregiver is competent in completing the task. Have the caregiver provide a return demonstration of any task and document completion.

Ethical and professional boundaries. Maintain professional boundaries. By nature, nurses are caring people, but it is important to keep your relationship with patients, families, and caregivers professional.

Operational and system-level issues. This can be the most difficult area for home health nurses. It is worth repeating that you should not take on a patient you do not feel competent to care for, even if there is pressure to do so. However, you can certainly be an advocate for change to address problem areas such as insufficient staffing, lack of needed supplies, and communication barriers.

Reducing risk

Here is how home health nurses can reduce their liability risk in each of the areas discussed.

Scope of practice and role clarity. Follow your state’s nurse practice act and accept only assignments where you have the competencies needed to care for the patient. This can be particularly challenging for early-career nurses but is essential for liability protection. Adhere to professional standards such as those in the Nursing: Scope and Standards of Practice, 4th Ed.

In addition, follow agency policies and procedures. If you feel agency guidance is unclear, ask for additional information and collaborate to revise materials as needed.

Patient assessment and monitoring. After reviewing materials provided by the agency and, if applicable, the hospital, perform a comprehensive initial patient assessment. The assessment should include social conditions that could affect care (e.g., lack of support for any interim needed dressing changes). Follow-up assessments during ongoing monitoring are also important. Depending on the environment, assessments can be challenging, but thoroughness is key to reducing liability.

Medication management. At the initial visit and each following visit, check for patient factors that could affect medication safety (e.g., poor vision). Also, check storage conditions to ensure the medication is being kept at the proper temperature and that safety measures are in place to avert accidental poisoning by children. Verify that medication bottles are clearly labeled with name, dosage, and instructions that are understood by the patient.

Ensure you are familiar with possible side effects (and communicate that information to the patient) and check for potential negative interactions between prescribed medications. If unsure, consult a pharmacist or a reliable drug database. Patients should use standardized tools for measuring liquid drugs, rather than relying on household items, which may not be accurate.

At each subsequent visit, ask the patient about medication side effects and act as needed (e.g., contact the physician to change dosage) Reconcile all medications (prescription medications, over-the-counter drugs, and supplements), checking names and dosages. Reconciliation is particularly crucial with controlled medications.

Provide medication-related education to patients and caregivers and explain how to dispose of discontinued medications properly. Caregivers and family members can be helpful in promoting medication adherence, but only if they sufficiently understand their responsibilities. A study by Gil-Hernández and colleagues found that educating caregivers involved in medication management in the home reduced the number of errors. In addition, a systematic review study by Gilva and colleagues found that structured educational interventions (combining counseling, health literacy-informed materials, and standard dosing tools) for parents of pediatric patients in the home significantly improve caregiver medication knowledge and reduce dosing errors.

Documentation and communication. Obtain and document that you received the patient’s permission to deliver care. Document every visit thoroughly and in real time whenever possible to promote accuracy. Include assessment findings, education provided (and the person’s understanding of it), and communications with patients, family members, caregivers, and physicians. Document progress towards goals, since there is usually a limit to the number of visits that can be provided.

It is especially critical to document negative changes in the patient’s condition and actions taken, including addressing nonadherence and notifying physicians of a patient’s deteriorating condition. If the physician provides a verbal order, obtain a written order later.

If you need to correct the patient’s record, clearly indicate the change and do not backdate entries.

Finally, if at some point the patient refuses care, document the reasons given and that you provided clear information as to the consequences.

Environment and safety. Perform a safety assessment of the environment at each visit, including checking for signs of patient abuse or neglect. Document and report issues in accordance with reporting obligations. Be familiar with your state’s requirements, which will provide details such as report timing and who should receive the report. Do not transport patients to other locations. 

Delegation and caregivers. Delegate appropriately to any caregivers; use the nurse practice act, nursing standards, and agency policies as a guide. Provide education and determine that the caregiver is competent in completing the task. Have the caregiver provide a return demonstration of any task and document completion.

Operational and system-level issues. This can be the most difficult area for home health nurses. It is worth repeating that you should not take on a patient you do not feel competent to care for, even if there is pressure to do so. However, you can certainly be an advocate for change to address problem areas such as insufficient staffing, lack of needed supplies, and communication barriers. 

Protection for nurses and patients

Home health nursing is a rewarding career, but its demands expose its practitioners to significant liability risk. Home health nurses can reduce that risk through several actions, including being aware of potential liabilities, adhering to legal and professional standards, engaging in effective practice behaviors (e.g., providing education, using patient-centered communication), documenting thoroughly, pursuing ongoing education, and maintaining professional liability coverage. By taking these steps, home health nurses can protect themselves from legal action and protect their patients from harm. 

This article does not constitute legal advice. 

Article used with permission: https://www.nso.com/Learning/Artifacts/Articles/Home-health-poses-unique-liability-risks-for-nurses 

References

Agency for Healthcare Research and Quality. Teach-Back: Intervention. 2023. https://www.ahrq.gov/patient-safety/reports/engage/interventions/teachback.html

American Nurses Association. Nursing: Scope and Standards of Practice, 4th Ed. 2021.

CNA, NSO. Nurse Professional Liability Claim Report, 5th Ed. 2026.

Cornell Law School. S.C. Code Regs. § 61-91.1000.1002 – Medication Orders (I). 2024. https://www.law.cornell.edu/regulations/south-carolina/R-61-91-1000.1002

Gil-Hernández E, Ballester P, Guilabert M et al. Enhancing safe medication use in home care: insights from informal caregivers. Front Med. 2024;11:1494771.

Gilva S, MacDonald F, Cleary B, McCallion N, O’Brien F. Improving medication safety in the home: a systematic review of educational interventions for parents of paediatric patients. Acta Paediatrica. 2026;115(4):759-771.

Hadaway L. Part 2: Home care negligence and the legal aftermath: focus on IV medication safety. Home Healthc Now. 2025;43(4):256-257.

Hinck SM. A theoretical framework of home-based professional nursing practice. Home Healthc Now. 2022;40(3):146-53.

Hinck S. Home health nursing: Patient-centered care focused on self-sufficiency. Am Nurs J. 2024;19(6). https://www.myamericannurse.com/home-health-nursing/

HumanCare. How to prevent medication errors in home care. 2025. https://www.humancareny.com/blog/how-to-prevent-medication-errors-in-home-care 

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She was not from “a wealthy family,” he said. “This was her dream and it was taken away from her at a young age in just a horrific fashion.”

But according to some on the right, Doe has not suffered enough for reporting her alleged assault to the police and then later suing the accused, the university and the fraternity. It’s not enough that she saw no charges filed, or that reportedly only two of the accused were expelled from campus. On top of her existing pain, therefore, many of the MAGA faithful are punishing her further by calling her a liar, implying she’s a slut and even threatening to out her, which would put her personal safety at risk. Whatever their intent, by doing this, they are sending a strong message to any victim of rape who might feel tempted to seek justice: Stay silent, or you’ll be next. 

In 2017, the #MeToo movement took the nation by storm. A veritable flood of women, and some men, spoke out about their own experiences with sexual abuse, leading to a slew of firings, lawsuits, arrests and social opprobrium of the accused, especially since so many accusers produced compelling evidence. Despite this, it was barely weeks before the backlash began, with countless articles about how #MeToo had gone “too far,” despite scant evidence that innocent men were getting entangled. That response swelled until it overcame #MeToo, which has largely faded into the background. 

The Cornell case shows, though, that far from going too far, the #MeToo movement didn’t go far enough. Much — if not most — of the time, alleged victims still face far more serious consequences than their accused assailants, and for many people and institutions, it still feels much easier to make the issue go away by suppressing accusations than dealing with these cases which are, admittedly, often complex. 

There is no doubt that the Cornell case is messy. By her own account, the victim was initially consenting, though perhaps not enthusiastically, to a threesome with two fraternity members. But the situation apparently took a turn when she took ketamine during the encounter and more fraternity members joined in, even communicating about “free p—y” on Snapchat. She describes hiding and swatting the new men away, but being too incapacitated to fight back.

“I can say with 100% confidence I was raped,” she told police during a November 2024 interview. 

It took time for the alleged victim to get to the point where she was ready to file a report, which right-wing pundits have seized on as evidence that she was not really raped. The New York Times, using campus police documents and witness statements, laid out the timeline showing that she initially reacted with confusion and shame. While she didn’t call it “rape,” she was clearly unhappy about what had happened. Over the course of a few weeks, she came around to first texting one of the accused that “90% of what happened that night was not consensual,” and then filing a police report. 

“After rape, it’s common that victims don’t realize what happened was rape,” explained Anne DePrince, a psychology professor at the University of Denver and author of “Every 90 Seconds: Our Common Cause Ending Violence Against Women.” 

Victims “feel some shame about reporting it,” especially if they initially “liked the boy or they wanted to go to an event,” Sharon Gandarilla-Javier, an assistant professor at the John Jay College of Criminal Justice, told me. She noted that it’s also common for someone to initially consent to one activity that then becomes “totally different than what they expected.” 

Journalists and feminist writers have been cautious in addressing this case, making it clear that the claims haven’t been tested in court and that New York’s rape laws may not be enough to secure an indictment, much less a conviction. Tompkins County District Attorney Matthew Van Houten has reopened the case, arguing that this new lawsuit presents evidence he didn’t have when he initially made the decision to not charge the accused. New reporting also shows that Van Houten was given a condensed version of Doe’s report to Cornell police, one that omitted her use of the word “raped.” 

But on the right, there appears to be no similar care when lobbing unproven — and unevidenced — accusations that Doe is lying. 

“Her account has radically changed,” The Daily Wire’s Ben Shapiro said on Tuesday’s episode of his podcast, insisting “it turned out that the details of the police report did not amount to anything like rape.”

While he may be proven right if prosecutors can’t secure an indictment, this is not the same thing as saying that all Doe reported was “bad things happening with consent,” as Shapiro claimed. She herself said she was “raped,” and as many have pointed out, the very fact that she filed a police report is relevant. Calling the police suggests that a person believes they are reporting a crime. 

Matt Walsh, also of the Daily Wire, accused feminists of “rushing into the next Duke lacrosse/UVA-style hoax” and argued on X that the situation was nothing more than “a disgusting drug and alcohol fueled orgy,” where “the drunk men have just as valid a claim to being raped.” This, of course, ignores the fact that the alleged victim did not get on Snapchat to advertise “free p—y” to strangers, as well as her own testimony that she pushed them away and tried to hide.

The story “gets transformed from a night of regrets that the young woman is ashamed of into a night in which she’s a victim,” former Fox News host Megyn Kelly said on her podcast, where she also threatened to release the accuser’s name.

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Feminists and journalists are wise to use words like “alleged” and to be clear that the evidence has not been fully evaluated in a court of law, and it is true that there remains much about this case that is unknown. Still, there are the Snapchats and text messages, including one where the alleged victim uses the word “nonconsensual” and another where the accused wrote “I just wanted to apologize for how things went down the other night.” This alone makes it hard to believe the accusations are a “hoax,” as Walsh suggested, even if there are outstanding legal questions about whether a consensual encounter turned into something illegal. 

For people who insist on the principle of “innocent until proven guilty,” many on the right have proven themselves quick to make claims about the alleged victim’s motives. It’s worth remembering that E. Jean Carroll won a defamation civil suit against Donald Trump after he accused her of lying when she claimed he sexually assaulted her in the dressing room of a Manhattan department store in the 1990s. There is a demonstrable psychological and reputational toll on alleged victims when they face public accusations that they are lying, especially when they come from high-profile people who also insinuate that the victim is an immoral person because of their sexual history.

In this case, no one is required to have an opinion about the accuser’s character. They don’t know her history or her life or why she was even at the party, beyond her stated desire to have some fun. They could, like most decent people, consider the allegations and assume that, even if there is not a crime here, what is described should never happen to anyone. Shutting up is free.

But the past decade of Trumpism has largely been built on stirring up male anger at women’s growing equality. Paranoid and unsupported claims that women have immense power to ruin men with false accusations have been the bread-and-butter of a MAGA media industry designed to exploit men’s resentment for profit. Their audiences yearn to hear that Jane Doe is the real bad guy here, and so attacking her without a single shred of real evidence against her is an opportunity that many right-wing pundits can’t seem to pass up. 

Despite the hysterical claims of its critics, #MeToo was never about ruining the lives of innocent men. In a very real sense, the movement was about leveling the playing field, which is so dramatically tilted against victims that it makes justice nearly impossible to achieve. No one truly disputes the importance of due process to handle accusations of sexual violence. That’s why Jane Doe is going through the court system. It’s also why it’s good that, in light of new information, the district attorney is re-opening the case. 

But due process is endangered if victims can’t report allegations without facing  public abuse and threats of being falsely accused themselves that it becomes psychologically impossible to live their lives. As its name suggested, that was the whole point of #MeToo: to create enough solidarity between victims and allies to make it safe for victims to speak out without their lives being destroyed. If the right really believes in the value of due process, then they would let it play out, instead of dogpiling and harassing accusers so that future victims are too scared to report crimes. 

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Born on the carnival circuit, the pseudo-sport maintained a here today-gone tomorrow feeling until relatively recently. Promoters scraped out regional fiefdoms where transient performers would fight for a spell before jumping ship in search of better deals. Sometimes they took their name with them; other times they molded themselves to whatever gimmick their new promoter needed on the roster. It makes a mess of any timeline, and that’s before you get to the kayfabe — the illusion — of it all, the fact that all these real men and women are deadly serious about keeping up their fake characters. 

Grasping for concrete facts can leave you with two immutable bits of data: when a wrestler was born and when they died, with everything in between being a show on some level. Get enough of those dates together, and it’s hard not to notice a pattern: These sideshow athletes don’t live very long. 

Gorgeous George, one of the most famous faces of wrestling’s Golden Age, didn’t make it to his 50th birthday. “Macho Man” Randy Savage and his ex-wife/manager Miss Elizabeth both died before reaching Social Security eligibility. High-flying technical wrestler Eddie Guerrero died at 38. Windham Rotunda, who freaked out the WWE for years as a swamp-dwelling cultist named Bray Wyatt, passed away at the age of 36. And earlier this week, All Elite Wrestling star Pac died in the parking lot of an Illinois chain restaurant, just a day after his most recent match.

Born Benjamin Satterley in a blue-collar community in Newcastle upon Tyne, England, he first came to national attention stateside in the WWE, where he wrestled under the decidedly English name Neville. He took the cruiserweight title twice before jumping for AEW in 2018. His star rose exponentially as a regular heel for the young promotion. At the time of his passing, he was only 40 years old.

Playing a fake brute who’s willing to take a folding chair to the face to settle a disagreement is hell on a body. Learning how to fall and pretending you have superpowers can’t cancel out physics. If a 240-pound man turns you upside down and drives your head into a padded floor, you’re going to feel it the next day (and probably several days after). The wear and tear is cumulative, adding up over time like it does for all contact sports. Just take a boxer’s blown-out ears and a running back’s trick knee and expand it to account for the fact that, in wrestling, shots to the back of the skull are frequently necessary to move the story along. Recruiting almost exclusively among the huge and jacked — it’s easier to appear larger-than-life on camera if you’re real-world large — makes the list of heart conditions start to pile up. It’s all a recipe for a brief career, and a correspondingly short life.

The situation is exacerbated by wrestling’s employer-employee relationship. Staying true to its seasonal carny roots, almost all professional wrestlers are gig workers. The average star of WWE or AEW signs on as an independent contractor, meaning they are responsible for their own health insurance and are subject to being fired for nearly any cause. The situation has been even worse for wrestling’s women, who spent decades subject to the whims of Mary Lillian Ellison, better known as The Fabulous Moolah, a wrestler-promoter-extortionist who controlled virtually all of women’s wrestling, loaning out talent to regional promotions and taking cuts of stars’ pay.

Unlike the four major professional sports in the U.S., wrestlers have no pension and no retiree health benefits. If you wrestle for a living, you’re faced with significant pressure to perform for as long as you can, through as many injuries as you can. Unsurprisingly, the list of premature wrestler deaths is heavy on accidental painkiller overdoses and acute toxicity from mixing medications with alcohol. 

The central role of the promoter — and the lack of genuine athletic competition in matches — puts wrestlers and management on remarkably unequal footing. It’s hard to cause trouble for a boss who can simply write rabble-rousers out of the scripted action. Attempts to unionize the talent were mounted in the 1980s, first by hoo-rah heel Sgt. Slaughter, and then by wrestler-turned-governor Jesse “The Body” Ventura. The latter seemingly bought into some of the era’s storylines and ringside magic, believing that a rousing speech to the wrestlers in the locker room would convince them to strike. But he was ratted on by company star Hulk Hogan, and promoter Vince McMahon quickly summoned Ventura to let him know that any future outbursts of class consciousness would come with walking papers. 

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“Vince . . .  basically threatened to fire me if I ever brought it up again and read me the riot act,” Ventura explained on The Steve Austin Show. ”I then did WrestleMania 2 and immediately left and did ‘Predator’ and was a member of the Screen Actors Guild now, my union that I get retirement from now, healthcare from, all of that from.”

The situation only got worse as WWE muscled out nearly all regional promotions. McMahon’s anti-union behemoth spent decades as the only game in town for professional wrestlers who wanted the reach of a televised promotion. In recent years, AEW has pitched itself as an antidote to the WWE, but its roster is also almost entirely composed of independent contractors. Stars like CM Punk and Ray Fenix have complained loudly about the way the promotion handles wrestler health.

AEW, likewise, has seen an astounding number of early deaths in its seven years of existence. Pac is the second wrestler who performed in an AEW ring to have died just this month. Andy Williams, the former guitarist for metalcore act Every Time I Die who wrestled under the name “The Butcher,” collapsed shortly after a match with a regional promotion and passed away on Sept. 5 at 48. 

Wrestling’s treatment of its employees is a bit too abstract to be listed on either man’s autopsy report. Coroners are in the business of endings, putting a neat period on decades of damage with phrases like “cardiac arrest.” Still, anyone who has followed wrestling for years can see the way it hobbles its heels and heroes alike. In a sport that heavily encourages everyone watching to follow the narrative, it’s hard not to notice a pattern.

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This story is part of Gen Z at the Ballot Box, a collaboration between States Newsroom and The 19th. 

WINDHAM, Maine – As 24-year-old Maya Brooks walked winding roads in rural parts of Maine, a water bottle hooked to her fanny pack and a stack of “lit” on absentee voting and candidates her group has endorsed in hand, she was focused on reaching voters who either haven’t voted in recent years or have shown they’re willing to vote for both parties. 

Mainers frequently cross party lines, as evidenced by the fact that U.S. Sen. Susan Collins is the only GOP senator running for reelection in a state Donald Trump lost in 2024. Maine consistently ranks among the highest in the country for voter turnout, even among young voters, despite having one of the oldest populations in the country. 

That’s led Maine to be viewed as the top state where young voters could sway Senate outcomes in 2026. 

While Brooks canvassed for the state’s largest progressive community action organization, she thought about one of her first interactions knocking doors this cycle. A woman — not much older than herself— told her she probably wouldn’t vote. Whoever she voted for, whatever their party affiliation, she felt it would not make a difference, Brooks recalled.

“I don’t blame her,” she said. While a registered Democrat, Brooks would rather do away with the two-party system altogether. “Politicians aren’t delivering.” 

Generation Z, now roughly 14 to 29 years old, is a growing portion of the electorate with about 50 million eligible voters in the upcoming midterm elections. But these young voters have soured on both parties. 

Younger people have long been more likely to identify as independents, but Gen Z is doing so at a significantly higher rate than any previous generation at the same age. 

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Being independent does not mean being moderate. Gen Z’s ideological gender gap is driven more by women moving further left than men moving further right. 

“Really, what’s notable is that Gen Z women are the distinct group compared to both their young male counterparts but also to other American women,” said Melissa Deckman, a political scientist who studies the impact of gender, religion, and age on public opinion. “Simply put, Gen Z women are the most liberal and progressive group of voters in America today.” 

A unifier among Gen Z is a belief that the government is failing to protect and address their needs, notably the high cost of living. 

Trump capitalized on that discontent in 2024, making gains with young voters, particularly young men. Now, Trump’s net approval rating is underwater, especially among Gen Z, with 31 percent of young people who voted for the president saying they regret it, according to an August Navigator poll. 

Both parties are trying to remedy mistakes of elections past in the hopes of winning over the Gen Z vote, launching targeted recruitment efforts, hiring more young people and leaning into social media.

     

No longer taking the youth vote for granted

At a time when many young people were running away from the Democratic Party, Anderson Clayton, chair of the North Carolina Democratic Party, ran to it. 

That is not to say Clayton, who at 25 became the youngest state party chair in the country in 2023 when she ousted an establishment-backed incumbent, has not at times been disappointed.

She wants to see Democrats embrace progressive candidates who win primaries. She wants to get rid of the churn-and-burn cycle of campaigns prioritizing immediate national victories over long-term local sustainability. And she was “so pissed” after Democrats left 44 North Carolina legislative seats uncontested in 2022 that she decided to run for her current role. 

“If you don’t like a party right now, you’re the only one that can change it,” she said in her high-energy cadence.

Clayton got hooked on political work a decade ago, when her county party pushed back on Republicans trying to eliminate the voting site on her college campus. She’s up against similar issues now, after a federal judge ruled against restoring early voting sites on several college campuses in her state earlier this year. 

She has fellows on those campuses to try to turn out the student vote, part of the party’s broader voter protection program, which is in addition to 30 active college chapters and a 100-county, year-round organizing operation. 

“When people look at me and they’re like, ‘Well, young men are leaving the Democratic Party,’ I’m like, ‘Well, let me introduce you then to the leadership that I have right now leading my young Dems, because they are young men,’” Clayton said. “I think that the ability to organize and to help other people see themselves in the party is to also give them that representation.” 

North Carolina Democrats collaborated with Voters of Tomorrow, an entirely Gen Z-led organization seeking to promote political engagement among that demographic, for its national summit in August. Communications director Jessica Siles, 26, said she has seen state parties in particular having more success appealing to young voters. 

“I think in some ways that’s because obviously those ties to the direct local communities are stronger,” Siles said. 

That is borne out in research, which shows relational organizing works because young people trust their neighbors or community networks far more than national parties. Siles sees a sweet spot in engaging Gen Z in events that offer in-person connection in a more social, cultural setting.

That’s an approach being used by the Community Organizing Alliance in Maine, a civic group focused on engaging Black and immigrant voters. Executive director Safiya Khalid, 30, said young people are leading voter registration and education efforts, which include more traditional methods like canvassing, but also events to strengthen community, such as an upcoming concert featuring Somali music, where the alliance will share election-related information to attendees outside the venue. 

The alliance is based in Maine’s 2nd Congressional District. One of the most rural areas east of the Mississippi, it’s an open seat being eyed as consequential for the balance of power in Congress since moderate Democrat Jared Golden is not seeking reelection. 

Another youth-led group in that district, Maine Youth Power, started in 2021 to offer young Mainers clearer paths to engagement in a state with one of the highest median ages. 

“All of our politicians and parties cater towards old people, which is not a bad thing,” said Phoebe Dolan, 28, co-director and one of its founding members. “But it does leave young people often with not a clear sense of a county party that they can join and take leadership in.” 

The nonpartisan organization now reaches roughly 200 young people annually and ahead of the midterms is launching a series of hubs across the state for members to make regional connections. Continuing year-round, the hubs will offer lessons on political history and organizing training, Dolan said. 

In Alabama, GOP chair Scott Stadthagen brought on Brilyn Hollyhand, a 20-year-old content creator from Auburn, who previously advised Trump on youth strategy, to launch Project Future Generation in late July.

The statewide effort to engage teens and young adults in the conservative movement “is not a separate auxiliary group,” Stadthagen said. “We’ve got the young Republicans, the college Republicans. This is creating new Republican members to our county parties.” 

It is a three-pronged approach: a “student strike force” focused on door knocking and registering GOP voters in purple districts, “semester summits” where the party meets with student leaders on campuses, and tours of colleges and high schools. Hollyhand and Stadthagen have ambitions to expand the model to other red states, and eventually swing states.

Comparing the Grand Old Party to a Southern Baptist church, Hollyhand said that without a thriving youth ministry, “when the good ol’ Southern church’s congregation inevitably passes away, the church passes with it.”

     

The social media factor

When Hollyhand worked for Trump’s campaign, he led the initiative that brought content creators to the 2024 Republican National Convention and urged Trump to make appearances on podcasts and TikToks to reach young people. 

That’s being mimicked by Democrats now. The Democratic National Committee is investing in thousands of content creators to aid wins in 2026 and beyond. Former first lady Michelle Obama launched a “Voting Squad” made up of popular content creators to try to encourage young people to get to the polls. 

More locally, too, campaigns have been leaning on influencers. Independent of Brooks’ job as a senior canvass manager for the Maine People’s Alliance, she regularly posts political content for her more than 85,000 followers on TikTok, an account initially spurred as an outlet to air political rage when Trump got reelected. She was invited as an influencer to one of Maine Democratic gubernatorial nominee Hannah Pingree’s events.

Despite this focus, research on the effectiveness of influencers is limited. While some studies find that influencers may help boost political awareness among young people, that doesn’t necessarily translate into action. 

“The sort of influence of influencers, if I can be redundant, has been a little bit overstated,” said Alberto Medina, communications manager at Tufts University CIRCLE.

Less than 1 percent of young people said an influencer had been one of their top three motivations to cast a ballot in CIRCLE’s 2024 post-election youth poll. And in its national pre-election poll this year of 5,549 young Americans aged 18–29, social media posts from influencers or celebrities ranked last for the sources of information they turn to for learning about politics and elections.

Most Gen Z voters do get their news on social media, but mostly through posts from advocacy or news organizations, according to the latest survey. 

“Social media algorithms tend to send young men and young women to different places,” said Deckman, who is CEO of the nonpartisan Public Religion Research Institute. 

She attributes some of the gender divide to the fact that the two demographics are often presented with different informational realities, though it is difficult to quantify. Overall, Gen Z women have been raised with a greater sense of agency, she said, and were brought up politically amid the #MeToo movement and the first Trump presidency, during which his sexist comments shaped public discourse.

In addition to being ideologically divided, young men and women have vastly different beliefs about religion and gender. While young women, and Americans overall, have been shedding religious labels, young men have seen essentially no change in Deckman’s research. Young men are also far more likely to support pronatalism, which the Trump administration has embraced in encouraging families to have more children. 

“No generation is monolithic,” Deckman said. “There definitely are conservative young women. There’s lots of liberal young men. But the trends are such that you’re seeing this gap emerging.” 

     

Not party but issue motivated

Nelson Dorsey, 20, voted for Democratic presidential nominee Kamala Harris in 2024. Now, the Bowdoin College student is campaigning for Collins, explaining in Brunswick after his early morning football practice that her pitch as an independent voice for the state resonates with him. 

“I’m not necessarily afraid to go across a party line if that means doing what I think is best for the country,” said Dorsey, a registered Republican. “At the time, I was drawn to [Harris’] campaign because she really was drawing on the whole idea of ‘Let’s put politics aside, let’s put our parties aside.’”

Dorsey’s refrain from party loyalty is common among his generation, which is continuing to identify as independent at relatively high rates as they have gotten older, a contrast to older generations who had been less likely to identify as independents over time. 

“You have really a story where Gen Z is really put off by party,” Deckman said. “It’s part of a larger distrust of institutions in society.” 

As Gen Zers struggle to make ends meet, a point of common ground regardless of political leanings, they are seeing the rich get richer and the powerful gain more control. They are united in their concern about the abuse of political and economic power, including the United States’ role in foreign wars and lack of accountability for bad actors named in the Epstein files. 

“Growing up in America at this time, there is a significant lack of hope,” said Katya Fromouth, a 17 year old from Yarmouth, Maine, who thinks she will likely never be able to buy a house and questions what her future will look like because of climate change. “That is the sort of thing that young people need — hope when we are envisioning our future.” 

Fromouth was one of the young Mainers who initially saw hope in former Democratic nominee for Senate Graham Platner, who energized voters with a pitch to rally against corruption regardless of their party affiliation. Platner won over many young people by embracing some of the most polarizing issues at the center of the widening generational divide, such as calling to abolish U.S. Immigration and Customs Enforcement.

Seeing a candidate for national office with those values was “refreshing and frankly exhilarating,” said Cheyenne Hunt, who had initially endorsed Platner while leading the group Gen Z for Change. 

But after several women came forward alleging sexual misconduct, which he denies, Hunt withdrew her support. She helped support his exes in speaking with media, leading to the publication of an assault allegation in Politico that ultimately ended his campaign. 

While Hunt, founder of Reckoning Action, a nonprofit aiming to combat misogyny, said she received pushback because of the hope Platner inspired, she ultimately sees his swift downfall as evidence of the new kind of politics he had tapped into. 

“Young voters are routinely disappointed with the quality of representation that we’ve been offered,” Hunt said. “They are really ready for a class of representatives that across the board — whether it’s with issues of violence against women, with issues of corruption in general — do not believe that they are above the law and that they deserve special treatment.”

Tufts University CIRCLE has found some links between the issues young voters are focused on and their shifting politics. Those moving to the left care most about healthcare and abortion. Those shifting more conservative are prioritizing immigration and housing.

But regardless of whether their politics are shifting, young people are prioritizing economic issues.

“The centrality of economic issues and of those economic struggles that youth are experiencing is one of the big changes that we’ve been tracking in the last couple of election cycles,” Medina said. 

Young people on both sides think their party needs to change how they talk about the economy. Hollyhand said he wants the GOP to outline solutions, not just offer speeches blaming Democrats. And Clayton said Democrats can’t just rely on the buzzword “affordability.” 

“It’s got to be ‘Here is why the minimum wage is set at $7.25 and here is who’s doing that and who can help make it better,’” she said.

Young people are motivated most to cast a ballot in order to take action on issues they care about. In the Tufts University post-election youth poll from 2024, 46% said that was their top motivator. 

Issues are what Brooks starts with when she speaks to voters canvassing across Maine. As she tries to beat the sun knocking doors into the evening, she asks what matters most to them before sharing what she likes about particular candidates, starting with a local race and not mentioning political affiliations. 

After nearly 40 doors, more than 10,000 steps and three hours, mostly what she’s done is listen. 

“People don’t want to be talked at,” she said. That’s also her message for how the party could improve its chances of courting her generation: “I wish they would just ask.” 

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“More than half of adults say the country as a whole, the national economy, and their local economy are worse off since Trump was reelected in 2025,” the survey reports. “Most Americans (73%) say the country is heading in the wrong direction, including 92% of Democrats and 47% of Republicans.”

The president seems to realize this growing frustration could cost Republicans dearly in the midterm elections next month, possibly losing GOP control of the House, Senate or both. “It’s possible,” Trump mused to reporters outside the White House Thursday. But he continues to insist that the Iran war is worth it — ostensibly to prevent the nation from obtaining a nuclear weapon, despite the nuclear stockpiles of both the U.S. and Israel — while doubling down on threats and deploying even more troops to the region. 

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On Thursday, officials told the Wall Street Journal the Pentagon is sending a third aircraft-carrier strike group and additional Marine Corps ships to the Middle East, expected to arrive at the end of November. It would add around 10,000 more troops to the region, putting further strain on the Navy, which has been under pressure from near-record deployments and supply shortages.

But it does seem like Trump is waiting until after the voting to renew bombing Iran, as the Journal reported in late September. In a sprawling interview with Time published Thursday, the president said as much. “Because by annihilating Iran, we’ve created peace in the world,” he said. “With Iran, I don’t think you could ever have peace.”

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Ten drugmakers will see 21 of their drugs move from upfront discounts to after-the-fact payments in the drug discount program at the start of next year, an expansion from the Trump administration’s first attempt at kickstarting a rebate pilot.