September 9, 2022
On this episode of Talking Pediatrics, we talk about hair and health, and not in the ways you might expect. Health equity manager and Kid Expert Adriene Thornton interviews nurse Courtney Kenefick on what hair symbolizes in Black culture, why hair is so important to Black culture and why knowing this history and importance can help us take better care of our patients and decrease health disparities. From examining our policies around ethnic hair, to checking our supply shelves for appropriate hair care products, little steps can go a long way in creating a more inclusive care experience for our patients.
Dr. Angela Kade Goepferd: This is Talking Pediatrics, a clinical podcast by Children’s Minnesota, home to The Kid Experts, where the complex is our every day. Each week, we bring you intriguing stories and relevant pediatric health care information as we partner with you in the care of your patients. Our guests, data, ideas and practical tips will surprise, challenge and perhaps change how you care for kids.
Welcome to Talking Pediatrics. I’m your host, Dr. Angela Kade Goepferd. On this episode we talk about hair and health, and not in the ways you might expect. Our health equity manager and Kid Expert, Adriene Thornton, interviews nurse Courtney Kenefick on what hair symbolizes in Black culture, why hair is so important to Black culture, and why knowing this history and importance can help us take better care of our patients and decrease health disparities. From examining our policies around ethnic hair to checking our supply shelves for appropriate hair care products, little steps can go a long way in creating a more inclusive care experience for our patients.
Adriene Thornton: Thank you for tuning in to the health equity segment of Talking Pediatrics. I am Adriene Thornton, the manager of health equity and your host for today. I am excited to talk to my guest. Today we are going to be talking about hair story. All about hair. All things hair. Everything hair, and why it matters. Today I am welcoming Courtney Kenefick, who is a registered nurse on our med-surge unit in St. Paul, and she is also completing, very, very soon, her doctorate in nursing practice. Welcome, Courtney.
Courtney Kenefick: Thank you. Thank you so much for having me. I’m so excited to talk to you.
Adriene Thornton: Yeah. I’m excited to talk to you because, as I’ve said before, it’s very important for Black people and Brown people and minorities to reach back, reach out, and work on helping to fix some of the health disparities that we have, but it’s always wonderful when we have allies. We need our allies to step up and help us as well. And so I’m just so excited to talk about your project today. Aside from being a proud auntie, I am excited for what’s going to happen for our patients. And so we’re going to be talking about hair, how to take care of ethnic hair in the hospital, and we’re also going to talk about why it’s so important.
And so to quote Solange Knowles, “Don’t touch my hair when it’s the rhythm I know. Don’t touch my crown. They say the vision I’ve found.” And that is from the song Don’t Touch My Hair by Solange Knowles. And it’s a common knowledge thing that Black women do not like for you to touch their hair. And that is because it is our crown. It is truly our crown. And we’ll get into some of the history. But I want to start by asking you, Courtney, are you familiar with the history of Black women and hair and how we style our hair and why we style it in the ways we do and the historical context to that?
Courtney Kenefick: Well, first of all, I will be looking for your Grammy soon. But as a white woman, I have really had the opportunity to learn. I did not know, previous to working as a nurse, the history and the importance and the agency and the historical context of ethnic hair before I became a nurse and started caring for patients and caring for children who required and deserve that understanding and that treatment and context. I am so excited to be here to talk to you about it.
Adriene Thornton: So, in Africa, prior to slave times, the way we styled our hair, and it wasn’t just women, it was men and women, it indicated a lot of things. The way you wore your hair could indicate your status in your tribe. It could indicate which tribe you were from, which part of the continent you were from, which country within the continent. It could signify so many things. And we did elaborate hairstyles in Africa to indicate all of these different things. So, we took great pride in our hair. We still do. We always have. And we’d use things like animal fat and mud, pre-slave times, to style my hair, because if you ever see pictures you would see these elaborate designs with braid. And then of course during the slave times, slavery, the slave masters decided the slaves had way too much pride. Because even after we were enslaved, we still would style our hair in elaborate hairstyles. We took a lot of pride in that.
And to give us a little more humility, the slave masters made us start shaving our hair. So, we lost some of that during slavery. And then fast forward to when slavery was over, there were laws enacted that said we had to wear our hair covered because it intimidated some of the white women in society, and frankly they were jealous of our elaborate hairstyles. So, then we started wearing very colorful scarves and we would style them in these elaborate ways because that’s what we do. And if anybody knows me, they know how extra I am. And it’s just natural. It’s just a natural part of who I am. And so all these laws were enacted to try and steal our pride from us and to make us be more humble. And nothing has worked. Fast forward to now where we’re having to try and pass a law, the Crown Act, that states that Black women and men cannot be discriminated against, whether it’s employment or anything, based on their hair.
Because what we’re seeing is that there are a lot of employers that are saying, “Oh, well, you have to cut your dreadlocks,” or, “You can’t wear your hair in an afro if you want to work here.” And I remember as a new nurse back in 19, I don’t even remember what year it was now, I think it was ’89, ’90, somewhere back there, it was a long time ago, but I had braids. Because we always wore braids. I mean, it was easy, it was cute and we always styled it in these beautiful styles. And I had to take my braids out before I started my new job as a new nurse because it was against the dress code of the hospital where I was going to work. That is the history of our hair. And like I said, we used to use animal fat and mud to keep the oils in our hair, but also to style it. And so, that’s where you come in because I want you to tell the audience all about your project at the hospital.
Courtney Kenefick: I started my nursing career actually as a home care nurse and one of the patients that I took care of, she was a adolescent who was recently in an accident where she was paralyzed. As a result, we needed to do everything for her. This was new for her. She was Black and had afro-textured hair. And one day her hair just started coming out in chunks. And I said to her, I was like, “What’s going on?” And she said to me, “You guys aren’t treating my hair right. You guys are not putting oil in my hair. You guys are not treating my hair properly.” I felt horrible. And I said, “I’m so sorry. Why didn’t you say anything?” And she told me, “I tell you how to do everything. I tell you how to do every part of my day-to-day cares. I shouldn’t have to tell you that.”
And it was so powerful to me as a new nurse. She was absolutely right. And it just opened my eyes. It was incredibly impactful. And then moving into the hospital setting, I would be able to gain some more information from families about how they like their hair and what kind of products they like to use. But we often had to use their products from home. So, then for school, on one of my first day of clinicals, my preceptor Heidi in the CDICU asked me what kind of projects I was interested in. And one of the projects that had just been brought to her was as a result of a family coming to her expressing real sadness and disappointment about how their child was cared for just in a hygiene basis.
And said, “If my child was white, she would have a bow in her hair.” But because she isn’t, it was not kept the way that they would prefer and that they wanted and that she deserves. And so she asked me, “Would you be interested in doing any education around this?” And I got incredibly excited and interested. It was a long time coming to bring products to the hospital. And so that is what we worked on.
Adriene Thornton: Wonderful. And it’s so exciting because as a Black woman and a mother and a nurse, I’ve always understood the importance of using the right products and the right processes for taking care of Black kids’ hair. And when I was a nurse on the floor, of course, I did, but never thought to expand that education beyond myself. I might tell one or two nurses, “Hey should do this, you should do that.” I might put in the care plan, “This is what you need to do for this child’s hair,” but not really building an education program around it. So, that was one of the reasons why I was so excited for your project. So, tell us a little bit about what you and Heidi found and what you implemented in the hospital.
Courtney Kenefick: So, we found that there’s just a real gap, and part of it is because the nursing workforce is so predominantly white. And so that is something that we instantly saw. It was a blind spot for a lot of people. And so we started asking around, asking the unit that I was working on, just seeing, “What do people know? Are you interested?” And the overwhelming response was, “Yes, I am interested, but I’m kind of almost scared.” And I’ll be honest, as a white woman taking on a project like this, I was also intimidated by it. It was something that I understood that I can never fully understand, but I also saw such an opportunity to implement and bring the right patient care to all of our families.
So, we were so lucky to get the support that we had in the hospital and we were able to get products that were more appropriate for the patients that we serve. So, we got some coconut oil in little individual packets. We got calendula oil and we got a wide toothed comb. Which seemed so basic, one of those things that it was just a no-brainer. And then some better shampoo and conditioner to support the right oils and the right hair maintenance for some of these kids that stay at the hospital for so long.
Adriene Thornton: And the one thing I loved was that you all realized we needed bonnets. We needed silk bonnets. Because you will be hard-pressed to go to the home of a Black or a Latino or a mixed child that does not have a bonnet on their hair. And we wear them because we have to protect our hair. Because if our hair rubs against those cotton pillow cases, it can break our hair off. And so we wear those, one, to protect the hair, but also because the moms spend time styling that hair. And once we get it styled, we don’t want that hair to mess up. And so oftentimes moms will style the hair before the child goes to bed and put the bonnet on so that when they wake up, all they have to do is take the bonnet off and they are gone. So, I really appreciated that it’s-
Courtney Kenefick: I know. And that’s one of those things. These two, I am so hopeful because that was the one thing that we just could not secure bonnets in the future.
Adriene Thornton: And I saw the video that you all created to teach the nurses how to use the products because now you have the products. And even just writing it down on a piece of paper. Sometimes people need to see it and actually be shown how to do it because it’s not intuitive. And so I really appreciated the video that you all filmed with one of our patients to explain and illustrate to our nurses how to actually comb the hair out and how to oil the scalp and how often. I mean, that was just wonderful. I thought, “Wow, this is going to be a game changer for our nurses and our patients.”
Courtney Kenefick: And I really think the families that we worked with were so wonderful at teaching and wanting just to talk about it and to teach and the real world hands-on visual learning of how to actually do this. That’s how I learn really well too. And I knew that that would be a huge component to this, not only the why but the how and the carry it forward too. That was [inaudible 00:13:53] of the project. And how to make it a lasting impact within the hospital.
Adriene Thornton: We talk about when you improve health disparities for one group, you improve healthcare for all groups. And this project is a classic example of that. Because the products that you all have brought into the hospital, they’re not just for Black kids. They’re for any ethnic hair. If you have a mixed child, these products are great for them. If you have a Latino child, this is good for them. If you have a white child who has really, really, really curly hair, these products, and maybe not the oils, but the shampoos and the conditioners and the detanglers are great for curly, curly hair.
And so I have a lot of friends who have children who are white but they have really curly hair and they love using the hair products that we use. Because for Black people, most of our hair has a coil to it. And there are different types of coils. Some coils are tight, some are looser and fall as loose curls, but it’s all coil. And so the products that are created support and enhance that curl pattern in our hair. And so these products will improve hair care for all kids, not just Black kids and not just Brown kids, but for all kids.
Courtney Kenefick: Absolutely. And I loved in how you described history and what the history means. And also I was able to enlist help with friends and I was so grateful for your involvement so early, but also my own reading and my own learning about the different coils, the different types and the different levels of hair. I really got into it. And it was so illuminating to see the wide variety of children that will be affected by this, whose confidence… And just being in the hospital, you’re not comfortable ever. And having that sense of feeling like you’re being taken care of is so important. That’s, I think, a huge, huge thing that this project was able to bring to all things.
Adriene Thornton: Oh, exactly. Because the worst thing you want to do is come into the hospital for whatever reason, whether you’re having a procedure or because you’re sick, and then while you’re here start to lose your hair. And especially for girls. And that goes across the board. White, Black, Brown, Asian, your hair is everything to you. Hair determines how cute you’re going to be today. And you might want a bow. You might want a ribbon. But hair is very important to little girls. And so it’s important for us to help them maintain their hair while they’re here because we don’t want them to go home and say, “Well, I don’t ever want to go to that hospital again because I lost my hair while I was there.”
Courtney Kenefick: And I think giving nurses and support people at the hospital the foundation to be able to provide that care, I think is just so essential.
Adriene Thornton: So, I know that once you graduate from school you will be done with this project, but do you have plans of expanding it to other hospitals or doing more work on the project once you’re done with school? Or what are your plans?
Courtney Kenefick: So, one really cool thing, and I am so lucky that this project will have long-lasting impact at Children’s. It’s already a part of new employee orientation for nurses, which is really exciting. It is amazing that that has made it on there because I think it really will highlight and set a tone for people right away. And I think especially new nurses, nurses who don’t fully understand the importance, and just to make people aware of the products. So, that is something that I’m very proud will be long-lasting. The videos will live on Starnet eventually and just people can be able to look at them and watch them. And right now, no plans to expand outside the metro, but I am right now in the process of disseminating the project. So, anybody who’s interested, certainly I’m happy to talk to you, but I’ve felt so grateful for the support ind the organization on this project and I have no doubt at all that it is going to be long-lasting and not just a one and done project.
Adriene Thornton: Yeah. That’s the one great thing about Children’s Minnesota is, we walk the talk. Marc Gorelick, our CEO, said he is serious about improving health disparities, dealing with health inequities, and making care better for all kids. And he was serious about it. And so as a result, the organization is supportive. They are doing the work. They are providing the resources to get the work done. So, it is absolutely wonderful to see a project like this get so much support and be so successful. And so before we go, I know that you’re not done with your project and you don’t want to give too much away because you have to use it for graduation, but how’s it going so far? Are you seeing that families are happier? Are the nurses doing good with the new products? What are you seeing and hearing?
Courtney Kenefick: Yeah. So, right now the products are in use on all units in the hospital, which is just so exciting. I think that was also a huge part of this project is that once one group heard about it, everybody wanted to be a part of this project and everybody wanted these products on their unit and they’re using them. Every unit has ordered at least one or two of our products, which is very, very exciting. And then as far as the people who watched the video and who have participated in the pre and post survey, there is a significant increase in knowledge and understanding of this work, which is so exciting.
And I think it just demonstrates the importance of the work. I think it demonstrates the need for it and that that need… We did a pre-survey on understanding and baseline knowledge versus after. It demonstrates why this was an important project, and then it also demonstrates the effectiveness of the video with the product rollout and the general organizational support. So, it has been received so well. As far as how families are feeling, we did track response surveys and they’re great. We’re super, super proud of the result of this project and of this work.
Adriene Thornton: I have no doubt that the families that are using our products and are seeing the changes in our nurses will explore sharing their happiness through our patient surveys at some point. So, thank you so much for your project, Courtney. I am so excited for you and so proud. And thank you for letting me be involved. It is just wonderful because as a Black person, we do get tired of trying to fix everything. So, it’s wonderful when we have allies like you who see a need and step up to fill that need and to fix the issue.
And so, I so appreciate you and the work that you and Heidi did and I am excited to see what comes after this because I’m willing to bet that after this podcast there will be invitations to share your work and to perhaps speak about the work that you have done. So, don’t be surprised if I reach out to you and say, “Hey, can we go and talk to this group or that group.” Because we want to see this at every pediatric hospital in the United States. Thank you again for sharing your information and knowledge and being here with me today, Courtney. I am so excited for you and I so appreciate you.
Courtney Kenefick: Thank you so much, Adriene. I really appreciate you inviting me and coming along on this work and being such a helpful and wonderful mentor in this process as well. And I am just so grateful to be able to have the opportunity to share this news and this project.
Dr. Angela Kade Goepferd: Thank you for joining us for Talking Pediatrics. Come back each week for a new episode with our caregivers and experts in pediatric health. Our executive producer and showrunner is Ilze Vogel. Episodes are engineered, produced, and edited by Jake Beaver. Amy Juba is our marketing representative. For more information and additional episodes, visit us at childrensmn.org/talkingpediatrics, and to rate and review our show, please go to childrensmn.org/survey.