Getting Started with Graphic Medicine in Nursing
Liaison: Esther Saltzman
Welcome to the Graphic Medicine Nursing Page (a.k.a. Graphic Nursing? We hope so!)
Whether it is about patient care or one’s own experiences with health, illness, disability, or caregiving, graphic medicine has resources from a variety of disciplines of interest to nurses in many specialties.
The aim of this resource is to provide an introduction to the many ways nurses can benefit from integrating graphic medicine into their nursing practice, their teaching, and personal reflection; I will update this page periodically, and I hope that nurses, patients, and related providers will contribute as well. Special thanks to MK Czerwiec for contributing resources to this page.
My name is Esther Saltzman, and I have combined careers in nursing and literature to specialize in graphic medicine. I have been a graphic medicine enthusiast since my first conference in 2011. This vibrant community of academics, healthcare providers, and artists has been a continuing inspiration for ways to implement comics and graphic narratives in the healthcare field and in the classroom. Graphic medicine is a supportive, creative, and international community bringing together diverse perspectives to address many issues in healthcare relevant to nurses.
Benefits of graphic medicine for nurses
Graphic medicine can contribute to the field of nursing in many ways, and its subjects and contributions are as varied as the many arenas of nursing practice. Opportunities for graphic medicine to benefit nursing practice that I will discuss in this post include:
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- reading comics and/or graphic narratives for self-education
- using comics as a patient education tool
- making comics to reflect on and problem solve in nursing practice
- using comics in nursing education to encourage reflective practice and promote professional identity formation
- comics and nursing research
- comics for improving patient care
Reading Comics:
For reading graphic medicine, a great place to start would be MK Czerwiec’s Comic Nurse website, as well as her graphic memoir, Taking Turns: Stories from HIV/AIDS Care Unit 371. MK is a nurse and also a co-founder of the field of Graphic Medicine. Her book is a combination memoir and oral history, and tells the story of Unit 371, one of the earliest dedicated AIDS care units in the U.S.. Nurses will relate to her need to process difficult experiences, and she explains how comics became her method of coping. As soon as I saw the depiction of her nursing station, I could immediately relate and feel a sense of community. You can read an excerpt from the book here.
Other resources for reading are available in the book review section of graphicmedicine.org. These mostly non-fiction, book-length, comics aimed at adults are often referred to as “graphic pathographies.” Most of them are created by the very people living with health problems, caregiving, and/or disabilities. The insights they provide about their experiences can be very useful for us as care providers. They also allow us to reflect on our practice, to learn how our patients and families are impacted by our interventions in their lives.
Issues addressed include patient responses to illness, family responses to caregiving, experiences within the healthcare system, the provider experience, and social justice. Some terrific examples include:
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- Tangles: Alzheimer’s, My Mother, and Me
- My Degeneration: A Journey Through Parkinson’s
- Cancer Vixen: A True Story
- Mom’s Cancer (currently in reprint, will post link when available)
- 8 texts about reproduction, pregnancy, birth, reviewed
- 5 texts about eating disorders, reviewed
- Can’t We Talk About Something More Pleasant (elder care, advance care planning)
- Last Things (ALS, caregiving, family response to illness)
- Rosalee Lightning (loss of a child)
- Things to do in a Retirement Home Trailer Park When You’re 29 and Unemployed (COPD, hospice, family caregiving)
In March 2020, the managers of the graphic medicine website began curating emerging COVID comics and providing initial analysis of them. There are now also anthologies of COVID comics. In addition, mainstream comic producer Marvel also published an online tribute to nurses dealing with COVID.
In addition to the graphic pathographies, more information on the scope of graphic medicine can be found at the National Library of Medicine exhibition page. In addition, book discussion materials are available.
Patient Education Comics
Comics are a powerful intervention for patient education, especially when the learner is stressed, needs to learn a great deal, and learning is important. Comics are at their best in this situation because they present information in a stepwise fashion, bring attraction and appeal to information, and can potentially transcend language and literacy challenges. One terrific example among many you can find on this website is Diabetes & Me: An Essential Guide for Kids & Parents. This resource was a class text for my college art students. They found it extremely helpful in preparing them to make patient education materials for the LeBonheur diabetes clinic.
Making comics to reflect on nursing practice:
Making comics can also help nurses process difficult experiences. It is not necessary to consider oneself an artist; comics can be done with very basic visual language. MK Czerwiec explains the benefits of drawing as part of one’s experiences in caregiving in her chapter “The Crayon Revolution” in Graphic Medicine Manifesto. The benefits of making comics apply to experienced nurses, nursing students, and at all stages in between. Comics about our experiences as nurses give us an opportunity to examine unconscious influences on our caregiving, process difficult experiences, and parse challenging situations. Consider the example below.
Possibilities for implementing graphic medicine into a nursing curriculum
One way to incorporate graphic medicine into a nursing curriculum would be having students read graphic pathographies. Stories of patient experience can help with understanding the patient’s perspective; they can also help to maintain empathy. Graphic medicine texts can be integrated into existing curricula or offered as electives.
In addition, it would also be helpful to have nursing students make comics. Some medical schools have implemented comics courses to help medical students process their training experiences with the intention of fostering empathy, preventing burnout, and examining professional identity formation. Michael Green and others have been teaching comics courses in medical schools. Examples of medical students’ comics can be found at Michael Green’s University of Pennsylvania site. A similar approach would also benefit nursing students. If you are interested in how you might consider teaching comics to nursing students, please be in touch! If you are teaching comics to nursing students, please do get in touch.
My personal experience: teaching graphic medicine to college art students
In Memphis, it was a joy to teach courses on graphic medicine to visual art students at the Memphis College of Art, and to introduce my students to the graphic medicine community. My students read graphic medicine comics and graphic narratives and produced their own personal graphic narratives about health or illness.
For a project with LeBonheur Children’s Hospital, the studio art professors and I worked collaboratively to have our students produce patient education materials for the diabetes and high-risk asthma clinics at the hospital. First, the students read materials already available for patient education. The following are some of these materials:
Our graduate student, who acted as liaison between my background course and the studio course, produced a zine about a teen with asthma going to a rock concert.
After reading patient education materials produced professionally, my students worked with clinic staff to produce materials addressing concerns of each clinic. Some examples, provided with the permission of the hospital, are below.
Another class produced patient education comics for the LeBonheur diabetes clinic. Topics were aimed at different ages and included nutrition, driving, and identity. Below is the first page of “Poppy the Loudest Puppy,” a comic book designed to make young children comfortable with asking for help if they don’t feel well because of an increase or drop in blood sugar:
This example course is just one way that nurses can integrate graphic medicine into their teaching and collaborate with artists or other disciplines to improve patient care.
Comics and Nursing Research
Comics can be very useful interventions in nursing research. For more on this topic, see this blog post. For even more on this topic, see Chapter 5, “Graphic Medicine” in Research Methods in Health Humanities, edited by Craig M. Klugman and Erin Gentry Lamb, Oxford University Press, 2019.
Comics as a tool of activism to improve patient care
Comics have a long history of enabling and promoting social activism. Health care can certainly use interventions to explain and/or share stories of issues that need improvement. One powerful example is this comic by Susan Simensky Bietila, “An Unshackled Birth.”
Do you have ideas for how graphic medicine can improve your nursing practice? For any questions, comments, or contributions for this page, please be in touch!
Esther Bendit Saltzman (saltzman.es@gmail.com) graduated from the nursing program at California State University Los Angeles. She has a background in pediatric and post-partum nursing and lactation education. She is currently a PhD Candidate in Literary and Cultural Studies at the University of Memphis and is specializing in graphic medicine. While in Memphis, Esther taught graphic medicine classes at the Memphis College of Art. Having relocated back to Los Angeles, she is working on her dissertation, Graphic Agency: Teaching Graphic Medicine in the Liberal Arts Classroom. She co-edited, with Stephen Tabachnick, Drawn from the Classics: Essays on Graphic Adaptations of Literary Works, and she contributed to his edited volume, The Cambridge Companion to the Graphic Novel.
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