On Saturday, amid demonstrations over Immigration and Customs Enforcement activity in Minneapolis, federal agents fatally shot Alex Jeffrey Pretti, a 37-year-old intensive care unit nurse. Videos of Pretti’s last moments show him acting nonviolently: filming officers’ actions, directing traffic, and attempting to help a woman who had been pushed to the ground. Still, he was pepper-sprayed, restrained, shot multiple times, and, per sworn testimony, denied timely CPR.
I was not surprised to learn that Pretti was a nurse. In his final moments, he did what nurses are educated to do: notice, care, and respond to an emergent threat.
I did not know Alex Pretti, but I know others like him. In videos of his death and the moments immediately preceding it, I saw a clinician, community member, and federal employee placing himself between armed agents and a vulnerable other. I saw preventable death, shock, and collective trauma likely to reverberate far beyond Minneapolis.
In media coverage following Pretti’s killing, I, like others, learned that he was known for his compassion, intellectual curiosity, and community engagement. Reading a statement from Pretti’s family, I learned that he was “a kindhearted soul who cared deeply for his family and friends and also the American veterans whom he cared for.”
I was unsurprised to learn these things, in part, because Pretti’s demonstrated concerns — for an individual and for a community affected by escalations in federal force — reflect core values of our profession.
At our best, nurses are helpers and leaders who build bridges, improve clinical care, and advance social movements for equity. During the Crimean War, Florence Nightingale laid foundations of modern nursing practice by identifying and intervening on overlooked determinants of mortality, including nutrition, sanitation, and hygiene. Clara Barton, a Civil War nurse once known as the “angel of the battlefield,” founded the American Red Cross and was instrumental in U.S. ratification of the Geneva Convention. Lillian Wald, the founder of public health nursing, was also a champion of women’s suffrage, poverty alleviation, and racial equality. Mary Eliza Mahoney, our nation’s first Black licensed nurse, overcame pervasive discrimination to build a robust clinical career and lead movements for inclusion that persist, necessarily, today.
We honor these histories because they are aspirational, but also because they offer instruction on how to uphold our profession’s core values while working through stress, conflict, and broken systems. We have institutionalized their lessons in a code of ethics that calls on nurses to “enact and resource practices, policies, and legislation to promote social justice, eliminate health inequities, and facilitate human flourishing.” We have carried them into guiding reports on the future of nursing and health equity.
It matters that Pretti was a nurse: not because this makes his life more valuable than others, but because his final actions reflect the instinctive application of ethical principles of a profession charged with responding to harm. Honoring his legacy requires that nurses commit to sustained engagement and mutual support across geographic and political divides. It requires that we remain focused on structural factors — within and outside clinical settings — that contribute to poor health.
The greatest consequences of the public health hazard of immigration enforcement will fall on communities targeted by discriminatory policing, arrests, detentions, deportations, and violence. But recent federal actions also create spillover effects — collective trauma, lost trust, moral injury, and a chilling of bystander care — that undermine health for us all.
Addressing these intersecting crises requires that nurses — all 4.7 million of us — continue to pay attention. It requires that we work to understand and address the needs of the hardest-hit communities. It requires that we reflect on the power of our collective voice to advocate for conditions in which all of us — patients, community members, and colleagues — can be safe.
Patrick Smith is a registered nurse and public health researcher writing in a personal capacity. Views expressed in this piece are his own, and do not reflect those of his employer.
