Nurses Unite But Is It Enough?


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I have been following the brouhaha over the derogatory comments made by Joy Behar on The View about Kelly Johnson, Miss Colorado and a nurse.

I last saw the Miss America pageant sometime in my preteen years and caught snippets of The View as I surfed channels years ago so I am no expert on either venue. However, what I do know is that Ms. Johnson came on stage dressed in scrubs with a stethoscope around her neck during the talent part of the Miss America Pageant on Sunday September 13th and spoke about her love of nursing rather than dance, or sing, or play the trombone. Her concluding statement was “I’m a life saver. I’m never going to be ‘just a nurse.’”

The next day on The View her performance was the subject of mean, gossipy and clueless remarks made by the hosts, such as she wore a “costume” and a “doctor’s stethoscope,” and seemed like she was “reading her emails.”

You may be aware of all of this. And like me you were proud to see nurses pull together communicating under the hashtag #NursesUnite and demanding an apology for demeaning the nursing profession.

Nurses got results. The women from The View did attempt an apology. It may have been too little, too late since two sponsors have pulled out (Johnson & Johnson and Eggland’s Best) and there is momentum afoot to terminate of the program.

I was feeling pretty good about the power of nurses’ collective voice.Then I read this open letter on by a disillusioned nurse. I try to keep my posts short but I think this letter needs to be read in its entirety.

An open letter in response to #NursesUnite movement:

It is amazing that you have finally found a cause to unite over (#nursesunite), however, I find it hard to jump on board this superficial bandwagon that actually serves the nursing profession no purpose whatsoever.

I have pondered over the last week why it is that so many nurses take such offense to the few words of an ignorant television host, being that Ms. Behar has zero impact or influence on the healthcare profession or the role of nursing, yet they do nothing to end the many real issues plaguing the nursing profession.

The only conclusion that I can come up with is that nurses feel that they can’t do much to change the real problems in nursing, so they unite and attack over something that really makes no difference at all to us as a whole.

There are so many other REAL aspects of the nursing profession to unite over to influence change that will actually make a difference to nursing. There are many “dirty secrets” of nursing that go unspoken and ignored, many of which are cultivated by nurses themselves.Bullying, horizontal violence, inadequate training, nurses “eating their young”, 12+ hour shifts, no breaks, high acuities, too many patients per nurse, etc.

I went into nursing because I like to help people. I am empathetic. I am a quick thinker. I am smart. But that isn’t actually what makes a nurse successful in this profession, as I have come to find out. As I have come to find out, nursing has less to do with how competent or compassionate you are, and more to do with how much you can, or are willing to, put up with. The nursing culture is full of “suck it ups” and “oh well, it is how it is.”

What seems to make a nurse successful is the ability to withstand bullying, intimidation, being talked down to by supervisors, patients, family members, and doctors. The ability to get over inadequate training and support provided by management and your peers and to be okay with unsafe (patient) to nurse ratios. You’ll feel more confident in time, it’s just a part of nursing.

To be successful in nursing, you have to be okay with having zero time to take a break (even a bathroom break) and most times, taking your lunch sometimes 8 hours past your start time, or sometimes not even getting a lunch. You have to be okay with being dehydrated while hanging patient’s IV bags and shaking from not being able to take a break and eat while you are checking diabetic’s blood sugars and teaching the importance of proper urinary hygiene to avoid UTIs while you’ve been holding your own urine for the past 5 hours. Nurses are expected to just be okay with it. It’s just a part of nursing, right?

You have to be okay with coming in early to “get familiar” with your patient load and not getting paid for that time. You have to be okay with staying well past your shift to give report on a regular basis, taking your total time on the clock (and off) well into 14-15 hours, which means that you are so tired driving home that you hope you make it there without crashing because your brain is tired mush. But long shifts are just a part of nursing.

You have to be okay with having to do more with less, even if it affects patient safety and outcomes. You have to be okay with doctors yelling at you and treating you like you’re an incompetent idiot rather than a professional colleague in health care. You know that if you call a doctor to clarify orders or to update on your mutual patient, you may be met with disdain and sarcasm. But that’s okay too, because it’s just a part of nursing.

Nurses know this to be true. Nurses know these are the dirty secrets of nursing. Nurses know that bullying is rampant. Yet, the answer to this problem is “grow a thicker skin” or “you’ll just get used to it”.

Nurses know that understaffing is a given and that high acuity and high patient loads per nurse is more common than not. Nurses know this isn’t safe, they know the care being given isn’t what it should or could be, but they do not unite together against it and demand change.

Nurses know that there is often a lack of adequate training and preceptorship for new grads and new employees entering new specialty areas and that too many times nurses get thrown to the wolves and it’s a sink or swim mentality. But, this is just a part of nursing we accept.

Nurses know this. They live it. They experience it. It is the culture of nursing. Yet, there is no call to end it. No hash tag. No selfies. No viral campaign on social media. No standing up to it. Just the continued mentality that these things are just a part of nursing that you have to accept or leave.

So, instead of uniting together against something or someone that has no impact on nursing, why not stand up and unite against the things that are killing the nursing profession and demand they change?


A disillusioned nurse

I hope that nurses’ collective voice only grows stronger and wields the power it possesses to effect positive change in the nursing profession.


Rewriting the Book


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writing a bookI’m doing what I said I would never do. Rewrite my book. I completed my manuscript late last year, sent it out to 20 small presses and one agent. While I have been waiting for the results to trickle in—those returned so far have been rejections—I’ve been troubled by a lingering discomfort that I have left something out. Something significant. Something that I couldn’t, shouldn’t ignore.

So for the past few months I have been having an internal dialogue:

“Leave the book alone. You did the best you could do.”

“No, something isn’t quite right. I’m not happy with the final manuscript.”

“You could be rewriting this book for the rest of your life. Let it go. You don’t want to be that writer who never submits her book because it ‘isn’t good enough’.”

“Aha! I know what it is that’s troubling me.”

My book shows how I managed a Senior Clinic in a Chicago Housing complex. I was a new nurse practitioner (not a new nurse). I show the role of the NP. However, in writing the book, I had totally overlooked the fact that while I was indeed a new nurse practitioner, I was also practicing in a new specialty—Gerontology. I say this but I DON’T SHOW IT.

Why is this important? Well, because when I became a Gerontological NP in the early 80s, studying old folks was a rarity. Older persons were generally ignored or worse, discounted and ill-treated. The 1978 best seller House of God by Samuel Shem, an irreverent book about medical interns in an renowned teaching hospital first coined the derogatory term GOMER, meaning “get out of my emergency room.” A term used frequently to classify the old person as someone without worth to cure, much less treat in our medical facilities. Some believed most old folks disengaged from life, deriving no pleasure in longevity. The fact that elders over 60 would still be interested in sex was shocking. WY SURVIVE: BEING OLD IN AMERICAAnd in this same time period the groundbreaking book: Why Survive? Being Old in America by Robert N. Butler, M.D. discussed whether or not to introduce geriatrics in postgraduate medical education.

Nursing was early to recognize geriatrics as a specialty but thought that the medical definition—specializing in the treatment of existing disease in older adults—too narrow.

Nursing developed a much broader vision and used the term gerontology rather than geriatrics.

Gerontology encompasses the following:

  • studying physical, mental, and social changes in people as they age

  • investigating the biological aging process itself (biogerontology)

  • investigating the social and psychosocial impacts of aging (sociogerontology)

  • investigating the psychological effects on aging (psychogerontology)

  • investigating the interface of biological aging with aging-associated disease (geroscience)

  • investigating the effects of an aging population on societyapplying this knowledge to policies and programs, including the macroscopic (for example, government planning) and microscopic (for example, running a nursing home) perspectives. (Wikipedia)

In 1981, the American Nursing Association certified me as a Gerontological Nurse Practitioner. A Board Certification was developed by the Medical Community 7 years later.

After I rewrite my book, you will see a Gerontological Nurse Practitioner in action.



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stock-photo-doctor-with-mammography-292061516I’ve written in a previous post about my experience of being diagnosed with breast cancer 18 years ago. I’ve always wondered if I should have forgone a mastectomy and adopted a watch and wait stance. However, when my doctors never gave me that option and my family was aghast at my doing anything less than full warfare on the invading cells in my body, I gave in to surgery.

The type of cancer I had, ductal carcinoma in situ or DCIS, is still under investigation. Is it or isn’t it cancer? If it doesn’t leak out of the lining of the milk glands and metastasize, is it truly deadly? The treatments given to women can sometimes cause more problems than living with cells that, in some instances, resolve. So I was happy to see more attention given to finding answers in a new study about DCIS in the JAMA Oncology (online) August 20, 2015.

I had become an advocate of taking “cancer” out of DCIS label. That way women wouldn’t panic and rush to having mastectomies and in some cases prophylactic double mastectomies. Hopefully “watch and wait” would be an added choice rather than have women succumb to unnecessary treatment.

After I read the original article in JAMA—I am not going to tell you I understood all the statistics—I realized that DCIS is what most cancers are: complicated. Some types of DCIS can predict that a lethal breast cancer can occur in the future. I am more sympathetic of the tightrope that physicians and surgeons walk in counseling their patients.

The accompanying editorial by Laura Esserman in the same JAMA issue gives the following suggestions:

  1. Much of DCIS should be considered a “risk factor” for invasive breast cancer and an opportunity for targeted prevention.

  2. Radiation therapy should not be routinely offered after lumpectomy for DCIS lesions that are not high risk because it does not affect mortality.

  3. Low-and intermediate-grade DCIS does not affect mortality.

  4. We should continue to better understand the biological characteristics of the highest-risk DCIS (large, high grade, hormone receptor negative, HER2 positive, especially in very young and African American women) and test targeted approaches to reduce death from breast cancer.

Hopefully these suggestions will become a common practice in health care settings so women like me won’t be regretting a choice they made based on incomplete knowledge and overdiagnosis by the medical professionals.



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Joan Didion

Joan Didion

I am always on the lookout for positive trends in aging. Here’s what I found in Creative Review. The Age Issue, (June 2015) on page 40:FullSizeRender

Cooler older women are having a bit of a fashion moment. What started a couple of years ago as a trickle of magazine covers and ads featuring women over 60 has recently turned into a flood: Helen Mirren for L’Oréal, Charlotte Rampling for Nars, Jessica Lange for Marc Jacobs, Joni Mitchell for Saint Laurent . . . the list goes on. When Joan Didion was announced as the new face of Céline SS15, via an ad showing her looking almost unbearably hip in a photo shot by Juergen Teller, Twitter exploded with excitement. For those of us weary with the endless parade of blank-faced young models, the arrival of some older faces—complete with both wrinkles and a story to tell—comes as a relief. (Bold and italics mine). . . Could we finally be seeing a shift away from the obsession with youth and a renewed respect for older womenkind? Could we?

Later, I found an article in the Travel and Style section of the Wall Street Journal: Smith, Erin Geiger. “Websites Predict Your Perfect Dress,” The Wall Street Journal, (6 Aug. 2015), which discussed online shopping. One web site, MM.LaFleur, offers a “ ‘Bento Box’ of clothes and accessories ” based on a series of questions to discover the preferences of the prospective buyer. MM.LaFleur goes on to ask buyers to select their “girl crush.” (I take this to mean which woman you most want to look like). The choices are not supermodels but real people. Okay, famous people and some dead ones, but not with unattainable physical perfection or youth. People like Oprah, Sonia Sotomayor, and Amilia Earhart and wait for this, Joan Didion.

I can only surmise that there is a growing trend, however subtle, toward an expanding female ideal that includes, finally, older women with wrinkles, character and brains.

May this trend continue.



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I couldn’t pass up sharing this article in Consumer Reports about nurse practitioners and physician assistants especially since I just registered with my new provider, a nurse practitioner a week ago. She and a physician assistant cover for each other. Best of both worlds.

Check the comments, which are so positive.

When a nurse is as good as a doctor
Nurse practitioners and physician assistants can offer first-rate care
Published: July 14, 2015 08:00 AM BY

Across the country, nondoctor health care professionals—usually nurse practitioners (NPs) and physician assistants (PAs)—are turning up in a range of medical settings. We see those so-called advanced practice providers most often in primary care and family medicine practices, but they also work as specialists in hospitals and retail clinics, and more. In rural areas, they may be the only health care providers who are regularly available.

Their ranks are growing fast. In the past 10 years, the number of licensed NPs in the U.S. has almost doubled to 205,000. Between 2003 and today, the number of certified PAs grew from about 43,500 to more than 102,000.

One major reason: Demand for doctors, especially family physicians and internists, is outstripping supply. The Association of American Medical Colleges expects a shortage of up to 31,100 primary care doctors and up to 63,700 other physicians by 2025.

Advanced practice practitioners can make up the shortfall. But can they give you the care you need? And how does the care compare with what you’d get from a doctor?
What they do, what they don’t
PAs and NPs are handling many tasks that were once the exclusive domain of doctors: They can write prescriptions in every state. In 21 states and the District of Columbia, NPs can practice autonomously. Some NPs and PAs substitute for residents at academic medical centers.

But there are differences between them and doctors. One distinction: What advanced practice practitioners are permitted by law to do can vary from state to state and even from hospital to hospital. For example, NPs can’t prescribe controlled substances in Florida. In some states, a supervising physician needs to be on site when a PA treats you; in other states, it’s not necessary. Nationwide, an NP’s or PA’s authority to admit you to a hospital is up to the hospital.

Training differs, too. Doctors and PAs train under the so-called medical model (though primary care doctors have about 23,000 hours of education and training, PAs have around 3,000). That teaches physicians to “work through a diagnostic process that directs the questions you ask, the physical you perform, the diagnostic studies and treatments,” says Reid Blackwelder, M.D., chair of the American Academy of Family Physicians’ board of directors. Nurse practitioners are educated under the nursing model, which stresses health promotion and education.

Ultimately, what an NP or PA does in your doctor’s office will depend on his or her experience, the setting, and the speciality, notes Marc J. Moote, PA-C, chief physician assistant at the University of Michigan Health System in Ann Arbor. “Often, each physician/PA/NP team will decide the best use of everyone’s skills on the health care team, and this can vary from practice to practice,” he adds.

6 big benefits
NPs and PAs are indispensable in handling everyday problems such as sore throats or urinary tract infections, freeing primary care doctors to handle more complex conditions, says John Santa, M.D., medical adviser to Consumer Reports. They can also prescreen patients, make hospital rounds, do follow-up care, monitor treatment, manage chronic conditions, and have a place in specialty care as well. “They can be very good at the history taking, reviewing a patient’s records, and coordinating everything the specialist needs,” Santa adds. What’s more, many PAs work as surgical assistants. Though seeing an advanced practice practitioner is unlikely to lower your co-pay, it can help reduce overall health costs. Other benefits may include:

Shorter waits for appointments. Merritt Hawkins, a health care search and consulting firm, found that in 15 metropolitan areas, new patients wait, on average, 18.5 days to see a cardiologist, dermatologist, family physician, obstetrician/gynecologist, or orthopedic surgeon. But with more providers in the office, the PA or NP can see a patient if the doctor can’t.

A team approach. Having an NP or PA on staff makes some aspects of team-based health care more feasible. He or she can check a cough, cut, or sprain, and ensure vaccinations and blood pressure and cholesterol checks are done. A 2013 review in the Journal for Nurse Practitioners reported comparable blood glucose and blood pressure levels in people cared for by NPs as in people seen by doctors.

Convenient care. NPs and PAs staff some walk-in clinics at drugstores. So if you develop a urinary tract infection, for example, you can get the care you need ASAP.

Faster emergency-room treatment. Canadian researchers have found that in ERs with NPs and PAs on duty, people without life-threatening symptoms were twice as likely to be treated within 15 to 60 minutes.

Help with chronic conditions. Once you and your physician decide on a treatment, a PA or NP can make sure it’s going smoothly, for example, that your blood glucose levels are well-controlled.

APPs are especially helpful for seniors with chronic illnesses. A study in the Journal of the American Geriatrics Society noted that older patients managed by both an NP and a physician had higher quality care for dementia, falls, and urinary incontinence than those treated only by a physician. Co-management “is most appropriate for conditions that require a lot of close monitoring, patient engagement, and education,” says study co-author David B. Reuben, M.D., chief of the division of geriatrics at the David Geffen School of Medicine at UCLA.

Lower risk of hospital readmission. Leukemia patients in the hospital for chemotherapy cut their stays by about 6 days and were less likely to be readmitted within 14 days when cared for by PAs instead of doctors in training, according to a small study in the Journal of Oncology Practice. A 2013 study in the Journal of Thoracic and Cardiovascular Surgery found that when PAs make home visits to heart surgery patients as part of a PA home care program, it lowered 30-day readmissions by 25 percent.

See our Guide to Doctor Ratings and get advice on how to choose a doctor.

When to stick with a doctor
More research is needed to definitively assess when seeing a doctor might be preferable to seeing an NP or PA. Advanced practice practitioners have the know-how to play a primary role in diagnosing and treating common ills and an auxiliary role managing complex ailments, says Marvin M. Lipman, M.D., chief medical adviser to Consumer Reports. “Doctors are good for those 5 to 10 percent of patients whose symptoms don’t add up and need more detailed investigation,” he notes.

NPs and PAs say they can handle more than routine tasks. “It’s a misconception to assume they can’t diagnose or manage complex care,” Moote says.

That said, some research suggests physicians may be more skilled in some areas. For example, one 2013 study found that family physicians who referred patients to a medical center better understood what the symptoms might suggest and were more likely to order the right tests than NPs and PAs. The doctors’ referrals showed “a much more logical approach,” says William Mundell, M.D., assistant professor of medicine at the Mayo Clinic in Rochester, Minn. “They were getting closer to the diagnosis.”

Another key question: How many tests are different types of providers ordering? Recent research in JAMA Internal Medicine found that NPs and PAs tend to order slightly (less than 1 percent) more imaging tests than primary care physicians for similar Medicare patients.

The takeaway: All of those providers have an important place in health care. Make sure that you see the right one for you at the right time.

Editor’s Note:
This article also appeared in the August 2015 issue of Consumer Reports on Health.



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TEAMLast week, I attended the second and last part of the TeamStepps workshop. In another post (“Was I Dreaming?”) I described the first workshop and my surprise at how the doctors willingly and enthusiastically participated in the dialogue and group activities. What would I find this time around?

TeamStepps is a program that promotes teamwork and teaches “team strategies and tools to enhance performance and patient safety.” The audience was a group of professionals who worked in the surgical area of a large teaching hospital. I volunteer at the hospital and attended as an observer, although I did participate in some of the exercises.

The first thing I noticed when I entered the room was the empty chairs at each of the four tables. After we finished with introductions, it was clear most of the absentees were doctors/surgeons. I felt disappointed. Was their eager involvement at the last meeting just a charade?

This seminar was pivotal for implementing TeamStepps. The group in attendance—nurses, OR techs, surgeons, anesthesiologists—were to be the “coaches” who would model effective team work and help “change the culture” of the hospital. The leaders of the workshop, two doctors and four nurses, were poised to teach how to be an effective coach. Furthermore, there had been homework. Each table had been given a “discussion question” at the end of the last meeting with the expectation that the group would present a three to five minute demonstration. The occupants at my table included two nurses, one OR tech and an orthopedic surgeon who was preoccupied with the open laptop in front of him. I had already excused myself from participating in the skit.

When time came for the demonstrations to begin, those at my table seemed to be looking at the question for the first time. The other three groups appeared to be scrambling also. In the meantime, some doctors had slowly been slipping into their seats. Two appeared at our table and joined the activity. The surgeon at the end of the table had closed his laptop. Unbelievably, to me, each group, in turn, stood in front of the room and showed, as instructed, the right and wrong way to address their question.

(Our table was to communicate how the team would handle a situation when a necessary piece of surgical equipment fell to the floor and was contaminated).

In the skits, the surgeons played nurses, the nurses played doctors, OR techs were the anesthesiologists. The shows prompted much laughter and recognition of obnoxious and unprofessional behavior in the “wrong way” skit and applause for “right way” team interaction.

For the remainder of the meeting the leaders introduced peer-to-peer feedback, not easily understood by some of the surgeons who saw themselves as designated leaders and superiors and staff as subordinates. The coordinators, especially the nursing coordinators, gently suggested that the team was made up of peers regardless of occupational titles.

Like the first TeamStepps session, I was impressed with the positive vibes and enthusiasm from the audience. My world of hierarchical structure and deference paid to the medical staff was changing. I believe that this change in culture will bring a safer patient environment.

On the last page of the handout this statement stood out:

Important that staff realize this is not a passing phase—it is our model for patient safety moving forward.

 I think this model will indeed move forward at this hospital even though the ride may be a bit bumpy.



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I have been a nurse for eons. Sometimes I feel I go back to Flo’s era. Even though I have been retired for ten years, I try to keep current with nursing/health issues. One evening two weeks ago I attended a TeamStepps workshop sponsored by the large teaching hospital where I volunteer. The purpose of the seminar was to promote teamwork among the hospital staff to ensure patient safety. As a member of an advisory committee, I was encouraged to attend in order to learn about new initiatives at the hospital. I walked out of the workshop four hours later wondering if I had dreamt the whole scenario.

There were about 50 folks in attendance. I approached my assigned table where one woman was seated, a nurse who worked in the operating room. Attendance was mandatory, she told me. She was paid for her time. A few minutes later a skinny guy in scrubs plopped down next to me and said, “What the hell is this all about?” I answered his question by introducing myself. He was an orthopedic surgeon, as were two other men who later joined our table.

Would any of the three last the whole four-hour session? I braced myself for a lot of muttering and antisocial behavior. In my biased mind, orthopedic surgeons stand out as the most paternalistic of all the medical specialists.

A second nurse and a cardiologist rounded out our group.

After we finished introducing ourselves, I realized most worked in surgical areas (The cardiologist inserted stents, a surgical procedure that he performed in the OR).

What followed was not what I expected. The main leaders, one older orthopedic surgeon, who asked to be called by his first name, and two nurses, led the group though team building exercises, videos and discussions. The nurses, OR techs and doctors in the audience, including those at my table, participated. To my surprise, my table built the highest Lego tower demonstrating our superior use of “team work.”iLEGO TOWER

'Relax - we're all in this together.'

‘Relax – we’re all in this together.’

What the workshop demonstrated to me was that the team had replaced the doctor as “Captain of the Ship.” Or at least team members had a say in what happened at the bedside, or in the OR. All professionals were encouraged to speak up if they saw something that would negatively affect a patient outcome. In fact, a bright yellow card to wear hidden behind the staff’s nametag was inserted into our handout folder. It said “I Need Clarity.” It could be flashed at the attending/surgeon, or any team member, so as not to cause a patient anxiety. The team would then go out of earshot of the patient and family to discuss the potential problem. Every team member’s input was important.

As I walked to the parking garage at the end of the class, I wanted to call my old nursing school classmates so they could appreciate along with me how far physicians had come in becoming team players. My classmates and I came from the old school when nurses stood when doctors entered a room. We endured prima donna surgeons that had temper tantrums and threw instruments in the OR when they were angry. The doctors I had just observed took part in an effort to discard old actions and engage in team building behaviors.TEAM BUILDING

Well, things were changing. Okay it’s only one workshop, but it so impressed me.

I am going back for the second half this week. Let you know if I had been dreaming.

Why Caring Lessons Goes to Printers Row Lit Fest

Marianna Crane:

My very good friend, Lois Roelofs, says “Too few nurses write their stories.” Read about her interaction with the visitors that come to her table at the Printers Row Lit Fest in Chicago.

Originally posted on Ramblings by a Retired Nurse (in Chicago):

“Pardon me,” said the well-dressed older man. “But could you tell me when this festival got so big? Last time I was here, there were only a few tents. And today,” he paused, his smile wide, “this is huge, and so many people.”

imageSo began a conversation with a visitor from the East Coast last Saturday at the Printers Row Book Fest, the Midwest’s largest outdoor literary fest. His surprise and enthusiasm is one reason I’ve gone for several years and then displayed my nursing memoir, Caring Lessons: A Nursing Professor’s Journey of Faith and Self, for the past two.

I get excited already when I approach the street where it starts. There are several blocks full of tents with tables lined up on the sides of the streets. You hardly know where to start. Plus there are large outdoor tents and indoor venues for author presentations. When I’m…

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painting of house and boatsI am at the beach with my family—our annual get-together. We found a new rental house, one with enough space for the grandkids to enjoy time away from the adults. Need I mention the adults enjoy this situation, too? We are thinking about renting this house next year.

As I type, the sound of the ocean competes with chattering from the birds. This idealistic scene is so unlike what my husband and I left behind in our new community. We are the second wave of about fifteen residents to move into the future eighty-three-townhouse neighborhood. The remaining homes are in various stages of completion. Recently, the most active construction surrounded and bombarded us daily with noise. Cement trucks blocked access to the street and the roads were covered in mud from multiple plantings of trees and shrubs.

Here I feel tranquil. The deck where I am sitting is sheltered from the sun and cooled by a gentle breeze. I can hear my grandkids laughing down by the water. It’s time to put away the computer and slip on my bathing suit and join them. After all, I’m on vacation.

Florence Nightingale: The Crucial Skill We Forget to Mention


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Marianna Crane:

Read this wonderful post about all the compelling reasons nurses need to write.

Originally posted on Off the Charts:

“Suppose Florence hadn’t been a writer? Think about it…”

Karen Roush, PhD, RN, is an assistant professor of nursing at Lehman College in the Bronx, New York, and founder of the Scholar’s Voice, which works to strengthen the voice of nursing through writing mentorship for nurses.

karindalziel/ via Flickr Creative Commons karindalziel/ via Flickr Creative Commons

When we talk about the diversity of what nurses do, there is no better example than Florence Nightingale herself.

She was an expert clinician working in hospitals in Europe and London and caring for soldiers in military hospitals during the Crimean War. She was a quality improvement expert, implementing improvements in military hospitals that had a major impact on patient outcomes. Her work as an educator created the very foundation of nursing as a profession. She was a researcher and epidemiologist, using statistical arguments to support the changes she demanded. She was a public health advocate, campaigning for improvements…

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