Ah…nothing sets the tone like a little music before all the talk. In radio they call that a “cold open”! Who knew? Here’s Casey and Dan…

“Of course that was the unmistakable voice of Patsy Cline the great country legend. That song came out in 1957 and like a good Cabernet—it just gets better with age. 1957…Dan…you weren’t even born then. I thought it might be fun to take a quick look at what was happening in 1957—here is what our crack research department found: The Space Age began by the launch of Sputnik I, interferon was discovered AND THE MOST IMPORTANT THING THAT HAPPENED…”beatnik” entered the vernacular as a description of the emerging “Beat Generation” counterculture movements.”

And so starts another episode of Nurse Talk.

Nurses keep up the fight for RN to patient ratios…we should all be very glad they do! We thought we’d check in with our friends in Massachusetts who are working on legislation—so Casey and Dan visit with RN and president of Massachusetts Nurses Association, Donna Kelly Williams. Donna brings us up to speed on current issues—with a central focus on staffing ratios.

2nd Annual Marin Advocates for Children Heroes for Children Gala March 3, 2012. Cocktails, auctions and dinner benefit a great cause.

Expert says compassion is key. Have you ever witnessed a parent or guardian verbally or physically abuse a child in a public setting? Did you walk away because you didn’t know what to do…or did you intervene? Find out what our expert has to say about what you should do. Cyndy Doherty, executive director of Marin Advocates for Children joins Casey and Dan to talk about what her organization is doing to help and prevent this epidemic. You won’t want to miss her advice and insights.

AND—We’ll have some fun as we continue our look back at callers from the early days of Nurse Talk. Lucille Jones and her cross-country trip with her ill mother. Oh, she was priceless! You can find this and more at Nurse Talk’s Comedy Pharm.

AND take a sneak peek of our resident funny lady Lynn Ruth Miller‘s new segment,In My Day. It’s amazing she lived to tell about it!

You can listen every week in the Boston area on station WWZN 1510AM every Saturday at 11 am EST or live stream at www.revolutionboston.com and in the San Francisco Bay area Sundays at 2PM PST on KNEW 960AM or live stream atwww.960knew.com. Check out the iHeartRadio app for free and live custom radio. You can also download and listen to any show anytime here at NurseTalkSite.com or on iTunes. Like us on Facebook, and you can listen there too.

And, remember, laughter is the best medicine!

Yes! a non-profit subscriber supported magazine, with in-depth analysis, tools for citizen engagement, and stories about real people working for a better world recently published The Yes Breakthrough 15 their list of people transforming the way we live.

Dr. Deb Richter, Photo by Kurt Budliger

Dr. Deb. Richter made their list for her advocacy of single payer healthcare in Vermont. Last May, Vermont became the first state in the nation to pass a single-payer health care plan.

“I never felt like I had a choice about getting involved in this struggle … I couldn’t stop and I never will.” —Dr. Deb Richter

In her interview with Yes!, Dr. Richter explains, “A lot of my patients didn’t have insurance. I would prescribe medicines for patients but they wouldn’t be able to afford them, and then they would just get sicker. I was mortified…I knew I couldn’t continue to practice if this situation continued. I didn’t want medicine to just be for wealthy people.”

“This will be an enormous change for people without insurance,” says Richter of the Vermont bill, which will guarantee every resident an essential health benefit package from birth. “Now that we have this in Vermont, we need to make sure it happens everywhere.”

Read the whole article from YES! Magazine, Oct 31, 2011 >  http://www.yesmagazine.org/issues/the-yes-breakthrough-15/deb-richter-a-cure-for-broken-health-care

Have a listen to our newest segment, In My Day, with comedian Lynn Ruth Miller.

I have been thinking a lot about death and funerals today. Missy’s best friend’s father died, and also her first boss at her first real job after college. I listened to her order flowers for each of them, and talk to their family members on the phone last night and today. She is going to both visitations and funerals in the next couple of days.

I thought about all the funerals I have been to in my life. A lot of people now put in the paper that they request no flowers, a donation to their favorite organization. I still always send flowers…I cant help it, I just know that all of the funerals I have ever been too, or involved with, that we always went around looking at the flowers, “Oh yes, those are from so and so, aren’t they beautiful?”, or, “Look at those roses, they are from so and so…oh how the deceased loved roses.” I always think too, walking into a funeral home and seeing the flowers just makes me smile. It’s kinda like…once you are in a room full of beautiful flowers…celebrating a life, anyway. I just like flowers.

My father died on Christmas Eve, and way back then the funeral was held the day after Christmas. My father was my hero, and it was a terrible winter when he died, lots of snow, and I remember being at the funeral home and thinking, “He won’t have any flowers, because people won’t see his death notice because of the holiday. The florists were closed for the Christmas holidays…” I was so happy as I sat in the funeral home before visitation and the flowers started arriving, one florist said he was called at home to please come in to make arrangements for [my father]. Another florist told me he drove back from another city to make all the arrangements. I was thrilled to go and read all the cards on the flowers. I remember crying as I read the cards, and my mother hugging me.

So just to let you know, if you put in the paper not to send flowers…sorry, I can not grant you your wish, it’s just still one thing that I want to do for you and your family…flowers, and a card…and oh, how I love gardenias.

Rallies Tuesday, 12 Noon, Kaiser Oakland, Kaiser South Sacramento

Kaiser Nurses Show Support of Striking Co-workers, Patients and the Community

OAKLAND—Registered nurses and nurse practitioners at Kaiser Permanente hospitals and clinics across Northern and Central California will honor the picket lines Tuesday in sympathy and solidarity with other frontline Kaiser staff who will hold a one-day strike Tuesday to protest Kaiser demands for substantial cuts in healthcare coverage, retirement benefits and inadequate staffing for mental health services.

RNs will complete final sympathy strike preparations Monday 3:30 p.m. at the Oakland headquarters of the California Nurses Association/National Nurses United, which represents 17,000 Kaiser RNs.

Media Availability Today:
California Nurses Association, 2000 Franklin Street, Oakland, 3:30 p.m.

Tuesday Schedule:
Picketing Begins: Tuesday, January 31, 7 a.m., Kaiser Permanente Facilities
Rallies: Tuesday, January 31, 12 Noon
Kaiser Oakland: 3801 Howe St., Oakland
Kaiser South Sacramento: 6500 Bruceville Rd., Sacramento

RNs will be supporting mental health clinicians, clinical psychologists, licensed social workers and opticians.

The nurses say they understand the concerns of their co-workers about the erosion of services that affect the quality of patient care, especially in mental health, as described in the report Care Delayed, Care Denied. It asserts that Kaiser has frequently failed to comply with California laws aimed at protecting patients’ timely access to appropriate services despite receiving more than $10 billion annually from Medicare to provide a full range of services, including mental healthcare.

“It is disappointing that Kaiser is refusing to bargain for sufficient staffing for mental health services, and a secure retirement and accessible health coverage for its frontline caregivers despite its record profits,” said Zenei Cortez, RN, CNA Co-President, who works at Kaiser South San Francisco. “We will continue to honor the basic tenets of nursing and stand in support of our colleagues, our patients, and communities.”

Read more >

Does your life feel like a tug-of-war? Nurses continuously juggle the demands of their personal and professional lives. At work, they provide high touch-high tech care for sick and dying patients. In addition, many nurses perform ‘double duty’—caring for friends and family members when not at work. Being pulled in so many directions can seem overwhelming. Learn how to manage stress and regain your balance by taking a few small steps each day.

Kayla is a nurse on a busy telemetry unit; she is married, has two school-aged children and helps care for her aging mother. Today she agreed to work another double shift to cover a last minute call-in. Kayla slammed the phone down after arguing with her husband Mike—he resents Kayla choosing her job over the needs of their family. Kayla was already feeling inadequate when her friend Terry excitedly announced, “I passed my certification exam.” Although Kayla bought a review book six months ago, she hasn’t started studying yet. She worries, “I hate not being there for my family… I am falling behind in my career and I never have time for myself.” Kayla felt a wave of nervous tension in the pit of her stomach. Tom, the patient care technician, interrupted Kayla’s thoughts, “Mr. Rodriguez is having chest pain.” Kayla mindfully refocused her attention to her work taking slow deep breaths on the way to Mr. Rodriguez’s room.

1. Take five deep breaths: to elicit the relaxation response

Deep breathing is a simple stress management technique that can be practiced almost anywhere. It can help quiet your mind, release tension, and decrease the symptoms of stress by eliciting the relaxation response. The relaxation response is the opposite of the ‘fight or flight’ stress response.
Take five slow deep breaths, whenever you begin to feel stressed. Breathe in through your nose and out through your mouth. Your abdomen should expand when you breathe in and flatten when you breathe out. Focus on your breathing until you feel calmer.
Integrate deep breathing exercises into your daily routine to decrease your stress symptoms before they occur.

2. Spend five minutes in nature: to experience mindfulness

Stress can promote automatic thinking or mindlessness. After a busy shift at work, have you ever arrived home without remembering the drive? This is a classic example of mindlessness—performing a task while preoccupied with other thoughts. Being distracted during patient care can lead to serious omissions and errors. In contrast, mindfulness is the ability to focus your attention fully in the moment.

A simple exercise for developing mindfulness is to spend five minutes in nature every day. Find time to go outdoors before work, on a break or after work. Be present in the moment and engage your senses. What do you see, hear, smell, or feel? During this exercise, do not think about the past or worry about the future—experience now. In addition to becoming more mindful, you have just taken a mini-break from the stress in your life.

3. Pause five seconds before responding: to avoid over committing

How often do you agree to help only to regret it later? Due to their helpful caring nature, most nurses have difficulty saying “no” to the requests of others. This can lead to fatigue and resentment from over committing. Learning to say no to out of balance requests frees you to say yes to your own needs.
Before agreeing to work an extra shift, babysit your friend’s children or bake cupcakes for the entire third grade, pause five seconds before responding. Five seconds is long enough to gather your thoughts. If you are willing and able to help—say yes. If agreeing is over doing—say no. If you are uncertain, a possible response is, “Let me think about it and get back to you.” If you are pressed for an answer before reaching a decision, it is generally safer to say no—you can always say yes later.

4. Record five thoughts or ideas: to process your emotions

Journaling is a simple yet underutilized stress management tool and path to self-discovery. A journal is more than a diary to record events—it is safe a place to process your emotions. Nurses are held to the highest moral, ethical and legal standards. In addition, they regularly witness the emotional and physical suffering of others. Nurses have a lot of daily stress to process.
Commit to recording five thoughts or ideas in a journal each day. Allow your thoughts to naturally flow onto the paper. Do not judge your handwriting or your feelings. Your feelings are your feelings—they are not right or wrong. Discover patterns of thought and behavior as you write. Periodically re-read your journal entries—you will be amazed at your progress and insights.

5. Read five pages a day: to promote life-long learning

All major goals can be broken down into smaller steps. Kayla could prepare for her certification exam by reading five pages from her review book a day. Reading is the fastest and least expensive method of becoming an expert in your nursing specialty. Imagine the knowledge you would gain by reading five pages from nursing journals or books each day.

Commitment to life-long learning is essential to the professional development of a nurse. The rate of change in health care is constantly accelerating. In order to remain relevant and keep pace with new technologies, techniques and trends—nurses must stay informed. Reading from a variety of fields can inspire creative solutions for the challenges facing the nursing profession. Readers are leaders.

Utilize the simple strategies of taking five deep breaths, spending five minutes in nature, pausing five seconds before responding, recording five thoughts or ideas and reading five pages each day to produce big results in your life and career.

This article was shared with us by NurseTogether.com.
Based in Charlotte, NC, NurseTogether.com is one of the fastest-growing, free online professional communities for nurses. Specializing in unique nursing lifestyle, career and professional development information, NurseTogether.com’s mission is to empower the nursing community through top-quality original content from experts, interactive web-based social media tools, and value-added services through key strategic partnerships in a variety of nursing and lifestyle disciplines.

Barbara's husband and daughter Missy at the Illinois State Fair

Oh what a day, a day to just relax…very rainy and dark here in Newburgh Indiana.

Last night I had a bad Alzheimer’s night. I was very tired this morning, so I knew it had been a long night. Missy told me I was upset over not being able to see my husband. I have been thinking a lot about him lately. Missy said I was crying saying, “I know you are not telling me that he is gone.”

Missy does not smoke, no one does in our house, but a friend told her that sometimes smells help Alzheimer’s patients. My husband smoked, a lot, so Missy told me that last night she lit a cigarette and smoked a little of it to get the smell in my room. She then told me that my husband was in the bathroom shaving, he always smoked while he shaved…she said she told me, “Don’t you smell his cigarette smoke?” That calmed me and I went to sleep.

She showed me the video today. So sad. I am just a another person in my body…the same in looks, but my mind is not my own. I wish I could explain how scary this is. I never was a drinker, but it must be kind of like a drinker’s blackout…with little memory the next day. I told Missy that I do not want to see any more video, that she can continue to video, that maybe in the future it will help someone else, but I do not want to see anymore.

I am glad to be back to myself today, happy, listening to music, and thankful.

Missy looks tired today, but she hugged me extra long this morning when I got up, and kissed my forehead twice, and told me loved me more than usual today. If you knew how she hates to smell cigarette smoke, and how she doesn’t let anyone smoke in our house…makes me love her more and more and more.

For me, she will do anything…I knew that.

Dan and Casey say they have really made an effort to stay away from the presidential primary but sometimes it’s hard. Roll clips of two presidential hopefuls with one having more hope than the other! We’re just sayin’—one of these men might need to look into “anger management.” Just sayin’. Check it out…on the show this week.

AND we talk with Rob Horgan. Rob is a recruiter for the University of San Francisco School of Nursing and Health Professions. “As nurses” Casey comments, “we just happen to think USF’s nursing program is among the best in the country.” Rob joins Casey and Dan in studio (true) to share about the Master of Nursing Program USF offers at their Santa Rosa, California campus. We just found out a few months ago they had a Santa Rosa, California campus. P.S. Rob, if you are out there, thanks for being such a good sport and boy, are you quick on your feet!

Check this out! We share a great video that is up on a site called ProtestINTheUSA.org. The video titled “A Nightmare On Wall Street” depicts an imagined encounter between a Wall Street banker and the victims of financial misdeed. Oh, the horror!

And as the assault on public healthcare workers continues—things are heating up in Fresno, California with major cuts proposed by that county’s Board of Supervisors. RN Mary Morrison joins us to talk about the proposed cuts and the potentially devastating impact on yet another community.

Available now on Amazon

And later we’ll visit with one of our favorite people RN, MSN, Karyn Buxman. Karyn has been on the show before. You might remember her as a great nurse and public speaker—as well as a humorist who really does employ humor in the healing process. Her mission: To improve global health through laughter and help heal the humor-impaired! She’s here this week to talk about her new book “What’s So Funny About Diabetes.”

MYTH: Popping your knuckles will give you arthritis? True or False? The answer is planted somewhere in the text of this blog post. Find out!

And remember you can listen and laugh every week in the Boston area on station WWZN 1510AM every Saturday at 11 am EST or live stream at www.revolutionboston.com and in the San Francisco Bay area Sundays at 2PM PST on KNEW 960AM or live stream at www.960knew.com. Check out the iHeartRadio app for free and live custom radio. You can alsodownload and listen to any show anytime here at NurseTalkSite.com or on iTunes. Like us on Facebook, and you can listen there too.

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Author, Spearker, Nurse Karyn Buxman, RN, MSN, CSP, CPAE

I’m super excited to tell you that my latest book, What’s So Funny About Diabetes? A Creative Approach to Coping With Your Disease is now available!

What’s so funny about diabetes?

Maybe nothing. Then again, maybe everything.

Especially if you understand the premise that so much of our humor comes from pain and discomfort—our own, or somebody else’s. And let’s face it; if you’re a diabetic, you’ve got more than your fair share of pain and discomfort.

Currently one in 10 US adults has diabetes, but those numbers could go as high as 1 in 3 by the year 2050. A long-term solution can only come from getting people to change their lifestyles: better diets, exercise and coping mechanisms to deal with this serious illness.

Available now on Amazon

The good news: Humor and laughter have been shown scientifically to have positive benefits for diabetic patients. Laughter has been shown to lower blood glucose in diabetics, as well as decrease hormones that can be harmful. Humor is recognized as a healthy coping mechanism. And humor has also been proven to increase the retention of information.

For these reasons, and more, author Karyn Buxman has written the first in a series of books for patients with chronic illness: What’s So Funny About Diabetes? When you’re a diabetic, you need to arm yourself with all the tools that you possibly can to become the healthiest person that you can be. You need a large repertoire of skills. Humor isn’t the be-all, end all; it’s not meant to replace your medical regime, but rather to be a complement to all the efforts you’re already making.

Now Karyn Buxman shows you how you can strategically use humor everyday to better manage your diabetes and live a healthier and happier life. And you don’t need to be funny. You just need to be able to see funny.

“If we took what we now know about laughter and bottled it, it would require FDA approval,” says psychoneuroimmunologist, Dr. Lee Berk. The perfect gift for yourself or someone you love, this book is filled with wise, witty, and life-saving advice. Whether you are a diabetic, a pre-diabetic, or the cheerleader for a diabetic, there is something in this book for you.

This article was originally posted on Karyn’s site at www.karynbuxman.com.

Vinnie Jones shows how hard and fast Hands-only CPR to Stayin’ Alive by the Bee Gees can help save the life of someone who has had a cardiac arrest. The Hollywood hardman is starring in a British Heart Foundation TV advert urging more people to carry out CPR in a medical emergency.

Author, Bobbi McCarthy

I was supposed to fly to Virginia on Jan. 13th with my son to be with my daughter, her husband and baby, (my 7 week old grandson) BUT I contracted strep throat and became quite ill rather fast on Jan. 12th. By 8pm on the 12th I was having bilat. ear pain, was feverish, chilled and having a hard time swallowing. By the time 330am on the 13th rolled around and I was supposed to get in the shower and get ready to leave, my fever was 102 and I ached all over! Needless to say I’m still home and NOT with my beloved children and grandchild in Virginia.

The lesson learned you ask? Stress and lack of Self-care WILL make you sick…and you WILL end up missing out on life’s fun during that time!

Prior to going back to college to obtain my BSN, I had not been introduced to the subject of nursing burnout and self-care. I have since been educated on the crisis of burnout in our nursing profession and one of the biggest weapons against burnout being self-care. Nurses as well as women (double jeopardy if you are a female nurse!) tend to put other people’s needs ahead of their own. We are taught this concept as young girls and we have it reinforced in nursing school! (Up until now that is) The other lesson that we are taught is that if we do not put other people’s needs ahead of our own we are NOT nice girls…hence if you take your breaks at work you are not tending to the needs of your patients and if you take your breaks during a busy day…you are a slack off!

Nursing educators and theorists have been writing about the effects of stress on the nurse and the eventual burnout that occurs from that repeated, prolonged stress for many years. Self–Care is now a term used to describe a variety of things a nurse can do to relieve stress and thus bring more balance and peace to our nursing lives…thus bringing us out of burnout or keeping us from becoming burnt out.

Now “taking care of myself” was certainly something I always thought I did~ you know…sleeping, having fun, eating right most of the time…etc. The term Self-Care encompasses a much bigger meaning than just taking care of myself. It means realizing that I am worth taking care of~ that if I do not take care of myself chances are no one will do it for me~ that in order for me to perform at my highest and best level I have to infuse peace, fun, love and balance as well as proper nutrition and sleep. It also means that I need to have boundaries and limits around my life…work hard AND play hard…give love and receive love…be creative and expressive. It also means that during a 12 hour work day I MUST eat and rest in order to recharge…I could also inhale some lavender and orange incense to promote relaxation or energy as I need it.

Another area that I have been learning about in the realm of Self-Care is being present…present in the moment~ Instead of running to catch up with my thought, allowing my brain to observe my thought without judgment and then moving on to the next thought, allowing my heart to feel the pain, the sorrow or the fear and then letting it pass. I tend to stuff things during my work day, (and in my home life)…in order to keep moving on to the next patient and the next issue. Once in a while I have a patient or family issue that forces me to stop~ observe~ feel and be present. These moments are the most rewarding so why do I run from them most of the time???

I can honestly say, as I have in this blog, that I have been in varying stages of burnout during my 21 year nursing career. When I began instituting self-care measures a year ago I felt the burnout lift and shift to a less severe burn. (Maybe it is now just smoldering but no longer a burn). I learned Reiki and went to yoga at least twice a week and I started eating better and drinking less wine. I felt happier and more able to face the long 12 hour ER shifts. At work I started taking my breaks for the full time and trying to get off the floor…I brought lavender and orange scents to work to sniff during the day for the calming or energy effects and I ate more healthy foods.

During the last several weeks I have let that slip greatly. I’ve been eating poorly and drinking more wine again at night “to de-stress” and sadly the yoga went to the wayside. I also have been allowing an emotional issue in my life to control me and to worry me…hence I let my energy level dip…my defenses break and just when I needed my health to be pristine…WHAM!!! It wasn’t.

I will take this illness as a learning moment. As painful as the moment is…it is necessary to learn that in order to be our best we have to give ourselves the best care! We can only give what we give ourselves and we can only be as strong as the strength we infuse ourselves with.

Self-Care…a much needed reminder for myself this week.

Video of Timm Sinclair, the son of a Kaiser mental health patient.

Kaiser nurses will be holding the sympathy strike on Jan. 31 to support their co-workers who are members of National Union of Healthcare Workers who charge that Kaiser Permanente, California’s largest HMO, systematically understaffs its mental health services in violation of California state law, leaving some patients to suffer delays in receiving treatment they have already paid for and urgently need.

The subject of  articles in USA Today and the Huffington Post,  A report by the NUHW “Care Delayed, Care Denied” documents the problem in detail.  To learn more and see the report visit: http://www.nuhw.org/caredenied.

From the Executive Summary:

“With more than 6.6 million members, Kaiser Permanente is California’s largest HMO and plays a massive role in the state’s healthcare delivery system by operating more than 35 hospitals and several hundred clinics across the state. Less well known, however, is Kaiser’s role in providing mental health services to Californians. Ranking perhaps second only to the State of California, Kaiser is one of the state’s largest providers of mental health services. The Oakland-based company guarantees its members a full array of inpatient, outpatient and emergency mental health services provided by several thousand mental health professionals. Each year, thousands of Kaiser’s members seek treatment for conditions ranging from autism, anxiety and bi-polar disorder to depression, schizophrenia and suicidal ideation.

Despite Kaiser’s pledge to provide comprehensive mental health services to its members, an in-depth analysis suggests that the HMO’s mental health services are sorely understaffed and frequently fail to provide timely and appropriate care. Patients often experience lengthy delays in obtaining services, an overreliance on “group therapies,” and frustrating obstacles that push many patients to forgo care or seek treatment elsewhere at their own cost…

Kaiser’s substandard care also comes at the same time that the HMO is reporting record profits of $5.7 billion [emphasis ours] since 2009.”

View Statements of Concern by the National Association of Social Workers – California Chapter, California Psychological Association and CAMFT.

Kaiser clinicians, patients and families can submit their stories too.

California’s senate appropriations committee voted 6-2 to pass Senate Bill 810,   introduced by San Francisco Senator Mark Leno.

Senator Mark Leno leads a rally with the California Health Professionals Student Alliance on the steps of the State Capitol for SB 810, the California Universal Health Care Act in 2011

At the request of millions of single-payer health care advocates, Leno authored SB 810, also known as The California Universal Health Care Act, “because it is the only health care reform that can truly contain health care costs and provide every Californian with comprehensive, quality, affordable health care,” according to his office. He says, “this “Medicare for All” type of program works by pooling together the money that government, employers and individuals already spend on health care and putting it to better use by cutting out the for-profit middle man.”

“California is being overrun by out-of-control healthcare costs, which have a significant impact on families, businesses and the state budget,” Leno said. “By guaranteeing universal access for all Californians, our single-payer plan will reduce the healthcare burdens that are hurting families and our state’s economy.” – Sen. Mark Leno

You can read more about the program and ways to help support it at  HealthCareForAll.com.

Well, this week we continue with our little walk down memory lane. We’ll hear from a caller named Mary Ellen who by the end of the call was not very happy with us. She recently sent us an email telling us her legs still hurt and we are crackpots!
For more where this came from check out our Comedy Pharm at nursetalksite.com.

And we share with you “Is Anybody Out There Laughing?” our campaign to change the world with laughter one person at a time. We’ll share the exciting response of a cashier in a pizza parlor when he is asked, “Is anyone in your place laughing right now?”

RNs from Chicago's landslide vote to join National Nurses United

And joining Casey (Dan was excused to go to Chuck E. Cheese with seven 8-year olds) is RN Dorothy Ahmad. Dorothy is a CCU nurse at Stroger Hospital in Chicago. Recently registered nurses at Jackson Park Hospital and Medical Center on Chicago’s South Side voted by 85 percent to join National Nurses United, the nation’s largest union and professional association of RNs. The Jackson Park RNs voted 94 to 16 to join NNU. The secret ballot election was conducted by the National Labor Relations Board. NNU will represent some 150 RNs at the hospital. “This is a victory for the nurses and the South Side of Chicago,” said one nurse.

Support Team Nurse Talk | Austyn's Allstars in the walk for a cure for MS.

Casey then visits with Jennifer Gainza, the communications director for the Northern California chapter of the Multiple Sclerosis Society. We asked Jennifer to come on the show and talk with us about MS, the signs the symptoms and current treatments. Approximately 400,000 Americans have MS- Multiple Sclerosis, and every week about 200 people are diagnosed. Worldwide, MS affects about 2.5 million people.

We were recently prompted to inquire about Multiple Sclerosis when our Nurse Talk web producer Tonia McCallum’s 20-year-old niece Austyn was diagnosed. Nurse Talk is sponsoring her team for the 2012 Walk MS in Santa Rosa, Calif. funding research for a cure. You can donate to Team Nurse Talk | Austyn’s Allstars or join a walk or volunteer in your town this spring by contacting the Multiple Sclerosis Society.

And of course we’ve got the Golden Bed Pan Award—no hints on the winner but we do get a call from a female media mogul thanking us for the award. Hmmmm. There’s also the Phobia of the Week and some email questions.

You can listen every week in the Boston area on station WWZN 1510AM every Saturday at 11 am EST or live stream at www.revolutionboston.com and in the San Francisco Bay area Sundays at 2PM PST on KNEW 960AM or live stream at www.960knew.com. Check out the iHeartRadio app for free and live custom radio. You can also download and listen to any show anytime here at NurseTalkSite.com or on iTunes. Like us on Facebook, and you can listen there too.

It’s all here on Nurse Talk where laughter is the best medicine.

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As a companion to their recently released comic book, M.I.T. health care economist Jon Gruber and illustrator Nathan Schreiber teamed up with the Center for American Progress to produce an three-minute animated explanation of how the health reform law works:

Originally posted at the Washington Post’s WonkBlog.

Around three hundred million people live in the United States. About three million of them are nurses. I make that one in a hundred.

This demographic worried me a bit when I first retired. Nurses just don’t share a shift or a workplace. They share a culture and a lifestyle. I wondered—and fretted—about what life would life be like when I wasn’t around a lot of nurses anymore.

What was I thinking? If you are a nurse, and do not live on a desert island, you cannot escape other nurses. And they cannot escape you.

The rule of Chaos Theory known as ‘strange attractors’ states that there is really focus and magnetism to seemingly chaotic and random social patterns. Nurses definitely have something like that going on. The only other thing similar to it that I can think of is gaydar.

Gaydar is the ability make an intuitive identification. The nurse-strange attractor thing is like that, but different. Consider this.

It is child’s play to pick working nurses out of a crowd. Once a nurse isn’t working, though, the characteristic nurse outfits, accessories and shift-related circadian rhythms are no longer in play.

How, then, do I always find the retired nurse in a crowd without even trying? For lack of a better word, I’m calling it radaRN. No offense meant to our LPN/LVN brethren. It’s my word and I’m counting you in it too.

When I first joined my new church, I was told to look out for someone named MaryAnn, who was a retired nurse. Two weeks later I tripped in a church hallway and fell at the feet of a 60ish blond woman. You know who it was.

Not much later, I plunked down onto a van seat for a day trip. The woman I chose to sit next to turned out to be a retired nurse too. Not MaryAnn. Another one. My new nurse friend and I decided to buddy up for yoga classes.

One day, my yoga nurse buddy couldn’t make class. I struck up a conversation with the woman on the yoga mat next door. She turned out to be a soon-to-retire OR nurse.

In another yoga class, I mentioned to a friendly fellow-yogi that I had worked as a psychiatric nurse. Her face lit up. “Are you a nurse too?” I asked.

“No”, she said, “but my husband is a psychiatric pharmacist.”

OK, so radaRN isn’t perfect.

Florence Nightingale advocated for her patients. Today, as in the day of Nightingale, the nurse is the patient’s voice. The nurse speaks for the patient, mediates between the patient and others, and/or protects the patient’s right to self-determination (Ellis and Hartley).

Too often competing priorities, the hurry to complete tasks, or to complete documentation, take precedence over advocacy. Yet, advocacy is an ethic of practice and integral to a philosophy of nursing rooted in caring. Heightened nurse advocacy contributes to making the health care system less intimidating, makes the journey of patient and families less lonely, and improves the image of nursing.

Patient Advocacy has long been a focus in nursing but with the increasing complexity of health care, the need is even greater. Roles for patient advocacy range from assisting patients with the transitions from hospital to home maintenance to lobbying government agencies for health care issues. Advocacy is a concept involving analyzing, counseling, responding, and, if need be, whistle-blowing (Beyea, 2005). Advocacy in nursing has its theoretical roots in the field of ethics. The ANA’s Code of Ethics states: “The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient.” The American Nurses Association (ANA) included advocacy in its definition of nursing in the words “the protection, promotion, and optimization of health…through…and advocacy in the care of individuals, families, communities, and populations.” (ANA Social Policy Statement, Second Edition, 2003, p.6)

Patients are vulnerable. This is particularly true if a patient with under-certainties of illness, undergoing surgery, altered level of consciousness, or is too ill or sedated to speak up for themselves. Clinicians sometimes decide what is best for a patient, sometimes without considering the patient’s wishes but also out of necessity. When the family care provider or the patient is afraid to speak, the nurse must advocate for the family. In some cases it can mean life or death. In other instances, it can provide the support for patients and families to help them cope with the uncertainties or inevitabilities that they face. Quite commonly, nurses translate, interpret and help patients and their families to understand what appears as healthcare gibberish. But, as Malik points out, although nurses are in the best position to act as advocate, “it can be a risky role to adopt” (Malik, 1997). As the nurse explores, informs, supports and affirms the choices of patients when conflicts arise, the nurse must remain the patient’s advocate even when it may not be the decision the nurse would make (Malik).

The challenges of advocacy became clear when I was put into the position of advocating for members of my own family. As a medical-surgical nurse for 30 years, a faculty member of a Health Sciences University for 20 years and a specialist in gerontology, I found the role of advocate not only risky but a lonely one. As nurses we are assumed to be able to manage the system, yet as I struggled to advocate, I appreciated how much more difficult this must be for many of our patients.

Recently, my husband, a 72 year old proud, strong man with a history of hypertension and Type 2 diabetes, was found by his endocrinologist to have a very high blood pressure and an elevated creatinine blood level. As luck would have it, this took place on a Friday. Of course, while my husband knew, he, like so many men of his generation, maintained his stoicism by not telling ME anything.

The next week, as he became more uncomfortable, I went with him to see an internist who promptly palpated the abdomen (at which point my husband tells us, “It feels like I have a football in my belly”). From the internist we were referred to the nephrologist, but as luck would have it, his was out of town. After a search for another, we hurriedly travel to another city to see him. The “stranger” nephrologist took a 2 minute history, as he was due in surgery in another city, and as he examines the prostate, states, “Whoa! THAT’S ONE BIG PROSTATE!!” I detected pride in my husband’s face.

The office nurse immediately catheterized his bladder and collected 1800 ml of urine! Though she used lidocaine jelly, the experience was excruciatingly painful. His BP went from 185/100 to 125/80 and he lost 5 pounds. The urologist quickly announces that my husband will need to catheterize himself (HIMSELF) daily, take three new medicines several times a day, and cancel all other medicines. As this plan was announced, my husband was experiencing profuse bleeding resembling thick tomato juice.

Home we went with trepidation and prescriptions in hand. Shortly after, the bladder spasms began and became unbearable. After four attempts to reach the doctor for his blessing to give over-the-counter pryridium for the pain, he prescribed it 10 days later.

From here we became very busy with:

• Catheter and leg bad by day and large bag by night, for six weeks
• Daily lab tests
• CT scans (when we met for the results of the first one, the nephrologist looked at the cd and said, “Did they use contrast?” “No”. “Well this is no good to me. If there are cancer cells I won’t see them!” He then rushed out of the office to reprimand the radiologist.
• KUB ultrasounds
• Cystoscopy (I held the information of what this procedure would entail)
• MRI for 2 hours

He refused, with a look that would kill, the urinary flow study. Some seven weeks after the initial symptoms, the diagnostic tests confirmed that there was a problem. The diagnosis now was to our great surprise, an enlarged prostate complicated by a “complex cyst” and a large kidney stone.

Eventually, a TURP was performed successfully. But like many older adults, my husband became somewhat “altered.” I spent the night at his bedside.

The postoperative surgery phase was a roller coaster ride. Vicodin for pain led to constipation/digital dis-impaction, the use of a catheter and leg bag for another week, three urinary tract infections (during one he had “rigors”, sudden paroxysmal shivering, teeth chattering and high fever), two trips to the Emergency Room, a lithotripsy, a disgusting intractable odor of putrid urine in the home. Can you feel it?? Frustration. Confusion. Exhaustion. ANGER.

Overall, the patient was very weak, anemic, depressed, and worried.

Cancer cells?

As his nurse advocate, I created a file for the hundreds of papers, some of which I had to demand. And I spoke out and questioned when the approaches to health care did not make sense. Our favorite frustration was the office staff who, for example, repeatedly explained that he would need to drink 1500 ml of water before the test to fill up his bladder. I repeated “He has a catheter.” “He HAS a catheter.” “HE HAS A CATHETER!!!” It appeared that THE HELPERS IN THE NEPHROLOGIST’S (8 nephrologists) OFFICE know little about nephrology!

My husband, like so many of our patients, was in pain, overwhelmed, and in denial. Of course, NOTHING would have happened without my consistent presence to translate, clarify, repeat, and advocate for my husband. I could barely follow all of this confusion, dates, times, preparations, follow-up. I have finally returned to work. When my husband appeared for his most recent exam, everyone asked, “Where is your nurse?” Irony to be sure. I was often angry, yet knew that it would be counterproductive to show it. I was not as successful with the patient.

Despite my frustration, I recognize that we are among the fortunate. We are well educated, intelligent, healthy people with excellent health insurance, outstanding physicians and facilities available to us. I am very aware of pathophysiology, medications, and treatments. I am a pleasant, agreeable person. Yet, overall, I felt that I was either expected to perform miracles in the way of communication or I was in the way. Not once did I feel useful or appreciated. The reality was that my husband was very ill and unable to think clearly. I cannot conceive of how anyone could have maneuvered our health care “system” on his own. Swimming through a maze as an outpatient!!

Tate, RN, states that not advocating on a patient’s behalf is a deviation from the standard of care (Tate, 2005). Yet, as she notes, far too many nurses have never learned or practiced this critical skill. She states, “I believe that no hospitalized patient should have to advocate for himself—ever. Nor should any family member or significant other ever be expected to have to have to advocate on behalf of their hospitalized loved one. This is a nursing responsibility” (Tate).

As a nurse educator for many years, I have reflected on my family’s experience and the lonely road of advocacy. I understand that advocacy must be taught. At my institution, the notion of advocacy may only be included in Health and Human Caring class or referred to at times in nursing classes. Learning about advocacy best occurs by observing other nurses or through experience.

Advocacy is a skill based upon a body of knowledge. Yet, the concept does not appear in the educational literature to the degree that it should. Among the current foundational resources available to nursing faculty, “advocacy” is hardy mentioned at all. In 2009, based on the Institute of Medicine competencies, Quality and Safety Education for Nurses (QSEN) faculty and a National Advisory Board defined the Knowledge, Skills, and Attitudes (KSAs) necessary to continuously improve the quality and safety of health care systems. These KSAs are to be developed in Nursing Pre-licensure, Transition to Practice, and Continuing Education programs.

Advocacy is mentioned in the first of six categories, “Patient-centered care”, defined as “recognizing the patient or designee as a source of control and full partner” in providing compassionate and coordinated care based on respect of patients’ preferences, values, and needs. This implies seeing “through the patient’s eyes.” Exploring ethical and legal implications of patient-centered care is another knowledge expectation.

Of the four Major Client Needs categories of the 2010 NCLEX test plan, the first is “Safe and Effective Care Environment”, enhancing care delivery to protect clients and health care personnel. One subcategory is “advocacy”. Advocacy should be implicit if not salient in ALL NCLEX categories.

Too often competing priorities, the hurry to complete tasks, or to complete documentation, take precedence over advocacy. Yet, advocacy is an ethic of practice and integral to a philosophy of nursing rooted in caring. Heightened nurse advocacy contributes to making the health care system less intimidating, makes the journey of patient and families less lonely, and improves the image of nursing.

This article was shared with us by NurseTogether.com.
Based in Charlotte, NC, NurseTogether.com is one of the fastest-growing, free online professional communities for nurses. Specializing in unique nursing lifestyle, career and professional development information, NurseTogether.com’s mission is to empower the nursing community through top-quality original content from experts, interactive web-based social media tools, and value-added services through key strategic partnerships in a variety of nursing and lifestyle disciplines.

REFERENCES
ANA Social Policy Statement. 2nd Ed. Retrieved from www.QSEN.org, 2003 Code of Ethics for Nurses.

“The Nurse’s Role in Ethics and Human Rights: Protecting and Promoting Individual Worth, Dignity, and Human Rights in Practice Settings” ANA Policy Statement. Retrieved from http://www.nursingworld/MainMenuCategories/HealthcareandPolicyIssues, June 14, 2010.

ANA Position Paper, “Workplace Advocacy” retrieved from /ANA Position…6/6/2011

Beyea, Suzanne C. “Patient Advocacy. Nurses keeping patients safe.” AORN Journal, May 2005.

Cronenwett, L., Sherwood, G., Barnsteiner, J., Johnson, J., Mitchell, P. et al (2007). Quality and Safety Education for nurses. Nursing Outlook, 55(3) 122-131.

Ellis,J., and Hartley, C. (2008). Managing and Coordinating Nursing Care (5th Ed.). Philedelphia, Lippincott.

Foley, B.J., M.P. Minnick, C.C. McKee “How Nurses Learn Advocacy” Journal of Nursing Scholarship 34 no.2 (2002) 181-186.

Institute of Medicine. Health professions education: A bridge to quality. Washington, DC: National Academies Press; 2003.

Malik, M, “Advocacy in Nursing—A Review of the Literature,” Journal of Advanced Nursing 25 Jan 1997;25 (1) 130-138.

National Council of State Boards of Nursing, 2010 NCLEX-RN Detailed Test Plan for the Educator, Chicago, Illinois

Scandanavian Journal of Caring Science 2006 September 20 (30): 282-292.

Tate, RN. “Patient Advocacy: The Nurse’s Responsibility”. Topics in Advance Practice Nursing eJournal 8/2005;(2).

“Welcome to Nurse Talk where laughter is the best medicine. I’m Casey Hobbs.”

“And I’m Dan Grady and we are two of the thousands of nurses on duty today.”

And so the show begins.

Laughter is the best medicine. Check out Nurse Talk's Comedy Pharm Funny(?) calls, stories, outtakes and bloopers

Let’s take a little walk down memory lane and listen to some old stories we told when Nurse Talk was first on the air. We think they are at least amusing—funny? Well, that is in the eyes of the beholder! Not sure any of you remember RN and co-host Maggie McDermott. Maggie comes back to visit from time to time and she always has a story about a funeral she just attended or a “fender bender” that wasn’t her fault, or a souvenir from her latest trip to the Great Wall Of China, (where she, of course, most likely offended someone). Oh, we love our Maggie. You’ll hear she and Casey in the early days on this week’s show and you can check out more clips on our website at the Comedy Pharm.

Moving on—Lost for many observers in last month’s end-of-the-year hullabaloo was the annual Gallup Honesty and Ethics Survey which by a wide margin again ranked nursing as the most honest and ethical profession.The survey found that 84% of Americans believe that nurses have “very high” or “high” honesty and ethical standards. It marks the 11th straight year—and the 12th time in 13 years—that nursing led all professions in the survey. Gallup says the only time nurses haven’t topped the list since they were included in 1999 was in 2001 after the 9/11 terror attacks, when firefighters were No. 1.

RN and co-president of National Nurses United Karen Higgins is with us to talk more about the survey and what it means for the nurses, health care and social activism.

“We hold that trust as a sacred bond with our patients and our communities. Patients and their families expect nurses to fight for them at the bedside, even when it conflicts with the profit motive of far too many hospital managers, insurance companies, and others in the healthcare industry who put the bottom line above patient interest,” said Higgins in an article about the survey on the NNU web site.

Author, Joann Spears

AND we share a wonderful story from RN, writer JoAnn Spears. JoAnn has generously contributed some stunning blog posts about her life and career as a nurse. On a recent post she describes what she learned from a mute patient in a chronic psychiatric ward. She writes, “One night, I was working on charts at the nurses’ station when I felt eyes bearing down on me. Looking up, I found the patient with the blue eyes looking down at me. I asked him what he wanted, a rhetorical question with no answer expected.” We’ll talk more with JoAnn about her post, Behind Blue Eyes | A Life Lesson from a Patient.

And Casey and Dan get a few email questions that are…well…both about feet. Ever have an in grown toenail or a heel that hurts so bad you want to cry? All I can say is God love the people who have enough nerve to send in their questions! Remember—the nurses cannot prescribe, diagnose or treat and you should always consult your physician! Now that is something we NEVER leave out of the program.

You can listen every week in the Boston area on station WWZN 1510AM every Saturday at 11 am EST or live stream at www.revolutionboston.com and in the San Francisco Bay area Sundays at 2PM PST on KNEW 960AM or live stream at www.960knew.com. Check out the iHeartRadio app for free and live custom radio. You can also download and listen to any show anytime here at NurseTalkSite.com or on iTunes. Like us on Facebook, and you can listen there too.

Remember, laughter is the best medicine.

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Ah, the possibilities of an open mind.

Other rich countries have universal health care. FRONTLINE teams up with T.R. Reid, a veteran foreign correspondent for “The Washington Post,”   in “Sick Around the World,” to find out how five other capitalist democracies–United Kingdom, Japan, Germany, Taiwan and Switzerland–deliver health care and what the United States might learn from their successes and their failures.

Watch the whole show online at http://www.pbs.org/frontline/sickaroundtheworld/ Share widely.

Virtually every other consumer sale is taxed. Why not Wall Street’s?

A robust tax on Wall Street transactions would raise far more revenue – as much as 17 times as much – than more limited proposals, even accounting for the worst case scenarios of reduced trading as a result of a tax. That’s the findings of an important new research brief from prominent University of Massachusetts Amherst economists Robert Pollin and James Heintz.

This study is the most recent serious effort to quantify current, actual costs and evaluate the impact of the trading costs on trading volume. It can be viewed at: http://www.peri.umass.edu/fileadmin/pdf/research_brief/PERI_FTT_Research_Brief.pdf

The data in the study come from three sets of sources: the most recent academic and financial market research; a 2011 survey study by the International Monetary Fund; and the most up-to-date and comprehensive data on market trading from specialized firms that obtain these figures directly from the financial market trading businesses themselves.

One of the stories of the past year has been the growing international and U.S. movement for a financial transaction tax (FTT) on the trading of stocks, bonds, and other financial instruments.

An international coalition of labor, environmental, and non-governmental organizations have prodded the European Union to adopt a continent wide FTT, also referred to as the “Robin Hood tax.” Several European governments, including conservative leaders in France and Germany support the FTT and the EU which is predicted to adopt the tax by the end of this year.

In the U.S., a renewed push for an FTT has also mushroomed, encouraged by a campaign led by National Nurses United as a vehicle to raise badly needed revenue for healthcare, jobs, and other basic needs. NNU last year sponsored protests advocating for the FTT on Wall Street, the White House and Treasury Department, outside Congressional offices, and while participating in Occupy Wall Street protests throughout the fall.

Titled “Transaction Costs, Trading Elasticities and the Revenue Potential of Financial Transaction Taxes for the U.S,” the paper by Pollin and Heintz analyzes potential revenue from three different FTT proposals.

The three are a new bill in Congress introduced by Sen. Tom Harkin and Rep. Peter DeFazio, which would levy a miniscule .03 tax on stock and bond trades, or 3 cents on every $100 of trades, the main proposal in the EU for a .1 tax or 10 cents per $100, and a .5 tax, or 50 cents on a $100 transaction, favored by NNU and other activists.

The U.S. had a FTT from 1914 until 1966, and following a market crash in 1987, former House Speaker Jim Wright proposed reinstating a fee of .5, which was endorsed by leading Republicans as well, including top economic advisors to President George H.W. Bush.

Opponents of an FTT have claimed that any tax on Wall Street activity, which, unlike virtually all consumer sales is presently untaxed, would so discourage trading that it would substantially reduce any potential revenue – thus the reason given by proponents of the Harkin-DeFazio bill for introducing such a small tax.

However, examining existing FTTs currently in place in other countries and reviewing data on current U.S. private transactional fees on market activity from two firms private business firms, Pollin and Heinz reach a far different conclusion. They find:

A tax of .5, such as favored by NNU and presently in place on stock trades in the U.K., would generate as much as 17 times more revenue as the .03 tax included in the Harkin-DeFazio bill.

Additionally, Pollin and Heintz cite little evidence that a FTT would substantially reduce trading activity, as claimed by its opponents.

Pollin and Heintz note the work of one researcher cited in a paper from the International Monetary Fund which found no decrease in trading with the introduction of a transaction tax in some Asian markets. “Elasticity,” the term of art referring to the responsiveness of trading to a change in the transaction costs of the, “was zero in these markets when transactional costs rose as a result of an FTT,” the authors write.

Additionally, the UK market remains the fourth largest in the world, and transactional costs of .5 have “not prevented the City of London from operating as one of the world’s leading stock markets.”

Overall, Pollin and Heintz survey a number of potential scenarios that could occur from introduction of an FTT in the U.S. Even in the worse case scenario, a highly unlikely event, a .5 percent tax would still raise more than three times as much as the minute .03 tax, they conclude.

“There is no scenario in which a 3-basis point FTT (.03) [as proposed by the Harkin/DeFazio bill] will generate more tax revenue than a 50-basis point (.5) FTT,” write Pollin and Heinz.

Focusing on stocks alone as taxable entities, Pollin and Heintz conclude the Harkin/DeFazio proposal of .03 would raise just $8.1 to $9 billion a year, compared to from $24.6 billion to $150 billion every year with a .5 tax.

NNU and many other activists favor applying the FTT to currency trades, derivatives, swaps of all kinds including credit default swaps, and other Wall Street activity, which could produce revenue as high as $350 billion a year in critically needed revenue, says NNU.

“With so many Americans struggling with lack of healthcare, high unemployment, foreclosure, and other family crises, we need a meaningful way to heal our nation,” says NNU co-president Karen Higgins. “It’s time for the Wall Street banks and investment firms to pay to rebuild the economy they did so much to run. The small tax on major trading that we propose is a critical first step.”

###

For Profs. Pollin or Heintz, contact Debbie Zeidenberg, at PERI, dzeiden@peri.umass.edu or 413.577.3147

Nigerian children Photo credit Joe Carey

Founded by Christy Turlington Burns, Every Mother Counts is an advocacy and mobilization campaign to increase support for maternal and child health. They have created a new blog series called Tales From the Field stories from the front line where inspiring and dedicated people can share their experiences. The first installments feature Betsy Freeman, a nurse midwife who has spent the past 10 years working with underserved women, both in New York City and throughout Africa. They are heartrending:

I am two months into my six-month mission in northern Nigeria. My world here is small: base, hospital, base. I walk the path between them several times a day. At night our beat up Land Rover shuttles me back and forth bleary eyed. We work six days a week and I’m on call for two nights as well. Most calls I’m at the hospital for most of the night.

Our two main services here are emergency obstetrics and obstetric fistula repair. I spend my days and nights supervising the local midwives and managing the emergencies that come through the door. I have to step back from the experience from time to time.

It is, in a word, mind-blowing. Here’s a snapshot….

Last night I’m on call after working my usual day shift. I get called in around 11pm because there is an eclamptic patient who has blood pressures of 220/140, already being treated with magnesium sulfate. We give her hydralazine to bring the pressure down. She is fully dilated but comatose so we do a vacuum delivery with fundal pressure to get the baby out. As we are doing this delivery, I watch as the patient beside her, a postpartum eclamptic also starts seizing, also already on magnesium. We turn to her for five minutes push more mag, then the other one has a full on postpartum hemorrhage. We get both of them stabilized and I leave the hospital for about 30 minutes. Just as I’m turning off the light to go to bed, they call me back in.

This time I arrive to a woman sitting up in bed in respiratory distress. She is sweating, incredibly anxious, and has a hemoglobin of 1.7; she’s in pulmonary edema. Her oxygen saturation is 50% on oxygen. We give her lasix, blood, then more lasix. We roll her to our ICU, which is essentially a room very similar just down the hall. She lies next to the woman who is status post uterine rupture and hysterectomy and the postpartum para 16 (that’s 16 pregnancies!) who has malaria and typhoid and a suspicious chest infection. I’m home by 2am and have dreams all night about triage.

Read more about Betsy’s experiences or if you are someone you know would like to contribute to “Tales From the Field” you can submit your essay to info@everymothercounts.org. Every Mother Counts seeks to engage new audiences to better understand the challenges and the solutions while encouraging them to take action to improve the lives of girls and women worldwide.

Rep. Alan Grayson, former US Congressman, wrote in the Huffington Post this week, Rick Santorum is Wrong. As reported by ABC News, in a speach at Christian college, a student citing a Harvard study published in the American Journal of Public Health, asked Santorum how he thinks God feels about all those Americans dying because they lack health insurance. Rick Santorum “replied, “I reject that number completely, that people die in America because of lack of health insurance.”

According to the study, 44,789 Americans die each year because they have no health insurance. That’s 1 out of every 6 Americans. Rep. Grayson put it this way, “If you take two Americans who are physically identical — same age, same gender, same race, same weight, same smoking history — and one of them has health insurance and one does not, then the one without health insurance is 40 percent more likely to die each year.”

Public health care option naysayers like to point out that people are not turned away at an emergency room. Grayson says, “I ask them to show me an emergency room that will provide chemotherapy to a cancer victim. There isn’t one.” He continues:

To answer that challenge, I started a website called www.NamesOfTheDead.com. I invited surviving family and friends to tell me about people whom they had loved and lost, because they had no health coverage. And they did — thousands of them.

Every single other industrialized country in the entire world has universal health care. Why can’t we? How many more people have to die? How many more sacrifices on the altar of Almighty Greed?

Any health care system that denies necessary care on the basis of wealth is evil. It doesn’t matter how you micromanage it, or tinker with it. It’s evil.

When Justice Harry Blackmun began voting against death in every death penalty case, he gave this simple and eloquent explanation: “From this day forward, I no longer shall tinker with the machinery of death.”

We need to reach the same kind of realization in health care. Forget about the tinkering. This is America, not Myanmar. People who are sick need to be able to see a doctor. Because we are human beings, not cattle. End of story.

Read Grayson’s whole article and the study for yourself and share the facts widely.

By John Commins, for HealthLeaders Media, January 3, 2012

Lost for many observers in last month’s end-of-the-year hullabaloo was the annual Gallup Honesty and Ethics Survey which by a wide margin again ranked nursing as the most honest and ethical profession.

The survey found that 81% of Americans believe that nurses have “very high” or “high” honesty and ethical standards. It marks the 11th straight year—and the 12th time in 13 years—that nursing led all professions in the survey. Gallup says the only time nurses haven’t top the list since they were included in 1999 was in 2001 after the 9/11 terror attacks, when firefighters were ranked No. 1.

Not surprisingly, National Nurses United is well aware of the survey results and appears poised to capitalize on that hard-earned public regard.

“We hold that trust as a sacred bond with our patients and our communities,” Karen Higgins, RN, co-president of National Nurses United, said in a media release. “Patients and their families expect nurses to fight for them at the bedside, even when it conflicts with the profit motive of far too many hospital managers, insurance companies, and others in the healthcare industry who put the bottom line above patient interest.”

“For nurses, that obligation also goes beyond the bedside,” Higgins continued, citing the NNU campaign for “sweeping changes to heal our communities and nation, with a program for a Main Street Contract for America premised on jobs with dignity, healthcare for all, a safe environment, and support for public education.”

The union is also pushing for a Robin Hood tax on financial transactions to be levied against “Wall Street banks and other financial firms who created the current pain and suffering in our communities….”

NNU has smart, tough leaders and compelling “us-versus-them” and “patient-first” messages that resonate not only with the nurses they hope to organize, but with tens of millions of Americans who play by the rules and still feel like they’re getting a raw deal.

The union has gained considerable success and notice since it consolidated the California Nurses Association/National Nurses Organizing Committee, United American Nurses, and Massachusetts Nurses Association in December 2009. The “super union” now boasts more than 150,000 members within a national network and has won most —if not all—of the organizing efforts it has undertaken.

Savvy leadership and a compelling message—while important—are not the only keys to NNU’s success. Seasoned and tough leaders can be found in other unions that have not fared as well. In 2010, only 11.9% of the U.S. workforce was unionized, down from 12.3% in 2009. Unions have seen a mostly steady decline in membership since 1954, when about 28% of the workforce was organized, according to the Bureau of Labor Statistics.

Union supporters believe that more U.S. workers would join unions if they could. They don’t, the explanation goes, because these workers haven’t the leverage to bargain with management, especially in a weak economy plagued by high unemployment.

The frustrations and pressures that nurses encounter on the job can be shared with workers in other sectors from agriculture to retail to heavy industry. Bad bosses, declining wages, and benefits, job instability and lousy hours are not unique to a particular sector.

Nurses, however, know they are in high demand. They know they are not easily replaced. They know their skills—for the most part—cannot be outsourced. Because of all that, they know they don’t have to tolerate a dysfunctional workplace. They can vote with their feet and find a new job elsewhere, or they can vote to organize.

NNU’s success suggests that when workers are given the chance to organize, usually they will. That annoys a lot of people who want to believe that unions are no longer needed in this era of enlightened management.

Instead, union successes are dismissed as some sort of trickery such as heavy-handed organizing efforts that pressure non-affiliated workers to join. How else to explain the failure of management to contain NNU’s organizing efforts, other than to acknowledge the failure of management?

If NNU’s only purpose were to increase dues-paying membership, as some critics suggest, that is not necessarily a grand deception on its part, and it does not explain their success. Nor is it explained by the suggestion that unions now hold some momentary advantage thanks to a temporarily pro-labor tilt on the National Labor Relations Board.

The explanation is simple. NNU is succeeding because many nurses—like many workers in many sectors—believe that nobody else in a position of power and influence is looking out for them. The only difference is that nurses are in a position to do something about it.

John Commins is an editor with HealthLeaders Media. He can be reached at jcommins@healthleadersmedia.com.

Author, Bobbi McCarthy

The ER was in a rare state of calm…several patients being tended to but NO chaos!!  I was assigned to the patient coming in by Delta~ I prepped the room and waited. The patient arrived, awake but tearful.  His wife was with him. It seems the patient was having pain in an area that he hadn’t had pain in a while—his cancer treatments had been over for several months—he is awaiting a second opinion. His complaints were pain, loss of appetite, and dry mouth.

As I cared for him he talked to me. He told me of his life, many children and several new grandchildren, how he and his wife cared for his ailing father who recently had passed away.  He cried, a lot.

He began to tell me how he felt failed by the caregivers in his cancer care.  He shared with me that he only saw the primary doc 4 times in his many months of treatment and that he was seen by varying other PA’s or NP’s.  He was very upset over the “many times the doc would see him in the waiting room and just walk by, without a handshake or a how are you?”  We talked about this…he told me that very few of his doctors and nurses had the “gift” of bedside manner.  “So many nurses and doctors just see me as a pain in the ass and someone to rob them of their time.”

Two liters of saline, pain meds and many minutes of hand holding at the bedside garnered me the real reason for his ailing health.  Four days ago his 2 teenage grandsons were killed in a car accident…Christmas day. (I do have his permission to talk about this.)  The tears would not stop…his pain increased…but he continued to tell me about them.  His wife sat off to the side, wiping her own tears.

I was granted an unusual amount of time to spend with this man that night in the ER.  He needed me; he needed my hand, my heart and my time.  I thanked God several times while this man was talking to me—for the gift of time. Time is so unusual in the ER…but this is the treatment that this man needed.  Sure the narcotics and the fluid replacement helped…but it was the human experience that made the difference.

When he was in the wheelchair ready to be discharged home he hugged me and looked me in the eye and thanked me for my “bedside manner” and for “caring about what happened to me.” “You, my dear, have the gift of bedside manner,” he told me.  It was my turn to shed a couple of tears!

I don’t tell this experience to toot my own horn.  I tell it because it is such a powerful example to me of what you see at first is not usually what the problem really is, and how important it is for patients to feel cared about by their providers. It is a rare blessing for my ER gang to have the minutes they need to sit with a patient and have the time to establish a relationship so that the patient feels comfortable enough to share the real reason they are ill. Unless we have to intervene with life saving measures initially, we need to remember that they need our presence first…

Much like a forest fire, our spirits can experience a natural disaster.

A forest fire is destructive and dangerous, it wipes out all that is good and healthy and beautiful. It exerts its power and overwhelms everything in its path.

In nursing many of us come to a point in our career where the fire has overwhelmed our soul and we haven’t realized it or stopped to take a moment to appreciate the toxicity of the smoke surrounding us. We may fail to do the important growth work that is so integral to how we care for others. We forget to periodically evaluate our own forest—to look for the old and the brittle, the dry bushes, the dry earth, the lack of flora.

When we care for others it is so easy to forget what your forest looked like when you began your walk on the nursing trail. Our time is devoted to service for thirty six hours and then we go home for four days and spend half of that catching up on sleep and then the rest of it running around like mad to get all of our errands taken care of, the bills paid, the kids to where they need to be. Keeping our insides nourished is not on the priority list.

Combustion in nursing can have many causes. There are issues innate to the work. We care for our fellow man…and care….and care…and care some more. At the end of the day…or six years…or twenty years, we may have lost the vitality and possibility that were once in abundance in our own forests. The shady trees are gone, the creeks have emptied of fish and water. As he does in nature, man can keep taking until everything is gone and then stand before a desert and wonder what happened. Our patients take from us—our strength, our love, our hope, our compassion, our patience and they forget (as do we) that our resources can run dry.

If  you’ve taken a look inside and realized there’s only a desert left…well then, it’s time to plop down in the middle of that desert and look around you for signs of life. It’s there, and when you find it you will know what to do to grow your forest again. Is it time for a change in nursing specialty? Are you passionate about educating nurses or people? Maybe you’ve been ignoring the desire to get involved and learn more about nurse politics. Whatever that little piece of greenery inside of you is—don’t underestimate its strength and possibility.

Not only can we be drained by caring for patients, we drain each other by the way we treat one another. Humans are very good at setting fires not just in nature but on the inside of each other. Nurses are experts. If rangers knew about us we’d be banned from natural parks all around the country. Instead of helping to put out fires within each other to save the good things and help them grow stronger—we may throw matches in the middle of the beauty and watch destruction happen.

It’s called HORIZONTAL VIOLENCE…STOP!…. Look at the nurse next to you and don’t look at him or her as merely a person, but as a very important part in the balance in nature. When you do this it’s a reminder that all living things need nourishment and careful attention and handling. What can you do to add to another nurse’s forest so it flourishes? Make an effort to discover something new about the nurse next to you. What’s unique about them? As you would stop and admire a rare flower on a trail, admire the something new and different about the nurse sitting next to you. “Wow, look at this rare flower, there aren’t any others like it! How cool is this!” SHARE admiration with the nurse next to you. You’ve just now made a small contribution to their spirit and to the resources he or she will have to provide care to others.

Amid the destruction, fires also clear away what is no longer useful. They can be a source of renewal. They rid the earth of the old so that creation can begin again. Where there is destruction and ruin there is also the possibility of creation. Things may never grow back the same or in the same place, maybe there will be some completely different species of plants that crop up that have never been seen before. There is beauty in a recreating oneself after a fire, reevaluating the remnants, deciding what’s necessary to keep and what’s necessary to “let go.” Our work as humans is not static. Life and change are one in the same. You will change, your heart will change, your colleagues will change, and your dreams and goals pertaining to nursing will change. We don’t have control of change, for the most part. But as nurses we can put out the forest fire burning its way through our profession.

The next time you are at work, GET OVER the workplace politics, the gossip, who is answering the most call lights or who is getting the best assignments, who got to be resource nurse for two days in a row, or who took five minutes too long on their lunch break. These are the matches and the gasoline in our profession. When you find yourself engaging in these behaviors—remember you have the power to save and nourish the forest around you or the power to contribute to its destruction and the depletion of your own inner forest. It takes a few seconds to water a plant or flower at your house. If we all took just a few seconds a day to provide some water and nourishment and soil to one another as nurses…just imagine how insanely, blindingly, beautiful our forest would be…and its future.

Happy New Year. We wish you lots of laughter and renewal in 2012. We will do our best to contribute toward the tickling of your funny bone. Take on caring for yourselves as well as your patients. We liked a post by our Facebook friend, Nurses Interrupted with some ideas on how to make microchanges to help transform the workplace through transforming our relationships with one another:

Ask yourself this question before you go in for a shift: “When was the last time I put my hand on someone’s shoulder and told them thank you?” Its okay to nurse each other—it just takes a simple touch, making eye contact, a smile of reassurance—all those things take just a moment in time, but they have the power of changing your workplace…and your profession. You never know who might *really need* that reassuring human contact from a colleague…

On the show this week we replay of our interview with Dr. Connie Mariano who was nominated to the rank of Rear Admiral by President Bill Clinton and eventually served as the White House Physician for President Clinton and President George W. Bush. She has written a wonderful book called The White House Doctor, a riveting look into the personal lives of our presidents. Dr Mariano has also achieved an impressive list of “firsts” that include being:

• the first military woman to become the White House Physician to the President,
• the first woman Director of the White House Medical Unit, and
• the first Filipino American in US history to become a Navy Rear Admiral!

The White House Doctor by Dr. Connie Mariano

NURSE TALK IS GROWING…GROW WITH US. ADVERTISE to our active and engaged audience. Email to reserve your spot on the air or online: pattie@nursetalksite.com.

You can listen in the Boston area on station WWZN 1510AM every Saturday at 11 am EST or live stream at www.revolutionboston.com. Our San Francisco Bay area station is the same, but with new call letters: we broadcast on Sundays at 2PM PST on KNEW 960AM or live stream at www.960KNEW.com. You can also download and listen to any show anytime here at NurseTalkSite.com or on iTunes. Like us on Facebook, and you can listen there too.

Fighting the fight is all well and good until the fight needs to be ended…ended in time to allow for time…

I cannot get into specifics but I have a question for all of you fellow nurses. What do you do when you have a patient that is young, experiencing end stage metastatic cancer and they do not know it. The oncologist has not given them the realistic and total picture of their disease process NOR have they been given the tools to deal with the fact that the treatment they are undergoing IS NOT WORKING.

I worked in hospice many years ago and I had a bitter taste in my mouth then, as I do now, when the oncologist continues to throw one chemo/radiation therapy after another at a person who is just getting worse… and then they die in the midst of treatment and everyone around them, including often times their children and spouse are left with the thoughts of “but they were getting better….the doctor said the treatment was hopeful.”

While I was a nurse in the hospice world I had a voice and I could council my patients as they directed me to…I could also have a voice with the team that was treating the patient. I often feel left out in the wind while working these people in the ER. My role as the ER nurse is to deal with the situational issues that arise with this patient population, not to have a role in their treatment plan. I feel like I’m standing in the corner of the room with duct tape on my mouth and my hands tied behind my back…watching from afar as this confused, sick and often times dying patient enters our doors and needs help…and the most sickening part is they and their families are so unaware of what is truly happening.

As a nurse we have the obligation to provide the total and holistic range of care that each of our patients needs and deserves…I cannot help but wonder where the moral compass points on this issue for both nursing and with the medical professionals who treat these types of patients. The “never give in and never say die” attitude with which many oncologists practice is all fine and good to encourage hope and strength in the patient population, but when is it okay to tell the patient the truth from the facts of their case… I know that it is a struggle of thought that when you tell the facts…the patient may lose the will to fight or may give up…but what if that patient and their family needs that information to stop the insanity and come together for some last weeks of time with saying goodbye?

Each person that we come in contact with has the right to be told the truth of their situation…and sometimes that truth is, “we have done all we can do and now we need to make you as comfortable as possible so you have some good weeks left to be with your family, free from treatment and free from pain, to have the strength and mind to say goodbye. Fighting the fight is all well and good until the fight needs to be ended…ended in time to allow for time…

What is your experience?

Before I was a nurse, I had occasion to be a young patient.

I had a brief but painful procedure to undergo. My nurse was named Anne. She told me that if it hurt, I should just go ahead and scream.

It was nighttime, and all the other patients on the floor were asleep. It must have been the incipient psych nurse coming out in me; I was determined that those other patients not be woken up.

“I’m not going to scream,” I said gamely.

“Well, then, here’s my hand, squeeze it really tight if you need to,” Anne said, resting her right hand in mine.

I needed to, all right. I squeezed really hard, and I screamed anyway, waking all the other patients and probably a couple of the dead down in morgue, not to mention shattering a few glass pipettes down in the lab. I also suspect that I broke a couple of small, unnamed bones in Anne’s hand; as soon as it was all over, I could see that it was already turning purple.

I remembered Anne when I was a student doing a rotation through a same-day surgery unit. They were preparing to do an I&D on a man with a badly suppurating scrotal abscess. It was a dead heat as to what was absolutely the worst thing about the situation: the sight, the smell, or the man’s embarrassment at having a skinny little nursing student in the room. I remembered Anne, gave the man my hand, and told him to squeeze it if it hurt.

It had to have hurt him, bad. He squeezed my hand, hard. Really hard. Hard enough to keep himself from screaming. The fact that he was able to endure the pain in silence seemed to give the man some of his dignity back. The fact that I hadn’t flinched in spite of a badly bruised hand somehow righted my own undignified scream of years before.

Lots of research has been done about the occupational hazards of nursing. Back injuries in our Orthopedic colleagues. Workplace violence experienced by our ED sisters and brothers. Teratogen exposure faced by our Oncology nurses. The effects of shiftwork on the graveyard crew and the Baylor cohort.

I don’t think anybody’s ever put any research effort into our hands, though. Since the ‘squeeze my hand’ thing is so intuitive and universal in nursing, I think it bears investigating. Maybe we could all volunteer our hands for X-ray, and see how many of us are carrying around old fractures of our phalanges, carpals, metacarpals, and sesamoids. I have a feeling that many of us would turn up positive for Big Squeeze Syndrome.

Sharon Tobin, RN and 23 year ICU veteran at SUTTER MILLS PENINSULA HOSPITAL talks with Nurse Talk about the upcoming one day walk-out at Sutter hospitals in California. What has happened to big hospitals? Sharon says Mills Peninsula in Burlingame was once a wonderful community hospital, is now a shadow of its former self. LISTEN TO FIND OUT MORE ABOUT THE ONE DAY WALK-OUT AGAINST SUTTER SET FOR THURSDAY, DECEMBER 22. Learn more at NationalNursesUnited.org.

We live in a world of constant pressure and stress, which seems to be getting more challenging all the time. Especially in healthcare, organizations are forced to do more with less, putting pressure on the staff to exceed the superhuman pace that they are currently working at. Nurses are especially vulnerable to this level of stress because it seems that we, as a profession, are always “picking up the slack” when cutbacks are made in other departments or holds are placed on hiring. I used to laugh in my leadership positions when the CEOs would say, “but we’re not cutting nursing positions”, and, as a CNO, I would argue in a sense, yes, we are. When nurses “pick up the slack”, nurses are absent from the bedside, performing tasks that can be done by other people and at a premium cost. As nurses, we can also add on the emotional stress of what we deal with on a daily basis, followed by the tremendous responsibility of having precious lives in our hands. Oh, and let us compound the work stress by layering on family responsibilities, school responsibilities, day to day activities of survival, and, let’s not forget, somewhere in there we need to sleep.

Over time, this level of stress takes a tremendous toll on our bodies and our minds and somehow we need to disconnect and renew. Webster’s dictionary (2008) defines renewal as the process of repairing something that is run down or broken. When have you not felt run down at the end of a long shift and yes, there are times our spirits are broken. We have to take time to do something for ourselves that helps us return to that place of rest and well-being. It is not a luxury, it is a necessity.

In order to rebuild the body and quiet the mind, it is necessary to mentally disconnect from your world of stress and chaos. You do this simply by engaging in an activity that mesmerizes your mind. It is important to understand that your brain can perform one conscious activity at a time while your mind can only entertain one thought at a time. If you don’t believe that, the next time you are brushing your teeth, try to do something with your free hand. Notice what happens to the hand that is doing the brushing. Your body can only engage in one conscious activity or one thought, so knock out the stressful activities and thoughts for some that will renew you.

Start simply by scheduling ten to twenty minutes a day to do something that you truly enjoy (no-taking a shower that you have to take anyway does not count, where a wonderful soaking bubble bath would). Pick a good time in the day when your activity level is generally reduced and when you can be somewhat alone. Ask your loved ones to help you by giving you a little time to relax and be alone. The activity you choose should be your own. Something that you enjoy or something that you would like to learn that will mentally challenge you. I recently took a class in lampwork beading. It is challenging, artistic and fun, as well as absorbing. You have to pay attention to what you are doing while handling molten glass and fire, so while lampworking I cannot think about anything else. Exercise, yoga, meditation, reading a book that you do not have to read, engaging in a craft, getting a massage, facial, hot bath or even sports are other great options that will keep your mind mesmerized and provide a mental disconnect.

There is also something magical about being outside and enjoying nature. Just staring at the beauty of a flower for ten minutes will occupy your mind and help you appreciate your world in an amazing new way. Follow a butterfly, take a walk or hike, sit by the beach, enjoy the sun. Just renew. You are worth it! As a nurse, for all you give to others, you deserve some precious time for yourselves. You will be able to give more, when you give to yourself.

This article was shared with us by NurseTogether.com.
Based in Charlotte, NC, NurseTogether.com is one of the fastest-growing, free online professional communities for nurses. Specializing in unique nursing lifestyle, career and professional development information, NurseTogether.com’s mission is to empower the nursing community through top-quality original content from experts, interactive web-based social media tools, and value-added services through key strategic partnerships in a variety of nursing and lifestyle disciplines.

As nurses, you are certainly aware that stress is one of the major medical problems of our times. Studies show that nurses are the single sickest group of workers in the workforce. Ouch! This is appalling. When I worked nights in the PCU, I noticed that there were many more obese nurses working nights than days. What have you observed? In my experience, I have noticed that without exception, obese nurses apply to work nights. They want to work nights. These dedicated, long term night shift nurses also are on multiple meds and often discuss how many meds they are on, compare them, etc. What strikes me is that they speak about it in such a way as if it’s the most natural thing in the world. Please understand, I am writing this out of compassion for my fellow nurses, not as a critique. I am telling the truth, and yes, sometimes the truth hurts. We all know by now that working nights increases your risk for disease.

A nurse is the classic poster child for, “Is this job making me sick?”

Talk about, “the patient complained of pain on a scale of…” Many nurses consistently complain of pain. As a nurse working in the HR department of my hospital, shockingly, I have researched that stress related disability claims are estimated to increase by 50% in the next decade. Stress wreaks havoc with the circulatory, immune and digestive systems, to name a few. Stress is a killer, literally. Constant and chronic anxiety, worrying, and over-doing is literally burning brain cells, releasing toxic hormones into the blood stream, causing harmful sleep deprivation, wrinkling our skin, de-calcifying our bones and wreaking havoc with our insulin levels, which causes weight gain. Hence, stress makes you sick, fat and old.

The people who will have these disabilities will have used, knowingly or unknowingly, negative coping behaviors such as:

Avoidance: Procrastination, withdrawal, sleeping too much
Distractions: TV, video games, shopping
Violence: Hurting others or themselves, throwing things, yelling, hitting
Chemicals: Smoking, sugar and caffine, drugs
Employees come to see me every week and take fifteen or twenty minutes to discuss stress management. They re-connect to that place deep inside in each one of us where there is no upset. Nurses learn methods to experience deep, healing peace, and emerge rejuvenated and ready to return to their service at the hospital with greater focus, clarity and peace.

The foundation for abiding in the heart of wellness, happiness and peace can be found by learning how to “be still.” This is realized through the practice of ancient yogic breathing techniques and meditation. These tools transform and realign all the systems in the body/mind which have separated from the very source of peace which is not the body/mind, but the consciousness, pure awareness, spirit which is not at the effect of the struggles of daily life. I encourage all nurses to return to source, to “know thyself.” This is the oldest and surest method to wellness and happiness now.

Nurses, if you are feeling stressed and overwhelmed with work, consider trying yoga as a therapeutic method for reducing that stress.

This article was shared with us by NurseTogether.com.
Based in Charlotte, NC, NurseTogether.com is one of the fastest-growing, free online professional communities for nurses. Specializing in unique nursing lifestyle, career and professional development information, NurseTogether.com’s mission is to empower the nursing community through top-quality original content from experts, interactive web-based social media tools, and value-added services through key strategic partnerships in a variety of nursing and lifestyle disciplines.

Walkout to Target Bay Area Sutter Hospitals, Long Beach Memorial
Nurses Cite Patient Care Issues, Cuts in Healthcare Coverage

Nurses are poised to hold a one-day strike at California’s second largest private hospital, and one of its most profitable corporate hospital chain December 22.

The strike will affect 2,000 RNs at Long Beach Memorial Medical Center and Miller Children’s Hospital in Long Beach, and 4,000 RNs who work at eight Bay Area hospitals that are part of the Sutter corporation.

Long Beach RNs have been at odds with hospital management for months over assuring there is safe RN-to-patient staffing at all times. The nurses will also protest hospital demands for sweeping increases in healthcare premiums for nurses. The health care takeaway the hospital is pushing would cost RNs nearly $3,000 more out of pocket in premium costs.

“Nurses are tired of having to fight everyday to protect their patients because of speed up and cost cutting measures,” said Long Beach RN Margie Keenan.

“We are finding it harder to give the quality care we want to give when our employer, like insurance companies, is only focused on the bottom line,” said Keenan.  “This undermines our ability to deliver safe patient care.   Our serious safety concerns have not been answered at the bargaining table and we will not be able to reach an agreement until they are addressed.  Patients are more important than the bottom line.”

For the Sutter hospitals, this will be the second work stoppage following a one-day strike in September that was prompted by nearly 200 demands for major contract concessions made by the hospital giant despite amassing over $3.7 billion in profits since 2005.

Since the walkout, nurses have met with management officials repeatedly, ten negotiations just at Alta Bates Summit, but there has been little progress with Sutter continuing to press a hard line for cuts that would erode safety standards and further engorge company profits with little benefit for patients, RNs say. System wide, more than 150 takeaway demands remain on the table, nearly 100 at Alta Bates Summit alone.

Sutter continues to push changes that would RNs’ their ability to effectively advocate for patients against the budget-focused priorities of Sutter managers and effectively force nurses to work when sick, dangerously exposing extremely ill patients to infection.

The one-day Bay Area walkout will affect Alta Bates Summit Medical Center facilities in Berkeley and Oakland, Mills-Peninsula Health Services hospitals in Burlingame and San Mateo, Eden Medical Center hospitals in Castro Valley and San Leandro, Sutter Delta in Antioch, and Sutter Solano in Vallejo.

Sutter’s proposal to eliminate sick leave will force nurses to come to work sick which will further jeopardize our fragile patients, “ said Hebron Viray, oncology RN at Alta Bates’ Berkeley campus.

At Alta Bates Summit, Sutter has added a new concession demand, to end any collective voice for charges who make clinical assignments of a collective voice, eliminating their ability to speak out on staffing problems without fear of retaliation, as well as  requiring them to take on additional patient assignments, further eroding already under staffed units for patients.

“Sutter’s proposal to eliminate charge nurses threatens high-quality patient care and our ability to maintain patient safety and patient advocacy,” said Teresa Mullen, a charge nurse at the Oakland campus of Alta Bates Summit.

Additionally, Sutter RNs oppose management’s bid to reduce nurses’ healthcare coverage, with huge increases in nurses’ out-of-pocket costs for health coverage, elimination of health benefits for part-time RNs, and other cuts that would result in thousands of dollars in economic loss for RNs. All at a time when Sutter is sitting on $11.6 billion in assets and paying salaries of over $1 million a year to 20 top executives none of whom provide bedside care.

“We told our management that we would pledge not to strike if they pledged to not put takeaways on the table.  They would not make that commitment.  They are the ones who are forcing us into this situation.  We must stick together to fight on behalf of our standards and our patients,” said Sutter Solano (Vallejo) RN Rowena Modesto.

Long Beach RNs have been working without a contract since September 30 and held a candlelight vigil attended by more than 400 RNs last month to emphasize their concerns.

Nurses are particularly alarmed about their ability to take meal and rest breaks during which the hospital frequently does not have sufficient staff to meet minimum safety standards required by California law.

The nurses want the hospital to provide additional resource RNs to guarantee nurses can safely take their breaks without worrying about their patients safety, or having to continue working without breaks while fatigued and more prone to making mistakes.

“When the hospital does not staff to provide meals and breaks for nurses, it is detrimental to patient care.  Our patients require and deserve to have the continued care they expect from our hospital,” said Long Beach RN. Allison Miller.

Another contentious issue is lift practices. The RNs want the hospital to assure a safe patient lift policy to reduce the large numbers of musculoskeletal injuries among nurses and other staff, and to limit patient falls, accidents and pressure ulcers.

Despite the enactment of a state law signed by Gov. Brown in October requiring all California hospitals to have a safe patient handling policy, including lift teams trained to lift patients using proper equipment, Long Beach has continued to stall, putting nurses and patients at risk, say the RNs.

“We need to make improvements at LBMMC/MCH and it has been difficult to make corrections of practices that have been ingrained for years,” said Long Beach RN Mary Bailey.

See the original media advisory on NationalNursesUnited.org.

‘Twas the night before Christmas and the nurse is at work

Many a creature is stirring, including a jerk.

All the IV’s are hung by their poles with care

In hopes that 7am would soon be there.

The patients are snuggled all safe in their beds

While drug induced dreams dance in their heads.

My fellow nurses and I who are no longer in caps

Are just sitting down at the station to rap.

When out of room seven arose such a clatter

I sprang from my seat to see what was the matter.

Away to the bedside I flew in a flash

Where I grabbed the puke bucket from the cabinet stash.

The light I turned on, in order to know

Exactly what the bucket contained and would show.

When what to my wondering eyes should appear

But a disgusting recycled bucket of beer.

Lifting my leg to hit the call bell with a kick

My fellow nurse came to assist quick as a lick.

We changed him and flushed the bucket of shame

And he whistled and shouted,

“All hale the dames
They are the queens of the ER…maybe one is a Vixen.
Lets order some pizza! and we can call it a Mix in
We’ll sit on floor or lean on the wall
or maybe Ill just lie down in the hall”

We guided the poet who was on such a high

Back to his bed so sleep could apply.

Within 5 seconds he was snoring anew

His monitor showing vitals not to warrant Code Blue.

And then in a twinkling we heard something aloof

It was only the tech Ben, always being a goof.

As I let out a laugh and was turning around

He hit me with a spit ball and it fell to the ground.

The patient in room seven was again up and on one foot

And this time his gown was all wet and stained with “soot.”

A bundle of sheets flung over his back

He looked like street walker complete with a sack.

His eyes how they twinkled, his mood was so merry

His cheeks were like roses, and his nose like a cherry.

His droll little mouth was drawn up in a bow

And the beard on his chin was no longer white as snow.

The spittle of puke held tight to his teeth

And the bed pan he held on his head like a wreath.

He had a thin face but a big round belly

That now shook with a laugh like a bowl full of jelly.

He was nothing like a plump jolly old elf

And we laughed when we saw him in spite of ourselves.

A wink of eye and twist of his head

He turned around, showed us his butt…and went back to bed.

He spoke not a word but flashed us a smirk

Even I had to say he was no longer a jerk.

And putting his finger up inside his nose

Then giving a nod he declared, “this blows.”

We moved back to our seats and sat down with a whistle

His room looked as if it was hit with a missle.

But all together we laughed and said, while keeping the patient in sight

Merry Christmas to all…and to all a good night.

I had the awesome privilege of being able to speak to an Associate RN class on my experience with nursing, burn out, self-care and Reiki the other day. As I stood in front of the class and reflected on my 21 years of experience it struck me how easy it had been to just go along with the motions of every- day life and let the memories fade away.

As I drove home from that day I thought back to nursing school. I made a couple of really long-lasting friendships from those long study days…shout out to Robin and Kim!! I also still have close contact with 2 amazing instructors who touched my life in many ways…shout out to Terry and Lynn… I recalled the excitement of imagining being a “real nurse” and the fear of not knowing all I needed to know.

In fact I was sooooo green that on my first day of clinical I walked into a male patients room and the side rails of his bed were up, and his urinal was hanging off the side rail…I picked up the urinal and asked him if he would like me to fill his water jug! Yup…I thought the urinal was a water jug—for real. That man laughed so hard and I didn’t know why. After his hysterical laughter he said, “Oh my you really are a brand new student nurse aren’t you…honey. I piss in this jug!” LOL. I have learned a lot since then!

I remember the pride of the pinning ceremony and of graduation…wearing my professional nurse uniform (white dress with white hose and white shoes and yes, a white cap) to my first day of work. I have very fond memories of my nursing preceptor, Laverne, who treated me so kindly and taught me so much about being a professional, caring nurse.

I have had the privilege of working in many different settings and with many different patient populations, medsurg, post op ortho, homecare/hospice, emergency room….I can say the ER is my favorite as it gives you the variety of cases that are different every day and the rush of a trauma or an MI…being able to intervene and really save someone’s life is amazing!

What I shared with that class the other day again cemented for me that patient care is not just about all the technical things we know how to do and love to do…it’s about touching someone’s life in a positive way…I often times forget that and that is when burnout hits me the hardest. The patient does not give 2 hoots that you can read their EKG and intervene, or that you can start their IV, draw their blood, hang their medications, dress their wounds or collect evidence from every orifice known to man!

They only care that you, the nurse, gives 2 hoots that they are there…that your eyes and face convey to them that you are listening to them, caring that they are in pain, offer them a warm blanket and a hand to hold. Now, I’m not saying our nursing skills are not important, because we all know if we do not perform those skills well the patient will notice! But, we could mess up every task we have, but if we sit with that patient for 10 min, hold their hand or give them a warm blanket and a warm smile…they think we are the best nurse on the planet! I don’t know about you but my thank you cards from patients NEVER mention my awesome skills…but they always mention the warm blanket and the caring smile.

Here’s to remembering your early years as a student…being a new nurse…and why you love nursing…take some time to think back to those early days…it’s a fun recall.

From our friends at the Massachusetts Nurses Association:

Our  allies at Massachusetts Jobs With Justice are taking nominations for  their annual “Scrooge of the Year” competition, an effort to shine a  light on those policymakers, institutions or corporations that have  undermined the interests of working people in our state and the nation.   OK, nurses, who do you nominate?

An example might be Cerberus/Steward  Health Care, headed by CEO Ralph de la Torre.  This giant Wall Street  private equity firm, which has gobbled up hospitals in Massachusetts,  has refused to provide a pension plan promised to its nurses, has fired  nurses without cause, has cut back on the most basic supplies for patients and is now threatening to close services and hospitals, despite  promises to the Attorney General to maintain those services.

Visit the  link below to make your nomination.
http://www.massjwj.net/news/who-2011-scrooge-year

Barbara Taylor Vaughan

Our Facebook friends, Compassion for the Elderly shared one of their friends with us. Her name is Barbara Taylor Vaughan. She is 89 and in the beginning stages of Alzheimer’s. She started a Facebook page to help chronicle her illness and put a face on Alzheimer’s. She  hopes educating others will inspire them to volunteer to help ease the suffering of those with the disease, families, caregivers.  In her bio she writes,

“Hello buddies, this is my new page. It is a page about my alzheimers, about my daughters MS, just what happens around our house daily. I wanted to start out by saying that I have early alzheimers. I was diagnosed almost a year ago. People will tell me and my daughter, I dont agree with your doctor you seem fine. Then Missy will show them a video of one of my alzheimer days. When I get brave enough, and we all get to know it other better, I will have her post one of them here.

My alzheimers started with me not being able to balance my checkbook, misplacing things, for me that is very unusual. Then other things, names, happenings. Now, I have days that I do not recognize my daughter, I will be fine and all of a sudden want to go home, I will tell her to call my parents to come get me, I dont remember any of this, but have seen it on video, all I remember is confusion, and what I call my alzheimer sadness.

I think that alzheimers is terrible, you lose yourself, but most of all I think it is hardest for your closest family. When I think that my daughter has to watch me lose myself, and not know her it hurts me worse than the disease itself. My daughter is 58 and has MS, her biggest fear with MS is having to have someone take care of her, bathing her, taking her to the bathroom, wearing adult diapers, a wheelchair, not driving, she is living her worst fear by taking care of me. She is seeing first hand what might happen to her with her MS.

Sometimes I think that is why she has so much patience with me, she realizes she doesnt have a Missy, that is her name Melissa, to take care of her like I do. She has a wonderful partner Mike, they have been together 29 years. He is the true saint in our home. Anyway, just wanted to get going on here…I want all of you to volunteer if you can. I talk alot about volunteering in nursing homes, but also, if you know someone that is taking care of an alzheimers patient at home, bake them some food, call and make arrangements for them to take a break, even if it is for them to take a nap….tell them you are there, and dont just tell them you are there….be there!

Her compassion and humor are an inspiration. You can subscribe to her on Facebook at https://www.facebook.com/pages/Barbara-Taylor-VaughanAUTHOR/198891276863829.

We think this a great resource for patients and family. Share on. Bravo Barbara.

Yoga Nurse, Annette Tersigni

Nurses are the backbone of any successful healthcare facility and are prone to crippling stress. Stress related chronic anxiety is now the major medical complaint of our times. Stress is a killer, literally. Constant thinking, planning, worrying, wanting, and doing is literally burning our brain cells, releasing toxic hormones into the blood stream, causing harmful sleep deprivation, wrinkling our skin, de-calcifying our bones and wreaking havoc with our insulin levels…the nurse becomes the patient. Help is on the way!

As a practicing RN and certified medical yoga teacher, I have helped to heal over three thousand patients and students over the past fifteen years in Canada and the United States. How? Yoga is an ancient 5000 year old art and science which utilizes diaphragmatic breathing, gentle stretches and relaxation techniques to increase quality of life. Yoga Nursing® is the holistic, healing practice of caring and compassion provided by licensed nursing professionals who are also certified yoga teachers. I took training in Ayurveda, the sister science of yoga, in the mid 1990’s with the brilliant Deepak Chopra and David Simon Mds. At that time, I was a full time yoga teacher and they inspired me. I thought “Wow! If I became a nurse as well as being a yoga teacher, I could really make a difference in the quality of people’s lives.” Once, while I was still in nursing school teaching a yoga class, one of my students called me the yoga nurse! That‘s when the “Yoga Nurse” and the field of Yoga Nursing was officially created. I graduated from nursing and it became crystal clear that there was a natural fit between traditional western based nursing knowledge and the ancient eastern science of yoga.

Try this quick yoga nursing stretch now. You can easily integrate this powerful stretch while you are on the job. It’s called the downward dog using a chair or desk. Stand up and put your hands firmly on chair or desk. Walk your legs back, arms straightening out, then bend over making a bridge shape with your spine and melt your head and chest toward the ground. Let your head hang heavy like a ripe piece of fruit. Breathe deeply and feel the release of tightness in the entire backside of your body – back, aching shoulders and neck. Feel your chest opening, freeing tension. Enjoy this delicious stretch several times on your shift.

Watch this cool video to see exactly how it’s done.

Nurses, consider trying a gentle, restorative yoga class to restore and renew your energy; many nurses tell me they have tried everything, and that yoga is the first thing that has finally helped them and they love it! The KEY words here are gentle and restorative. So what if you say you are stiff…that’s why people come to yoga…to undo the stiff neck, knots in the body and mind. Check out your local yoga studios and inquire into the styles available and the background of the teacher. Safety first, the first law of yoga is the same as in medicine…non-violence or do no harm. Yoga will change your life, increase your self-esteem, and empower you to continue to serve as the nurse hero that you are. Find out for yourself that yoga is good medicine.

This article was shared with us by NurseTogether.com.
Based in Charlotte, NC, NurseTogether.com is one of the fastest-growing, free online professional communities for nurses. Specializing in unique nursing lifestyle, career and professional development information, NurseTogether.com’s mission is to empower the nursing community through top-quality original content from experts, interactive web-based social media tools, and value-added services through key strategic partnerships in a variety of nursing and lifestyle disciplines.

I recently bit the bullet and started text messaging. It’s not like face time and it ain’t Hallmark, but it has its advantages. It was an added bonus to discover that a career’s worth of nurses’ notes was the ultimate preparation for a would-be texter.

I avoided texting for a long time because I was put off by all the cutesy abbreviations. What was I thinking about…nurses invented abbreviations. KCL? We know what it is, what it can do, and how not to kill people with it. We can tell if someone is AAOx3 at 50 paces. We know if an LBM calls for NPO or BRATT. LMAO (laughing my ass off) or TTYL (talk to you later) is small stuff compared to a G10P9, V-fib, or calling Dr. Strong.

I was also text-resistant because of my grammatical principles. I went to Catholic School in the 1960s, when grammar had glamor. There was nothing of subtle, sexy, Audrey-Hepburn-in-a-little-black-dress-restraint about prose as I learned it. Less was not more. Less was…less.

Then came nursing school, where I committed sacrilege against everything the good Felician Sisters taught me and took up ‘telegraphic speech’. Old-time telegraphers got right to the point because they paid for their messages by the word. I learned to write my nurses notes as if I did the same.

If non-nurses read those notes, they would probably say the same things that naysayers say about text messaging. Disjointed. Poor grammar. Unfamiliar words, phrases, and abbreviations. Impersonal. Redundant. Lots of minutiae. A scary language, and I don’t understand it.

I was privileged in the latter part of my career to do a lot of auditing, so I’ve read more nurses notes after the fact than most. They were quite full of emotion, some of those impersonal and disjointed bits of minutiae, when you understood about them.

Jubilation can ooze out of a note, carefully signed with the letters ‘GN’, that simply says ‘TLC given, pain ↓’d’… if that note follows five or six others documenting PRNs that have had no impact at all. Vigilance, instinct, and intuition jump out from a dozen entries of ‘VSS’ at unordered fifteen minute intervals, followed by the code note that reveals that the @#$%, as some wise nurse knew in her gut it would, had hit the fan.

Some nurses notes are like the prizes at the bottom of a cracker jack box…just like some text messages are

Compassion Fatigue?

Stress—Life’s Storms
Stress is a naturally occurring phenomenon in the life of a nurse. As a nurse, you regularly witness the pain and suffering of others. You work under demanding conditions in stressful environments. Staffing issues, budgetary constraints, and regulatory scrutiny complicate the care you provide.

Stress is like a storm—anything from a quick cloudburst to a hurricane. Like storms, stress follows a predictable life cycle—there is a preparation phase, a time to “ride out the storm”, and a recovery phase. All storms eventually pass.

To prepare for life’s storms build your support network, practice authentic self-care, and study stress management strategies. During the storm, use your resources, implement your survival skills, and ask for support. After the storm, survey the damage, recover, and prepare for the next storm.

Bonnie is a staff nurse working on a busy medical-surgical floor. After arriving at work this morning she learned she would be in charge and that one of the nurses had called in sick. Another nurse on the unit snapped at Bonnie, “I am tired of working short, what are you going to do about it?” Bonnie immediately implemented her conflict resolution and time management skills. Next, she called the nursing supervisor and asked for help. Bonnie effectively managed “the stress of the day.” After work, Bonnie was able to “let go” of her stress—she went to her yoga class and soaked in a warm bubble bath.

Burnout—a Destructive Forest Fire
The metaphor of a forest fire for burnout describes the destructive depletion of life-sustaining resources. Burnout is the frustration, loss of interest, decreased productivity, and fatigue caused by overwork and prolonged stress. The potential consequences of burnout are emotional distress, physical illness, and interpersonal conflict. In the workplace, burnout leads to low morale, high absenteeism, high turnover rates, and occupational injuries.

Just as most forest fires are preventable—burnout is preventable. Protection and conservation of your precious resources is the key to burnout prevention. Your primary resources are your time and energy.

Anthony is a critical care nurse; he has recently moved into his dream home with his wife Marie and their two children. Anthony began working extra shifts at another hospital six months ago to offset their moving expenses. Anthony spends most of his time off working on his endless to-do-list of home improvement projects. Marie is concerned —Anthony no longer has time for their regular “date night” or the energy to play with his children. Anthony’s nurse manager has noticed a decline in his attitude and the quality of his work. Anthony is burning out.

Anthony began working with a life coach. His initial goal was to “learn how to get more things done”. His coach guided Anthony as he modified his plan; Anthony’s new goal is creating work-life balance. Anthony began by clarifying his values and priorities. Next, he developed a sustainable self-care plan. Anthony has cut back to working occasional extra shifts and is developing a realistic timeline for his home improvement projects. In addition, he has resumed his “date nights” with Marie and regularly arranges “play dates” with his children. His nurse manager recently remarked, “I am happy to see the old Anthony back again.” He is confident that she will like “the new Anthony” even better.

Compassion Fatigue—a Barren Desert
Compassion fatigue can feel like being lost alone in a barren desert. Fighting for your survival drains your depleted energy and scarce resources. You need help and hope as you find your way through the desert.

Compassion fatigue, also known as secondary post-traumatic stress disorder, is emotional, physical, and spiritual exhaustion from witnessing and absorbing the problems and suffering of others. Compassion fatigue most often affects caring self-sacrificing individuals prone to neglecting their self-care. The symptoms of compassion fatigue include despair, hopelessness, numbing, apathy, cynicism, anxiety, depression, hypervigilence, sleep disturbances, accident proneness, somatic complaints, decreased work performance, and exhaustion.

Recovery from compassion fatigue is complex and individualized. If you suspect you may be suffering from compassion fatigue, please tell those closest to you and consult your health care practitioner or a mental health professional.

Monique is having trouble getting out of bed in the morning—she feels severely fatigued and depressed. Monique desperately tries to hide her symptoms at work. She doesn’t know how she will “make it through another day.” Monique has been a nurse for over twenty years; in that time, she has consistently put the needs of others before her own needs. Caring for her terminally ill mother naturally fell on her shoulders, as “the nurse in the family”. Lately, Monique’s symptoms have become unmanageable and undeniable.

Monique’s recovery began by overcoming her denial. After seeking the support of a mental health counselor, she requested a family medical leave from her work. Her counselor is helping her to establish a self-care routine, set healthy boundaries, and to mobilize her resources. Monique asked her siblings to help care for her mother; together they have arranged for hospice care. Monique knows that her recovery will be a slow process—she no longer feels alone.

Whatever your status—transient stress, burnout, or compassion fatigue—there are countless strategies and resources available to you. We become stronger when we help our selves and each other.

Do you suffer from compassion fatigue? Have you overcome compassion fatigue? Leave a comment below sharing your experiences.

This article was shared with us by NurseTogether.com.
Based in Charlotte, NC, NurseTogether.com is one of the fastest-growing, free online professional communities for nurses. Specializing in unique nursing lifestyle, career and professional development information, NurseTogether.com’s mission is to empower the nursing community through top-quality original content from experts, interactive web-based social media tools, and value-added services through key strategic partnerships in a variety of nursing and lifestyle disciplines.

Photo: Brano Hudak

Occupational violence is not a new concern here in the nursing world but it is getting worse. The dept. of labors 2011 report states that being a nurse in the ER or in the mental health unit or community is ranked top highest job for violence. A nurse in the ER, nationally, is at a higher risk of being injured than a coal miner and a police officer. The Emergency nurses association did a report on occupational violence in 2010 that polled over 13,000 ER nurses and the statistics of that study are astounding.

A middle aged man is brought to the ER by the local PD after they were dispatched to the street that he lives on for “a man walking up and down street aggressively, yelling and screaming at things that aren’t there.” The man is cuffed and wide eyed, sweating with spittle on his chin. His cloths are filthy and he has multiple sores on his exposed arms. He is looking at things and muttering. He does not know his name or wear he is. He is fighting the officers and they physically have to drag him to a room. He has to be strapped to the bed for safety of the staff after he spits in the nurses face and tries to lunge at her while she is assessing him. This is a man on bath salts. (This is a case I am familiar with.)

A newly 20 something young man is brought to the ED by the police in cuffs after he took a few swings at his mother while intoxicated and angry. He made some suicidal statements so the holding tank becomes the ER. The patient is uncooperative and spitting at the officers and the nurse. He is sneering and making vulgar sexual comments to the nurse. His raised voice echo’s down the hall as he swears and threatens the nurse. Another all too often occurrence in the ER. (A case I am familiar with).

A male family member of a young woman gets very angry that they are waiting over an hour for the doctor. (Actual time 25 min) He begins slamming the door repeatedly and yelling threats down the hall. Security is called and the nurse asks him to please calm down, the doctor is with another patient and he will be down in just a few minutes. He then tells the nurse to go **** herself and slams the door again. Security asks him to wait in the waiting area to which he refuses. Police are called for staff safety. (A case I am familiar with).

A 20 something male patient is in the ER requesting narcotics for back pain. The patient does not receive any narcotics after the doc does his assessment, x-rays and lab work. The patient throws the discharge paperwork in the nurse’s face after calling her a name that makes my skin crawl and then he proceeds to push the nurse into the wall before leaving. (A case that I am familiar with).

As I write about these instances I can feel my heart is racing. Every day in our ER we nurses and techs are met with at least one patient every few hours that is angry at something or is on something that causes them to be dangerous. Our ER is just like every other ER across the country. Patients are getting angrier and their behavior is escalating quicker to violence against us and our staff. This behavior is NOT what we signed up for and it is NOT a part of the job. Why do you think that many nurses and many nursing administrators feel that “it’s just a part of the job?” I am lucky to work at a place that puts nurse safety above all else and that does not penalize us for reporting the violence~ and our local PD are very protective of us as well. That is not so for many nurses across the country. How has the violence changed in your work area? How do you stay safe?
A few press releases recently on nurses being targets of violence.

http://www.ena.org/media/PressReleases/Pages/workplaceviolence.aspx
http://www.wpix.com/news/wpix-bronx-hospital-emergency-room-shooting,0,5266436.story
http://vitals.msnbc.msn.com/_news/2011/11/08/8705246-swearing-spitting-choking-er-nurses-endure-this-and-more

More than three million embattled British nurses and other public employees were on strike (11/30/2011) to protest attacks by the British government on pensions and retirement security.

Like their U.S. counterparts, British officials want to slash public worker pensions to cut public deficits — even though, like Social Security in the U.S., British pension funds are financially sound.

As the 19 unions, representing nurses, other healthcare workers, teachers, and other public employees say, the government position is “pay more, work longer, get less.”

“These plans are just a cynical move to raise £4 billion to pay down the deficit caused by the bankers. Instead of raiding the pensions of hard working public service workers, why not impose a tiny transaction tax on the banks instead — this would raise £20 billion a year?”

— Karen Jennings, assistant general secretary of UNISON, which represents tens of thousands of nurses and other healthcare worker.

In the U.S., National Nurses United is leading the call for a financial transaction tax on Wall Street. The tax would tax Wall Street to heal Main Street. Similar taxes are being proposed by workers around the world. Nurses are rallied to show their support for British nurses and workers whose pensions are in jeopardy.

Find out more at: www.mainstreetcontract.org

With up to two million British workers expected to join the biggest strike in the United Kingdom in a generation, the National Nurses United announced that it will hold support rallies for British nurses and other workers in six U.S. cities on Wednesday, Nov. 30.

National Nurses United has created an online tool that you can use to send messages of  support to the millions UK public sector workers – including tens of thousands of nurses – who are on strike Nov. 30. The strike is to protest the British government’s assault on workers’ pensions. You can learn more about it this previous post.

Visit NNU’s site, send a message.

From our friends at National Nurses United:

With up to two million British workers expected to join the biggest strike in the United Kingdom in a generation Wednesday, Nov. 30, the largest union of registered nurses in the U.S. announced today that it will hold support rallies for British nurses and other workers in six U.S. cities Wednesday.

U.S. nurses, joined by other union members in Washington and several other cities, will hold noon rallies at the British Embassy in Washington and at British consulates in Boston, Chicago, Los Angeles, Orlando, and San Francisco.

The actions come amidst huge corporate cash reserves on both sides of the Atlantic while government officials in both nations push reductions in retirement security and other cuts. In the U.K., some 30 unions representing nurses, teachers, paramedics, civil servants, and other public workers will protest plans by the conservative government to cut public pensions. In the U.S., support rallies will also remind the public of threats to Social Security as well.

U.S. rally locations, all actions at 12 noon local time:

• Washington, DC – Embassy of the United Kingdom, 3100 Massachusetts Ave NW
• Boston – Consulate, One Broadway, Cambridge
• Chicago – Consulate, 625 N. Michigan Ave.
• Los Angeles – Consulate, 11766 Wilshire Blvd.
• Orlando – Consulate, 200 South Orange Ave.
• San Francisco – Consulate, One Sansome St.

In both countries, politicians seek to slash deficits at the expense of working people. Unions in both countries warned that deficit reduction as proposed will lead to increased levels of economic inequality, unemployment, and poverty, exacerbating the crisis in both nations.

In a letter to be delivered Wednesday to Sir Nigel Sheinwald, Great Britain’s Ambassador to the U.S., NNU Executive Director RoseAnn DeMoro said U.S. nurses strongly support British workers “who are standing up for their rights and for the integrity of public services in your country.”

“We urge the British government to stop its attempt to make public-sector workers pay more and work longer to receive a smaller pension when they retire. The government’s plans will impact women the most, who already suffer from lower pensions. This attack on the people who provide patient care at the National Health Service, teach school children, and provide essential public services is unconscionable,” DeMoro said.

Among major participants in the U.K. strike is UNISON, whose members include many nurses and other healthcare workers. The strikers are saying no to “pay more, work longer, get less,” a so-called “triple squeeze” in which pensions are reduced and age eligibility extended.

“The plans are just a cynical move to raise 4 billion [British pounds] to pay down the deficit caused by the bankers,” said Karen Jennings, UNISON’s assistant general secretary.

One solution put forward both in the U.S. and in the U.K. is for passage of a financial transaction tax (FTT) – in Britain termed a “Robin Hood Tax.” An FTT is a sales tax aimed at speculative trading and would raise up to $350 billion a year in the U.S. alone.

“Nurses see what this economy is doing to our communities in stress, dislocation, and poverty,” said Karen Higgins, RN and NNU co-president. “We are going out in support of UNISON, drawing the line against cuts to retirement security and other essentials for working families.”

Most of the time, nurses are also employees. We go to work, and we leave work. While we are at our workplace, we practice nursing. Does that mean that I am only a nurse when I am on the clock and cease being a nurse when I am not at work? When that time card gets punched as I leave my workplace, do my nursing skills remain behind or do they come with me?

My husband is a Christian pastor, and we (along with our daughter, son-in-law, and two granddaughters) are currently living in the Eastern European country of Romania. Our mission here is open-ended, meaning we have no idea how long we will be here. This also means, at least for the time being, that my American registered nursing license is nothing more than a piece of paper. I have no workplace in which I can use my nursing skills. Am I still a nurse?

To address this question, we need to look at what nursing really is. Is nursing a job or a way of life? For example, we have all received the after-hours phone calls…from neighbors, family members, or friends who are asking if we can give them advice based on our medical knowledge. Perhaps they have a strange, sudden pain, are undergoing a medical test they don’t understand, or have a sick child at home, and they need advice because “you’re a nurse.” In light of these requests for help, I think that the nursing that I have done outside of the job has been, in many ways, more vital than my on-the-job nursing. You can reach and serve people who are not confined to a hospital or nursing home. It’s a big risk (what if I tell them the wrong thing?), but at the same time, we have the opportunity to touch people’s lives who may never go close to a doctor’s office.

As you can imagine, the standard of living in Romania is somewhat below that which is found in most of the United States. The people in the cities live relatively well, but there are thousands of villages where people live in shacks with dirt floors and holes in the walls. This is a country where there are four months of hard freeze every winter. How do these folks survive? And further, what can one little middle-aged American nurse do in the face of so much need? I can do one thing at a time. I can answer a medical question, give some advice, provide a heavy coat, or change a dressing. I can also do lots and lots of praying.

The point is that each of us, as nurses, are going to encounter situations in our lives where we can serve our fellow human beings outside of our workplaces. There are circumstances where we cannot practice as a registered nurse. However, we can still maintain that attitude of servanthood and service to those around us. And isn’t that what being a nurse is all about anyway?

To follow Susan and her family through their adventures in Romania, visit http://kieffersinromania.wordpress.com.

This article was shared with us by NurseTogether.com.
Based in Charlotte, NC, NurseTogether.com is one of the fastest-growing, free online professional communities for nurses. Specializing in unique nursing lifestyle, career and professional development information, NurseTogether.com’s mission is to empower the nursing community through top-quality original content from experts, interactive web-based social media tools, and value-added services through key strategic partnerships in a variety of nursing and lifestyle disciplines.

When I graduated nursing school wayyyyyy back in 1991, I was hired immediately by the hospital I currently work for. I began my nursing career on a med-surg floor working the day shift alongside the nurse who was chosen to be my preceptor, Laverne Pellitier. I had never met Laverne prior to this and I was very nervous, not only to meet her but to “be a real nurse.”

Laverne was a seasoned nurse, very professional and very nice. Her nursing skills were top notch and I learned sooooooooo much from her. She met me with a smile and a detailed packet of what I was to learn and how long I had to learn it. I received a full 6 months of training alongside Laverne. When the 6 months were up I truly felt ready to be on my own and to go to the night shift…Laverne had done her job and I was confident in my skills. Now this isn’t to say there weren’t moments of fear, tears and pain BUT there were more moments of joy, laughter and learning.

I wish I could say that every nurse I worked with during those first few weeks was kind…but that isn’t the case. There was quite a bit of “nurses eating their young and initiation type attitudes” going on towards myself and the 2 other new grads that had been hired. We now know that these attitudes are called lateral violence and sadly it occurs far too often! I hear horror stories about it all the time and in fact this type of unprofessional behavior causes many new grads to leave the nursing profession all together within their first year of nursing! (According to a literature review I performed on this topic recently).

All of this to say how proud I am of a young nurse that I had the honor of precepting as a new grad 3 years ago in the ER. Her name is Sarah and today she received an award for excellence in patient care in the ER. She is a remarkable young woman and nurse who I have the privilege of working alongside now in the ER as a fellow nurse. She came to me as a new grad full of intelligence and vigor! Her passion for nursing was evident and my job was to orient her to ER nursing and to assist her in putting the pieces of all she had learned together in that world of ER NURSING. I wish I could say she got a full 6 months to learn and stretch her wings but we do not have the luxury of having that much time to give…BUT she was ready to go off on her own despite the less amount of time…

When I decided to become a preceptor I wanted to treat the new grads as I had been treated by Laverne…I view the job of preceptor as an honor and a privilege. I want the new grads to feel safe and cared for and I pray they all have! It is our job as professional nurses and human beings to treat our new grads with respect and kindness while assisting them in learning. Being in their new position is terrifying and how can they learn compassion for their patients if they are being treated with such hostile attitudes…and how can they feel safe to learn new skills and even make a mistake in that environment? I’m sure many of you have horror stories from your new grad days, but I hope more of you had a preceptor like I did! Thank you Laverne, where ever you are!

Republished from National Nurses United’s Blog
By Rose Ann DeMoro
November 10, 2011

Amidst the scourge of inequality sweeping the world, marked by continued profits, pay-outs and record levels of cash hoarding — the spoils of the 1% — one group has come forward with a remedy, refusing to stand down. Nurses from four continents gathered at the G-20 Summit last week to tell world leaders that time is running out: revenue is needed now and the starting point is a global finance tax.

That call for remedy is resonating. It is loud and it is getting louder, and half measure legislation is not a substitute for a movement.

Just last week, in addition to the actions at the G-20, 2,000 people, including RN members of National Nurses United joined by the AFL-CIO and other unions, environmental and community groups, and participants from the Occupy Wall Street movement, marched on the White House and Treasury Department.

Like the nurses at the G-20, they were calling on the Obama administration to support a tax on Wall Street, the U.S. version of a financial transaction tax to raise desperately needed revenue to heal our economy. Similar marches occurred in Los Angeles and San Francisco.

Nurses have been rallying for months, and putting pressure on the White House and members of Congress to support a meaningful tax on Wall Street to provide the funding necessary for such basic needs as health care for all, jobs with dignity, and quality public education.

An FTT, a sales tax on trading in stocks, bonds, derivatives and targeting speculative activity, is now on the world agenda. For the first time, the 20 most powerful countries convened to discuss raising revenue from such a tax.

Pressure is also mounting within the U.S. One bill by Sen. Tom Harkin (D-Iowa) and Rep. Peter DeFazio (D-Ore.), has been introduced. However, the estimates cited in print of $350 billion are over nine years — far short of what is needed to reframe our devastated economy. We do not have nine years to wait. A better approach would be an FTT that raises $350 billion every year.

Moreover, the revenue in the current bill is earmarked for deficit reduction, i.e. further job reduction and infrastructure destruction which would only make matters worse. There are trillions of dollars sitting idle or wasted in the market casino, as such, and we are building a social demand for the FTT to be used as an economic stimulator and to reorganize the social priorities of our country. The 99% want a solution now that actually changes our lives now.

FTT proposals share critical underpinnings: speculation and manipulation in financial markets triggered collapse from which the world has not emerged; poverty and near-poverty are rampant and spreading, engulfing millions of families in the U.S. alone; financial profits should be tapped for meaningful revenues to save the many communities in crisis; and financial taxes are a starting point— a down payment. In this country today we are witnessing the greatest transference of wealth upwards in our entire history. That dynamic, here and elsewhere, must stop now.

The financial tax the nurses support would provide up to $350 billion every year in the U.S. alone and billions more in other societies. We know what is needed to put Americans back to work, provide quality health care and schools for all, to start restoring our environment and address hunger and homelessness. “The number of people living in neighborhoods of extreme poverty,” wrote the New York Times on November 4, “grew by a third over the past decade….” Nearly 50 million Americans live in households deemed “food insecure.”

Wall Street firms, in the meantime, including banks and their trading arms — are making massive fortunes, “more profit in the first 2 1/2 years of the Obama administration than they did during the entire Bush administration,” according to the Washington Post, November 6.

We also know that in the face of overwhelming community need, trillions of dollars sit on the sidelines. Trillions.

Cash holdings of non-financial S&P 500 are over $1 trillion–”more cash than in decades,” according to the Templeton Income Fund, with cash held abroad by U.S. companies adding $1.5 trillion. Cash holdings at European non-financials is now 800 million euros, putting Greek protests in some perspective. Trillions more sit in the accounts of wealthy individuals on both continents.

“How can the financial sector triumphantly continue to march,” said President Sarkozy of France at the G-20, “indifferent to the world around it, carelessly and without a care for the disorder it has more than its share in causing?” German Chancellor Merkel agreed. And President Obama, disregarding the unwavering counsel of Treasury Secretary Geithner to leave Wall Street to its own devices, indicated that while not favoring the tax he would not seek to block others from enacting it.

Sarkozy, Merkel and Obama were listening when thousands protested, including the nurses, last week in France — an outcry of global proportions certain to repeat. An array of support comprised this protest — Oxfam, unions, consumer groups, ecologists, Occupy Wall Street and other armies of occupiers — all committed to a reordering of world priorities and in support of a finance tax. “[A] billion people [are] on the edge of starvation or worse, but not beyond reach by any means,” said Noam Chomsky on November 2. We won’t stand down in the face of this challenge.

This extraordinary commitment to cash by the 1% is incendiary.

Meanwhile, Congress considers cutting essential programs, including in Social Security and Medicare. All these programs are on the cutting block even as the Census Bureau announces increases in poverty. Millions more would be in poverty, the new study contends, but for the programs government intends to curtail.

Nurses will continue to focus on building a movement. The nurses bear daily witness to the awful effects of the colossal demise engulfing communities everywhere and we will not stand down. The nurses commitment to care does not end at the bedside.

For more about the movement in the U.S. as well as globally, and to find materials, literature, bumper stickers, and more, visit our website at www.mainstreetcontract.org.

AND NOW—drum roll please—it’s time for a new feature on Nurse Talk! Out with the old and in with the new—-it’s time for THE GOLDEN BEDPAN AWARD! That’s right—EACH WEEK OUR GOLDEN BEDBAN AWARD GOES TO A DESERVING PERSON OR ORGANIZATION THAT HAS SOMEHOW PUT THEMSELVES IN THE NEWS OR OTHERWISE COME TO LIGHT FOR A CHARITABLE ACT OR CAUSE. THIS WEEK’S GOLDEN BEDPAN AWARD GOES TO…LISTEN THIS WEEKEND AND FIND OUT.

If you know someone who should receive an award for their generosity or contribution please let us know. 1.800.977-1863 or emailpattielockard@yahoo.com with the subject line: GOLDEN BEDPAN AWARD.

Patsy Cline, The Lady, The Legend

Living in Tennessee as I do, I hear a lot of country music.  It occurred to me recently that no one has ever written a hit country song about nurses.  I trolled the internet to confirm my suspicion, and it seems to be true.  I think this is an egregious omission.

Nursing as we know it and country music were born around the same time.  I have my doubts about whether Florence would approve—she was, after all, pretty uptight—but I think it’s time we call on country music artists to fill this gaping void in the country music canon.  The themes of a nursing career and the themes of country music are naturals together.

Tragic Incidents

“Phantom 309” immortalizes a truck driver who crashes for the sake of others.  Randy Travis’ recent “Three Wooden Crosses” honors teachers, farmers, preachers, and prostitutes in a car-wreck scenario.  Isn’t there a place for a dedicated ER or OR nurse in a song from this gut-wrenching sub-genre?

Loneliness

Anyone who has ever done 1:1 or private duty with a sleeping patient on a long, dark night of the soul knows all about this one.  The subconscious thoughts of the protagonists, if they are of opposite genders, might make a great male-female duet in the Tammy Wynette-George Jones tradition.  It wouldn’t be the first time a talented country duo had a hit song about a dream.

Renegades

Surely, some hell-raiser somewhere has encountered a psychiatric or correctional nurse worth memorializing in song.  Hank Williams Jr.’s “Family Tradition” (“Hank, why do you drink?  Hank, why do you roll smoke?”), which sounds a bit like a mental health assessment, cracks the door open for an outlaw country nurse song.

Obstacles to Healthy Romantic Relationships

You work Baylor weekends, and the object of your affection works Monday to Friday, nine to five.  He or she could sing a heart-wrenching ballad about waiting for you to come home from after twelve hours on the front lines of patient care, and what happens when you finally walk in the door.  In the song, you can’t get out of your clothes fast enough to get into bed.  In reality, you can’t get out of your contaminated scrubs fast enough to get them into the washer.

Neon Lights, Noisy Honky-Tonks and Fancy Footwork

Flashing alarm lights and call signals, alarming ventilators and wander-guards, the “don’t slip in that puddle” two-step…how about a song about an overworked ICU nurse pining for a well-deserved night out?

Home

“The Bed by the Window” is about patients in a nursing home, and it’s a real tear jerker.  Surely there’s a nurse in that nursing home with a story to tell too.  I’ve experienced shift-to-shift reports that would make great country music songs in and of themselves.  Maybe I should take this idea home, and write that song myself.

A nurse rolls her eyes at a co-worker as she picks up the assignment sheet that was created by a younger charge nurse. An ICU nurse pretends not to see her co-worker is drowning and ignores her request for help saying she is ‘too busy’. A newly hired RN who was previously a scrub tech finds she is now shunned by both groups. Is this just life as a nurse – or a nurse’s right of passage? Or is it something more insidious?

These behaviors go by several names: lateral or horizontal violence, incivility, nurse-to-nurse bullying, sabotage – “nurses eating their young.” In general, bullying in the United States is a term used to describe uncivil behavior from someone who has power over you – vertical aggression. Rude behaviors from peers are referred to as horizontal or lateral hostility and are defined as: “A consistent pattern of behavior designed to control, diminish or devalue a peer (or group) which creates a risk to health or safety” (Farrell, 2005). Some specific examples are:

Overt: name calling, bickering, fault finding, criticism, intimidation, gossip, shouting, blaming, put-downs, raised eye brows

Covert: unfair assignments, refusing to help someone, ignoring, making faces behind someone’s back, refusing to only work with certain people – or not work with others, whining, sabotage, exclusion, fabrication

Estimates of lateral violence in the nursing workplace ranges from 46–100% (Stanley et al. 2007). Nursing literature abounds with examples of prevalence. In one study, one-third of nurses perceived emotional abuse during their last five shifts worked (Roche). In another survey, 30% of respondents (n= 2,100) said disruptive behavior happened weekly, and 25% said monthly (Advisory.com). And a study of emergency room nurses found that 27.3% had experienced workplace bullying in the last six months with many staff bullied by their managers, charge nurses or directors as well as physicians and peers (Johnson, Rea). Bullying behaviors are like gangrene – when tolerated from a few physicians or nurses with strong personalities, the behaviors spread and infect the entire team – and eventually, the patient.

Lateral violence needs to stop. Bullying behaviors create a toxic work environment which not only harms nurses, but also our patients. Experts agree communication breakdowns and lack of teamwork are a root cause of errors. If nurses are afraid to speak up because they are intimidated by fellow nurses and physicians, patients can be harmed. Research also shows that simply witnessing rude behavior ‘significantly impacts our ability to perform cognitive tasks’ (Porath). From a very ethical perspective, tolerating bullying behaviors is wrong and violates our basic oath to keep patients safe.

But maybe we need another oath? Maybe it’s time we promise to keep each other safe; to nurture, support and protect each other because we understand and recognize how vulnerable we all are and the critical role we play in healthcare. In April, after accidentally drawing up the wrong medication which resulted in a child’s death, an experienced nurse took her own life. Her suicide is a result of our failure as a system, and as a profession, to provide a safe harbor for the delivery of care. Who knows what else was going on in her mind, or the details of the situation? All I know is that it could just as easily have been me who made the error.

Where do we start? A Chinese magician once said, “If you want to take power away from anything, call it by its name”. The overt and covert behaviors listed above are not ‘normal’. They are examples of lateral violence that cause serious and long lasting damage to our patients and to each other. They are wrong. Work your magic – say so!

Bibliography

Farrell, G. (2005). From tall poppies to squashed weeds: why don’t nurses pull together more? Journal of Advanced Nursing 35 (1): 26-33.

Johnson, S., Rea, R. (2009) Workplace bullying: concerns for nurse leaders. Journal of Nursing Administration Vol. 39, Nov. 2, pp. 84-90.

Pearson, C., Porath, C. (2009) The cost of bad behavior. Penguin Books

Roche, M. et al. (2009). Violence toward nurses, the work environment, and patient outcomes. Journal of Nursing Scholarship, Vol. 42:1, 13-22.

Stanley K., Martin M., Michel Y., Welton M. & Nemeth S. (2007) Examining lateral violence in the nursing workplace. Issues in Mental Health Nursing 28, 1247–1265.

Have you seen or experienced nurse bullying in the workplace? What was done about it?

This article was shared with us by NurseTogether.com.

Based in Charlotte, NC, NurseTogether.com is one of the fastest-growing, free online professional communities for nurses. Specializing in unique nursing lifestyle, career and professional development information, NurseTogether.com’s mission is to empower the nursing community through top-quality original content from experts, interactive web-based social media tools, and value-added services through key strategic partnerships in a variety of nursing and lifestyle disciplines.

Happy Thanksgiving. May you spend it beachside.

Oh dear it is almost Thanksgiving! We at Nurse Talk wish all of you a wonderful holiday with family and friends—and DO remember—laughter is the best medicine! Yes, of course we all love our families—but—we know too much about each other and that can lead to—well—o.k. fill in the blank. We say that with love and affection.

This week on the show we shake things up a bit. O.K. we got tired of the weird news and all of the sound effects…so now we are looking for a really good way to create a useful and fun first segment on our show. ANY ideas? Oh, we could tell you about all kinds of medical breakthroughs or bad things insurance companies do, and, while useful, not particularly stimulating or fun. This week we shared some good articles from our blog. If you have any ideas for our show—send them our way at casey@nursetalksite.com or 1-800-977-1863.

Karen Higgins, RN

Massachusetts RN Karen Higgins joins us. Karen is a good friend of ours and she always takes time out of her busy schedule to talk with us. As a matter of fact we want to make it perfectly clear that Karen was on her BREAK when speaking with Dan and Casey. Karen weighed in on the Financial Transaction Tax, a.k.a. the Robin Hood Tax that nurses and others all around the world asked the G-20 leaders to adopt. The tax would be .005 on stocks and other financial transactions. The money raised COULD dramatically change and add to funding for healthcare, education, infrastructure and more. Karen is the past president of the Massachusettes Nurses Association and is currently one of three co-presidents for National Nurses United.

And we’ll talk with the author of Critically ILL: A 5-Point Plan to Cure Healthcare Delivery. Dr. Frederick Southwick, author, teacher, respected researcher and decades-long medical practitioner, is an advocate for change to our country’s current healthcare practices, which cause thousands of hospital deaths and complications each year. Dr. Southwick strongly believes in empowering nurses to help alleviate this tragic trend. This, Dr. Southwick’s fifth and forthcoming book, presents a clear and comprehensive blueprint for reversing the negative healthcare outcomes that result from preventable medical errors. Very interesting.

AND NOW—drum roll please—it’s time for a new feature on Nurse Talk! Out with the old and in with the new—-it’s time for THE GOLDEN BEDPAN AWARD! That’s right—EACH WEEK OUR GOLDEN BEDBAN AWARD GOES TO A DESERVING PERSON OR ORGANIZATION THAT HAS SOMEHOW PUT THEMSELVES IN THE NEWS OR OTHERWISE COME TO LIGHT FOR A CHARITABLE ACT OR CAUSE. THIS WEEK’S GOLDEN BEDPAN AWARD GOES TO…LISTEN THIS WEEKEND AND FIND OUT.

If you know someone who should receive an award for their generosity or contribution please let us know. 1.800.977-1863 or email pattielockard@yahoo.com with the subject line: GOLDEN BEDPAN AWARD.

You can listen in the Boston area on station WWZN 1510AM every Saturday at 11 am EST or live stream at www.revolutionboston.com and in the San Francisco Bay area Sundays at 2PM PST on Green 960AM or live stream at www.green960.com. You can also download and listen to any show anytime here at NurseTalkSite.com or on iTunes. Like us on Facebook, and you can listen there too.

And, remember, laughter is the best medicine.

Author, Bobbi McCarthy

How many of us nurses have been patients a time or two?  What do you recall from your experience in the hospital?

I have been a patient only a handful of times in my life~ thank you Jesus!  I have had 2 children that were delivered in the hospital…one experience, from my patient perspective, was good and one was very bad.  I had a day surgery experience which was wonderful and I have a childhood memory that was horrific.  What is interesting to me about the memories of these experiences is that my barometer of rating the experience is how I was treated by my nurses.  I cannot for a second recall the doctor in most of these experiences…hmmmmmm.

When I had my first child I was 19 years old, married and scared out of my mind! The labor was long and painful.  The nurses that tended to me during labor and delivery are somewhat of a blur…  After my daughter was a born, that night I was in terrible pain and alone in my room, (babies were taken to the nurse’s station area back then)  I rang my bell to tell the nurse I was in terrible pain with cramping…a very long time seemed to pass…an older nurse came in, didn’t identify herself and said, “what do you want?”  I told her my problem and she said, “What did you expect when you have a baby at 19…it will pass” and she left the room.  I cried myself to sleep.   I didn’t dare to ring that bell or ask a single question after that.

When I was 7 or 8 I was in the hospital for a few days with an acid problem in my stomach.  My mother came and went but at night I was alone.  I only remember one nurse and she had red hair, was overweight and mean.  She practically growled at me from what I recall…the one thing that really sticks out in my mind and I remember it vividly is night she came into my room and told me to roll over.  I was in bed playing don’t break the ice…I asked her why…she said, “I have to check your back for a rash.”  My mother wasn’t there and the other woman patient was gone too…I remember feeling scared but I wasn’t sure why.  I asked the nurse if she was going to give me a shot.  She said no.  I rolled over and she pulled my bottoms down and quickly shoved a needle into my butt cheek and then left the room……I remember just crying and feeling so scared.

I wonder what was going on with the 2 nurses that I just spoke of?  From what the first nurse said to me I can presume she was hostile towards me because I was 19 and she felt  I was perhaps “loose…” and from the second nurse I can presume she didn’t like children…  either way their attitude toward their patient was disturbing and extremely unprofessional. Maybe they were burnt out?

I had not thought of these experiences in many years until yesterday when a scared pregnant teenager entered triage and asked where labor and delivery was.  My experience came rushing back like a flood. As I reflected on both of the mentioned experiences I cringed.  I have always made it a practice to enter the patient’s room with a smile, tell them my name and title and then address their issue.  I hope that I have NEVER treated anyone in such a manner as I was treated.  I am thankful for the experiences now and I’m thankful for the recall of them so that I can keep in mind the patient perspective.  Treating people/patients as we want ourselves and our families to be treated should be our motto as a nurse.  I’m thankful for the reminder today.

Walk into any nursing home today, and you’ll see them: The aging lonely. They are easily recognizable. Look for the sadness on their faces, the pain in their eyes. With a television on for company, these men and women sit alone in their rooms. Their shelves are bare, their bulletin boards void of pictures, cards, or any memento denoting love from the outside. Those sad eyes may even hold a twinge of bitterness, asking, “Why am I still here with no one to love me?”
~ by Karrie Osborn

We found a great pair of pages on Facebook. The Forgotten Ones: Compassion for the Elderly and The Forgotten Ones : International Card Exchange for the Elderly. The latter was set up to facilitate sending cards, letters, photographs, post cards or small gifts to the lonely and forgotten elderly in nursing homes worldwide. Nurses, you know who they are! Add the addresses of facilities where you work where there are elderly patients who have no one. Here are the details:

____________________________________________

The Forgotten Ones: Compassion for the Elderly Facebook page is a place to collect addresses of places from all over the world where you may send cards, letters, photographs, post cards or small gifts to the lonely and forgotten elderly worldwide.

Simply address the envelope to a “lonely man, woman or resident” along with the address you have selected. If you are mailing to a country whose language is not your own, you may prefer to send photographs, postcards or small gifts. Get creative! Love has no language barrier! If you would like a response it may be preferable to send a self addressed stamped envelope with paper, however, it is quite possible that the person you are corresponding with will be unable to respond. Rest assured that you will be brightening the days of someone who truly needs some light in their life. Imagine their faces when they receive postcards, drawings from your children or grand-children, entertaining magazine or newspaper articles, or small gifts from all over the world!

Choose one address, or many, and try to keep the communication going whether you receive a response or not. Be sure to scroll far down the wall to view all the adresses. Please, also, feel free to share addresses of places you may know that could use some cheer. You may refer them to this page as well as The Forgotten Ones: Compassion for the Elderly. Thank you in advance for your participation, and please, do share your experiences with us! Much love and many blessings…

Go to the Facebook page: The Forgotten Ones : International Card Exchange for the Elderly.

____________________________________________

“What we have done for ourselves alone dies with us; what we have done for others and the world remains and is immortal.” ~ Albert Pike

Nurses led the fight at last week’s G20 Summit protests in Cannes, France at several events and at simultaneous rallies in Washington, D.C., San Francisco, and Los Angeles, garnering national and international press coverage. Did you see this? Three-minute video: Nurses from around the globe at the G20 Summit show how to heal the world’s economy with a financial transaction tax.

“Protests matter. Pressure matters,” concluded John Nichols of The Nation, writing about the shifting sands in the White House, and noting NNU’s role and the erupting support for an FTT that now includes billionaire Bill Gates and the Pope. “The nurses aren’t just making noise. It looks like they’re changing the debate, altering the policies of the most powerful players in Washington–and perhaps the world.”

On with the show. When the cats are away…the best of Nurse Talk must play!

Coming up this week Casey and Dan visit with Texas RN Monica Sanchez about the union vote that recently occurred in Texas and made history as the first of its kind. Texas RNs in five cities voted to join National Nurses United. They will now join thousands of other bedside nurses across the country who are fighting for patient rights and better conditions for RNs.

Janet Izzo

Also with us is Janet Izzo. Janet is a Minneapolis RN who has written a book called Hotel Hennepin (named after the Hennepin County, Minnesota Hospital where Janet works). In the newly released book Janet chronicles her career working in a large county hospital as a staff and charge nurse on the obstetrics unit. The stories are poignant, sad, hysterically funny and all amazingly true!

And, we have a winner in our “Dan’s Thing” contest where we challenged listeners to follow the clues and guess, “What’s Dan’s Thing?”  It’s fun and funny.

Get your tickets to Menopause the Musical in Concert. Menopause is on tour and coming to a city near you. Nurses and their friends receive 10% off with code “SG” (or “SUPER” for Santa Cruz shows).

NURSE TALK IS GROWING…GROW WITH US. ADVERTISE to our active and engaged audience. Email to reserve your spot on the air or online: pattie@nursetalksite.com.

You can listen in the Boston area on station WWZN 1510AM every Saturday at 11 am EST or live stream at www.revolutionboston.com and in the San Francisco Bay area Sundays at 2PM PST on Green 960AM or live stream at www.green960.com. You can also download and listen to any show anytime here at NurseTalkSite.com or on iTunes. Like us on Facebook, and you can listen there too.

Until next time remember “laughter is the best medicine!

If the freedom of speech is taken away then dumb and silent we may be led, like sheep to the slaughter.
-George Washington

At a recent legislative meeting, as I was physically encouraged to stop speaking and leave the premises.  I have been an outspoken and passionate patient advocate for many years and I make no apologies.

I have been a victim many times over of covert bullying. However, this was the first time someone literally attempted to physically terminate my freedom of expression! I ask the readers, what would you have done if your left shoulder was grabbed by a nurse saying, “That’s enough, Helen…It’s time for you to leave”?

During my 33 years of working in the operating room arena, I had to pick my battles of when to stand up for myself and when not to. Although retreating was never in my makeup, the loss of dignity in the face of fire was not pleasant! The loss of sleep at times was not conducive to my spirit. The loss of my hard earned monies being siphoned off to my attorney to ensure my continued employment at a time when my children were in college was hard to bear. The intentional cajoling whispers behind my back as I passed certain staffers were hurtful.

The saddest realization as a nurse was when it finally dawned on me that some of my nursing managers were part of the lateral violence, as it is called today! Bullying for the most part is the easiest and most simple method to get a nurse to quit her or his job, i.e. no documentation, no precipitating event which would have to be validated in the future by Human Resources and therefore no litigious issue ensues. Being bullied for being outspoken is not a justification for the act.

Later, more bullying came not just by individual nurses but by organizations, i.e. powerful organizations. Those episodes were a real kick in the heart! We all know that eventually one violent act, actual or covert, precipitate and condone more violence in all walks of life when it is done in an effort to thwart free speech.

So now I am a 67-year-old retired operating room nurse who is no less outspoken or no less passionate about patient care and patient safety than I was when I first graduated from nursing in 1974. Patient safety to me is nursing excellence! I never entered nursing to become rich, powerful, or self-serving! Being so naïve for the first few years of my career, I believed this ideal also holds true for my peers. Sadly, I was wrong! When money becomes the god, patient safety becomes the victim.

Why am I so passionate about patient care? The new statistics are unbelievable: one out of every five hospitalized Medicare patients died last year; one out of every seven hospitalized Medicare patients were injured; the figure of 99,000 hospital deaths is a very “old” statistic, i.e. it now shows that there are over 200,000 hospital deaths yearly; the data on infections, medication errors, falls, wrong site surgeries, wrong patient surgeries, retained instruments and retained sponges are astronomical and not “added” properly into the equation since data on “sentinel events” are not able to be fully revealed. Settled “cases” behind closed doors are also not public information. President Clinton supported transparency, but other agendas prevailed.

I don’t need a PhD to understand what bullying is all about. I have lived it! I don’t need to know what freedom of speech in the name of patient safety is. I am still living it and it is our right!

Respectfully,
Helen ‘Frenchie’ M. French RN, BSN

[This article has been edited from the original version. You can read it on NurseTogether.com]

This article was shared with us by NurseTogether.com.
Based in Charlotte, NC, NurseTogether.com is one of the fastest-growing, free online professional communities for nurses. Specializing in unique nursing lifestyle, career and professional development information, NurseTogether.com’s mission is to empower the nursing community through top-quality original content from experts, interactive web-based social media tools, and value-added services through key strategic partnerships in a variety of nursing and lifestyle disciplines.

I had two pieces of furniture delivered yesterday:  a really nice lingerie chest and a basic nightstand.  They joined two pretty little tile stands that I bought for bedside use a few weeks ago.

This is not Joann's nightstand, but it does have a drawer AND a shelf.

I did not buy the basic nightstand to use at the bedside; I bought it to put under my internet router.  Don’t ask me why, but in my new house the internet router is hooked up from about a foot above the bedroom floor in the middle of one of the walls.  I had to do something to get that router off the floor; you know how nurses are about clutter on the floor.

The little nightstand is perfect for the job.  It has just enough top surface to hold the router.  It doesn’t stick out enough from the wall to get in the way of walking through the bedroom and to the bathroom, and I don’t have to tell you how nurses are about ANYTHING obstructing the path to the bathroom.  And as if all that weren’t enough, it has a drawer.

The decorative tile tables do not have drawers, so there was just something that made having a real live nightstand with drawers in the room seem…well, right.

My realtor friend Sheila came over to see my new furniture.  She admired my pretty little tile tables.  She thought they were unique and different.  She thought the nightstand was boring.  “It has a drawer,” I pointed out.  “Not to mention a shelf.  And it only sticks out from the wall by twelve inches, so it won’t block the path to the bathroom.”

“It sure won’t”, said Sheila, noting the path and its full thirty-six inches of clearance.  “And what is this fetish you have for little tables with drawers in them?  Your new living room tables have drawers too.”

“And they have shelves with recessed spaces for glasses”, I pointed out proudly.  “Always good to have a safe place to rest a glass of water.”

“You must think you’re decorating a hospital room,” Sheila said. I denied the allegation, but wondered to myself if she wasn’t right.

Sheila then proceeded to admire my new lingerie chest.  She thought that a pretty little rug in front of it would look really nice.  I pointed out to her that if I put a rug there, it would be right under my feet as I got out of bed every morning.  “On that polished wood floor,” I told her, “my trajectory on that rug would put my forehead right at the corner of the regency bench under the window in no time flat.”

That’s when I stopped wondering if Sheila was right.  I knew she was.

Note: Registered Nurses Linda Hamilton, Bernadine Engeldorf and Jean Ross wrote this column for the “Labor Voices” featured in the October 2011 edition of The St. Paul Union Advocate. It also appears on the blog at www.nationalnursesunited.org.

From Madison to Wall Street, from St. Paul to Washington D.C., people are seeing nurses dressed in red scrubs, holding not a stethoscope but a megaphone. We are carrying signs. We are marching en masse. And we are raising our voices. This may seem unusual behavior for our profession, but in truth, our history is deeply rooted in social advocacy, as well as the bedside advocacy you’ve come to trust. We’re doing more because we must.

We are facing a crisis in our profession and in the realm in which it serves. Anger is building. We see it in the weary faces of our colleagues, hear it in the exasperated tone of our voices and feel it in the now-permanent clench of our jaws.

But we’ve recognized that if this is true for the majority of us, an insidious grand scheme is working. Wall Street power brokers are counting on us to assume the role of submissive, quiet caregivers who don’t question or protest.

Imagine their surprise to discover, instead, enraged and engaged nurses. We’ve connected the dots that directly link power and greed to inadequate staffing and unsafe conditions for the patients in our care. The deplorable conditions in which we work right now are fully intentional. Wall Street is literally getting away with murder.

It is up to us to expose the travesty that financial inequity inflicts on our society; 2.7 million nurses in the United States do have a voice – and we are obligated by our social contract to use our influence for good.

We witness Main Street hurting. Millions have lost their jobs and their homes, face bankrupting medical bills and are jammed into over-crowded classrooms and emergency rooms. Soup kitchens, food pantries and food stamps now provide sustenance for millions more. Meanwhile, Wall Street-funded politicians are intent on stealing more from working families.

That is why nurses across the nation have been leading the movement for a Main Street Contract. We protested last spring on the streets of Madison, where our supply of signs demanding a “Tax on Wall Street to Heal America” was drained within minutes. And on Sept. 1, nurses held 61 actions all over the country urging elected officials to commit to the principles of the Main Street Contract to rebuild the American dream.

We are cheering and marching and even lending our professional hands now with the Occupy actions arising all over our country.

Nurses are turning our anger into action, realizing our power – and making a difference.

We must make Wall Street pay for the devastation it has caused families on Main Street. Our clear-cut, concise solution is a Financial Transaction Tax. It is a modest levy on trades of stocks, derivatives and currencies that could generate billions in revenue to help our ailing economy, stimulate job growth, re-fund essential services, and discourage the reckless, high-volume/short-term profit computer-driven Wall Street gambling that lead to our current economic crisis. First proposed by a Nobel Prize winning economist, the initiative is already in play in more than 40 countries around the world.

But as we all in the labor movement continue to speak up on this larger scale, we have no doubt we will be subject to ridicule poisonous onslaughts from every corner. It has already begun. An editorial in the Boston Herald in response to our Nurses National Day of Action questioned our organizational right to demand economic justice.

Here’s their direct statement: “We assumed a labor union that represents nurses was in the business of negotiating fair pay and decent working conditions for those who do the difficult work of caring for the sick. We didn’t realize that federal tax policy and securities regulation were part of its portfolio.”

This patriarchal, condescending venom is directly aimed at instilling self-doubt among our ranks. It is meant for us to question our role in social justice – both as nursing professionals and labor activists. It is a menacing shot across the bow to intimidate us from using the strongest tool any society has against oppression – that of collective action.

So get out the vaccine, friends. Take the strongest dose possible, and duly prepare yourself for more vicious attacks.

This is no time to question ourselves. Indeed, question everything else except our own role, our own power and our own vision of a healthy America.

– Linda Hamilton is president of the Minnesota Nurses Association. Bernadine Engeldorf is first vice president of the MNA. Jean Ross is co-president of National Nurses United. All three labor leaders are registered nurses.

Author, Bobbi McCarthy

Apparently I always wanted to be a nurse.

I got home from work last night and on my counter was a book, “All About Me,” my mother had sent in the mail. It was one of those kindergarden through 12th grade books (including pictures and comments!) about friends and aspirations, grades and boyfriends.

My husband was dying to flip through it with me (he had already looked at it!) and laugh at my ongoing short bobbed haircut that had a few layering variations, and comment on the outfits I chose to wear for the first day back to school. I had to laugh as well as we looked at them. I always thought I looked so cute! I will never make fun of the photos of him wearing his orange Toughskins again! (O.K., so I probably will.) I enjoyed looking at the book and remembering some old times, and some outfits I really thought were awesome!

But what I noticed most was the running theme, “what do you want to be when you grow up?” Since Kindergarden I either wanted to be a nurse or a teacher. Nurse won out with the most votes of 7.

(At this stage in my life I want to be an educated nurse! hahhhahaha…)

Looking back at the schoolgirl book has been a gift in a few ways…one, it brings me back to some very fun times in my life…two, it shows me NEVER to wear my hair that short again…three, it has given me a kick in the pants to get exercising again…as my weight has dramatically increased since graduation!

But, most importantly, it has reminded me that I have always wanted to be a nurse…and that being burnt out in the everyday grind is different than being burnt out with nursing.

The gift of being a nurse is so multi-layered. Besides the patient care aspect of touching people’s lives physically and emotionally, we are privileged with a profession that takes us anywhere we want to go…the ER, the OR, ICU, NICU, Med-Surg, school nursing, clinic nursing, home health, hospice, nurse educator, flight nurse, interventional radiology, psych nursing, travel nursing, clinical nurse specialist in many fields, NP…and on and on it goes.

When did you know you wanted to be a nurse? Where are you in nursing now? Where do you want to go?

Heal the world economy!

John F. Kennedy said, “One person can make a difference and every person should try.”

National Nurses United is making it easier with a mobile app called Payback.  It provides information about vital political issues for nurses such as the Main Street Contract and Occupy Wall Street. Plus tells you how to support nurses fighting to keep patients safe and how to make your voice heard in support of a Wall Street transaction tax.

Check it out by texting the word “payback” to 53000 from your mobile phone. You will receive instructions and a link to download.

I think we made a mistake. You know how sometimes when you gain a few extra pounds you feel like you have to let the seams out of your clothes? Well, this week on Nurse Talk we had so many topics we wanted to share we got a little carried away and packed the show to the point of bursting our time clock!

Mobile App

We visited with two of our friends from CNA/NNU (California Nurses Association, National Nurses United) RN/Communications Specialist Liz Jacobs, and Colette Washington, On-Line Communication Specialist. Colette shared about a new mobile app that NNU has created that makes it possible to be involved in shaping national and international policy and politics without leaving the comfort of your own home.

The app provides information about the day’s most vital issues such as the Main Street Contract and Occupy Wall Street. Plus tells you how to help support nurses fighting to keep their patients safe. Make your voice heard to help pass a Wall Street transaction tax to support healthcare and more. You can get points for being an activist! Not like weight watchers but what you do makes a difference. Check it out by texting the word “payback” to 53000 from your mobile phone. You will receive instructions and a link to download.

Presidential Pop Quiz

Suffice it to say we have some—well, interesting candidates running for president! Tune-in to see which one gets our vote!

15 Minutes

AND Casey and Dan talk with author and EMT Kim Kircher. Kim has written a book called The Next 15 Minutes: Strength From the Top of the Mountain. When she wasn’t rescuing wounded skiers as a member of the ski patrol or bombing snow-congested mountainsides to control avalanches, she and her husband, John, were proving to the world that a full life was possible in spite of each living with an autoimmune disorder.

Their days were full of early morning runs on perfect powder and slicing through the stellar crystals to the envy of holiday skiers. When John’s congenital liver condition – primary schlerosing cholangitis – approached the terminal phase, Kim was determined to use all of her mountain-borne skills to save him and return them to the adventurous life they both loved. Kim shares her story with us. You can learn more about Kim at kimkircher.com.

Fall Flu Fashion Show

AND LAST…strut your stuff because its time for Nurse Talk’s second annual Fall Flu Fashion Show. That’s right wait until you see the new strains for this year…and, some of the old ones are back for an encore—such as H1N1! Oh, she will sweep you off your feet this year and she’ll be a show stopper all over the world! Listen for more of the madness.

 

Check out University of San Francisco’s Master’s of Nursing, Clinical Nurse Leader – starting May 2012. ADN/RN and BSN/RN Entry Option. Informational meeting coming up on November 9th.

You can listen in the Boston area on station WWZN 1510AM every Saturday at 11 am EST or live stream at www.revolutionboston.com and in the San Francisco Bay area Sundays at 2PM PST on Green 960AM or live stream at www.green960.com. You can also download and listen to any show anytime here at NurseTalkSite.com or on iTunes. Like us on Facebook, and you can listen there too.

Remember, laughter is the best medicine.

Are you ready for Thursday? That’s when nurses and other community activists are going to press President Obama and Treasury Secretary Timothy Geithner for a meaningful financial transaction tax. Nurses from four continents, including a delegation from NNU, will be at the opening of the G-20 summit in France to demonstrate how to “inject an FTT” to resuscitate the ailing global economy.

List of events:
G-20 Summit: 9:45 a.m., Salon Palm, Casino Palm Beach, Place Franklin Roosevelt – Pointe de la Croisette, Cannes, France

Washington, D.C.: Rally, Lafayette Square, 11:30 a.m., followed by march to U.S. Treasury Department. Nurses head to Capitol Hill to lobby Congress at 3 p.m.

Los Angeles: March from OccupyLA site, 11 a.m., First and Main, rally, plaza adjacent to U.S. Bank, W. 633 5th St.

San Francisco: March 11 a.m., from 101 Market, across from the Federal Reserve Bank, rally at 12 noon, Wells Fargo bank headquarters, 464 California St.

Read the full press release at nationalnursesunited.org.

If you haven’t seen that little musical that took us all by storm a few years ago–Menopause The Musical–here’s your chance to see it in concert.

I’m telling you it is so much fun and some of us at Nurse Talk have seen it –well too many times to count. It’s now in concert and the tour is coming to California.

AND they are offering a 10% discount to all nurses and listeners of Nurse Talk. Really don’t miss it! Use code “SG” to buy your tickets (or “Super” for the Santa Cruz show) at www.menopauseinconcert.com/tickets-shows/.

NNU Midwest Director and RN Jan Rodolfo appeared on Keith Olbermann’s show on Monday, October 24 to talk about the Occupy Chicago arrests on Sunday. If you missed it, here’s the clip.

Coming up on the show this week…

Casey and Dan check in with our friend and NNU Legislative Organizer Donna Smith. They talk with Donna about the Occupy movement, the nurses’ participation, the upcoming Day Of Action on November 3rd, the G-20 Summit and the nurses demands for a Wall Street Transaction Tax and continuing movement on the state by state single payer healthcare efforts.

National Nurses United nurse volunteer provides first aid to a protester at #Occupy LA, one of several cities where NNU has set-up stations around the country.

RN Maria Fehlig, a Las Vegas nurse calls in and gives us an on-location report from NYC Occupy. By the way…she says she sees no “hippies” there and in fact a lot of people don’t even know what a “hippie” is. Very interesting times we are living in. Spoken like a true “old person!”

We talk with Judy Farrell the Assistant Director of Enrollment for University of San Francisco‘s Master’s in Nursing Clinical Nurse Leader program. With Judy is RN Kristina Smith who is a manager of the ICU Unit at Santa Rosa, Calif. Kaiser Hospital and a student in the USF Master’s program.

Hey, this is great information for anyone who has been thinking about going back to get their advanced degree. Nobody does it better than USF…and we found out they have regional campuses in Santa Rosa, San Ramon, Sacramento and San Jose. Check the program out at http://www.usfca.edu/nursing/msn/.

Nurse Talk pulled some strings and is offering a 10% discount for nurses to see…Menopause The Musical, In Concert on the California leg of the tour.

Hey, can we talk? If you haven’t yet seen the mega hit Menopause The Musical—then pack your coolers and grab 10 friends or a 100 and—go see one of the just announced Menopause The Musical concerts. Really!

The hit show has been seen by Millions (with a capital M) and there is a reason. It’s just pure fun and God knows we can always use that. Use the code SG (use code “super” for the Santa Cruz shows) to get your tickets at www.menopauseinconcert.com/tickets-shows/

You can advertise with us. Email Pattie Lockard, pattie@nursetalksite.com to reserve your space on air or online.

Check out our website, play with us on Facebook and call every once in while! Our message line is 800-977-1863.

You can listen in the Boston area on station WWZN 1510AM every Saturday at 11 am EST or live stream at www.revolutionboston.com and in the San Francisco Bay area Sundays at 2PM PST on Green 960AM or live stream at www.green960.com. Green 960 is NOW available on the iHeartRadio app too.

You can also download and listen to any show anytime here at NurseTalkSite.com or on iTunes. Like us on Facebook, and you can listen there too.

Remember, laughter is the best medicine.

NNU Midwest Director and RN Jan Rodolfo appeared on Keith Olbermann’s show on Monday, October 24 to talk about the Occupy Chicago arrests on Sunday. If you missed it, here’s the clip.

And here’s a powerful video that shows nurses getting arrested early Sunday morning. At the 3:40-minute mark, you see the nurses who were the last ones arrested. You also can hear the crowd chanting, “NNU! We love you!”

Author, Joann Spears

Denial
The keys were not lost at all, I reasoned—they had to be somewhere. I rummaged through the garbage, but they weren’t there. Denial being denial, I went through the garbage three times. I only went through the compost pile twice. The resultant spider and worm activity checked any further emotional excesses. I hefted each of the cats to see if one of them had become suspiciously heavier. None of them had. I rummaged the laundry—no keys. I washed the laundry, figuring maybe I could float them out. Uh-uh.

Anger
I was less than gracious with the Kia lady who informed me that my replacement car key would arrive in two days, and cost about $20. I felt bad about that, but $20 is $20. I was no nicer to the Home Depot house key lady. Since that key cost only $3, I felt pretty small. When the lady at Food Lion made me fill out a great big form to replace my plastic keychain card, I got pissy. Since she was actually saving me money, there was no excuse for me. I had to get past the anger.

Bargaining
I asked God if getting a metal detector would reveal my lost keys to me. I priced out some metal detectors and realized the answer was, “no”. I thought that if I waited until I absolutely had to leave the house to go get the Kia key, it would give the missing keys an opportunity to resurface. I checked the fridge and I checked the calendar. I could easily stay in my house until 2015, if I wasn’t running out of cat food.

I remembered a nurse I worked with in the 80s, who accidentally flushed a bunch of irreplaceable nurse keys down a toilet. The plumbers went through the pipes till they found the keys in a trap. I asked God if he wanted me to call a plumber. God gave me the opportunity to learn that when you live within ten miles of the Bristol Speedway, all bets are off when it’s Race Week.

Depression
My old key ring was fat. It had a disc with a prayer on it, a little flashlight, a bunch of plastic club cards, my car key, my house key, and about fifteen “Jane Doe” keys, with no discernible origin, identity, or destination. My new key ring had…two keys on it. I went to the Dollar Store and tried to buy a key ring flashlight. It was too soon for me to commit to a new one. Flashlight-less, I walked the lonesome valley to my car, by myself.

Acceptance
This week, my Jazzercise class went bar-code, and I received a brand new plastic keychain-card. It’s red and white. It’s new. It makes the scanner go beep when I scan myself into class. I absolutely love it. It made me realize that sometimes, giving up old things and making way for new things go together.

I think the missing keys experience was so profound because of the nurse-key connection. If you ever lost a nurse-related key, you know what I’m talking about. Guilt, reprimands, embarrassment, and even worse, the long walk to institutional Key Central, and the baring-of-soul and putting-of-pride-in-pocket that you know will take place when you face the key-Nazi. Just one more lonesome nurse valley nobody else can walk for you.

When Shelli was a new scrub nurse with only six months experience, she failed to anticipate that the surgeon would need a particular scalpel. Immediately, her preceptor deftly slapped the correct blade into the impatient surgeon’s outstretched hand with a glare in Shelli’s direction. The surgeon said nothing, but a look of disappointment briefly flashed across his face. At that moment, Shelli learned that if she was not on top of the surgeon’s needs, she would end up feeling embarrassed and looking incompetent. Shelli did not find this information in her orientation manual.

We learn these unspoken rules very quickly in order to survive. We know which physician not to ever call in the middle of the night, which nurse talks about us behind our back when we ask a question, and whether we should even bother to write up an incident report or approach a coworker with a concern we have about ‘their’ patient. This knowledge is vital to our survival because it determines whether or not we will be accepted by the group.

It’s called culture. Human beings rarely, if ever, succeed at accurately perceiving their own culture. Anthropologists say, “It’s like a fish talking about water. It’s the last thing the fish ‘sees’ because it constantly surrounds him.” Yet nothing is more powerful than this unseen force. So deeply entrenched is culture that no one talks about it: the unspoken rules and behaviors (called ‘norms’) are never written down, and yet everyone knows them. We learn these norms the hard way by the process of assimilation – like Shelli’s story above.

When individuals merge and form a group, there are always things they can do, things they must do and things they can never do. For example, healthcare workers do not typically share their feelings in high-tech, high-pressure environments because feelings are perceived by the general culture to be ‘soft stuff’. Ironically, this belief couldn’t be further from the truth. Feelings not only matter, but are conveyed unconsciously because 93% of all communication is non-verbal. In a study of collaboration among residents, nurses and physicians the single most important factor to producing positive collaborative outcomes turned out to be affect – our bodies consistently express what we feel (McGrail). For example, think of your own workplace. Is there someone you work with who you think doesn’t like you?

They don’t.

The feeling you are getting that someone doesn’t like you –even if they’ve never said anything- is dead on correct. Herein lays the problem and the biggest contributor to nurse to nurse hostility – a culture of silence. We don’t check out the intended message in the non-verbal interaction. Nurses rarely if ever confront each other because their main style of communication is passive-aggressive and nurses are known to be conflict avoidant. When over 4,000 nurses were asked why they don’t speak their truth, the answers were consistent (Bartholomew):

1. Fear of retaliation: someone refusing to help me, a bad assignment, denied a vacation day, a bad schedule
2. Fear of hurting someone else’s feelings or making the situation worse
3. Why bother? Nothing is going to change anyway
4. Fear of isolation, rejection, gossip
5. They’ll turn it around and it will be my fault; it’s not worth it.

First, we have to admit that having some conversations requires courage – especially if the conversation should have happened a long time ago. And then, we need to learn a new communication model – like the “Juice Pull Conversations” -which allows us to confidently speak our truth. Remember starting your first IV? Remember the nervous fear of hurting someone unnecessarily, of puncturing the vein? But after starting a hundred IV’s, you feel skilled and competent. The same is true for the skill of engaging in difficult conversations – the first one is always the hardest. But the damage of not having the conversation is far worse – like gangrene for our profession because we don’t sense the urgency or see the damage.

This is what Ghandi meant when he said, “You must be the change you want to see in the world”. We could complain for years about staffing grids, missed meals or stressful work conditions. Or we could start a tsunami of change for our profession and our patients. If every nurse spoke their truth, we would heal ourselves; and thereby become a blazing beacon of healing for a wounded world.

Bibliography

Bartholomew, K and Nance, J. The Silent Treatment. OR Connection

Bartholomew, K. Breaking Our Cultural Chains. OR Connection

Bartholomew, K. The Silent Treatment. OR Connection

McGrail, KA, Morse, DS, Glessner, T, Gardner, K. (2009). What is found there: qualitative analysis of physician-nurse collaboration stories. Journal of Gen Internal Medicine. Feb 24(2): 198-204.

This article was shared with us by NurseTogether.com.
Based in Charlotte, NC, NurseTogether.com is one of the fastest-growing, free online professional communities for nurses. Specializing in unique nursing lifestyle, career and professional development information, NurseTogether.com’s mission is to empower the nursing community through top-quality original content from experts, interactive web-based social media tools, and value-added services through key strategic partnerships in a variety of nursing and lifestyle disciplines.

NNU’s co-president Jean Ross talks about our first aid tents at Occupy actions and the need for a financial transaction tax.

New aid stations have been set up on San Francisco, Los Angeles and Washington DC. You can volunteer to help.

This week on the show…we rewind. Hey you know you don’t listen every week (but you wish you could) so here’s your chance to catch something you might have missed. Enjoy our show.

Casey and Dan talk with a delightful woman named Judith Stark Frost. Judith was a second grade school teacher for 30 years. She loved teaching her kids how to read but even more than that she loved the humorous things they said. She wrote a very funny book called Priceless Proverbs From the Tongue of the Young. How about these: “A penny saved is…not much” and “He who marries for money…better be nice to his wife.” We all know how funny kids can be without even knowing it!

And later in the show RN Rita Batchley talks about her career as a labor and delivery nurse in a southern California public sector hospital. Rita has written an inspirational book for all nurses called Labor Pains, about authentic power and finding your true purpose. A very interesting perspective on connecting with your “inner nurse,” health care reform and social change.

And of course all the tricks…some funny…some….well, questionable.

A warm welcome to our new sponsor, University of San Francisco’s Santa Rosa Campus. Check out their Master’s of Nursing, Clinical Nurse Leader – starting May 2012. ADN/RN and BSN/RN Entry Option.

And of course as always a big shout out to our great partners at National Nurses United, theCalifornia Nurses Association and the Massachusetts Nurses Association and YOU all of our listeners, without you nothing happens.

Watch our blog for a special Nurse Talk discount to the runaway hit Menopause the Musical in Concert coming to a venue near you.

You can listen in the Boston area on station WWZN 1510AM every Saturday at 11 am EST or live stream at www.revolutionboston.com and in the San Francisco Bay area Sundays at 2PM PST on Green 960AM or live stream at www.green960.com. Green 960 is NOW available on the iHeartRadio app too.

You can also download and listen to any show anytime here at NurseTalkSite.com or on iTunes. Like us on Facebook, and you can listen there too.

Remember, laughter is the best medicine.

How many legacies are you creating today?

You need to know this as a nurse: you’re not treating one patient at one particular moment in time. You’re leaving a legacy. Your actions are woven into the patient’s lifelong health tapestry.

As a lifelong patient, trust me on this one. Forty years of close care by the medical community has given me insight not commonly gained.

I marvel at your dedication, day in and day out, through cranky coworkers and perturbed patients.

Many times over, I’ve seen you at your best. Many times over, you’ve seen me at my worst. And still you treat me with kindness and respect.

My story began forty years ago at age seven, when I was unexpectedly admitted to the hospital. It was my first time away from home on my own. I was terrified. My diagnosis-finding stay extended out to three months, smack over the entire holiday season, November through January.

Either Mom or Becky, our good friend and neighbor, was at my side on a daily basis. As each evening fell, though, of course, my visitors needed to leave.

At 3 am, it was the nurses who kept me company. It was nurses who offered me a cool, life-giving sip of water (I’ve not tasted anything as refreshing since then), nurses who soothed my burning forehead, who checked on me when sleep wouldn’t come, and from whom I tried to hide my tear-soaked pillow in the enveloping darkness.

Each morning, nurses were the first people my mom looked to for reassurance about her little girl.

They were nurses 40 years ago. Yet I still remember their kindnesses.

I still remember.

Eventually, I was diagnosed with Juvenile Rheumatoid Arthritis. Professional health care givers have kept me going, on a daily basis and through eight challenging surgeries.

You’ve taken care of me when I couldn’t. You’ve allowed me to retain some degree of dignity even while taking care of my most basic needs when I was unable to do so.

You’ve treated my loved ones with kindness and respect, too, and that has become a cherish legacy of yours in my life.

You’re leaving a legacy for all those connected to each of your patients, down through the ages. A quarter century later, although I did not have the chance to meet them, I’m still comforted by the nurses who comforted my mom.

A decade and a half after my first stint as an inpatient, my mom found herself in the same hospital.

She praised her nurses who kept her as comfortable as possible as she lay dying of cancer. She fondly recalled oncology nurses from months before who’d seen her through all her treatments.

She was comforted by them then, and I’m still comforted by that fact now, a quarter century later.

I still remember. Know that you will be remembered, too.

You leave a legacy. What will it be?

This article was shared with us by NurseTogether.com.
Based in Charlotte, NC, NurseTogether.com is one of the fastest-growing, free online professional communities for nurses. Specializing in unique nursing lifestyle, career and professional development information, NurseTogether.com’s mission is to empower the nursing community through top-quality original content from experts, interactive web-based social media tools, and value-added services through key strategic partnerships in a variety of nursing and lifestyle disciplines.

The Vermont legislature has pioneered a bill creating a path for a universal, publicly funded healthcare system. James Haslam from the Vermont Workers’ Center is coming to California to share their story and inspire Californians to do the same. Donna Smith, featured in the movie “Sicko”, is a community organizer and health care activist with the California Nurses Association/National Nurses United, and will join James on a California Health Care Justice Tour.

Please join other concerned community members who are committed to making healthcare available to all Californians.

Together We Can Make This Happen — The California Health Justice Tour is in support of the Campaign For A Healthy California, and is raising funds for it, as well as for the Vermont Workers Center.

Download the tour brochure here.

TOUR DATES

TUESDAY, OCTOBER 18
7:00 p.m. — Los Angeles ILWU Local 26 Union Hall
5625 South Figueroa Street, Los Angeles
Contact: Lisa Patrick-Mudd – (323) 316-8933

WEDNESDAY, OCTOBER 19
7:00 p.m. — Irvine United Congregational Church
4915 Alton Parkway, Irvine
Contact: Bill Honigman – (949) 246-6283

THURSDAY, OCTOBER 20
6:30 p.m. – San Diego Machinist ?Local 725 Union Hall
5150 Kearny Mesa Road, San Diego
Contact: Kathy Rallings – (760) 927-0049

FRIDAY, OCTOBER 21
7:00 p.m. – South Bay CLC, Hall A
2102 Almaden Rd, San Jose
Contact: Greg Miller – (408) 254-3311
or Katherine – (408) 977-1275, (408) 834-9165

SATURDAY, OCTOBER 22
10:00 a.m. – San Francisco St. Mary’s Cathedral
1111 Gough Street, San Francisco
Contact: Jodi Reid – (415) 515-2156
3:00 p.m. – Watsonville Civic Plaza
275 Main Street, Watsonville
Contact: Carol Roberson/Gail Olson – (831) 359-5494

SUNDAY, OCTOBER 23
1:00 p.m. – Sacramento CWA Local 9421 Union Hall
2725 El Camino Avenue, Sacramento
Contact: Carolyn Negrete
cnegrete@comcast.net (916) 424-5316
7:00 p.m. – Fresno CWA Local 9408 Union Hall
4422 E. Ashlan Ave, Fresno
Contact: Judy Hess – (559) 907-0279

MONDAY, OCTOBER 24
6:30 p.m. – Chico Trinity United Methodist Church
285 E. 5th Street, Chico
Contact: Forrest Harlan (530) 513-3594
or Tom Reed (530) 966-3414

You could say that Ol’ Arthur beats my butt, or that I have a hitch in my git-along. I