Forces for Change: Labor Pains

Nurse protests are occurring all over the United States. Anyone who has ever been a health worker or a patient knows that a doctor admits you to the hospital, but it’s the nurses that make sure you get to go home. Now more than ever, the world needs a story that pushes to keep the care in healthcare. Labor Pains, the story of an RN on the hero’s journey, is a life-changing read that is long overdue. Nurses work hard to protect their patients; yet most nurses have no idea that the same protections apply to their own practice and well-being.  Labor Pains offers an inside peek into the political issues nurses must face to provide patient safety that also protects the nurses themselves from burnout and bodily harm. This unique view into the battle between the essential workers of healthcare and the pencil pushers of corporate greed will resonate with nurses and patients alike.

On Sale Now for Nurses Day May 6, 2020

At Mercy General trouble is brewing. Outside nurses protest for patient safety and worker protections. Inside nurses work hard to care for the sick while most of their patients don’t realize that illness may be the least of their worries. A huge corporation threatens to turn their community hospital into a big box medical center. In the middle of the fray, Paige O’Neill, a labor and delivery nurse brings babies into the world but can’t seem to have another of her own. Paige knows how to relieve the pain of her patients; but when it comes to her own suffering she relies more and more on alcohol. From the tender moments in the delivery room to the secrets shared in boardrooms, this timely tale of essential workers and pencil pushers awakens the spirit to the heroic powers of the nursing profession: courage, caring and hope. Amid birth and death, joy and betrayal, greed and caregiver burnout, Paige O’Neill endeavors to triumph over the most terrifying of forces: Labor Pains.

What Every Nurse Knows

Bernie- Born to Run 2016Nurses value life, not just breathing and a pulse, but a quality life that entails an opportunity to fulfill your potential and use your talents and skills.

With the cost of health care premiums exceeding the average mortgage payment for a home, life has been sold to the highest bidder: corporations that profit from you dying.

Why? Because politics are driven by super Political Action Committees (PACS) that spend billions to elect politicians that push special interest groups like healthcare corporations who are more interested in making money than alleviating suffering.

The only special interests that nurses have are our patients. We want healthier lifestyles, affordable medications and compassionate care.

Bernie Sanders is the only candidate that embodies these values. I challenge you to look at Bernie’s track record, study the other candidates’ platforms and show me a leader who can deliver the caring, compassion and community that we need to turn our country around.  Vote nurses values because every nurse knows that life is a terrible thing to waste.

A Nurse’s Remedy for Racism: Faith and Action

MLK quote

Today I want to start my day in prayer and meditation to remember Martin Luther King and his legacy of peaceful resistance.

His work brings tears to my eyes and I emphasize work because while others would call it a fight for social justice, I believe the word fight contradicts much of the miracles he accomplished.

It was a bloody battle on racism, and still is, yet Martin Luther King acted as a conscientious objector: an “individual who claims the right to refuse to perform military actions on the grounds of freedom of thought, conscience, disability, and/or religion. Martin Luther King Jr didn’t hand out rifles, tear gas and brass knuckles to retaliate against the U.S. military who tried to break up his protests. Instead, he dispersed education, community values and hope that Black Lives Matter.

For this, he is the face of heaven on earth: a leader of a peaceful movement. Today, his comfort rises up in memorials all over the nation that honor his loving actions against the “mountain of despair” of all people who are disrespected because of color, gender or disability.

Take a moment to meditate on the fact that Martin Luther King worked hard to battle racism not with violence but with faith and action. Every time you start to say the word “fight”, consciously replace it with a word that exemplifies hope. Share this.

Are Nurses Guilty of Healthcare Disaster?

U.S. Healthcare is on its Titanic voyage.
Who wants the award for steering the modern Titanic?

It would seem that 2016, would be a great time for nurses to celebrate. After all, the nursing profession is golden as deemed by the recent Gallup poll results which found nurses to be the most trusted profession for an amazing 14 years in a row. In fact, over the last 17 years the only time nurses didn’t rank number 1 was when firemen received the prestigious award after the 911 disaster.
This merit, voted on by the American public, is a lot to be proud of when you consider that nurses had some tough competition. The highest rating for honesty and ethical standards, was won by nurses over twenty other esteemed vocations including doctors, judges, teachers, safety officers, military and clergy!
So what gives? Are nurses to blame for the bad news in healthcare? How can we fault the angels of mercy for what is happening in America? My answer, after 25 years of bedside nursing and being a healthcare crusader is this: While nurses aren’t the cause of our failing healthcare system, we ARE guilty of not using our influence to impact the changes necessary to make our healthcare system great. Great would be fantastic, let’s start with adequate. Because let’s face it, what’s so great about being #1 in a system that causes more than 75% of the bankruptcies in the United States? What’s so great about an organization that tells the American people to use the emergency room for primary medical attention? What’s so great about a structure that pays the most money per capita for healthcare, yet loses more lives to diabetes, cancer and heart disease than any other industrialized country?

To me, this award is like getting the Titanic award. Our levels of morbid obesity, unchecked mental illness and deaths due to medical errors are disasters that should make a nurse’s head explode. Instead of celebrating, we should be outraged enough to want to revamp the system to give the safe, unparalleled care that the American people deserve.

Let’s look at three ways nurses can use their influence to change America’s healthcare delivery.
1. Nurses need to demand compensation and recognition for what they do. One of the most daunting tasks of the Affordable Care Act (ACA) is the lack of providers available to actually care for the sick let alone educate the public on lifestyle changes known to prevent debilitating and costly illnesses. Utilizing public health nurses and home health nurses to prevent and treat obesity, diabetes and tobacco use can save hundreds of millions of dollars a year. According to the Partnership to Fight Chronic Disease, these conditions cost more than a trillion dollars per year, and if there is no changes, this number could balloon to nearly 6 trillion dollars by the year 2050. Preventable and highly manageable diseases account for 75 cents of every dollar we spend on healthcare in the United States., every day, every year. Even more daunting, chronic disease costs consume 90 cents of every dollar spent on Medicare and Medicaid. In contrast, we spend less than 5 cents on prevention. There are over 3 million nurses in the United States, the largest number of medically trained and licensed personnel available, yet nurses are finding it difficult to find work. Let’s insist that more nurses be employed by public health.
2. End violence in the workplace: Yes, patients are more violent toward nurses but I’m talking about the unspoken violence of bullying. The hazing of new nurses and lack of teamwork among healthcare workers causes a huge turn-over rate in nursing. The RN Work Project, a Robert Wood Johnson Foundation-funded study of new RNs and the only longitudinal study of RNs in the United States, showed that of newly licensed hospital-based nurses 43% leave their first jobs within 3 years of employment. Turn-over is costly. The recession has slowed resignation rates from 46 % to 43% since 2008, but nursing is still a profession that is known for “eating its young.” A much needed revamping in the mentorship and training of new of nurses could change this culture by re-setting its priorities by utilizing more on-the-job teachers and nurse apprentice programs.
3. Finally, the most influential duty that nurses, the most ethical and trusted professionals, must do to improve healthcare is to stand up and say “NO!” to unsafe patient care assignments. In some states, like California, there are nurse-ratio laws that mandate no more than 1:1 or 1:2 critically ill patients per nurse but in other hospitals across the country one nurse may have 4 or even 5 critically ill patients to juggle. Yet, hospitals across the nation are betting that fear of losing their job will more often, than not, dictate a nurse’s behavior to accept an unsafe patient assignment. With more than 100,000 injuries or deaths per year caused by hospital errors there is nothing ethical about accepting assignments that a nurse knowingly cannot handle.

Nurses need to adhere to the Florence Nightingale oath to do no harm. I agree with RN, Cynda Hylton Rushton, Professor of Clinical Ethics at Johns Hopkins University when she said: ”Many of our challenges facing our healthcare system is related to the overall task of balancing quality and safety with efficiency.” Nurses have known for decades that the business of providing healthcare cannot be run like an assembly line. The value of medicine is not in its size, as in the Titanic, but in the outcomes of a healthy nation. RNs at the bedside save lives and whistle-blower protections must be upheld to protect nurses who tell on employers who knowingly place patients in harm’s way.

Being a nurse is a calling ruled by a higher law. Nurses care even when you don't care about yourself. As elections draw near, look to the nurses who endorse the candidates who challenge price gouging by pharmaceutical, insurance and hospital corporations. 
It’s no wonder nurses were voted the most ethical and trustworthy profession because we have to be. Patients, their families, and the public are counting on our values of caring, compassion and community.


This Is What Nurse Power Looks Like

The comments made earlier this week on the View about the Miss America contestant, Kelley Johnson, continue to spur nurses to remark in social media. The hashtags #NursesUnite , #JustANurse and the Facebook page  #NurssesShareYourStethescopes are swarming with spirit and support for nurse power.

As The Nurses’ Nurse, I have spent years promoting the power of nurses in society. I am so grateful to Kelley Johnson who competed in the talent section of the Miss America Contest as a nurse. She recited a story based on the poem, Just A Nurse.  Her short speech, about being a nurse who gave dignity back to a man with Alzheimer’s disease was great.

Rather than appearing as just another female entertainer in a flowing gown and a push-up bra, Kelley dressed in scrubs and a stethoscope, to prove that the beauty of a woman should be judged from the inside out.

It took over 500 pages of my book, Labor Pains, to say what Kelley said in less than three minutes. Patients don’t cry out for the doctor to save them, they call for the nurse. It takes all the arts and sciences together at the bedside to give compassionate care. If that’s not a special talent I don’t know what is.

A Hospital without Nurses is like a World without Water

It is sad that the View, which should portray powerful women, presented themselves as a group of hens pecking at the integrity of a nurse for a few cackles. This type of catty behavior is at the  core of what makes it so hard for nurses to break out of the social stereotyping that has portrayed us as sex objects who are incapable of being both feminine and smart.

Kelley Johnson may have taken third place in the Miss America contest but she will always be #1 with the nurses. Never underestimate the power of a nurse.

Nurses are First Responders Too

Nurses are First Responders Too. In all my reading and social media contacts I found nothing that honored the nurses and their heroic contributions during the attacks on 9/11.

I want to thank the brave nurses, medics and all the medical staff that worked nonstop to provide life-saving care on that day. We, as nurses forget to give a shout out to who we are in the realm of service and protection of others. One article, Nurses on 9/11 written by Kristen Rothwell,  gives a detailed account of the nurses role that day. I can see the NYC conference building, the Jacob K. Javits Convention Center, which had been set up as a giant triage and emergency center becoming like a MASH unit.

Nurses Killed on September 11

Touri Bolourchi, 69, retired nurse, passenger aboard United Airlines Flight 175

Lydia Bravo, 50, occupational health nurse at Marsh & McLennan Companies, Inc.

Ronald Bucca, 47, fire marshal, New York City Fire Department

Greg Buck, 37, firefighter, New York City Fire Department, Engine Company 201

Christine Egan, 55, community health nurse visiting from Winnipeg, Manitoba, Canada

Carol Flyzik, 40, medical software marketing manager, passenger aboard American Airlines Flight 11

Debra Lynn Fischer Gibbon, 43, senior vice president at Aon Corporation

Geoffrey Guja, 47, lieutenant, New York City Fire Department, Battalion 43

Stephen Huczko, 44, police officer, Port Authority of New York and New Jersey Police Department

Kathy Mazza, 46, captain, Port Authority of New York and New Jersey Police Department, and commanding officer, Port Authority Police Training Academy

Michael Mullan, 34, firefighter, New York City Fire Department, Ladder Company 12

As the most plentiful of providers, nurses play a huge part in patching the wounded and comforting the survivors, not only on that day but in the months and years that followed this disaster. Remember the nurses of 9/11.

Labor Day: Creating a Healthy Work Culture  

When I think of Labor Day I remember the working class heroes who have built our society and have won so many of the rights we enjoy: paid holidays, overtime compensation, child labor laws and the ability to come together as a voice for fairness.

Today I read that President Obama passed a measure for seven paid sick days for federal employees.

Healthcare Starts with Self-care
Healthcare Starts with Self-care

This shows there is still much work to be done to ensure fair practice that protect workers from harm. It seems ludicrous for someone to go to work sick because they can’t afford to take a day off thereby, infecting everyone else at their job.

What about nurses? I know many, myself included,  who work or have worked when they were sick because there weren’t enough co-workers to cover the shift.

Everywhere I look, hospitals aren’t hiring  enough nurses. Hospitals depend on nurses to work overtime to cover unfilled nursing positions because , ironically, it’s too expensive to pay for employee healthcare benefits.

Nurses work hard and need time off to recover from the demands of our job. It has become the nurses code of honor to work extra shifts to provide respite for each other. Yet, this unspoken rule spreads the work pool too thin to cover sick leave, especially for minor ailments like colds.  So it has become prevalent for bedside nurses to work even while sick .

Managers try to deter this behavior by scheduling nurses weeks in advance to prepare for slim weekend and holiday coverage. Yet, because a hospital census can be so unpredictable, there are always circumstances where shifts need to be rearranged to balance the experienced nurses with new nurses to provide mentorship and optimal care for the patients. No one knows better than a nurse that short staffing puts patients in jeopardy making it a real guilt trip to call in sick.

This holiday, I am taking a moment to recognize  the nurses’ responsibility to ensure fair work practices that protect others from unnecessary exposure to sick workers. We didn’t cause this nursing shortage, we didn’t create the uncertainty of situations that demand we adjust our schedules, but we can cure this dilemma.

Nurses can change the unrealistic expectations we put upon ourselves and our profession by sharing the awareness that we must advocate for our own health first. While it seems a brave and admirable sacrifice to work while mildly ill we are exposing these germs to other people’s immune systems  that may cause a life threatening situation.

Sure, we can pass more laws to ensure worker and public safety but it’s faster and cheaper to create a healthy work culture. To start, I must walk my talk and present myself as fit to do a good job. Instead of manipulating a co-workers by demanding that they defend a sick call, I have started creating a culture that protects and encourages nurses to be strong and healthy by saying, “I hope you feel better.”

Good Friday

As a nurse I’ve had to follow a higher law. Sometimes I had to do what was right instead of what was easy. There were times that I had to stand up to ridicule and berating from my supervisor because I disagreed with the staffing of our department.  I can’t help but wonder how it might be, if more nurses took a Garden in Gethsemane moment and surrendered to a crown of thrones rather than compromise safe patient care.

What Nurses Want and Need for Christmas

Don't Pay the Price of Silence or Brutality
Don’t Pay the Price of Silence or Brutality

Whether or not you agree with Sony’s recent reactions to North Korea’s threats, freedom of speech is a human right that many Americans have sacrificed their lives for.

Granted, I don’t have to like what other people say about a subject but I have the right to speak my opinion. After all, I don’t make up true north.

My favorite flavor is chocolate. I didn’t make that up. I don’t like what happened in the Sony hacking incident but I don’t like the fact that Sony stirred a hornet’s nest with Kim Jong-un either. Just because I like chocolate, doesn’t mean I should beat you over the head with it.

What does this have to do with what nurses want for Christmas?  It has to do with nurses being able to voice our true north without fear of losing our jobs. It has to do with being able to communicate with integrity so people don’t have to suffer.

Saying what I mean and meaning what I say doesn’t have to be said or done in a mean spirited way. When there aren’t enough nurses to cover tough situations we shouldn’t have to resort to shaming or bullying one another just because it’s been done that way in the past.

Christmas can be a very short-staffed time of year. I get it that nurses have families too and want time off. But there are plenty of nurses who want to work, yet staffing formulas don’t always reflect the true north of what patients need for optimal care.

Too bad nursing productivity and performance are based on customer satisfaction and not so much the basis of healthy outcomes like educating patients on getting and staying well. Making sure a patient’s dinner isn’t cold is important, but what makes nursing meaningful is providing lasting safety and support.

Yet patient satisfaction surveys, used to fulfill healthcare quotas, focus on comfort and costs rather than quality measures driven by lowering illness through intervention and education.

Too often, nurses are too busy or too tired to balk about the measuring of their pillow fluffing.  Working to save and improve the quality of life should be more important than encouraging patients to circle happy faces for food temperatures and mood lighting.

The political pressure for nurses to play these corporate games of following the money, lest we fear losing our job, has watered down our effectiveness as soldiers against suffering and disease.

Nurses need to learn to be assertive and provide scientific rationales for better hospital management to stop the bullying behaviors and focus on best medical practices.

After all, if Florence Nightingale had bashed her administrators in the beginning for doing such a lousy job, or worse yet if she had kept her mouth shut, the spirit of modern day nursing wouldn’t exist.

Instead, Flo became the voice for change by modeling effective communication that demanded respect. I know we can keep her flame burning bright to direct us to the true north for healthcare justice.

May we all be blessed with the courage and strength to be that voice. Happy Holidays.

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