Monthly Archives

February 2016

Paid Family Leave. How is it possible that we don’t have it?

By | Advocacy, International Nursing | 4 Comments

Most first-world countries have some sort of paid maternity/parental leave.  For that matter, check this out:

  • Haiti has 6 weeks of paid maternity leave.
  • Cuba has 18 weeks of paid leave.
  • SIERRA LEONE has 12 weeks of paid leave. All of these countries pay 100% of wages for this length of time.

And the US has notably ZERO weeks of paid maternity leave.

Multiple studies done all over the world point to increased difficulty with breastfeeding if the mother returns to work too quickly after a birth.  Breastfeeding is shown to reduce infant 1_maternity-leavemortality in dozens of studies.  Google one.  And the US has one of the highest first-world infant mortality rates on the planet.  Coincidence? You know better.

So, the cost of a reasonable amount of maternity leave is more important to your government and your employer than whether or not your baby survives.

If possible it gets even worse than that.

No, it really does.  Stay with me.

One of the members of Show Me Your Stethoscope donated a kidney recently.  Here is a quote:

I just donated a kidney and was forced to exhaust PTO. Even though I didn’t want to use it. My coworkers offered to donate PTO and they were told no. It’s sad. I had to sign papers agreeing that if I had any complications and my leave had to be extended that my position could not be held. 

So a nurse who saved another’s life by being a living donor was treated this way in the United States of America. In 2016. Her coworkers couldn’t donate PTO, and if her selfless act caused health complications, her job could not be held.  It would have cost that hospital exactly nothing to allow coworkers to donate leave.  Zero.  Not even a penny.Medical-Symbol

A HOSPITAL refused to allow this.  For organ donation.  To save a life.

So, the next time you think it isn’t “Right” to unite and work with your fellow nurses for safe staffing, to prevent workplace violence, and even (god forbid) decent salaries, please recall that your employer would rather that your baby died than let you have paid maternity leave.  They would rather a living organ donor choose to not donate a kidney than allowing their coworkers to donate leave. Because if her coworkers max out their leave, they lose it. And the hospital gets to steal it back.

It is about power.

It is about control.

It is about keeping you in your place.

Don’t allow it.





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How to not click on ridiculous spam online, and why it is actually ethically questionable to do so. – Guest Post By Nessa Wilson

By | online safety | No Comments

It’s an image that pulls at your heart strings: the pictures of a sick child in a hospital bed, or more frequently, the random photo of a person with a heart wrenching message written beneath it.

All of these posts have something in common: they all ask for the reader’s support and compassion, prayers and compassion. “Like” to show that you care, “share” to send a message that this person is in your thoughts, and reply with “amen” to show your support.

But then there’s the truth:

A recent article by Bankrate found that one of the most popular pictures circulating on Facebook was that of a cancer-ridden child in her cheer leading uniform, asking the world for prayers and compassion. All without the permission, or knowledge, of her family.

We have now entered the world of Facebook “like” farming.spam

Enter the waves of sickeningly-sweet posts that fill your news feed with requests for prayers, shares- and most importantly, likes. At its best, these threads are used to help bolster a stranger’s ego. At its worst, they’re used to by professional scammers to steal user information for quick cash.

How does it work?

Asking for likes on a picture in Facebook is called Click Farming.

Scammers are able to use this method to change the content to something different from what was initially posted. They do this in order to send advertising, or to gather user information. The scammer gets paid based on the number of people receiving the advertising, or liking/sharing the post.

Encouraging Virtual Slavery

An independent investigation by The Guardian found a “Click Farm” workshop in Bangladesh. Workers would work three-shift systems for as little as $3/day to generate fake Facebook popularity for a variety of items and vegetables. This is miserable work for workers: sitting infront of screens in filthy rooms with windows covered by bars. At times, working throughout the night to generate 1,000 likes or 1,000 followers on Twitter to earn a single US dollar.

“There’s a real desire amongst many companies to boost their profile on social media, and find other customers as well as a result,” said Graham Cluley, an independent security consultant.

This belief isn’t unfounded. Research has found that at least 31% of consumers will check ratings and reviews, including likes and Twitter followers, before investing in a product or service.

Click Farms, such as these, play a significant role in potentially misleading consumers. Many companies rely heavily on the social media measurements to estimate the popularity of their products. Major search engines, like Google and Yahoo!, use tools like Facebook liking and social media to gauge the popularity of websites.

It Gets Worse

Sometimes, the threat to users can be more direct.

Edited Facebook threads circulating the internet could spread dangerous malware ( malicious software that can attack someone’s computer), or used for phishing. Phishing attempts to trick the reader into giving out valuable personal information like passwords, credit card numbers or bank account information.

While simple Facebook liking or sharing a post or liking a page won’t spread a virus or malware, malicious Facebook apps and external links can.

Your Personal Information isn’t so Personal

Page owners and other users can collect data on the people who like their post. The information that they can gather can include names, gender, location and places of employment, which they can use or sell to companies for profit.

Users Beware

There’s no end to the pictures: it’s an image of a premature baby, military troops to photos of un-vaccinated children falling ill.

It’s anything that will pull at the heart strings: scammers strike where people are vulnerable, and play on their emotions.

What To Do

Due to Facebook’s sheer size, it takes a lot of reports to have a misleading or offending post removed. Overall, the best approach is to think before sharing.

If it sounds too good to be true, and it looks like it’s something geared towards tugging on the heart strings, don’t click on it. Check it out first. Protect your privacy.


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Broken system, flawed expectations

By | Healthcare Policy, Nursing, Uncategorized | No Comments


Ever since ZdoggMD gave us his thoughts on the ZVlogg yesterday, I have been considering the implications of our present situation from a wider camera angle.

The healthcare system we are currently operating in is completely broken. We are expected to triple document everything in the black hole EHR.  We are taking care of more patients, rounding hourly with almost no support staff, and giving bedside care that is reminiscent of a hotel concierge. We are exhausted.a3784f3c67e6a4883eeef691cba9d93f

And if an error is made or a ball is dropped, we are often crucified. Because we are ‘easy to replace’. Or so they think. Mostly because they have no real and recent connection to the bedside.  Some of ‘them’ have never actually used the EHR as part of their practice. They have never had to live with hourly rounding.  And when they were at the bedside we still had support staff.

The retention of experienced, calm, and knowledgeable nurses is completely undervalued by the healthcare system. New graduate nurses are our bright and enthusiastic future. However, someone has to help them along and give them the benefit of their experience. They simply have no idea how nursing and patient care actually work. The utopia of nursing school simply does not exist where actual patients are involved.  

I have precepted and mentored. My mentors were wonderful people who are still in my life. I have no idea what the mortality rate would have been if I had been dumped in the ICU with my nursing school knowledge and my enthusiasm, but it would have been tragic.3ee362637779cdd6a98b21ce12ff0b16

Like medicine, nursing requires a heck of a lot of on the job training. While nursing schools often talk new graduates into believing that they are ready for entry-level patient care, they are incorrect and the rest of us know it. You must have training and advice for everything from time management to how to make the IV pump stop beeping. In response, the experienced nurse is given the satisfaction of knowing he made a difference in nursing, and sometimes a dollar an hour. Also, a heavier assignment ‘because there are two of you’.

Thanks for that.

So, when you throw all of these things together. the gumbo you have prepared is a disaster.  It is like breaking a pitcher, and then attempting to fill it with water and expecting it to function optimally.  There are too many negatives, not enough positives, and the integrity of the structure is crumbling.  We are told that we are ‘tough and can take it’.  And we feel like complete failures when these overwhelming assignments rise up and swallow us.  When people get pressure ulcers, or aren’t cared for well enough.  When people die of neglect.

Not Fair.  Not Responsible.  Not Morally Right.

Not Nursing’s Fault.

What can you do to change these dangerous practices?  How can you make sure the public knows they are in danger? How do you send a message to healthcare organizations that they will have to put that seven figure bonus they had earmarked for the CEO into direct care staff salaries instead?51b0e99297fa3.preview-620

Join SMYS For Change by clicking on this line.  Besides a National Rally, we are planning rallies at State Capitals to bring awareness to the public.  We are working on local issues. Let your voice be heard.

Join the Rally for National Nurse to Patient Ratios by clicking on this line.  This is where the DC Rally headquarters live.

Encourage friends to join these groups and become active.  Notify your local media that staffing levels are unsafe. Network with local nurses at one of our meetups.  ORGANIZE A meetup!

Nurses are awful at advocating for themselves.  Be the change you want to see in the world.  Change the culture of nursing for your patients.  You will never be sorry.





#NursesUnite #NursesTakeDC



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Instead of what’s wrong with nursing….

By | Nursing | 6 Comments

I spend a lot of time talking about what is wrong with nursing right now. Everyone loves conflict.  This blog will have less views, less hits, and less retweets.

sharethecare1I don’t care. Sometimes you just have to brag about the best job there is.

No, not ‘professional sunbather and margarita consumer’.

I love nursing.  I love being a nurse, taking care of people, and everything about it.  My worst days in nursing are still better than my best days in my former career.  If I could bottle the feeling I get when taking care of people, I could sell it for billions. Even people covered in stool, vomit, urine, and dirt.

But you know that.

I am going to list here why I find it so cool to be me, in story tidbit style.  I will probably give you all of the stories one day. I need yours in the comments

  • Completely freaked out by a patient who wanted a Dr. Pepper.
  • Helped deliver a baby in the back of a Toyota.
  • Saluting as the patient went by, draped in the flag.
  • Brain bleed to better in a week
  • 29 minutes of CPR and no deficit
  • Held C-spine.  It was a good thing, too.
  • The king, his crown, and his cape, singing Stacy’s Mom
  • The day they picked up that SAFE exam kit.
  • Hypothermia works!
  • Holocaust victim.  She kissed me.
  • He walked back into the ICU, healthy now, and turned to me as soon as he heard my voice.
  • Delivered a baby on a table, alone. She was 15.
  • Gave rescue breaths then rubbed granulated sugar inside his mouth, 18 minutes from paramedics.
  • I took them to the rooftop garden, so they could process what was about to happen to their sister.
  • She came to the ER every few days so I could change her colostomy bag.
  • The not-stroke, the thank you card, and the newspaper article.
  • She said I taught her so much, and she is a big nurse now.
  • The first military-wide HIV test
  • His mother still writes me, every year on the day he died.

I know, a lot of flashes of small bits of information. If you are a nurse, you only had to hear that little bit to know what I am trying to communicate here.  The days I touched someone’s life that I will never forget, and the patients who have touched my life. This is a tiny sampling of the perfect job on planet earth.

Go ahead, be jealous. Unless you are one of us.







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Your Hospital’s Secret.

By | Advocacy, Healthcare Policy, Workplace Safety | 12 Comments

Let’s say you went to work tonight on telemetry and were given 8 patients. As we all know, the acuity on telemetry floors has gotten higher, but the staffing is the same or worse. Let us just say that tonight was a completely unmanageable 8:1 ratio.

What will you do? 

Ok so you took the assignment, knowing it was unsafe but that you had no choice if you wanted to keep your job. However, your hospital’s unwritten policy is that you may never, ever tell a patient you are understaffed. So you are constantly getting growled at by patients who want their soda, their bathroom trip, and their pain medications faster. They just think you are lazy. Or slow. Or worse.

What is the big secret? Oh right, patient; they want you to feel safe whether you are or not. Because honesty is not important. Your impression of your care gets you to mark ‘extremely satisfied’ on your survey. Then the hospital can get full reimbursement. Whether you were actually safe or not  AND YOUR NURSE IS FORBIDDEN TO TELL YOU THAT YOU ARE IN staffing

If healthcare facilities wish to admit patients, they should hire and staff appropriately. They should pay agency staff if necessary, hire more nurses and offer premium pay. There should be no excuse for this awful, unsustainable staffing level.

If the optimal staffing on telemetry is 4:1, then it should never be worse than that. Our patients deserve the best care they can get. We have a responsibility to keep them safe.

When we are discussing long term care, the ratios only get worse, and more dangerous. There are never enough CNA’s to take care of our elders, and they suffer. Make no mistake, they are often neglected, and they are lonely. No one has any time to spend with them. They are also in danger of dying of the simplest things;  UTI+Altered mental status+ fall+ broken hip+ sepsis is a common trend. Just because nobody had time to properly assess them

Would you like to hear my opinion? Probably so since you came all the way to the website to read it.

I believe that all healthcare organizations should have to post that they are understaffed at the front lobby and ER doors. I believe that shift report at the bedside should include: “Mr Smith, our patient to nurse ratio should be 5:1 to keep you safe. Our staffing tonight is 7:1.”  Our patients deserve to know that they are less safe than they should be.

This should be a law, and impact any facility that takes Medicare or Medicaid. Meaning pretty well all of them.

Miraculously, I am sure the staffing would improve immediately.



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