In case you don’t frequent twitter, the nursing blogosphere, Facebook or other online nursing communities, Amanda Trujillo is a nurse in Arizona who is under investigation by the State Board of Nursing there. In short (you can read her account here) Amanda relates that when she became aware that a patient awaiting a liver transplant had considerable misunderstanding about the procedure and the lifelong aftercare that would be required, she spent time with the patient discussing related issues and ordered a hospice/case management consult at the patients request so the patient could explore his/her options, something that was within her scope of practice and not against her employer’s policies.

The patient’s surgeon, when he found out about this, became irate and demanded that she be fired and her license taken from her. Amanda was then fired by her employer Banner Del E Webb and reported to the state board. Much of the nursing community is enraged about the situation while some nurses are reserving judgment, wanting more information or waiting to see how things unfold. There are also some who doubt the validity of her story and believe she is simply seeking publicity after getting fired. But regardless of what actually happened between Amanda, her patient, the physician and her employer, there are many troubling facts in the case – things that all nurses should be concerned about.

Regardless of your thoughts about/knowledge of the actual events leading up to Amanda’s dismissal, the case has evolved into something much bigger. Yes, Amanda’s license, livelihood and reputation are on the line and she deserves our support. If given the choice, I’d much prefer to err on the side of supporting her than on the side of doubting her. But what’s even more disturbing is how Amanda is being treated in the course of the investigation.

Reports are that the board notified Amanda’s university (she is an NP student) that she was under investigation even though other insider sources say that should/would never be done while any investigation is underway. What could have been the board’s motivation to do that other than to possibly negatively influence her university against her before the investigation is completed?

Even worse, Amanda has been required by the board to have a psych consult, allegedly because she brought the case to the media and is “speaking out.” Some might say that there is a witch-hunt going on – that the powers-that-be are searching deep and wide for anything they can use to make their case. Just for argument sake, even if there were communication, chain of command, or policy issues in question (I’m not suggesting that there are), how does that warrant the type of humiliation and violation of privacy issues that she is being subjected to? And then – what if they still find nothing? What lengths might the board go to, to prove a point or ruin her career?

The case is pivotal not only because of what is happening to Amanda but also because if it happens to her, what’s to prevent something similar from happening to any other nurse in any state? Didn’t we take an oath, public or private, to advocate for our patients, educate them, and operate in their best interests? I’m sure a case can be made for either side on this issue depending on your title, whom you work for, or what your credentials are. But the bottom line is that a fellow nurse is under attack in the course of doing her job to the best of her ability.

Let’s join forces and give Amanda our support and the benefit of the doubt. But beyond that, let’s speak up for fair and equitable treatment for all nurses and the allowance of due process. Remember, anyone can report a nurse for any reason to their state board. It’s then up to the board to determine if there was wrongdoing of any sort or not. It can easily turn into a David and Goliath situation when a board holds enormous power over an individual nurse and her license and exerts undue influence in the state.

While rummaging through the attic recently, I came upon my nurse’s cap. Now more than 40 years old, it had become a bit yellow and misshapen. As I held it in my hands, I felt a nostalgic smile cross my lips and was flooded with memories of what that cap had meant to me over the years.

I attended a three-year, hospital-based, diploma nursing program. As freshman students, we wore our school uniform but no cap, so we were easily identifiable as plebes. Those of us who survived that first rigorous year “earned” our cap and were presented with one at a capping ceremony. When I donned the cap, it was official: I felt like a real nurse.

At the end of our second year, we received a half stripe to designate our progression in the program and identify us as second-year nursing students. We affixed it to our cap mid way, continuing to one side. It was a status symbol, and it reminded each of us that there was a light (and a full stripe) at the end of the tunnel. I still get goose bumps recalling what it felt like to place that full stripe on my cap at graduation. That narrow piece of ribbon—and that cap—meant the world to me. It represented where I had been, what I had accomplished, and where I was going. It symbolized a dream come true.

I remember the ritual of washing our caps. The other nursing students and I would undo the folds (held together by a plastic grommet) and carefully, and lovingly, bleach and starch it in our dormitory room sink. Then we did the all-important “shaping” so it dried just right. My school cap was of the more traditional design. It had a boxy center and wing-like appendages off to the back when in its original form. But at my school, it was in vogue to get those wings to stick out to the side as much as possible, creating what resembled a crescent – the wider the better! To achieve this look, we rolled up a pair of white gym socks and inserted them behind the wings so they would dry in just the right shape. We had this procedure honed to a fine art form!

For those of you newer to the profession, each school had/has a distinct cap. You came to recognize those from the more prominent schools in your area. Interestingly, there is a nurse artist who paints caps to preserve the images and the memory.

I always felt proud to wear that cap. When I walked (or ran) down the hall in any healthcare facility, everyone immediately knew I was a nurse. The cap is a symbol that still represents the profession today.

Even though nurses don’t wear caps anymore (although there are a few holdouts), some schools of nursing still have pinning/capping ceremonies because the female graduates crave that iconic representation even if they won’t get to wear the cap at work. Many female new nurse graduates even have their graduation pictures taken with caps on their heads. It is a symbol that still evokes an emotional response from many.

I certainly understand why nurse’s caps have been relegated to attics, history books, and vintage photos, but I am proud and happy that I had the privilege and opportunity to wear that cap for so many years.

Feel free to share your “cap” stories here. I, for one, would love to hear them!

The NY Times has run yet another article on the “outrage” that some physicians feel related to nurses with doctoral degrees using the title “Doctor.”  Am I the only one getting tired on reading about this? Back in January of 2009, there was another article titled Health Controversy: Is Your “Doctor” Really a Nurse?  that ran in another publication. Here is my response to that journalist and anyone else who poses the question:

There have long been nurses with doctoral degrees whose title is ‘Dr.’ That is not something new. Anyone with a doctoral degree has always had the right to use that title and many nurses have done so. Your statement that “they’re bestowed the title ‘doctor’ even though they haven’t gone through medical school” implies they might somehow be misrepresenting themselves or don’t have the same rights that anyone in any profession has to use the title ‘doctor’ at that level of education. Physicians do not own that right. In fact, because of that ongoing confusion and the fact that many nurses already possess the title “doctor”, many nurses deliberately refer to MDs and DOs as physicians rather than doctors since that title could just as easily belong to a nurse or psychologist or even an administrator for that matter. The new DNP – Doctor of Nursing Practice – degree, as well as the push to have advanced practice nurses have a doctoral degree has stirred up the current discussion. And while it may cause some confusion, there are not any nurses who wish to misrepresent themselves. They do and should always clearly state their position and title just as a physician or any other healthcare provider should/does. Funny thing is, with the gender stereotypes that exist in our society, almost any man in scrubs in the healthcare setting is often mistakenly called “doctor” by patients and staff alike just as some female doctors as sometimes assumed to be nurses. The point being, there are many sources of ongoing confusion which is why clearly displayed (and easy to read) name badges and a proper introduction are important in the healthcare setting.

 You’re probably aware that many hospitals (and other healthcare facilities) across the country are not hiring new graduate nurses or are hiring very few. This has resulted in the newest members of our profession being forced to work in non-clinical settings right out of school, not finding any employment in health care for over a year after graduation, or leaving the profession entirely.  Hospitals cite that they do not have the funds, the personnel, or the desire to hire and train these new nurses. But, while as much as half of the current nursing workforce is poised to retire en masse and the healthcare system is increasingly stressed by the aging population, this trend will likely result in a catastrophic lack of experienced nurses over the next decade.  (cont.)

Read more from my latest guest blog post at American Nurse Today and weigh in on this important topic  http://ow.ly/5YAKA

Although many people use the terms “resume” and “CV” (curriculum vitae) interchangeably, they’re actually two different types of documents, each with its own distinct focus. Knowing the right format and use for each will save time and trouble (not to mention worry) with your future job pursuits.

A resume is the 1-2 page career summary that most of us are familiar with. It summarizes work experience, accomplishments, education and other pertinent topics such as professional associations and special skills. The resume is what is most universally used and expected by prospective employers. 

A curriculum vitae, or CV, on the other hand, is a longer, more comprehensive document. It’s usually multiple pages long and gets into much more detail, including a listing of publications, presentations, research projects, academic work, teaching experience, and so forth. A CV is generally used in PhD-driven environments, such as academia and higher level research. It attests to expertise and authority.

Does that mean that if you’ve had articles published or done some speaking or teaching that you should use a CV rather than a resume? Not necessarily. The format you use is determined more by the type of job you’re applying for than your credentials.

Not only doesn’t the average nurse need a CV, but it can be a hindrance in a normal job search. Even if you have had some articles published and made some formal presentations, you can still summarize them under headings such as Selected Presentations or Selected Publications. Then just list those that are most recent, significant, and relevant. Keep in mind that the purpose of a resume is to summarize your accomplishments, not to be a laundry list of everything you ever did.

There are even two different styles of CV, the American and the International. Which style you use would depend on where the company you’re applying to is located. The International version includes personal information, such as marital and health status, which would be inappropriate on an American-style CV.

It doesn’t hurt to keep a CV-style listing for yourself to keep track of every presentation, article, and so forth if applicable, but you certainly don’t want to provide that much detail in your resume. Remember, less is more today, when you’re talking about resumes. If people want more detail, they can always review your portfolio, if you have one, or ask for more details, which you could provide under separate cover.

Remember that many people use the terms “CV” and “resume” interchangeably. So the next time someone asks you for a CV, don’t assume she wants the long, expanded version. Unless you’re applying for a teaching position with a university or a high-level PhD type research position, an all-purpose resume is usually all you’ll need.

For more information about resumes and CVs check out: The ULTIMATE Career Guide for Nurses – Practical Strategies for Thriving at Every Stage of Your Career

Have you ever wondered how far you could move from the bedside in your career pursuits and still call yourself a nurse? Have you ever questioned whether your colleagues who work in nontraditional areas, such as quality assurance, are still working as nurses? Is your identity as a nurse tied up in the traditional realm of hospitals and direct patient care?

If you’ve had these thoughts, you’re not alone. Every nurse has. These are the same thoughts I had when I made the transition from the hospital to nontraditional work areas.

Early in my career, I worked for a medical weight control company, for a company that does medical exams for insurance companies, an HMO, an education company that prepared nurses to take state boards, and as a hospital quality and utilization review coordinator, among other things. In each position, I was working as a nurse. I was using my nursing knowledge and skills to impact healthcare in a different way.

Although I never questioned that I was still a nurse, my family and friends were confused as to what I was doing. They would introduce me by saying “This is Donna. She used to be a nurse.”

Usually I would bristle and remind my family that I’m still a nurse, just working in a nontraditional area. I also got tired of hearing from others, “So, why did you leave nursing?” I was tempted to wear my license around my neck to prove to the world that I was still a nurse.

Seizing opportunity

As I matured, I began to realize that each time someone asked me why I left nursing, I could seize a golden opportunity. I could enlighten them about all the ways and places that nurses work today.

I also realized that the average person, including the average nurse, thinks nurses only work in hospitals, schools, and physician’s offices, delivering direct patient care. What a limiting view, accounting for only a part of what nurses are doing.

Today, when people ask me why I left nursing, I tell them that, as a nurse entrepreneur, I’m every bit as much a nurse today as I was when I worked in the emergency department. I tell them that nurses are versatile and multi-talented. I say that nurses are healers and teachers and nurturers, and that I still do all of those things in my professional life.

Making an impact

As a nurse, you can have a positive impact in many ways and places. You’re vital at the bedside but just as vital in every other aspect of the healthcare arena. There are many different types of healing—physical, emotional, and spiritual. As a nurse, you can engage on each level.

Whether working with computers in nursing, doing forensic investigations for the FBI, as a pharmaceutical sales representative, or a quality assurance coordinator, each nurse brings something special, something compassionate, some healing touch to someone, somewhere. You also possess a body of medical knowledge which you can use, just as with your clinical skills, to make an impact in people’s lives.

Nursing isn’t about where you work; it’s about who you are. Don’t be afraid to expand your horizons. But more important, don’t be afraid to expand your vision of who you are as a nurse and about what nurses do. You owe it to yourself and to your profession.

I always advise nurses not to use phrases such as “I’m just a nurse” or “I’m only an RN.” My reasoning is that it demeans the nurse who says it and the entire profession. But interestingly I recently heard from a nurse who had read that advice in one of my articles and expressed an alternate perspective related to accountability. Nurse Sona Mahal stated, “How many of us attempt to avoid the accountability by using this boneless statement? If only it was that easy to avoid. It seems like lacking accountability for patient safety is falsifying the role of a professional nurse. There are many, many committed nurses, but there are many more for whom nursing is just a job and no one listens to them. I often question – how much do you want to be heard? Trying to be heard requires commitment and persistency and sometimes a set-back, but giving up means harm – we all know who gets harmed by our silence and fear of acknowledging our role.” What a powerful and intriguing statement! 

Sona may have a point. Sometimes it’s easier to shirk responsibility than to step up to the plate and stand up for who you are and what you do and take full responsibility for your actions, your knowledge, your license, and your decisions. By downplaying our role with such demeaning phrases, it may be easier to hide in the shadows when something doesn’t go as planned or there is a problem that needs to be solved and we don’t feel like taking responsibility for the action or the outcome.

Your first thought upon reading this might be, “Oh that’s not true. It doesn’t go that deep.” But sometimes we get so accustomed to hiding behind words, phrases and thoughts we don’t stop to think about where it comes from or what it really means. So what do you think - cop-out or put-down? Either way we lose each time the phrase is uttered.

Guest post by Jennifer Payan RN, BSN, CCRN

When many of us decided to become nurses, we viewed ourselves using our hard-earned skills within the walls of our workplace. We envisioned inserting IVs and foleys, changing dressings, hanging IV medications, and diligently educating at the bedside. What we did not foresee was the “off the clock” time we would be tending to friends, family, and even strangers who are perfectly comfortable seeking our advice about their hemorrhoids or showing us their child’s strange rash that even a dermatologist would have to Google. It is amazing the trust and confidence that the initials “R.N.” give to those around you. For me, being “your friendly neighborhood nurse” has been both a blessing and a curse.

The downside of neighborhood nursing has been two-fold for me. For example, sometimes a lunch conversation with a friend takes a gruesome turn and becomes about her latest bout with the stomach flu – in detail. Although I have been known to down an entire Lean Cuisine outside my patient’s room while they are vomiting up something bloody that has a lower GI smell, I’d rather not discuss the disgusting during my leisurely lunch date. Another time, one of my older in-laws wanted to show me the earwax ball that had fallen out of her ear when she pulled out her hearing aid. She wanted to know if it looked “normal”. Truth be told, I think I’d choose a patient’s bloody barf over having to view a nasty ball of earwax in a pudding dish.

The second down side is the assumption that as a nurse, I know it all. There is the belief that I know, in depth, the treatment for the rarest of bleeding disorders that their Uncle Erwin has or whether Grammy may have a bad interaction if she takes ginkgo biloba and digoxin together. I’m a critical care nurse, not the Surgeon General! However, of all these perplexing questions, my nemesis remains the elusive “rash”. I believe my text in nursing school had about 2 pages dedicated to skin disorders, so I have no idea what I’m looking at. I’ve been shown rashes on babies’ butts and teenagers’ armpits. Mere acquaintances have revealed red bumps and patches to me on areas that require the unbuttoning of their pants. “Whoa!” I say, closing my eyes and turning away, “save that for someone who requires a co-pay!”

While I’ve been shown every laceration (“do you think it needs stitches?”) and angry bruise (“should we go in for an Xray?”), I do have to admit neighborhood nursing does bring its share of satisfaction. This is where the “blessing” part has come in. First of all, I feel very privileged to have the trust and respect of so many around me. I’ve bandaged up knees for the kids and applied steri-strips when needed. I’ve given injections of fertility medications to friends and neighbors and looked in their fussy babies’ ears with my otoscope. Just having someone give an educated opinion that may save them a 6 hour trip to the ER or who is able to stop some bleeding without dry heaving means a lot to people.

One morning, I was awakened at 2 am by a call from a frantic neighbor whose toddler had woken up with croup. She was terrified as I ran over with my stethoscope to assess him. We wrapped him up and took him outside into the cold air where he started breathing a bit easier. I helped her load him up in the car and she was able to calmly take him to the ER with the windows down and his stridor under control. There was also a time when I was dropping my daughter off at a friend’s house where I was met at the door by a pale and shaking dad with the phone in his ear with a 911 operator. “Help! Jen, Mason isn’t breathing!” I saw the young boy, blue, in his mother’s shaking arms and quickly grabbed him, put him on the floor, opened his airway and which allowed him to take a few gasping breaths. I found his pulse and started reassuring them that he was breathing on his own and appeared to have had a seizure. I heard his relieved father say to the 911 operator “There’s a nurse here now and she says he is OK.”

 A few weeks after helping Mason, his family came by and gave me a necklace with an angel pendent. They couldn’t thank me enough for being such calm and reassuring presence when they felt so helpless, even though I felt I hadn’t really done much. So while my neighborhood nursing interventions may not compare to the high tech skills I have to use in critical care they fulfill my deepest love of my profession – giving comfort.  I realize that while I love nursing at the bedside, my biggest impact as a nurse may just be hanging out in the cul-de-sac with my family and friends. Neighborhood nursing isn’t too bad of a gig after all.

Guest Post by Lynn Visser RN, BSN, CEN

As I think back to nursing school, I clearly remember being told “Be a patient advocate!”  I always held that message close to my heart, though found as a New Graduate Nurse being a patient advocate was something that was easier said than done.  I started working in a busy Emergency Department (ED) straight out of school.  I clearly remember wanting to be a patient advocate but was so busy starting the intravenous lines, providing the pain medications, and titrating the vasoactive drips, that truly focusing on “being an advocate” seemed nearly impossible.  As the years pass, I have certainly gained experiences making me a better patient advocate and more confident in my abilities. 

Recently I cared for a frail 81-year-old woman in the ED who was ready to take her last breaths.  The ED physician met with the family and they all agreed comfort care was the best route for this woman.  The physician was eager to admit the patient to the hospital floor as it was a typical busy night, gurneys lined the walls, and we needed the bed for other incoming patients.  The ED physician called for an admitting physician, but as usual, this took time.  In the meantime, the family had gathered; all six of this woman’s children, including their husbands, wives, and many of her grandchildren.  They were all present at the bedside, packed like sardines into the 10 by 13 foot room.  The patient’s husband approached me and said, “We’re ready to take the oxygen off and let her go.”  I recognized the tremendous strength it took the family to make this final decision and knew transferring the woman to the floor meant a change in continuity of care.  I relayed this information to the ED physician who encouraged me to transfer the patient to the floor before taking further action.  I professionally explained it was in the best interest of all for the woman to stay in our department and advocated for some intravenous morphine sulfate.  As the matriarch of this family took her last breaths, it was important to me she experienced no pain.  I gave the medication and removed the oxygen. 

We really don’t withdraw support in the ED often, as the length of time it takes a patient to expire is often unpredictable.  On this particular day though, I saw the family gathered together, holding hands, praying, and coming to peace with their decision.  There was no way I was going to disrupt the dignity and grace of the woman’s final moments on this earth all out of convenience for me, the ED physician, or even the next patient waiting.  After death was declared, the family lingered.  I told them to take all the time they needed. 

As the family was preparing to leave, one woman leaned over, gave me a hug, and said “I am an Oncology Nurse, but today you let me be a daughter, sister, mother, wife, and friend.  Thank you for being our advocate.”  There are times when being an advocate means more than anything to a patient and their family.  In moments such as this one, there is nothing more important than the presence of a nurse who will do just that!

Many years ago, after conducting a seminar out of state, I went to the hotel dining room for dinner. I noticed one of the seminar attendees sitting alone and I asked if I could join her. She appeared delighted and excited and we went on to have a lovely dinner. At the end of the meal, she said with a great deal of enthusiasm and sense of pride, “Dinner is on me!” I thanked her but stated that it wasn’t necessary because the company that was sponsoring the event was paying for my expenses. She replied, “But I want to. Please let me do this.” Because I did not feel comfortable having her spend her money on me when I would be able to get reimbursed for my meal, I said, “Save your money. We’ll let my sponsor pick up my tab.”  Afterwards, it dawned on me that it wasn’t about the money at all. This nurse wanted to do something nice for me and it would have made her feel good to be able to do that. I should have simply graciously accepted her offer and thanked her for her kindness. To this day I regret my insensitivity and imagine how deflated I must have made her feel.

My husband, who is disabled and uses a wheelchair, prides himself on his independence. When we are out in public, strangers often run to hold a door for him or something similar. Initially, he would get rather annoyed when this happened, perceiving that people saw him as helpless or “needing” assistance when he was perfectly capable of doing these things himself. But eventually he realized that when others were helping him, it made them feel good. So now, rather than refusing their help, he simply allows it and says something like, “Thank you. That was a big help” or “Thanks – very nice of you to help.” It always puts a smile on the other person’s face.

When my father was hospitalized after a very serious illness, I was impressed with, and grateful for, the expert care one of his primary nurses provided. I told her so one day and she replied rather brusquely, without even making eye contact with me, “That’s my job. That’s what I get paid for.” I got a knot in my stomach and felt so deflated that she would reject or brush off my heartfelt expression of thanks and appreciation. If only she had said something like, “It was my pleasure. And thank you for taking the time to mention that to me.” Graciously accepting a compliment or expression of thanks from another is a way to honor and acknowledge that person.

Next time you contemplate rejecting someone’s offer of help or kindness – or even a compliment, whether you feel you deserve it or not – consider the other person’s perspective. Start being more ‘generous’ to them by giving them the gift of accepting, allowing and acknowledging.

Guest post by Kat, Student Nurse

That is: What would Florence Nightingale do?

I’m a fourth semester nursing student now. It’s hard to believe it…. the time is flying by now, and I can see the end of the tunnel.  I can practically taste graduation!  There are times now where I feel like a nurse.  Where all the pieces fit together and the material makes sense.  There are still PLENTY of times where I sit down to chart in the hospital and think to myself: “Seriously, how will this ever feel like I know what the hell I am doing?!”   The good news, I guess, is those moments are starting to feel like they happen less.  :)

Lately in the hospital, I have started to become discouraged. And it’s not because the material is hard, or because I’m not particularly fond of my floor this semester (I’m working on an endocrine/MedSurg floor).  It’s because more often than not, I find myself watching the floor nurses and thinking that this isn’t what I want to do.  Now, don’t go crazy when you read that and think that I don’t want to be a nurse anymore.  Believe me, I want it more than anything. But the hospital environment has become something of a stressor for me.  In my head, I have all of these iconic and probably unrealistic visions of what I want to be like in my own practice.  The way I want to take care of my patients.  The kind of NURSE that I want to be.  And the longer I work in the hospital. the more evident it becomes to me that that just isn’t going to happen.

This semester the goal is to take on more responsibilities and more patients.  Right now we are running with two patients every week.  It’s not a problem. I enjoy it.  I get to spend some time with each of my patients.  Take detailed assessments, document effectively, and then I have lots of time to plan some care for these patients.  My patients ambulate, they turn, cough, and deep breathe, they get educated about their disease.  They get harassed about their incentive spirometer.  They get on time meds and dressing changes.  I’m able to do teaching. I’m able to do lots of little interventions…. like bring a packet of crackers and a sprite into a patient’s son that has been bedside all day and hasn’t left to eat ANYTHING.  It’s little things like that that make me feel like I make a difference.

The nurses that are actually working (for money) in the hospital, it’s a different story.  They have six, maybe more,  patients at times.  And we (meaning anyone working in medicine these days) know that the patients that are in the hospitals now are no longer “easy” patients who are there to rest and  recover. Even on the “general” MedSurg floors, you have a vast majority of acutely ILL patients.  Acutely ill patients that need CARE, and lots of it.  So here we have a nurse taking care of six + complicated patients, and by they time they pull meds, do their morning assessments, hand out those 548765876387687633333 meds,  hang IV meds, and then finally sit down to document it all, they are back to square one for the next round of meds.  When they aren’t doing those things, they are answering call bells (which they should be), and from what I can see you have some basic nursing interventions that aren’t getting done because the nurses just CAN’T.  They don’t have the time.

They teach us in school how to get rapport going with patients, how to earn trust, how to connect with these people that we are taking care of.  It just can’t be done in the real hospital world of today. It’s hard to get that rapport going when you see a patient 20 minutes a day, and of those 20 minutes, 15 of them are spent shoving meds down their throats.

I didn’t get into nursing to be a glorified pill popper and professional “charter”. I want to take care of patients.  I just don’t see real “patient care” going down in the hospitals these days!

Please don’t get me wrong. This isn’t the nurses’ fault.  They are all wonderful nurses, and in my time spent in the hospitals under these remarkable women and men, I have learned a LOT.  There are so many great nurses there that are GREAT teachers.  But the hospitals have made it so that these wonderful nurses… well, their talent and compassion is snuffed because of the corporate business healthcare machine and their staffing ratios.

I really think that everyone in medicine should start DEMANDING safer staffing ratios.  You can’t tall me that if a nurse had three or four patients, that the quality of their care wouldn’t improve.  It absolutely would.

What would Florence do?

This post was reprinted with permission from Kat’s blog http://justcallmenurse.com/  Find Kat on twitter at @Kat_SN