I wonder what Flo would say about some of the headlines today? Aside from wars and rumors of more wars, technological miracles, and the odd ritual of camping outdoors once the weather is nice, what would she say about California Senate Bill 491?

I’m sure she would be very interested in the latest political action here in California, where nurse practicioners are fighting to practice to the full extent of their licenses.

Indeed, California is one of 34 states that have laws prohibiting licensed nurse practicioners from practicing unless they do so under the supervision of an M.D.

Would that be safe, you may ask? Good question. The Institute of Medicine [an arm of the prestigious National Academy of Sciences] asked the same thing, then studied the situation. Results of the research show that nurse practicioners [NPs] have a stellar record: They should be allowed to practice to the full extent of their education and training, just like any other professional group. How so? All the prime nurse – indicators of “what can go wrong” have been avoided with percentages rival or exceed the MD outcomes. Throw in golden patient satisfcation scores, and you can understand the ire of Advanced Practice Nurse Practioners [APRNs] who are ready and willing to take on more patients, but cannot.

Time to get out your ink and quills, and let’s flood the Senate halls with paper!

And please, recycle.

CRE = Carbapenem Resistant Enterobacteriaceae [entero-bacteria-a-see]…

Say that fast 10 times!

So what’s the big deal?

These microscopic critters, which appear naturally in our digestive tracts (along with e coli and klebsiella clans), have the ability to resist yet another type of antibiotic (the carbapenem family). Yes, you heard right. ANOTHER antibiotic-resistant strain of bacteria.

And how does this happen? [Sounds like the same song, third verse...]  The identical route other MRSA and VRSA infections take, namely: inappropriate and/or overuse of antibiotics, the carbapenems, as treatment.

But wait! You may ask, aren’t the US and other modern countries attempting to DECREASE antibiotic use and prevent such crises?  True.

Latest info from the CDC mentions infections emanating from other countries, namely, Pakistan, India, Vietnam, Greece and Italy. They site medical tourism as a possible addition to the problem, as some countries do not have as stringent healthcare policies and practices as others. lesson: Do your homework before you or your loved ones traipse off to a med-cation. 

You may bring home more than you bargained for.

The CDC mentions that healthy persons shouldn’t need to worry. Understandably, the more immune-suppressed the person, the more the risk of infection when exposed to the source.

Florence would say that she knows how enacting change in healthcare is difficult.

She fought long and hard to overturn the convention of the times. This included a mindset of denial, e.g., there was no need to wash if your hands looked clean.

Today’s healthcare workers exposed to MRSA, VRSA, or CRE need remember to:

• scrupulously cleanse hands with soap and water before/after any patient contact
• enforce strict contact precautions

• isolate cases to assist in decreasing the chance of  contagion.

Although Pasteur didn’t discover microorganisms until after she returned from the Crimean War experience, Flo writes that she believed washing hands often, and certainly between patients, made perfect sense (from her naturalistic view).

And that’s what Flo would do!

Our hearts and prayers go out to the affected families with loved ones who have been senselessly maimed or killed by dissidents and/or human error. The past few weeks have also  revealed triumphs amidst the tragedies. Random acts of kindness lift our spirits, when we see neighbors helping neighbors who are brought together by  harm’s way.

Those of us who live in the San Francisco Bay area, recall a different tragedy, long ago, this week in history.On April 18th, 1906, the Great Quake decimated the city. Much was learned in terms of emergency preparedness.

Florence Nigtingale lived through similar distress when she and her 38 nurses arrived at Scutari Barrack Hospital, in 1854. The army was so unprepared for the casualties of war, the wounded lay stretched out on the floor, without beds and few mattresses. Nightingale brought to the work a knowledge of how to run an estate and a small hospital, but her diaries show how she felt overwhelmed every day. Yet, she pressed on.

Fortitude in the face of disaster is this week’s theme. Although Florence didn’t know Viktor Frankl, psychologist, author, and concentration camp survivor, I’m sure she would agree with his thoughts about living through difficult circumstances:

“When we are no longer able to change a situation – we are challenged to change ourselves.”

May this week find you thankful for family, friends, and goodness that triumphs over tragedy.

Here we will discuss anything that pertains to healthcare in this century or the last two… since Florence Nightingale’s influence spans > 150 years!

Whether you are involved in direct patient (or “client”) care in your worksplace, or other work under the larger healthcare umbrella, or if you are/ have been a receiver of healthcare services and happen to hold Florence Nightingale in high esteem, THIS BLOG’s FOR YOU!

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 In my study of many of the 200 white papers and > 14,000 letters written by Florence Nightingale (FN), there exist many pertinent themes for today. I’d like to begin the discussion with the idea of creating random acts of kindness.

FN had some very old-fashioned ideas about this. In one of her letters to student nurses, she mentions the need for professional (i.e., “trained’) nurses to have a desire to serve humankind, as opposed to merely wanting to become a nurse to secure a working wage. She mentions that we need to treat our “sister nurses” as family. She decried the meanness of some women to one another and called for us to keep our high calling foremost in our minds as we deliver care to patients..as well as care for one another.

We have surely “come a long way, baby,” but reports of incivility continue.

Flo would ask us to encourage someone getting caught doing something good, charge us to create random acts of kindness, and/or pay it forward.

That’s what Flo would do!

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What does this mean? And who cares?

You should, dear reader. The HCAHPS is the next generation, Ralph Nader-type of brainchild that healthcare consumers (i.e., all of us, eventually) conceived in the early 2000’s.  It all started as a back-lash movement against the atrocities reported in the original 1999 IOM report that outlined close to 100,000 hospital deaths due to system errors… per year!

If you follow public health policy news, you know we healthcare advocates have been arguing for the general populace, in places like Sacramento and D.C., in favor of just such an instrument, for years. We have labored through a prolonged, and complicated gestation, to see it grow into a real-live-tool, for about 3 years now. The results are helping shape the future of healthcare. So, when you have the opportunity to complete a “patient satisfaction” or other survey from your healthcare provider, DO SO!

Like the right to vote, it doesn’t help if you just complain.

Ya gotta say something to be heard.

She has lived abroad before, so I know she knows how to navigate in a foreign country. She is also going to meet up with one of her best friends, and they will visit one of our previous exchange students, so I know she’ll be in good company. She’s brushing up on her german, so I know she won’t starve. 

Then why am I fretting? If she were married, or in her own place,  I wouldn’t be a part of the getting-ready process. Out of the loop, I’d be just waiting for the postcards.

But, no.

When a grown child lives with you, a parent has the opportunity to let go and hold-on simultaneously. This can be confusing for both parties.

Speaking of parties, it feels like that most of the time, with her around.  

The cat is eyeing her suitcase, suspiciously. He wants to jump in, and so do I. We will both howl when she leaves.

Seems like moms never outgrow their need to nurture.

     Then what sense can we make of the newest adult-fad, barefoot running? Despite the much-touted book on the subject, there exists no reliable scientific evidence to cushion the fall.  (Could it be a nefarious podiatrist’s plot to garner more customers??) Not surprisingly, sports’ medicine experts and cast-adorned would-be runners have “come out” against the practice, pointing to the painful (and expensive) fruits of their labor-of-love. Experts warn that running with shoes can lead to anatomical injuries, since folks often run “recklessly” with highly padded footwear.

     Whether it’s the Chocolate Diet, (and other  fantasies), texting while driving and /or walking, or barefoot running, let us not forget the words of P.T. Barnum, circus entrepreneur, who reminded, “There’s a sucker born every minute,” and “Opinions are like assholes- everyone’s got one.”

     For those 21st century running enthusiasts, who’d like to mimic their third world counterparts, here’s a healthful sports tip : Take it easy; know your limitations, or just say NO !

Hello, Readers!

‘Coming up for air after having finished a business plan for an interprofessional healthcare workshop for communication and team building, and I realized this is Nurses’ Week!

Considering that in an annual survey, nurses have earned the highest ranked public trust for the 11th straight year,what does that mean to you?

We  function as patient advocates and professional healthcare providers, both at the bedside and behind the scenes. Since I have the distinct privilege of playing a part in several healthcare areas, I’d like to take a moment to reflect on lessons learned, and to encourage those nurses out there, or would-be nurses, to keep up the good work!

My work on the university campus is such a blessing. What an invigorating assignment, to help shape the nurse of the future. We faculty shoulder the academic load with (mostly) grins, as we see the progress of neophyte nursing students. This is a double blessing ~ first, we see them grow; second, we know when we are old there will be competent professionals to assist us!

The work with the American Nurses Association (the professional organization, not a union) allows input into health policy on the state and national level. What an honor, and what fun! (Stay tuned, as I will post a podcast from the Washington, DC House of Delegates in June.)

So here’s a word of encouragement to all you healthcare students out there – nursing is a profession with great lateral mobility and opportunities for growth. Study, study, study. You’ll  soon be entering a rewarding profession.

    click here for Reuters article 

Hello healthcare leaders everywhere,

Attending the California Action Coalition (a group of  healthcare leaders) seminar today, the same day as the article about my healthcare speakers video series hits the press in > 2000 newspapers and media outlets! This is fortuitous and accidental timing, as the need for healthcare leaders to hone their critical speaking skills is never more paramount than now!

The California Action Coalition is the first inter professional state group (funded by Robert Wood Johnson Foundation). The coalition serves to plan interprofessional education to meet the goals of healthcare change which is mandated to happen in this country.  Four promising areas across education drive the move to position nurses into the fore of patient care, in order to adequately serve the country’s burgeoning population and healthcare needs.

Can I hear an amen?!

Forty eight years ago today, The Beatles landed in New York (of course, they flew Pan Am).

If you are old enough to recall that occasion (and the mass hysteria that followed), where were you?

While watching them on the Ed Sullivan show, I recall being SO upset that no one could hear anything above the screaming fans! One thing’s for sure, though: They communicated a joyful, new sound to an international audience.

Yes, there was poverty, inequity, and political turmoil in many parts of the world then, as now. However, their music and optimism set the stage for people to unite. Not everyone chose to be a part of this “revolution.” but many of us did.

That’s not such a bad example, eh?