A Vision for Obamacare

Let's take a trip into the hypothetical United States of the future where the Affordable Care Act has transformed the health care industry* into one whose prime interest is health. In this election year, driven by hope of meaningful health care reform… Read full post »

A few years back, I diminished my employment by 30%, from full-time to 70%.  Instead of crying out, "But what will we do without you?", my boss, who had given me glowing yearly reviews, thanked me. More cutbacks in nursing education were occurring at Big Fat University (BFU) up on… Read full post »

This week the New England Journal of Medicine published an evaluation of Premier HQID, a Medicare pay-for-performance program that provides monetary incentives to hospitals to improve quality of care. Hospitals that perform well on certain measures get 1-2% bonuses and hospitals that underperform are… Read full post »

It was not an unfamiliar line-up:  three innocent passengers, one drunk driver, two pedestrians, an assault victim, a ground-level fall, and, near the end of the day, a lung resection, residing in the Trauma ICU. 

At 7 a.m., I took the ground-level fall, which meant I would later accept the… Read full post »

Damn you, Indians! 

Okay, you couldn't know.

But still - you could have beaten

the Marlins in the 11th inning,  when

my father was dying

and the Tribe was playing its last Series

of his life that

we would discuss, 2500 miles apart,

on the phone that… Read full post »

"What the...is that you, Freaky Ed?"

"Yeah, it's me!  And it's you, Bonehead Jason! Ha!" 

"Great to see you, my friend! What have you been doing since high school?"

"Working. Going to the community college. I'm almost done with my degree. You?"

"On break from college. Starting my junior… Read full post »

Several years ago, my practice included palliative care for people with late-stage cancer.  In this realm where no one survives, many of my assumptions as a health care provider were challenged.  Among the things that people facing death taught me to reconsider were the judgments underlying… Read full post »

All 330 pounds of Joey were lying in the intensive care unit, transferred from an outlying facility after he was resuscitated.  The other hospital had him on a benzodiazepine infusion to calm him down in his delirium, but it made him stop breathing, and now poor Joey not only was withdrawing… Read full post »

People ask me for advice about difficult conversations. I guess because I'm a nurse, although nurses certainly do not always do this well. I mean the kind of conversation you dread when someone's been hurt by cancer/mental illness/crime/disaster/loss; the kind where you want to show you care, but you… Read full post »

Frail 49-year-old Maria lay in her bed, thin and weak. Her bronze skin and swollen belly belied a history of alcohol abuse, and the breathing machine she could not abandon was there thanks to years of smoking. The right side of her neck and chin were covered with dark brown, leathery… Read full post »

70-year-old Mrs. Edwards rolled into the ICU at 0100, pale, sweaty and tachycardic with a blood pressure of 80/49.  The night shift nurse, Rebecca, and a crowd of others deftly hooked up the heart monitor, intravenous lines, and other devices, checked her urine output, and peeked at he… Read full post »

In 1999, the esteemed Institute of Medicine, in a landmark report titled To Err Is Human, noted that between 44,ooo and 98,000 people die yearly in U.S. hospitals from treatment errors.  An error was defined as "the failure of a planned action to be completed as intended or the use of… Read full post »

Theresa Brown, RN, writes a periodic NY Times blog  that gives us a glimpse into the beautiful and awful stories that occur on a hospital oncology floor. This week, she wrote about privilege, money and health care reform: her story was of a VIP patient on the cancer floor receiving china-and-lin… Read full post »

Waitresses, sex workers, mothers, child care workers....all are included in the welcoming arms of a feminist ethos that values the work of women in society. Women in historically male occupations such as lawyers, physicians, business managers, and such are allowed entry, too.

But not nurses. Why?

Mis… Read full post »

As mentioned in a previous post, at 7:10 on a Saturday morning, I assumed the care of two Trauma Intensive Care patients.  In bed #3 lay a restless, unkempt, dirty, alcohol-addicted Hispanic male, 42 years old, whose eye was kicked out by a bunch of young thugs. The contrast between him… Read full post »

It's Saturday morning, 6:55 a.m.: Eight nurses sit around a conference table bemoaning the selection of rotten assignments on the Trauma Intensive Care Unit.  Not a posh assignment among them. Everyone paired; two rooms are empty for admissions. The charge RN gives us a quick rundown that goes l… Read full post »

At 5:39, I was dreaming. At 5:40, hoping the alarm was only a remarkably realistic dream feature, I tried to resist awakening. I failed.  So I crawled out of my queen-size haven and headed for the coffee pot.  Waking early is actually a good thing; today I'm working in the Trauma… Read full post »

Undoubtedly you've seen the Nurse Jackie ads occupying every sidebar and banner ad on the Internet.  Perhaps you've read my previous posts about the inadequacies of the popular media in representing nurses.  All of those less-than-completely-truthful rearrangements of electrons notwithstand… Read full post »

I cannot stomach television medical dramas. I cringe as gross misrepresentations of handsome doctors, submissive nurses, absent clerks, transporters and housekeepers spew forth rapid-fire from across my family room. I roll my eyes at physician omnipresence, omniscience and omnipotence, cackle knowing… Read full post »

Another Day in the Life of an Intensive Care Nurse

7:10 a.m.  I got report on a 43 year old alcoholic, comatose from liver disease, and a 73 year old woman with emphysema and heart failure brought on by an adulthood of smoking and obesity. When she stopped smoking, she got… Read full post »

No more white stockings.

Silly cap and starchy dress

are hard to run in.

Ignore the lobby's

shining glass, ferns, waterfalls.

Hands do the healing.

  Read full post »

Mr. Nailor came to me about six months ago from the senior assisted living facility where he resided. They had a  large communal kitchen, a well-equipped craft room, and raised beds for gardening outside in the summer.  He'd lived there independently, generally sound but for a few chronic i… Read full post »

It was 7:30 a.m.in the medical ICU.  My shift, one that promised to be busy, was just beginning when I entered Mrs. Paysons' room. Her daughter was softly speaking to her of matters I decided were not meant for my ears.  Trying not to eavesdrop, I checked alarms, verified  intravenous… Read full post »