Rights and responsibilities

I waited to post my opinion out of respect for the dead.

I have seen what people are saying, I can’t wait anymore.

Bear with me for a sec – this is long, try to read until the very end.

Some are saying this is a “Muslim” issue. They impugn an entire religion based on the actions of one deranged individual. We saw it before in San Bernardino. Some person goes on a rampage because he hates his job and hates his coworkers. Oh, he happens to be Muslim. Ban all Muslims. Some person who hates being gay goes on a rampage in the club he frequented. Oh, he is Muslim. Ban all Muslims. Never mind that both men were American citizens born in the United States.

I wouldn’t marginalize an entire religion based on the actions of one self-hating person who shot up the club he frequented and pledged allegiance to Daesh as an afterthought. This was not “Radical Islamic Terrorism.” This was not Durka Durka Jihad. This homicidal maniac hated gay people because he was gay and was taught by his religion he was an abomination. Could have been Amish, Baptist, Catholic, Jehovah’s Witness, Jewish, Mormon, or a Scientologist.

I will defend every member of the Islamic faith from the tyranny of the majority. I will also defend every Jew, every Jehovah’s Witness, every Mormon, every Pagan, every Wiccan, every Yazidi, and every Zoroastrian.

Now hear the corollary.

We keep hearing about how this is the “worst terrorist attack.” Many agencies are attempting to modify that so instead of being an outright fabrication it is at least partially true. “Worst attack since 9/11” seems to be the preferred piece of agit-prop to get everyone riled up.

Do you remember the weapons used on 9/11? I do.

Box cutters.

Some agencies are saying it is “the worst terrorist attack since Oklahoma City”

Do you remember the weapons that killed 168 people on April 19, 1995? I do.

Fertilizer and a Ryder truck.

McVeigh still holds the record for “worst domestic terrorist attack” and he was a Christian white nationalist veteran. Sure, Stormfront have distanced themselves from McVeigh but I remember the protests against Waco and Ruby Ridge and the people that were there. My father brought me to those protests.

People screaming, “ban the Muslim,” as well as people screaming to “ban the gun,” have short memories.

Daesh is counting on that.

There are people posting articles from hate groups that only serve as inflammatory pieces of agit-prop. They are making all sorts of inferences and claims about an entire religion based on a site that is no different from Stormfront. I do not see anyone arguing with them as they argue with the people supporting the second amendment.

FYI we have ten amendments in the Bill of Rights. This argument does not just concern the first two.

The First:
Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances

The Second:
A well regulated Militia, being necessary to the security of a free State, the right of the people to keep and bear Arms, shall not be infringed

You eliminate one, you eliminate them all.

Including the Fourth:
The right of the people to be secure in their persons, houses, papers, and effects, against unreasonable searches and seizures, shall not be violated, and no Warrants shall issue, but upon probable cause, supported by Oath or affirmation, and particularly describing the place to be searched, and the persons or things to be seized

Daesh is counting on that.

And The Fifth:
No person shall be held to answer for a capital, or otherwise infamous crime, unless on a presentment or indictment of a Grand Jury, except in cases arising in the land or naval forces, or in the Militia, when in actual service in time of War or public danger; nor shall any person be subject for the same offence to be twice put in jeopardy of life or limb; nor shall be compelled in any criminal case to be a witness against himself, nor be deprived of life, liberty, or property, without due process of law; nor shall private property be taken for public use, without just compensation.

Daesh is counting on that.

Let’s just do away with The Sixth as well:
In all criminal prosecutions, the accused shall enjoy the right to a speedy and public trial, by an impartial jury of the State and district wherein the crime shall have been committed, which district shall have been previously ascertained by law, and to be informed of the nature and cause of the accusation; to be confronted with the witnesses against him; to have compulsory process for obtaining witnesses in his favor, and to have the Assistance of Counsel for his defence

Daesh is counting on that.

Might as well chuck the seventh:
In suits at common law, where the value in controversy shall exceed twenty dollars, the right of trial by jury shall be preserved, and no fact tried by a jury, shall be otherwise re-examined in any court of the United States, than according to the rules of the common law.

Daesh is counting on that.

We don’t really need the Eighth Amendment? Right?
Excessive bail shall not be required, nor excessive fines imposed, nor cruel and unusual punishments inflicted

Daesh is counting on that.

They would also like us to forget The Ninth:

The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people

And The Tenth:
The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people

We are doing exactly what Daesh wants us to do. We are arguing with each other over semantics and specifics instead of focusing on the system.

You know what Daesh hates? What happened spontaneously in front of Stonewall last night. What happened in Los Angeles.

What happened in Athens, Brussels, London, Paris and Sydney.

Daesh hates it when ‪#‎LoveWins‬. You want to fight Daesh? You want to part of the solution instead of part of the problem?

Be unexpected. Jailbreak the system.

Daesh isn’t counting on that.


So I have been gone for a while because I was involved in IRL stuffs

So I have been gone for a while because I was involved in IRL stuffs.

As a result, I have become involved in various nursing advocacy groups (that are quickly becoming astroturfed, but that is another post).  I came across this gem today and just had to share the fabulous ideas promulgated by “Advisory Board” which appears to be a faceless consulting organization run by idiots with MBA’s who are desperate to pay back their student loans.

A colleague informed me that these fabulous recommendations  came from Steven Berkow.  He has a JD. It was expensive (I will be starting my own shortly, so I know how much debt I will be in) and stressful, because it took all his hair (I love bald guys. My husband is a bald guy).

Anyway, as an engaged nurse who owes $100,000 in student loans for my MSN, I thought I would provide by own scholarly perspective.  Okay in reality I just got off work and I am having a beer (hey it’s three o’clock somewhere) and got on my computer so I could actually address this *bullshit*cough* point-by-point.  In other words, TLDR warning but somebody had to say it.  I will try not to swear.  Promise

Hey – if it’s gets enough views I might make a swanky PowerPoint to make it all professional.

I see how long this is, so here is musical accompaniment.
15 best practices for improving nurse engagement

Translate Market Forces into Frontline Terms

    • Executives host unit-based, town hall forums
      • My facility does this.  Nobody attends because we actually work for a living and they are not paying us to be there. If I am not getting paid I am not getting dressed up to hear Dr. Fancypants w. Alottamoney, MBA, RN, NEA-BC, CENP, CPHQ, FACHE, verb nouns and noun verbs in an attempt to use jargon to obfuscate the fact that she in reality has absolutely no idea what is going on.
    • Staff nurse liaison relays information from senior leaders back to peers
      • Pray tell who is going to be hired for this position?  Nobody.  You are just going to have numerous meetings daily and force the charge nurse (who has actual work to do) to go to these meetings.  Then you will institute a “huddle” at change of shift where the charge nurse will disseminate the same information day after day to the same people who have to be at work early to clock in and sit around waiting for the charge nurse to be done doing the actual work s/he was unable to do while sitting in meetings so that s/he can read a prepared script and mispronounce all the big words.
    • Interactive exercise shows managers how adverse events affect unit budgets
      • if the managers do not know this, they need to be back on the damn floor (oops. I owe someone a quarter).
    • System identifies, addresses rumors circulating among frontline staff
      • this would be great is someone actually addressed the rumors instead of reading off prepared talking points in a disingenuous attempt to placate staff with empty reassurances and bullshit (another quarter, sorry).

Rationalize the Flow of Change OR who comes up with this horse pucky?

    • Limiting organization-wide emails helps minimize change fatigue
      • Actually, if the bloated administrative assistants would quit sending me stupid emails regarding crap that has nothing to do with my job, that would be great.  Also, I do not care what new MLM diet plan that marketing chick is selling.
      •  Get off my lawn.
    • Email color coding indicates priority level
      • no dumbass it takes up valuable bandwidth, just like you.
    • Change events calendar maximizes awareness, minimizes overlap
      • !!!!NEWSFLASH !!!!
      • We are working twelve hours a day, sometimes at night.
      •  No, I am not waking up at 0400 when I WORK NIGHTS so I can commute to a job when I am not getting paid to partake in your heart health/diabetes month/pride parade for patient safety.
      • No, this is not high school and even then I never went to pep rallies. I was behind the bleachers doing important things.

Pursue Quality Ideas Over Quantity (like “work smarter, not harder lol)

    • Structured idea submission form focuses suggestions on organizational challenges
      • WTF does this even mean?  Your organizational challenges revolve around making a profit.
      • We all know this.
      • Quit hiding it.
    • Frontline staff asked to not only identify challenges but also suggest solutions
      • Great idea!!  I tried that. I GOT FIRED.
      • Screw you meatpie I wasn’t born yesterday. I know that if good ideas do not appear to spring from my superior’s heads they will be ignored or sabotaged.
      • I also know that I should curate favor with my superiors by letting it appear they come up with all the good ideas so I can keep my job.
    • Idea progress board allows daily vetting, tracking of potential process improvements
      • This person sounds like they attempted to get one of those karate belts in LEAN and had their ass kicked by Sonny Chiba, Bruce Lee,  and Jackie Chan simultaneously.
      • I have an *EXPLETIVE* MASTERS DEGREE.  I *know* the Toyota way better than you asshole and you are screwing it up (I think I may owe y’all a dollar by now, just run me up a tab).

Build Meaningful Recognition into Leaders’ Workflow (I almost spit my beer out.  I now require another)

    • Frontline recognition kit equips managers to mail staff hand-written notes
      • If my manager gives me a hand-written note it *better* have a Starbucks card attached.
    • Special staff rewards, recognition triggered by specific performance criteria
      • See above. Also, take that Daisy BS and shove it up your ass along with all the nurse’s week crap you keep handing out.  I know that this will only happen when CMS gives the facility full reimbursement, which will *never happen* since CMS regs are *designed to prevent* them from fully reimbursing you greedy corporate whores.
    • Weekly organization-wide email recognizes individual/team achievements
      • *blinks*
      • I thought above you said we were not going to get the bullshit emails anymore.

Broaden Access to Nontraditional Development Opportunities (they do not have an appropriate emoticon for my reaction to this statement. Imagine an angry cactus that is also bewildered)

    • Have staff members build customized professional development portfolios
      • I gave you my fucking resume before you hired me.  If it wasn’t good enough then why am I here?
      • Asshole.
    • Internally train high-potential staff and backfill with new hires to reduce costs
  • I literally laughed out loud at this.”backfill with new hires” like new hires are dirt. Backfill. That’s rich.

    What exactly is a “high-potential” staff? Young, uneducated, and stupid? Or old, over educated and desperate? If the latter, sign me up. I am sick of the bedside.

    Because of crap like this.

Adam Lanza’s mother is at it again

That sinking feeling you get when someone not satisfied with their fifteen minutes shows up on your morning news from NPR as you drive home from work.  We just lost the greatest musician of all time.  Several of them.  In a row.  Our electoral process has reached a level of buffoonery  that makes us the laughingstock of the developed world.  Thousands of people are dying due to a civil war in the middle-east that we helped create. Xenophobia and racism are preventing us from helping those people.  Again.

None of that matters this morning, however, because we have the inspiring story of Liza Long, who struggled mightily with the internet four years ago after her attempt to capitalize on a national tragedy for her own gain.

Interesting that after being ignored for a period of time this woman once again finds a way to use her son to get attention.  I heard the interview on the way home from work today and it brought back the same flood of emotions I had when I first read the viral “essay” penned by what I can only characterize as a narcissistic windbag.  I am glad her son got the help he needed, but since her feelings, her emotions, and her issues are the only things she seems to be interested in, let us discuss those instead.

” ‘I really felt like a failure on that day,’ she says. ‘Here I had this child, he had seen multiple doctors, multiple specialists, numerous medications. Nothing had helped my child, he had been in juvenile detention four times at that point, every time for a behavioral symptom of a brain disease,’ she says…..

Two days later, the news broke out of Newtown.

‘I just put my head on my desk and started to cry,’ Long recalls. ‘I just had this overwhelming sense of empathy for Nancy Lanza. I know at that point people were already blaming her, but instead I could just see in my mind this little boy who probably had needed help.’ ”

“Hey wait
Great smile
Sensitive to faith, not denial
But hey whose on trial?”

In the original essay she wrote

“I am sharing this story because I am Adam Lanza’s mother. I am Dylan Klebold’s and Eric Harris’s mother. I am James Holmes’s mother. I am Jared Loughner’s mother. I am Seung-Hui Cho’s mother. And these boys—and their mothers—need help. In the wake of another horrific national tragedy, it’s easy to talk about guns. But it’s time to talk about mental illness.”

No, you are not.  You have no idea.

“It took a life span with no cellmate
To find the long way back”

“I am Adam Lanza’s Mother” pissed me off.  At first, it drew me in, as I was a desperate working mother supporting her demented mother,  a mentally ill brother, and a aneurotypical child.  I have been supporting my family my entire adult life.  Mental illness runs deeper in us than coal in the Appalachians.  I know mental illness.  I know it better than the “anarchist soccer mom” could in her worst nightmares.  I am writing in hopes that she realizes she should shut her mouth.

Ms. Long tried to drug, and humiliate, and threaten, her son into submission, because she was too busy blogging, on the blogosphere, to be a parent.  When was she planning to bring up her children?  Was she going to do it whilst inebriating them with antipsychotics?  How then would they understand a word she said in the medication induced fog?  Oh wait,
if they did not understand she had them incarcerated.

See, I know about having a child you love arrested.  I know about putting them out on the street.  This piece elucidates the rationale behind the rhetoric.  Long’s whines echo like my own mother’s hyperbole as she shuffles across the floor, bemoaning her life of self-induced oppression, always making the most of any situation, as long as it gets her a sympathetic ear and a way out of actual effort.

“Anarchist soccer mom” – what a wonderful moniker; suggesting that Long actually was just an unemployed housewife trying to score off a national tragedy.  She called herself a “Freelance journalist” – code words for unemployed housewife- and it fell to pieces around her as she realized that her very public lamentations were of no use to those of us who have to accept our responsibility for our families.  Did she divorce her attorney husband who provided her with the excellent lifestyle she repeatedly bragged about because he found some sweet young trophy to take to parties, or did he leave her because she was a useless piece of detritus?

And this morning I heard that boy, just sixteen years old, with his rehearsed answers, fed to him through the lens of psychiatry and the “right medication,” still being used to garner his mother page clicks.  I sincerely hope that young man success in this life.  It will start as soon as he gets away from his mother.

My family has guns.   They have trigger locks that only I have the keys for in a hard aluminum case that only my husband knows the codes for.  We couldn’t even kill each other unless we cooperated.

Instead of furthering the partisan divide, by claiming mass shootings are a “mental health issue” when your son has shot no one, what we should concentrate on is meaningful discourse on how to preserve human rights from a philosophical standpoint as well as our legal rights under the constitution.  When viewed through such an impartial lens, many of our disagreements vanish and it is obvious that the Powers That Be will use whatever suits them from both the right and the left to increase their power at the expense of our rights.  This is the root of conflict theory, is it not?  Those with power will seek to retain control over the disenfranchised.

That is my problem with Liza Long, who claims to be a dead woman  shot by her son because she gave a mentally ill person access to firearms and the means to use them.  Her position supports the ideas that the mentally ill should be deprived of their rights, to life, to liberty, because momma knows what color pants you are wearing.

“why can’t we look the other way?
Why can’t we just play the other game?
Why can’t we just look the other way?”

Be careful who you align yourselves with.  Many of those with a “liberal agenda” are not liberals at all, in that they seek control over my economic freedoms just as those who claim to be conservative seek control over my social freedoms.  The most damaging bills passed by Congress were bipartisan responses to national tragedy that eroded constitutional freedoms for all of us.


Balancing Discernment with Racism

I was passed this blog post by a friend who requested that it be read. Very interesting perspective. The writer begins by establishing her street cred, stating:

“My family and I welcome refugees to our city by taking them to get their Social Security cards or medical screenings and I teach ESL one day a week. We have also welcomed refugees into our home for meals from many different countries over the past 22 months. We have done our best to befriend these newcomers to our city so that they will have the best possible chance to be integrated into American culture.”

Integrated. Okay, maybe her grasp of the English language is tenuous. I will read on. She talks about friends and family in Germany who have reservations about the refugee situation there. I would argue that that is a uniquely German problem, brought on by decades of guilt for being one of the few countries with the dubious distinction of a history of genocide. Russia also has that distinction, as does Turkey, (although they won’t admit it). The United States also has that distinction.

The Writer quotes Emma Lazarus as if the knowledge of a poem inures her to the one charge that still carries some weight – the charge of racism. I believe say this is the charge that still carries weight because the United States has her own history of genocide. America perpetrated her crime in a unique albeit historical way, one that is not instantly recognizable even by most Americans.   But I digress, let’s move on.

The writer then relates the following story after further establishing her credibility by reporting how she dutifully changed her profile picture on Facebook to signify solidarity with France (apparently a significant achievement). “An Iraqi refugee family that has been living in the U.S. for 18 months (father, mother, 2 grown sons, 2 high school sons) that my own family befriended chose to change their Profile Pics to the colors of the Iraqi flag.”

Newsflash – they have that right.

“Under one of the grown son’s profile pic, his mother (a woman that I have shared many dinners with) wrote in Arabic: ‘Go to hell, America. May God curse America and Israel to hell.’ I replied with a warning to use great caution when making online curses against a country that has taken them in, provided them with refuge, financial assistance and free education.”

Another newsflash – in the United States, we have the right to request that G-D curse whatever we want it to curse that day, in whatever way it sees fit, by whatever means it deems necessary. The Ku Klux Klan has the right to march and rally and assemble. Westboro Baptist has the right to picket funerals. Satanists, both real and imagined, have the right to gather in their covens or whatever they’re calling them these days and call down the four corners or raise the great Cthulhu if they so desire. They are allowed to do this in English or Spanish or archaic Chinese or Pig Latin, they are even allowed to do it in Arabic if they are as fluent as the writer of this piece claims to be.

She goes on “ Up to this point, there was no indication that there were any negative feelings toward the U.S. I took them to be very friendly, engaged, thankful refugees.”


We destroyed their fucking country over imaginary weapons, killed or exiled the men fighting in their armed forces, allowed an impotent government to take over simply because they were willing to provide us with oil, and then got the fuck out of there just as soon as the exiled forces had reconnoitered enough to form a Caliphate that destroyed all the ancient artifacts Hussain had carefully preserved.

They are supposed to be appropriately “thankful.”

The writer then deactivated her fascistbook account, ”but not before screenshotting this damning post and reporting it to the refugee resettlement agency.”

Well, doesn’t that sound familiar, especially to anyone aware of the progroms in the USSR or the Gestapo in Germany or the Red Scare in the US.

In her conclusion, the writer helpfully suggests a new vetting process “What are your thoughts on American culture? Will you be willing to adjust your lives to Western society and teach your children to value our values? Will you promise to learn English as quickly as possible and integrate into your local community? And maybe one of the toughest questions to ask of Muslim refugees: What is your prayer for Israel?”

Why aren’t we asking this of the Vietnamese refugees who came to this country after the last pointless, unnecessary war we waged? Why aren’t we asking it of the Jewish communities in our country who speak Hebrew, send their children to special schools, and live in neighborhoods segregated from the rest of us? And why is it so difficult for Americans to understand the Israel≠Jew?

Then a tell :

“If Syrian refugees would like us to accept them into our country, then they need to be ready to lock arms, neighbor to neighbor, with people groups they may have a cultural or religious aversion to: Christians, Jews and homosexuals. They don’t have to agree with those peoples’ religions and values, but they need to be willing to join this great American melting pot. If refugees cannot do this, then the United States should not be encroached upon to accept them in our midst. It would not mean that we rejected them, rather it would mean that they rejected us.”

 Dude, there are Americans unwilling to lock arms with Christians, Jews, and homosexuals. Last night white supremacists shot up a black lives matter protest. Just last week Asatru terrorists (you read that right) were arrested for plotting to foment a race war for their imaginary friend Odin. Someone is setting churches on fire. People at church meetings were been mowed down for the express purpose of fighting an imaginary war against America. I have more to worry about from the Peckerwoods and Aryan Nations adherents in my own backyard. Someone (not the Vagos) terrorized Hemet in 2010: “Attempts on officers’ lives included booby-traps attached to squad cars, a gas line routed into an office building and a bazooka rocket — which turned out to be a dud — fired from a rooftop.”

How many Syrian refugees have committed terrorist acts? None. Zero. Nada. Should I write that in Arabic?

What is a “Nurse Against Mandatory Vaccines”?

Surgeons against mandatory time-outs.

Aerospace engineers against mandatory pre-flight safety checks.

Animal Rights Activists Against Mandatory Spaying and Neutering.

Okay, that last one might actually exist. The first one results in the wrong limb being amputated. The second results in the Challenger Disaster. Nurses Against Mandatory Vaccines (NAMV) is going to result in people losing their jobs, and possibly result in the death of patients.

According to the Google, “Nurses Against Mandatory Vaccines was formed to help healthcare workers and other working adults avoid and speak out against forced and mandatory …” (the preview ends there, and I cannot find  those words repeated elsewhere). NAMV had a website, (which appears to be down, but NAMV has a blog that is still active) where “Members pay a $20 yearly membership fee.”  NAMV raised $644 selling t-shirts . NAMV also has a Facebook page that makes for interesting late night reading, especially if you support science based medicine.

As a RN I was disturbed by “Nurses Against Mandatory Vaccines,” as anti-intellectualism in nursing is deeply troubling to me. Not wanting to jump to conclusions, I went to the Facebook page and what I found was far worse than nurses who do not want to be told what to do. There is dangerous propaganda on that page and I believe it violates the “Nursing Code of Ethics,” specifically:

“Provision 2: The nurse’s primary commitment is to the patient, whether an individual, family, group, or community…

Provision 3: The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient.” (ANA, 2001)

So what did I do? I found out who was running NAMV and sent her a message. I explained my concerns, particularly the violations of The Code of Ethics for Nurses with Interpretive Statements, with specific examples from the Facebook page. She banned me from the Facebook page, blocked me on Twitter, and started scrubbing her affiliation with NAMV from the internet. This was over a year ago.

Why am I bringing this up now? It is another flu season, and another chance for NAMV to get free publicity, as they did last year when I first became aware of the group. I have seen healthcare workers proudly sporting their refusal to get the flu vaccine on the page. The 2015 campaign is hash-tagged #showmeyourmask. It is a brilliant piece of propaganda, because it is impossible to claim these healthcare workers are endangering patients. After all, they are wearing their mask.

The woman behind this group had a blog that was linked from the Facebook page. That has since been scrubbed, but her status as founder and CEO of NAMV is still available online. This is the person in charge of NAMV. I first noticed that she has not been a nurse for very long, receiving her Associate degree in 2010 after a year at Excelsior. Thereafter she went to Western Governors University, and received her BSN in 2011. She obtained Her MSN from the same institution in 2012. She then attended Kaplan University with the expectation of graduating and an “Adult Geriatric Nurse Practitioner” in 2015, before switching to Touro University Nevada for her Doctorate in Nursing Practice.

I wondered, how many years of experience does she have working on the floor as a nurse in an acute care setting? What was her specialty? Did she ever see patients on oscillating vents or nitrous due to influenza? I noticed that she was a LPN (license #4703103254) before she became a RN (License #4704282245). I was wondering what she did while taking all those online classes, before becoming an entrepreneur, selling T-shirts. Therefore, I looked up her work history.

She has been a Director of Nursing Education for CHE Trinity Health (2013-2014), a Case Manager for Hospice of Michigan (2012-2013), worked for Spectrum Health at an Urgent care clinic (2012), and worked “with the public inebriate program of Grand Rapids” for Mel Trotter Ministries (2011-2012). She worked for project Rehab (2010-2011) and was a LPN at the Salvation Army (2009-2010). It appears she also worked in Long Term Care, both as a CNA and LPN from 2004 – 2008.

So What? Other social media users regularly advocate against not only the influenza vaccine, but against childhood immunizations as well. They use their professional titles to spread misinformation and pseudoscience, resulting in decreased rates of immunization and increased chances of morbidity and mortality due to preventable disease.

I think it will take more than traditional public health models to combat this misinformation, since traditional models do not include the epidemiological view of social media. In this age, ideas go viral. This results in actual cases of disease transmission, as we have recently seen with pertussis and measles (Leask, 2011; Poland, & Jacobson, 2011; Salathe, & Khandelwal, 2011; ).

A woman with no acute care experience whatsoever heads the organization known as Nurses Against Mandatory Vaccines. She has been a registered nurse for less than five years. Meanwhile I have been working in the Intensive Care Unit seeing people die of influenza. It took me three years to obtain my Associates Degree over ten years ago (degree requirements). It took two more years to obtain my BSN at a State University. It took three years to obtain my Masters degree from the same university. The whole time I was employed full time as a Registered Nurse in an acute care hospital. I worked there for eight long years.

There are numerous well-researched evidence-based articles regarding the safety and efficacy of the flu vaccine. There are also valid reasons why healthcare providers should be vaccinated (Crislip, 2014; Cortes-Penfield,2014). The Facebook page “Nurses Against Mandatory Vaccines” is perpetuating myths, and silencing critics. This is not professional behavior.

There are physicians doing this as well. have “Doctor Bob” Spears, “Doctor” Gordon, and various other “Doctors” (Reiss, 2015; Tracy, 2015; Lah, & Brumfield, 2015) going on major media outlets, which purport to present the “other side” of the vaccine “argument.” The science says there is no other side and there is no argument (I could develop and cite this thesis but it would be a dissertation- for my Doctorate).

We, as nurses, are used to  advocating for our patients. We need to start doing it publicly (Orac, 2015). We also need to hold our colleagues responsible for spreading misinformation. I once worked with a nurse who said she was not getting the flu shot because she did not want to “put all those chemicals in her body.” I do not work with her anymore, but I wish I had said something when I had the chance. Crislip, (2014) or this (if you do not have a subscription to Medscape) is a good start. I got my first flu shot after realizing that I was one of those to whom Crislip was referring.

American Nurses Association. (2001).Code of Ethics for Nurses with Interpretative Statements.  (2010, November 15).  Silver Spring, MD: American Nurses Association. Available from http://www.nursingworld.org/MainMenuCategories/EthicsStandards/CodeofEthicsforNurses/Code-of-Ethics.pdf

Cortes-Penfield, N. (2014). Mandatory influenza vaccination for health care workers as the new standard of care: A matter of patient safety and nonmaleficent practice. American Journal of Public Health, 104(11), 2060-2065.

Crislip, M. (2014, October 6). Budget of Dumb Asses: 2014 Edition. Medscape. Retrieved from http://boards.medscape.com/forums/?128@@.2a794c48!comment=1

Lah, K. & Brumfield, B. (5 February, 2015). Anti-vaccine doctor Jack Wolfson goes silent. CNN. Retrieved from http://www.cnn.com/2015/02/05/health/anti-vaccine-doctor-jack-wolfson/

Leask, J. (2011). Target the fence-sitters. NATURE, 473(7348), 443-445.

Orac. (2015, January 27). Quoth Katie Tietje: Stop being mean to non-vaccinators!. Respectful Insolence. Retrieved from http://scienceblogs.com/insolence/2015/01/27/quoth-katie-tietje-pro-vaxers-are-so-mean/

Poland, G. , & Jacobson, R. (2011). The age-old struggle against the antivaccinationists. The New England Journal of Medicine, 364(2), 97-99. Retrieved from http://www.nejm.org/doi/full/10.1056/nejmp1010594

Reiss, D.R. (2015, January 18). Dr. Robert Sears misleads parents about measles and vaccines. Skeptical Raptor. Retrieved from http://www.skepticalraptor.com/skepticalraptorblog.php/dr-robert-sears-misleads-parents-measles-vaccines/

Salathe, M. , & Khandelwal, S. (2011). Assessing vaccination sentiments with online social media: Implications for infectious disease dynamics and control. Plos Computational Biology, 7(10), e1002199-e1002196. Retrieved from http://journals.plos.org/ploscompbiol/article?id=10.1371/journal.pcbi.1002199

Tracy, B. (2015, January 27). Doctor explains why he lets kids avoid the measles vaccine. CBS Evening News. Retrieved from http://www.cbsnews.com/news/doctor-explains-why-he-lets-kids-avoid-the-measles-vaccine/

The good ole days weren’t always good..

A recent blog posted here urged readers to “SUPPORT NICHOLE BRUFF AGAINST THE BRAVE NEW NURSING WORLD.” Along with this request was a list of opinions with which most nurses working today would probably agree. The lines that particularly resonated with me were at the beginning, and they are a masterful hook:

“Nursing has entered an authoritarian nightmarescape. It bows to the hegemony of corporate enterprise. Nurses’ every decision is controlled and pre-conditioned. Conformity to the nursing hierarchy’s dictates brings harmony and agreement. No one who lives in the Brave New Nursing World questions authority by raising alternative ideas. Nurses are produced on an assembly line of uniformity. All the basic rules of the nursing hierarchy are expected to be carried out by every nurse.”

As an iconoclast who has never been particularly fond of cliquishness, I immediately felt sympathetic to the protagonist of this story. I too was ostracized in school, including nursing school, and I too have never “fit” within the corporate hegemony that nursing has become. The more education I attained the harder it was to fit in with demands that I behave as an automaton, doing things “because they have always been done this way.” In my master’s program, I became particularly fond of the concepts of “positive deviance” and complexity science, ideas that ended up forming the basis for my thesis (Clancy, 2010, Gary, 2013). Having established my defense, I have to admit that many of my problems are my own. I am bookish, easily intimidated, and extraordinarily inept in social situations. I am also quite opinionated and never shy away from argument. This is not conducive to success in nursing, much less gainful employment. This however is not my story.

Something about this story was a little too familiar. The problem with supporting one person against the brave new world of nursing is that we risk throwing all of our support behind someone with an agenda that does nothing to further the profession or the nurses having to endure what it has become. Remember Amanda Trujillo? No? Such is the nature of the internet. I will leave readers to look her up and formulate their own opinions (Clavreul, n.d. Kennedy,2012).

Who is Nichole Bruff (Rolfe)? An internet search leads to many less than reliable sources touting her as the poster child of patient advocacy who was unfairly expelled from nursing school in 2013 for opposing vaccinations. As of 2015, she is suing the college (Ridley, 2015, Apr 9). She bemoaned a traffic ticket in 2014 (Devereaux, 2014, Apr 9). She also ran for county commissioner in 2010. Her LinkedIn profile lists her obtaining an Associate Degree in Nursing in 2011, but that she works for a car dealership.

So, what, besides vociferously opposing vaccines, has she done for the profession of nursing? Has she urged nurses to advocate for safe staffing ratios? Was she unfairly targeted for noting that nurses are increasingly burdened by meaningless metrics or policies and procedures that are not evidence-based? Was she fired for mentioning unionization?

We have a bigger problem in nursing, a problem that is hindering our ability to do our job and resulting in increased morbidity and mortality. Stories like this are a symptom of that problem. The conformist, hierarchical, servile tenets of nursing are not the “brave new world,” they are as old as Nightingale. This is the brave old world of nursing, reinforced by the use of patient satisfaction scores to determine reimbursement (Robbins, 2015).

Nurses are working twelve-hour shifts with one 30-minute break, caring for higher acuity patients than ever before. We are routinely yelled at, spat on, punched, kicked, bitten and cursed, and forbidden from defending ourselves. We deal simultaneously with antiquated technology that does not capture nursing workflow and innovative technology that does not improve outcomes. We have to lead doctors to the right decisions without them knowing it was someone else’s idea and sometimes risk our careers to achieve the best outcomes. We have to placate families who at best have no clue what is happening and at worst are getting their medical advice from Dr. Google. All of this has been going on since the beginning of nursing, except for the internet. Now we also have patient satisfaction, IE HCAHPS, which, according to Brookes & Fenton (2014, 11 Jun), has resulted in the following:
“analysis of data from more than 50,000 adult patients indicating that the most satisfied patients (highest patient satisfaction quartile relative to the lowest quartile) were 12% more likely to be admitted to the hospital and had both total healthcare expenditures and prescription drug expenditures that were 9% higher. Most perplexing to many readers at the time, these patients were also 26% more likely to die.”

The original study can be found here. We have a powerful new tool at our fingertips, the ability to communicate the value of nursing to the widest possible audience. We have the ability to advocate for our patients in an unprecedented way. We can fight for safe staffing (National Nurses United, 2015). We can advocate for a more efficient EHR. We can put an end to bullying.

Until nurses reject anti-intellectualism, and embrace science based medicine, we will be at the periphery of healthcare, relegated to increasing HCAHPS scores instead of what we have entered this profession to do. When we, as a collective, align ourselves with those of dubious claims, who are using the ephemeral internet hate machine to gain their fifteen minutes of fame, we denigrate nursing. Nursing is not about you. It is not about me. If you want to change the brave old world, instead of spending our energy on individual trials and tribulations, advocate for “the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations” (ANA, 2015).


American Nurses Association. (2015). What is Nursing? Retrieved from http://www.nursingworld.org/especiallyforyou/what-is-nursing

ArgusPress.com (2010, May 13). Nichole Bruff releases candidacy information. Retrieved from http://www.argus-press.com/news/community/owosso/article_e7cc4b76-5e9a-11df-b568-001cc4c002e0.html

Brookes, L. & Fenton, J.J. (2014, 11 Jun). Patient Satisfaction and Quality of Care: Are They Linked? Medscape.  Retrieved from http://www.medscape.com/viewarticle/826280

Clancy, T. R. (2010). Diamonds in the rough: positive deviance and complexity. Journal of Nursing Administration, 40(2), 53-56.

Clavreul, G.M. (n.d). The Curious Case of Amanda Trujillo and the Arizona Board of Nursing. Retrieved from http://www.workingnurse.com/articles/The-Curious-Case-of-Amanda-Trujillo-and-the-Arizona-Board-of-Nursing

Devereaux, B (2014, Apr 9). New insurance, new leadership: Village of Oakley looks to move away from controversy. Retrieved from http://www.mlive.com/news/saginaw/index.ssf/2014/07/oakley_works_to_define_new_lea.html

Fenton, J.J.; Jerant, A.F.; Bertakis, K.D.; & Franks, P. (2012). The Cost of Satisfaction: A National Study of Patient Satisfaction, Health Care Utilization, Expenditures, and Mortality. Archives of Internal Medicine 172(5):405-411. doi:10.1001/archinternmed.2011.1662. Retrieved from http://archinte.jamanetwork.com/article.aspx?articleid=1108766

Gary, J. (2013). Exploring the concept and use of positive deviance in nursing. American Journal of Nursing, 113(8), 26-35.

Kennedy,S. (2012, Feb2). The Case of Amanda Trujillo. Retrieved from http://ajnoffthecharts.com/2012/02/02/the-case-of-amanda-trujillo/

National Nurses United. (2015). Ratios: Implementation. Retrieved from http://www.nationalnursesunited.org/pages/ratios-implementation

Ridley, G. (2015, Apr 9). Baker College instructor told students to threaten patients into vaccinations, lawsuit claims. Retrieved from http://www.mlive.com/news/flint/index.ssf/2015/04/baker_college_taught_nursing_s.html#incart_river

Robbins, A. (2015, April 17). The Problem With Satisfied Patients. The Atlantic. Retrieved from http://www.theatlantic.com/health/archive/2015/04/the-problem-with-satisfied-patients/390684/

A new cancer

The recent vote to defund Planned Parenthood is interesting because most of what Planned Parenthood does is prevent unwanted pregnancy and provide care to pregnant women.

It seems that some of our representatives in Congress and others in our State legislatures want more unwanted pregnancies, carried to term. Meanwhile, the same people attack the social safety net (ACA, SNAP, TANF, etc).

Therefore, some of our representatives in Congress and others in our State legislatures want more unwanted pregnancies, carried to term, without prenatal care or support for the children that result. Meanwhile, educational funding in the form of grants is being cut, forcing those who seek higher education to rely on loans or forgo education altogether

The same representatives who want to defund Planned Parenthood, repeal the ACA, and slash welfare programs also enact legislation making it more difficult to unionize. These representatives also oppose increasing the minimum wage.

What can this possibly accomplish? A vast underclass that cannot advocate on their own behalf.

I do not think this is a “vast right wing conspiracy,” I think that this is what is happening, perhaps not by design, but through intent. Add to this the prison-industrial complex and the school to prison pipeline as aspects, and we have a situation. Our representatives in Congress and others in our State legislatures are not intentionally doing this, it is happening by accident, due to their policies.

This underclass will have only two choices left: work for corporations that pay the absolute minimum or join the military. Therefore, not by edict, but piece by piece, our representatives in Congress and others in our State Legislatures are trying to abolish the Thirteenth Amendment to the US Constitution.

Note that our representatives in Congress and others in our State Legislatures have actively campaigned for abolishing the Fourteenth Amendment, on which Roe vs. Wade is based.

Our representatives in Congress, and others in our State Legislatures, are attempting the reinstatement of slavery in this country.