A love letter to nurses. And not a sweet sappy nauseating tribute to the “angels of mercy” kind of thing.

Dana Jennings, an editor at the New York Times and a former prostate cancer patient, has written a nice opinion piece called “In Praise of Nurses.” In it, he recounts his experiences as a patient, beginning from when he was a child all the way up to his bout of prostate cancer. Unfortunately, he has had a few health problems which necessitated hospital admissions and care. Fortunately, he was cared for by competent and professional nurses.

It is nice to see this sort of article, in that he offers praise to the nurses who provided his care, without the usual idiotic sugar coated rhetoric. It’s not sentimental, but simply shows the vital role that nurses played in his care.

He appreciated it. He remembers them even if he doesn’t recall their names.

Thank you, Dana! Happy New Year!

Not sure how I missed this story considering that I used to work at this hospital.

D.C. hospital fires 11 nurses, 5 staffers for snowstorm absences

The Washington Hospital Center, which I believe is the largest facility in the area, fired several nurses because they were unable to show up at work during one of the worst–if not the worst–snowstorms in the city’s history. Strange how most of the nurses that were canned have seniority and have been there a while. What a nice way of getting rid of the best paid people and those that might come around begging for a pension sooner rather than later.

In a letter sent to the staff on Friday, hospital President Harry J. Rider sought to quell rumors that hundreds of people had been fired. He said he expects fewer than 20 people will be dismissed.

“Sadly, we did experience some issue with associates who did not show the same commitment as most of their co-workers to the community, our patients and their fellow associates. They are the few who turned away from their scheduled shifts and who tried — and are still trying — to turn the focus on themselves rather than the thousands of Washington Hospital Center workers who fulfilled their commitment to their patients and colleagues, and made it to work,” he wrote.

I wonder if Henry and his other peons managed to make it into work during the snowstorm, and show their “commitment” to the hospital. Did management make it in?

If they hospital was really committed to its staff and patients, they would have made an effort to help nurses get into work. Send out army humvees if need be, but get the nurses to work. Or offer to pay them to come in ahead of the snowstorm, and give them a place to stay. It works both ways, Henry. Nurses are committed to their jobs, but they are not about to kill themselves trying to make it to work, or abandon their children (I guess that Henry never thought of that either–that schools and daycare were closed, so what should nurses do with their kids–not that he’d think to offer daycare at the hospital’s expense).

On one forum, some nurses were saying that their hospitals expected them to come in ahead of time if a storm or something was anticipated. They didn’t get paid for their time, and they could stay in an empty patient room, or stay in a hotel at their own expense. And baah baah baah, most nurses just follow like sheep.

Well I hope all of these fired nurses suit the crap out of the WHC, and in another article, it says that the nurses have voted to become part of a larger union. Yay!

Happy Veteran’s Day to all vets out there. And in keeping with the theme of this blog, I will specifically acknowledge healthcare workers who have served in the military.

Nurses became a formal part of the military following the Spanish-American War, after about 1500 civilian nurses had been contracted to serve in Hawaii, Cuba, Puerto Rico, Guam and the Philippines, as well as to the Hospital Ship Relief.

The Army Reorganization Act of 1920 gave nurses a little more status–and granted military nurses the status of officers with “relative rank” from second lieutenant to major (but not full rights and privileges). It wasn’t until after WW II that nurses were given permanent commissioned officer status.

Should be everyone’s worse nightmare, but in all fairness, some places are better than in others.

Florida, and in particular South Florida on the Atlantic side, is probably not one of the best places to either be a patient or to be an employee.  The pay sucks, unions are almost non-existent, the work force transient (there’s always an enormous number of travel jobs available in Florida), and basically, it shows.

No, I haven’t done a survey or scientific study, but many of the hospital horror stories take place in Florida. Nurses on forums report the often pitiful wages paid to them, and the severe under staffing. And although I worked in Florida quite a long time ago, I felt like I had gone back in time 20 years.  I briefly worked on staff and then through the registry/per diem, and it was an overall nightmarish experience.

But now, I guess I am aiming on one facility in particular. My mother fell and broke her hip, and I have to deal with an assortment of people, ranging from nice and helpful to total incompetent morons. We can start with someone from the county sheriff dept, who didn’t know where Seattle was and thought that I could just get in my car and drive right over. He didn’t seem to understand the distance from California to Florida either. And this is someone who is an officer of the law?

Next, the hospital operator was a total moron, who kept transferring me to arbitrary voice mails and fax machines.  The floor nurses were okay, although they could have been more helpful. I realize that they are probably extremely short staffed, and don’t have time to chat with me, and probably wish that I would just come in and take care of my mother. When I spoke with my mother, before she had surgery, she was trying to get a nurse to come because she had to use the bathroom. And nobody had bothered at first to help her with her hearing aids. They assumed she was demented because she couldn’t hear them.

The ER nurse had asked for my permission to do surgery because my mother is “demented.” Granted, my mother has a lot of mental problems, and she can drive you up the wall, but demented she’s not. I told the ER nurse that I would give my permission, but that the women was dehydrated, had been traumatized, did not have her hearing aids–and that does not add up to dementia.

The best one was this moron nurse caseworker (yes, she is a moron) who called me from the hospital and was trying to talk in that silly “nurse talk” like I have an IQ of 10.  Uh, I don’t think so. She wanted to know if I was the one who would help my mother make a decision on where to go for rehab. I told her that she might first try by asking my mother if she has a preference, or maybe doing something really radical like asking her primary care physician?

We already established that I live 3,000 miles away, so why would she think that I would be familiar with rehab in their area? Or does she think that I spend my spare time reading up on rehab in Florida. She seemed a little surprised by my answer–like it never occurred to her to ask the patient, or doctor.

Anyway, that’s my rant for today. My stepfather died in this hospital, and the ICU nurse that I spoke with right before he died was about as intelligent as the nurse case worker described above.  I’m not impressed with the place, and again, I imagine that the employees are overworked and poorly paid. The caseworker couldn’t wait to push me off the phone. Nice customer service.

I have long been opposed to this idiotic system of licensing nurses (and other healthcare professionals) state by state. There is one national licensing exam, and therefore, there should be one national nursing license.

The system as it exists now, allows individuals who have lost a license in one state, who are considered incompetent or even dangerous, to simply pack-up and move across state borders.

From the LATimes:

Because there is no federal licensing of nurses, each state sets its own standards on punishable behavior.

In general, states can discipline a nurse based solely on the actions taken by another state. But they vary widely in how quickly — or harshly — they act on this information, according to interviews with regulators in 14 states.

Under the law in Virginia and Louisiana, for instance, officials must immediately suspend nurses’ licenses for serious misconduct in another state. Nurses are barred from practicing unless they successfully appeal.

Missouri, on the other hand, must personally serve all accused nurses with written charges and offer hearings to contest them. If nurses can’t be found, their licenses remain clear and they are free to continue practicing, said Lori Scheidt, executive director of Missouri’s nursing board.

Delays in several states left Craig Smart free to practice. In 2000, he surrendered his license in Florida after testing positive for cocaine and flunking a treatment program. It took eight years for five other states in which he was licensed to respond to Florida’s action. California was the last to revoke his license, in 2008, after he had practiced here for several years, apparently without incident.

Even when states share borders, they sometimes fail to heed each other’s disciplinary actions. At least 10 nurses, for example, hold clear licenses in Massachusetts despite being disciplined next door in Rhode Island, including suspensions for drug thefts and violence.

Nurse Karen Rheuame’s Rhode Island license was suspended in 2007 after she was arrested on suspicion of assaulting a woman in a wheelchair in a hospital emergency room and trying to steal her pocketbook, according to state disciplinary records. She also had numerous other convictions and, records show, had once brought two beers to work, which she explained to her boss were for “the ride home.”

But she’s free to practice in Massachusetts. A health department official there said regulators are reviewing Rheuame’s case and others to see if action is warranted, but they haven’t received any complaints about the nurses in Massachusetts.

A unified national system would eliminate this. But of course, state Boards of Nursing would be reduced in size and number. They basically exist to keep this inefficient and dangerous system alive, and as we can see, they are totally inept in doing their job. Having dealt with the Board of Nursing in Washington state, regarding renewing a license, I can vouch for the lack of professionalism and total self-importance seen at least in this state. It took a threat to the governor’s office and other state regulatory agencies, for them to refund money owed to me for licensing fees.

State agencies would need to exist, but in a smaller form, and with less power (and yes, the BOR does not want to get off its power trip). Forcing a nurse to be licensed in each state is simply a means of revenue–it supports an unnecessary BOR, and allows incompetent/dangerous nurses to continue working.

Yesterday I posted about a new addition to the nurses health study, and put out the word, as requested, to recruit more victims..uh subjects for the study.

Now, there is nothing really wrong with the study, except that the data is used to make sweeping conclusions and statements about health. In my opinion, many of the questions are highly flawed in that they don’t allow you to answer correctly. In the questionnaire on diet and supplements, for example, they asked about your intake of fruits and veggies. They have a note in the margin that says..

Please try to average your seasonal use of foods over the entire year. For example, if a food such as cantaloupe is eaten 4 times a week during the approximate 3 months that it is in season, then the average use would be once per week.

Are they kidding or what? But yes, that’s what it said on the questionnaire. As if eating peaches a few times a week when they are in season and then not eating them all winter is the same thing as eating one peach a week all year round. So in other words, the nutrients and fiber that you get from a peach sort of paces itself, just a like a timed release capsule.

Now if that isn’t dumb enough, do I really know how many cups of blueberries I eat a week? I don’t measure them out, I just eat them. How many apricots do I eat in a week?

The only way to keep an accurate account is to have a food diary. But this is to be done from memory.

In some part of this particular questionaire, you also cannot specifically say that you don’t eat a certain food, ever. They give you a choice of “never or less than once per month.” That is not the same as never eating it.

In a few questions, they don’t even give you that.  For example, they ask “How often do you eat toasted breads, bagel or English muffin (e.g., slice or 1 half bagel)?”

There is no way to answer that you don’t eat toast, bagels or English muffins. The “least” answer is less than once a week.

Also omitted are very crucial questions pertaining to the type of food you eat. They ask about adding sugar to beverages, but don’t really ask about the consumption of sugar laden–yes, there are questions about eating cakes, cookies, etc, but it really doesn’t give a full picture. They also don’t ask about the amount of processed foods eaten, about foods containing questionable additives, organic foods, amount of raw food eaten, etc.  If the produce you eat is fresh vs. frozen vs. canned.

The questions about breads, cereals, etc, do not allow you to say that you eat whole wheat pasta, for example. Or sweet potatoes as opposed to regular potatoes. The list of vegetables and fruits  they ask about is pathetically small, and at the end, they allow you to add in any other “important” foods. Three to be exact. Wow, generous.

They ask about eggs, but nowhere can you enter if you eat free range/organic eggs. You can’t say that you absolutely eat no processed meats whatsoever. Or do not drink soda, diet or otherwise.  They list soy products, such as burgers, miso, tempeh, etc, in the vegetable section. I realize that soy is a vegetable, but many people eat it as a main dish, as in soy burgers and hot dogs. They really should split it up–soy as vegetable like edame, and put soy main dishes in a separate category. Ideally, they should really have a separate list for people who eat no meat at all, because it is impossible to answer this questionaire accurately if you happen to adhere to a vegetarian or vegan diet.

Anyway, this questionnaire is really sad, and it is frightening that they are pulling data out of it and drawing conclusions about diet and health. There is so much missing from it, and it relies totally on memory…oh, and idiocy like pro-rating your peach intake.

That was just to draw your attention–it’s not as bad as that. But if you, meaning nurses, are interested in participating in a study–here’s your chance. And its not just any study, its the latest phase of the hallowed Nurses health Study. Yes, that Nurses Study.

If you sense a bit of sarcasm in my tone, well, you’re right. I have very mixed feelings about the results that pop out of this study periodically, being that I have been a participant for 20 years. The methodology is somewhat questionable, as are many studies that rely almost solely on self report. This is especially true of the NHS, which relies on self reported questionnaires that ask questions that are near impossible to answer correctly. Plus, the data they collect has a lot of omissions in it that I think could really affect their results.

Self-reported questionnaires can be useful and accurate if they are focused on one narrow subject, such as side effects from a specific medication, or if yoga has relieved back pain.  But the questions they ask are epic in nature and require things like remembering how many peaches you eat a week, how many hours you stand at work per day…now, unless you are closely monitoring diet/exercise/patterns of daily life, at best, this is something you will only approximate.

Anyway, I’ll discuss it more tomorrow, but I just wanted to make the announcement, in case any nurse is interested in signing on.

For the new cohort,they are enrolling 100,000 or more female RNs and LPNs between 22 and 45 years old (born after January 1, 1965). The new study will be entirely web-based, as roughly half of Nurses’ Health Study II is already. To learn more and to join, nurses should visit www.nhs3.org

No, fortunately, there are people left with working brains. The shooting incident at Johns Hopkins Medical Center was tragic and certainly, terrifying for employees and visitors alike, but precautions have to be reasonable.

Nurses have long been at the receiving end of violence, as they are a vulnerable group due to the nature of the job. This time a physician was shot, which is a more unusual case.

Hospital security often sucks big time, to put it bluntly. Parking garages are often poorly monitored, if monitored at all, security is slow to come when called, security staff is often spread very thin, and there is often just a general lack of standard safety features such as good lighting at night in garages and walkways around the facility. In addition, nurses have often been discouraged from reporting incidents, or even threatened if they do so.  Accusing patients of violence does not make for good PR or customer service.

So in a way, this incident has helped bring to light that violence is a way of life for healthcare workers and that is an area in dire need of improvement. But metal detectors is not the answer since most violence does not involve guns. In fact, it may involve equipment that is already inside the building–a chair thrown at a nurse, for example. Or just being hit, bitten, punched, kicked…

Hospitals need more security and to get rid of the stigma of reporting a crime. Nurse and other staff need to be supported, not criminalized. Disruptive patients, family members, and other visitors need to be shown the door.

From the Baltimore Sun:

While Hopkins has long focused on safety at its sprawling medical campus in crime-plagued East Baltimore, the hospital does not require patients or visitors to pass through metal detectors, as Americans must do now at airports, courthouses and many federal buildings.

With a weekly stream of 80,000 patients and visitors, imposing such security restrictions is “impossible,” Hopkins officials say — and security experts agree. Even as violent incidents appear to be on the upswing at hospitals, they need to remain welcoming places, experts say.

Can you imagine metal detectors in a large hospital like Hopkins? It would take hours just to get inside the building.  As I said, it is fortunate that people are thinking with their brains for a change of pace.

Apparently, the National Nurse movement is alive and well, and still trying to push through an Office of the National Nurse. While all of the arguments for it are well and good, the bottom line is–is this something that we really need to be spending money on?

What many people don’t realize is that there is already a Chief Nurse Officer of the Public Health Service. Just expand this role a little, and you’ve got a national nurse. Make this nurse a little more visible. The bill that the National Nurse advocates are trying to get pushed through lists all of the responsibilities that the new National Nurse would have. But in reality, none of them are new, or require the formation of a whole new office.

In fact, some of it is really a little naive. I wrote up an article about this a few years ago, and one of the people I spoke with was–shall I say–quite unrealistic in what she thought that a nurse was going to accomplish. She kept repeating to me the rhetoric of how nurses are the most trusted profession, and how people listen to nurses (ummm…then why are they so abused in the workplace and so powerless), and so on. But that doesn’t translate to everyone dropping what they’re doing to come and listen to a nurse speak. Or that they will pay more attention to head honcho nurse than the Surgeon General.

Duties- The National Nurse shall carry out the following:

• `(1) Provide leadership and coordination of Public Health Service nursing professional affairs for the Office of the Surgeon General and other agencies of the Public Health Service, including providing representation for the Government of the United States at the Global Forum for Government Chief Nursing and Midwifery Officers and serving as a member of the Federal Nursing Service Council.

• `(2) Represent the Surgeon General and the agencies of Public Health Service in communications with groups and societies concerned with nursing issues at the local, State, national, and international levels.

• `(3) Provide guidance and advice to the Surgeon General and the Nurse Professional Advisory Committee on matters such as standards, recruitment, retention, readiness, and career development of nurses employed by and contracted with agencies of the Public Health Service.

• `(4) Conduct media campaigns and make personal appearances for purposes of paragraphs (5) through (7).

• `(5) Provide guidance and leadership for activities to promote the public health, including encouraging nurses and other health professionals to be volunteers and developing projects that educate the public about and engage the public in prevention practices to achieve better health.

• `(6) Provide guidance and leadership to encourage nurses to become nurse educators.

• `(7) Provide guidance and leadership for activities that will increase public safety and emergency preparedness.

Is there anything on this list that requires a whole new office to be set up? No. Is there anything on this list that the current CNO of the public health service can’t do? No.

Plus there are a lot of vague statements, like number 7. What kind of guidance, exactly, is the National Nurse going to provide? Go around and check up on all of the state and local public health departments? What those places need are more funding and manpower, not a National Nurse “giving guidance.”

Number 6 is not only naive, it is downright silly. Do they really think that “words of wisdom” from the nurse in the sky are going to convince nurses to become educators? That the only problem in convincing nurses to go into teaching is the “lack of guidance”  or “leadership?”

It sounds all nice and good in a document, but in reality, RNs with a 2 year degree from a community college can make more money than an educator with a PhD.  Bottom line is that nurses are not becoming educators because they can make more money (a lot more money) working in other areas of nursing. You need at least a master’s degree to teach, and a PhD if you hope to get a tenured position. Higher degrees cost money, and if you’re going to invest in education, then there are many more opportunities awaiting–for much better pay, that are a lot more interesting, that allow more independence and career advancement, and lack the headache of academia.

So unless the National Nurse is going to work some magic and substantially increase the pay of nursing instructors, nurses are not going to drop what they’re doing and run off to teach school–just because the National Nurse offers them “guidance.” All of this stuff sounds so nice and proper on paper, but in reality, its just silly talk.

If we didn’t already have a CNO in the public health service, then I would say we should consider the National Nurse. But all that needs to be done is expand the current CNOs role a little bit, and let him/her become more visible. That would involve minimal spending, and could easily be put into place.

On yesterday’s theme, about shortage vs. surplus, one thing we don’t need is money spent on more scholarships and funding to increase nurses. There are more than enough nurses, if only hospitals would hire them and improve working conditions.

We don’t need to waste money on trying to push more nurses through school. One major reason is that people will jump at the chance to take the funding, whether they really want to be a nurse or not, because they’ve “heard” that nursing is a recession proof career and plus they’ll get to go to school for free.

So Obama, you’ve got the wrong idea and you’re talking to the wrong people. This constant nonsense about the nursing shortage when nurses can’t find jobs is really getting old. How about using all that scholarship funding to to help fix the broken system? There’s a nursing shortage because hospitals aren’t hiring and working conditions suck–not because nurses are in short supply.

President proposes nurse scholarships

AACN Applauds the President’s FY 2010 Budget Request

President Proposes to Increase Funding for Nurse Loan Repayment and Scholarship Programs from $37 Million to $125 Million

WASHINGTON, DC, May 7, 2009 – Today, President Obama released his FY 2010 Department of Health and Human Services Budget that provided specific details on the funding levels he has proposed for nursing education and research programs. The American Association of Colleges of Nursing (AACN) is thrilled that the Administration provided $263 million for the Nursing Workforce Development Programs (Title VIII of the Public Health Service Act) and $144 million for the National Institute of Nursing Research (NINR).

The proposed funding for Title VIII programs represents a 54% increase over the FY 2009 level of $171.03 million. The greatest increase was awarded to the Nurse Loan Repayment and Scholarship Programs, which received $125 million, a 238% increase over last year’s funding level. The Nurse Faculty Loan Program received $16 million, a 39% increase over the FY 2009 level of $11.5 million.

“President Obama is a true champion for nursing. This proposed funding allocation marks a historical point for nursing education, recruitment, and retention,” said AACN President Fay Raines. “If the President’s request passes Congress, it would be the highest allocation these programs have received since created in 1964. AACN will work diligently with our top nursing advocates in the House and Senate to see this funding level enacted.”

The President’s request would offer significant relief to help alleviate the 11-year national nursing shortage that is projected to grow in the coming years. According to the U.S. Bureau of Labor Statistics (BLS), nursing is the nation’s top profession in terms of projected job growth with more than 587,000 new nursing positions being created through 2016. The demand for nurses will continue to grow as the baby boomer population ages, experienced nurses retire, and the need for primary and specialty health care intensifies. BLS projects that more than one million new and replacement nurses will be needed by 2016.

AACN is also pleased that the President’s budget proposes a 1.4% increase for NINR over last year’s funding level. Moreover, the President’s budget outlined that the NINR will receive $36 million in funding from the American Recovery and Reinvestment Act that would potentially bring the total for FY 2010 to $180 million.

“This substantial investment in nursing education and research signals a strong commitment to ensuring the availability of quality nursing care to all Americans,” said Dr. Raines. “AACN looks forward to working with members of the nursing community to secure these funding levels and will continue to work to advance nursing’s role in the national discussion about patient-centered healthcare reform.”

Here they are, happy grads, ready to go on the unemployment line, where most new graduate nurses are ending up these days.

As many nurses and wanna-be nurses have realized, the late great nursing shortage has virtually vanished. In its place has come a shortage of jobs. So what the…?

To reiterate, as most of us intimately acquainted with healthcare know, there was never really a shortage of nurses, as in living breathing bodies with an RN degree. Rather, nurses were leaving hospitals and healthcare altogether for greener pastures. Hospitals claimed to be interested in hiring more staff, and the drum roll was on to open more nursing programs, shorten the programs currently in existence (to push out fresh new grads sooner), or to break down the barriers to hiring foreign workers.

The idea, as many guessed, would be to flood the field with warm bodies, so that for every nurse who quit, another was waiting to take his/her place. Thus, the perpetual revolving door.

And now, with the current economic status quo, hospitals have jumped full force into the “poor me/financial woes” bit, and have frozen hiring, laid off workers–the whole 9 yards and then some.

To be fair, many facilities were facing financial problems before the great bust, but many were not. And many, as we know, dished out exorbitant executive bonuses at the same time workers were being slapped with their pink notices. And the economic situation was a prime excuse not to hire on more nurses and other staff, and just “make do.” Who needs nurses, aides and housekeepers when you’ve got suits and stockholders to keep happy and smiling?

Here is an excerpt from an interesting story that appeared online at AJN, and it is the epitome of what many nurses are now facing:

Although patient acuity and nurse skill level are considered in making shift assignments, certain situations can’t be predicted or planned for. An extra workload will always negatively affect the nurse and the patient. In the best of circumstances, the nurse won’t get lunch or breaks and the nonessential elements of patient care, such as baths and linen changes, will be skipped. The busier the assignment, the more likely that something critical will be missed. (For more on this, see the Muse, RN’s blog post, Nurse-Staffing Ratios: Nurse’s Perspective.)

I heard her say, “An extra patient shouldn’t make any difference in the standard procedure for passing medications.”

Does anything more need to be said? It would be just karma if that nurse manager ever became ill or in an accident, and she was that “extra” patient that the nurse got stuck with. And then faced the consequence.

This is rather frightening and also disturbing, although not surprising. It has been known for a long time that people can become ill from “second hand chemo” but now the subject is finally getting some attention.

Thanks to InvestigateWest, the story has now come out across the cyberwaves. MSNBC picked it up, as did the Seattle Times and a few others.

What is most disturbing is that the federal Occupational Safety and Health Administration does not regulate exposure to chemotherapy in the workplace, despite multiple studies documenting ongoing contamination and exposures and their potentially deadly consequences for human health. Studies going back 30 and 40 years ago have already shown this, but amazingly enough, OSHA has no regulations in place.

And it’s not because it’s a girl thing. I know, that’s what a lot of you are thinking–that this mainly affects nurses and nurses are a bunch of powerless little girls, so who cares if they “catch” cancer from their patients. Well, one of the primary targets of second hand chemo are pharmacists, a profession well represented by the male gender. Another healthcare profession at risk are veterinarians.

So why is OSHA lacking here? Why do individual hospitals, clinics, offices, etc, have to mandate their own regulations? And for the ones that don’t, there is no penalty.

This video is really sad, and shocking.

In the aftermath of the tragic earthquake in Haiti, many nurses have responded to calls to volunteer their services. It is commendable that so many thousands of nurses (and doctors and other healthcare workers) are willing to travel to a devastated nation to offer what help they can. On the other hand, many who volunteer on the spur of the moment may need to rethink their plans.

I’ve been reading a few articles about this, and all of the experts agree on one thing–if you want to volunteer, do not do so on your own. Do not get on board a plane and expect that you will be cared for once you hit the ground. This is not the movies or TV. This is real life, and volunteers who arrive without a plan or contacts tend to become part of the problem rather than the solution.

Join a reputable group, such as Medecins san Frontieres (Doctors without Borders), Americares, Partners in Health, etc. National Nurses United is organizing nurses in the U.S. But please, find a group to support you and who will direct you once you arrive.

Next, reevaluate your skills. While all kinds of healthcare workers are needed, right at this moment, the greatest need is for surgeons, surgical nurses, anesthetists, trauma care specialists, post-op nurses–basically, trauma care is the greatest need right now. If you work in psych and have never worked in a surgical setting, now might not be the best time to go. Your skills may be needed later on, after the immediate crisis, but you need to think carefully if you can truly be of help right now.

Third, take a long hard look at the situation. There is nothing romantic about going to a devastated nation, especially one that was already on the edge. Conditions in Haiti were pretty deplorable before the earthquake hit–ravaged by hurricanes and storms over the past few years, civil unrest, abject poverty, poor infrastructure, high rate of infectious disease—well, you get the picture.

Conditions are pretty bad, and as a volunteer, you are not going to be housed at the Ritz Carleton and get catered meals by a fancy French chef. It’s rough going, and you are going to be putting yourself at risk of infection, and injury. In addition, there have been many aftershocks, so the earth has not yet settled down.

Violence and looting have taken hold, so you would also be at risk in that sense.

It will be dirty, with poor to no sanitation. There will be terrible sights to behold–thousands of people with nowhere to go. Injured people unable to get help and living in the streets. Corpses piling up. Unbearable smells.

Many volunteers who do go to war zones and to places where an extreme disaster has occurred experience post traumatic stress syndrome. Yes, it can be as traumatic for the helper as it is for the victim.

Anyway, this is not to discourage anyone from going, but just to go into with your eyes open. The developing world, even in the best of times, can be shocking for Americans who have not done much traveling.

As in the United Arab Emirates. You think we have a nursing shortage here. Well, if it wasn’t for expat nurses, their whole healthcare system would cease to function. It is extremely difficult to get local people to enter nursing.

In an interesting, albeit short, article in Arabian business.com, the nurse-less plight of the part of the world is revealed.

Nursing colleges in the UAE are failing to recruit Emirati nurses, despite government-funded sweeteners including full scholarships, the dean of a prominent nursing school has claimed.

Dr Vijaya Kumaradhas, dean of Ras Al Khaimah College of Nursing, one of the country’s largest nursing schools, has said Emirati students remain significantly under-represented – a fact that is contributing to the country’s nursing shortage.

“There is a definite shortage, but Emiratis will not become nurses. There is a stigma where nursing is concerned. In our college, we don’t have any local student.” she said.

The article doesn’t cite reasons for the lack of interest among Emiratis, but several of those who commented offered their perspective. All of them live or lived in the region, so I imagine that they are speaking from experience. Most agree that it is cultural, and that nursing is not considered a desirable career for a young Emirati woman. And in fact, the attitude is prevalent in many Middle Eastern nations.

There are very few nurses who are natives of the region, and there are many reasons why the profession is shunned. One nurse expat working in the region wrote: It entails touching bodies, much intermingling with males, and for some, would mean that they would leave the profession when married anyway. As long as beliefs remain the same, nothing will change and they will be dependent on expats. They have to buck up and see this for themselves. I’ve worked in the Middle East as a nurse for many years and have yet to see reform on this issue.

Another commenter noted that shift work is unappealing, and goes against local custom; most Emiratis wouldn’t want their daughters/wives to work night shifts. It is against traditional values for the lady to be out of the house at such late hours.

As a profession, nursing is not highly regarded, and parents do not encourage their daughters (and certainly not sons!) to study nursing. Pay is low, hours are poor (sound like a familiar scenario?), and nurses are seen as maids, more or less.

So it doesn’t seem that the Emirates are going to be attracting a lot of their own citizens anytime soon, unless they increase the pay, and really make an effort to change the perception of the job. Attracting men into nursing would also help, since that would reduce the intermingling with males.

Either this nurse isn’t too bright, or she’s intentionally malicious. Hard to say from this short news clip from Associated Press:

The police were looking into possible criminal charges against a nurse at a South Florida hospital where officials say she may have exposed some 1,800 patients to H.I.V. and hepatitis by reusing medical supplies. Officials at Broward General Medical Center in Fort Lauderdale said this week that the hospital discovered that the nurse, Qui Lan, 59, was reusing IV tubing and saline bags during cardiac chemical stress tests.

Now is that too cute or what. Apparently Japanese researchers have created a robot nurse that can lift elderly patients from wheelchairs and beds, and rather than make it look like something out of your local sci-fi channel, they decided on cuteness. It looks like a giant teddy bear.

Riba, short for Robot for Interactive Body Assistance, was developed by the state-run Riken research center. Promoters are calling it the world’s first robot to lift people in its arms.

Here’s a comforting note from the National Institute for Occupational Safety and Health :

Occupational disease research and prevention activities represent a significant portion of the NORA Sectors’ program portfolios. The rate of nonfatal occupational illness across all U.S. private industry decreased from 30.7 per 10,000 in 2003 to 21.8 in 2007. The average rate of nonfatal occupational illnesses in the Manufacturing (NAICS 31–33) sector were 2.4-fold greater than U.S. Private industry averages (65.5/10,000 vs. 26.3/10,000). Two other industry sectors reported rates that exceeded the Private industry 2003–2007 average by 50%; Utilities (NAICS 22) and Health Care and Social Assistance (NAICS 62).

They’ve got a cute little graph that shows you where healthcare falls on the scale of non-fatal occupational illnesses (hint–it’s number #3).

Okay, this is a little advertising for the allnurses.com website. But I thought it was a nice video, and I really do think it is a great nursing website. And to answer the next question, no, I have nothing at all to do with the site. I have gotten some great information from there, keeps me up to date on nursing issues, but I am in no way affiliated with the website.

RN Pathways is an interesting venture. I’ve never really looked at it until right now.

This is their description:

RNpathways is the video channel for www.RNpathways.com, the most unique nursing organization in the United States.

At RNpathways, we are passionate about nursing. We’ve created the premiere online destination for nursing career management. On our site, you’ll find comprehensive information about career paths, education, nursing issues and informative industry news. Our goal is to empower nurses and allied healthcare professionals with information to make the right career decisions.

Several other blogs have also reported in on this story, which is really quite remarkable when you think about it. Most times, bureaucrats never get caught with their pants down.

The Wall Street Journal Health Blog has a short story about this, as does The healthcareblog.

But I haven’t seen any feedback yet from the California Nurses Association. I’m curious about their views on this. Can go either way with them!