Friday, May 24, 2019

Pinning Ceremony

Yesterday I was privileged to be asked to celebrate with the graduating Nursing Class of my Alma Mater, Three Rivers Community College. These were my words to them and the link to the video.

First, I want to thank you for the honor of speaking to you on this important day in your lives. 

It is an honor to celebrate with you, especially as a graduate of this program

So thank you for this opportunity.

Thank you also to your instructors for the dedication they have to the future of nursing.
And thank you to your family and friends for the support they have given

When you get a chance to speak, you want to be inspirational.


But the reality is, there’s no need for me to be inspirational today because YOU are the inspiration.
You have worked your tails off and you have succeeded! And although you will be lifelong learners, today you mark a milestone.
Today you enter the sisterhood and brotherhood of nursing.

I’d like to tell you about a few nurses I have worked with and what they have taught me and how that has formed my love for nursing. 

We are taught in school that being a patient advocate is the greatest role of a nurse, and it is.
Lesa Hanson is one of the best all round nurses that I have ever had the pleasure to work with. Lesa and I are about the same age, but she attended St Francis School of Nursing right out of high school and I entered the profession when I was 39. We worked together in the emergency room and she was one of my many mentors.
She told me that at one time she thought advocating for her patient meant advocating at the bedside and that is certainly true.  But as time went on, she realized that advocating meant advocating at the bedside, in the boardroom, and at the capitol. 

I think that is truer today than ever. In this day when technology is changing so rapidly and effecting our time with our patients, when the entire healthcare system is changing with consolidations and privatization of healthcare systems and insurance companies, in this time of incredible CEO pay and income inequality, not just in healthcare, A time when student debt and hospital debt bankrupt some families, we MUST be advocates for our patients.

Because if not us...........who?

And we must advocate in every setting.
Nurses have been ranked as the most honest and ethical profession in a gallop poll for the last 17 years!
People trust us. 
We have a voice if we use it.
And we have a responsibility to use it.

When Lesa and others realized this, we started speaking to fellow nurses. 
We visited many of these nurses in their homes.
We sat with an oncology nurse in her living room and we talked about the changes that the cost cutting consultant had started at the hospital.
We talked about the pension that was now gone, we talked about the decreases in weekend and shift differentials. These things concerned her, but they didn’t move her.
At one point she stopped talking and looked at the floor.
We waited.
When she lifted her head, she looked me right in the eye.
Her eyes were filled with tears.
She said, “John, they took away my peanut butter. They took away my peanut butter.”
They had removed the peanut butter from the kitchenettes on the floors to save a few bucks. She would give the peanut butter on crackers to her chemo patients if they had a brief window where they felt they could tolerate food. By taking it off her floor, it forced her to call downstairs and by the time it arrived, there window had passed.
It wasn’t the pensions or the differentials that moved her, it was the inability to advocate for her patients.

That is the heart of a nurse. 
It why we’ll work short staffed, with inadequate supplies, without breaks, and for double shifts.
To us, this isn’t just a profession, its a vocation.

It’s what makes us special.
It’s what allows us to fulfill our missions.
It’s also what can burn us out.

Wendy Dean and Simon Talbot have written about this, and Dr Z (Z Dogg) has a video about it.  Deem and Talbot say our 
moral instincts drive us to do the best we can for our patients and when we come up against a system that asks more and more, we give more and more. We adapt and adapt and adapt until we break.
They call it Moral Injury.
It was first use in combat veterans and is closely related to PTSD. It happens when a person’s moral instinct comes into conflict with their reality.
In nurses and healthcare professionals it is being unable to provide high-quality care and healing that we feel morally obligated to do.

So, what a nurse to do?
We must do what we have been taught, we must stay true to our moral code, we must be advocates for our patients and each other.

I was precepting a young nurse in the emergency room. She was recently graduated and in her early 20s.
We worked a trauma and we stabilized the patient.
We transferred the patient to the Life Star stretcher and I walked them to the door of the trauma room as was my costume as I felt the edge of the room was where I handed off their care. I said “safe flight” to the crew as I always did.
When I tuned to look back into the room, I saw this young nurse.
She was standing in the middle of the room by herself. They’re s blood on the stretcher, the floor and her protective gown. There were wrappings from IV bags, IV tubing and other supplies all around her. It looked like a bomb had gone off.
She stood in the middle of that mess and she was crying.
I walked over, gave her a hug, and told her, “You did good. You saved a life today.”
She was able to hold it together and finish her work during the trauma because, like you, she was prepared.
And when it was over, she broke down because, like you and me and all nurses, we are caring people. It is that ability to care which allows us to do our work.
You will be both of those nurses.
On some days you will need the hug.
On some days you will need to give that hug.
Be there for each other.

I’ll tell you one more story.
When I was with you recently, I think I spoke about a mission to the US Virgin Islands where 14 Connecticut nurses and other healthcare professionals were joining a team of 45 from around the country to do vision and hearing screenings in the schools.
St Croix, St Thomas and St John were devastated by the same hurricanes that hit Puerto Rico and are still recovering. The school children are not getting their screenings done in a timely manner and problems are getting missed which cause their schools work to suffer.
I was asked to join the team at the last minute because a few people had to drop off.
It was an extremely inspirational mission. Over the course of 2 weeks, the team screened over 10,000 children.
One of the nurses we met was from Ohio, her name was Deanna Miller. She was an energetic, positive person who was a pleasure to get to know. 

Deanna post on Face Book at the end of the week:

I can’t say enough about the past week.  Two teams of AFT healthcare professionals, teachers, and hearing specialists from all over the country were invited to screen students for hearing and vision in all the public schools in St. Croix, VI. 
I had a notable experience I kept to myself.  “A little girl asked me, “Oh, please don’t tell me I didn’t pass.”
I said, “Do u have trouble seeing the board?”
She said, “I do.”  
I hugged her and whispered, “This is our gift to you.  We are to hear to help.  Make it easier for you to learn.” 
She whispered back, “Thank you so much...” ❤️❤️

A huge thanks to AFT Nurses & Health Professionals and Ohio Nurses Association for entrusting me in this mission and the continued support in living my BEST LIFE.  

Now let me ask you... what motivates you to live your best life ? 

We Care.  We Showed Up.  Mission Accomplished.  #AFT #ONA #USVIRelief


If Deanna were here she would want us to ask ourselves the same question.

What motivates you to live your best lives?

Lesa Hanson, my oncology nurse, my young nurse in the ER, and Deanna are all nurses.
They advocate for their patients, at the bedside, in the boardroom, at the capitol, and in a warm school on St Croix, 
because their moral code demands that they do so.

And they support her sister and brother nurses (and their little patients) by giving and receiving hugs.

These are the things that motivate them to live their best lives and it is what motivates you and I also.
Because we are nurses.
Congratulations and thank you for this opportunity to celebrate with you.

Wednesday, May 8, 2019

Appreciation of Nurses

Recently, Washington State Sen. Maureen Walsh received nationwide backlash for saying nurses in smaller hospitals “probably play cards for a considerable amount of the day” during their shifts. This comment came during a debate on a bill that would give nurses uninterrupted meals and breaks at work and protect them from mandatory overtime.
She apologized after receiving national outrage, during which she received 1,700 decks of playing cards.

I am sure she is sorry, but it points to an issue that affects nurses and other healthcare professionals. That issue is the de-professionalization of these caregivers.
Today’s nurse practices at a higher level than at any time in history. The decisions that nurses make on a day to day basis, and the standard protocols they follow, were reserved for medical doctors a generation ago. Their level of training, their expertise, and their influence on the health and well being of the patients they serve has never been higher. Year after year, nurses are rated in gallup polls as the most respected profession.

Yet they have never been at greater risk of injury and burnout.
Nurses and other healthcare professionals are injured on the job more than any other industry and they are asked to do more and more with less and less.
Nurses routinely skip lunches, miss breaks, and are mandated to work overtime. Thrust into situations where they are short staffed, they struggle to provide the care they know their paints deserve. When they are unable, they struggle, and struggle and struggle and then they fail, suffering Moral Injury, which Journalist Diane Silver describes as “a deep soul wound that pierces a person’s identity, sense of morality, and relationship to society.”
In 2013, Beth Jasper was driving home from her Ohio hospital after working 12 hours short staffed. She fell asleep at the wheel as a result of her fatigue. In court proceedings, her widowed husband and father of Beth’s 6 and 11 year old daughters, stated about Beth and her colleagues working short staffed for long hours, “They’re passionate about their work. They don’t want to make a mistake, but when you’re working under those conditions, it’s going to happen.”

Nurses suffer workplace violence more than any other occupation.
Just last month, Lynne Trujillo, a nurse in Baton Rouge who had come to the aid of another nurse, was attacked by a patient, seen in her own hospital’s Emergency Room, sent home, and returned a week later suffering from a blood clot as a result of the injury. Lynne died as a result of this blood clot.

When I was union local president at Backus Hospital in Norwich Connecticut we had several cases of nurses being injured while caring for others. In one case, a nurse was hit repeatedly over the head with a tool used to scan medication bar codes, to the point of blood running down her head and the need for several stitches in the emergency department. She was so traumatized that she could not return to work. When we reported this to OSHA, they said their hands were tied. OSHA has no “standard” protecting nurses, Healthcare Workers, or social workers from workplace violence, as they do for workplace chemicals and other hazards.
When nurses try to speak out, they are often ignored or even worse, told to keep their place. But nurses continue to speak out, for their own safety and the safety of their patients.

I want to commend Representative Joe Courtney. He began a multi year process to have OSHA formulate a “standard.” Being unsuccessful, he raised HR 1309, Workplace Violence Prevention for Health Care and Social Service Workers, which would call for such an OSHA Standard. Thank you Reps Larson, Hayes, Himes, and DeLauro for cosponsoring. Thank you Sen Blumenthal for cosponsoring the companion bill SB 851. Sen Murphy is currently considering cosponsoring, which would make Connecticut the first state that had an entire congressional delegation sponsoring this important protection.

The comment by Sen. Walsh may have been unusual, but the disrespectful treatment of nurses is common. The American Federation of Teachers is the second largest union of Registered Nurses in the country and the largest in Connecticut. As a group, we have the power to stand up and fight for the only thing we have ever asked for-the ability to safely and adequately care for our patients and their families.

Nurse’s Week is May 6-12. I ask you to thank a nurse during this time and thank your legislators for co-sponsoring HR 1309 and SB 851, now in the United States House and Senate.

Finally, thank you to all the dedicated nurses everywhere. You service is remarkable.