DiversityNursing Blog

By Rebecca Maitland

With the aging population and with baby boomers moving into their golden years, retirement communities are opening across the city and surrounding areas.

Plus, many established senior living communities are expanding services and programs for continuum-of-care, known as transitional care.

This is all good news for nurses with experience in geriatrics and the senior population.

"Continuum-of-care is the progression of care from independent living, to assisted living, memory care, and to skilled nursing or long-term acute care, all in the same location. As a person's level of acuity rises, one can advance to the next level of care as needed," said Jeny Knight, executive director, The Abbey at Westminster Plaza, Houston, a senior living community.

Residents who live in retirement or assisted living communities have the convenience to age in place, without having to make an additional move in order to have additional care.

Moving is one of life's high stress points, but for senior citizens, it can be more detrimental. Therefore, retirement communities are providing additional services from either outside sources such as home health, rehab or hospice, or are providing transitional care services on site as part of their community.

For example, Houston's Parkway Place senior living community offers independent-living apartment residences, assisted living, continuum-of-care, memory care, and skilled nursing services, all within the location.

"In our skilled nursing, we also provide care for residents needing a short-term rehab stay that is covered by Medicare and for those residents needing long-term nursing care. We provide physical, occupational and speech rehab. We also work with hospice for those residents needing that special care. For residents needing long-term nursing home care, we provide 24-hour nursing care to meet all of their needs," said Jimmy Johnson, executive director, Parkway Place senior living community.

A skilled nursing facility is required to have a 24-hour licensed nurse on site for those who have a higher level of need.

"At The Abbey at Westminster Plaza, the wellness team includes a licensed nurse as director of health services and a wellness manager. We have two licensed vocational nurses, and a home health agency provides our community with an on-site registered nurse," Knight said.

Openings to fill

Most senior living communities that have openings are recruiting licensed RNs, LPNs or LVNs in good standing with the state licensing authority, who are able to remain calm in stressful situations and have a passion for helping seniors. Moreover, most senior living communities provide ongoing training throughout the year for the specific population.

Parkway Place has registered nurses and licensed vocational nurse on staff that participate in the facility's ongoing training throughout the year. The training, which is geared toward geriatrics, includes training in dementia, Alzheimer's, wound care, IV medications and others.

LVN staff at The Abbey also receives additional in-service hours of training in Alzheimer's care to educate them about special needs of residents with various forms of dementia.

"In addition, all of our staff has in-services monthly as part of their continuing education," Knight said.

"We are always looking for nurses, LVNs and RNs to work PRN, or as needed, and we look for staff who enjoy working with senior citizens," Johnson said.

Knight said there is a demand for nurses in skilled and acute care settings. The growing number of people age 65 and older will only increase this need. Therefore, the demand for LVNs and RNs, as well as certified nursing aides, in senior living facilities will continue to grow.

Source: Chron

One of our fellow nurses needs some help dealing with racism in the workplace. Do you have any advice or experiences that will help her out?:

"How do you deal with racist comments directed toward yourself from patients? I've experienced racist attitudes before, but never verbalized comments in a derogatory manner from a patient until this week. Naturally I felt very down for a few hours afterward and I continue to think about it. It wasn't the negativity toward me per se, it was the thought that there could be more people out there thinking/feeling the same animosity toward me over something I cannot control, my phenotype. I take pride in my cultural heritage and wonder how anyone cannot see the beauty in diversity. I also thought that because they are sick they let their true thoughts out. Could any healthy person walking around be feeling the same thing but be inhibited from making it known? Then I thought of the people who could be dealing with this on a regular basis. How do you deal?"

Faced with a shift in the healthcare landscape toward outcomes-based practices and quality improvements, the American Association of Colleges of Nursing (AACN) sought to update the scope of nursing practice with a new master's prepared role: the clinical nurse leader (CNL).

The first new nursing role in over 35 years, the CNL grew out of the 1999 Institute of Medicine report "To Err is Human" which challenged care providers to reduce medical errors and focus on patient safety. 

Rising to the challenge, the AACN initiated an investigation into the barriers to improved care delivery and in 2005 introduced the new role as a way to prepare nurses to thrive in the changing healthcare system, according to the AACN website. For many, it couldn't have come at a better moment.

"We are at a pivotal time for the role," said Bob LaPointe, MS, MSN, RN, CNL, president, Clinical Nurse Leader Association (CNLA), and MICU staff nurse at Penn Presbyterian Medical Center, Philadelphia. 

"Healthcare is increasingly complex, and we need leaders who are trained in complexity theory to be able to navigate that and understand it to have better patient outcomes and that's what clinical nurse leaders are uniquely trained to do."

CNL

As defined by the CNLA, the CNL is an advanced clinician who serves at the point of care as the lateral integrator, facilitating, coordinating and overseeing care within the unit while also collaborating across the healthcare continuum.¹ The CNL is trained to facilitate evidence based care at the bedside and ensure positive outcomes for even the most complex patients. Such training, especially these days, is a great option for nurses of all kinds looking for a way to make a difference at the bedside.

"The role really is about improving clinical outcomes-improving the care of the patient as well as improving financial outcomes," said Tracy Lofty, MSA, CAE, director, Commission on Nurse Certification (CNC), an autonomous agency of AACN, Washington, DC. "Regardless of practice setting, the ultimate goal is to improve outcomes, so really everyone benefits from the role."

When Veronica Rankin, MSN, CNL, Carolinas Medical Center, Charlotte, N.C., decided to go back to school, she chose to do so through a CNL program after her facility's assistant vice president introduced the role at a town hall meeting. Since graduating in 2011, she and her fellow CNLs have been making a huge difference for patients, colleagues and the hospital as a whole.

"We bring that continuity of care back to the bedside, so that even though the nurses may change every shift every day, you are still going to have the same clinical nurse leader Monday through Friday taking care of that patient," Rankin said. 

"It has given me the opportunity to stand back and see the big picture of my patients' journey. I can get in there and see, 'OK, out of everyone that is involved in this patient's care, we have all these hands in this pot, what are we missing and where are the bridges I need to help connect?'"

Rankin's ability to streamline care and improve both patient and hospital outcomes comes directly from her training, and nurses and facilities across the nation are starting to see the difference CNLs can make on a unit-by-unit basis.

"When you take a policy and implement it in your unit, in your hospital, in this city, with the resources you have available, it can be the best evidence based practice out there," LaPointe emphasized. "But we have to apply it to our patients and our staff as well, and that's really where the clinical nurse leader's role really comes into play. How does this make sense for us as a unit, and for our patients."

Education

Since the pilot program that tested in the fall of 2006, more than 2,500 nurses have earned CNL certification from CNC. Part of the success, according to LaPointe, is the fact that anyone inspired to become a CNL can do so.

"Nursing has always had multiple points of entry, which leads to lots of people being able to do it, but it also leads to lots of variability about the training and preparation," LaPointe said. "There is so much more to know and healthcare is so much more complex, that to have training in complexity theory, change management and in the science of outcomes, that's going to be good for anybody."

To make the CNL educational track available to nurses already practicing as well as those looking to get into the field, the AACN created five different models so that regardless of educational background, there is an entry into a CNL education program. The five models are:

• Model A - Master's degree program designed for BSN graduates
   
• Model B - Master's degree program for BSN graduates that includes a post-BSN residency that awards master's credit
   
• Model C - Master's degree program designed for individuals with a baccalaureate degree in another discipline
   
• Model D - Master's degree program designed for ADN graduates (RN-MSN)
   
• Model E - Post-master's certificate program designed for individuals with a master's degree in nursing in another area of study²

Following graduation of a CNL education program, licensure as a registered nurse, and successful completion of the CNL Certification Exam, candidates may be awarded the CNL credential.

With the role gaining momentum, the CNC decided to revamp the certification exam in 2012 to make sure it reflected the basic competencies of a CNL.

"The new exam is based on a CNL job analysis study that was completed in 2011, so the exam reflects the knowledge, skills and abilities of a competent CNL," Lofty said. "It's all about application, so you may be in an educational program, but then you need to be able to apply the knowledge, and that is demonstrated on the exam."

Integration

As new CNL graduates start the search for the right clinical setting, they need to keep in mind that some healthcare organizations have yet to fully integrated the clinical nurse leader into their staffing model.

"There are many healthcare institutions specifically recruiting to full clinical nurse leader positions," said Lofty. "For other institutions, it may not be that title, there may be a different title like care coordinator, or they are still looking for someone with the same skill set and they are still hiring individuals with those competencies and perhaps applying them to other positions."

But CNLs need not worry about their job prospects, because their CNL skills are valuable in just about every care setting. According to a 2012 survey conducted by the CNC, 96% of the respondents indicated that they apply their CNL knowledge in their current role, 92% feel they are an important member of their team and 87% said they are valued as an employee because they are a CNL.³ LaPointe knows from personal experience just how useful being a CNL can be regardless of job title.

"I am not functioning in a job that is called 'CNL' right now, and that is true for many people who currently have the certification," LaPointe said, who was confident he would still use his training despite not being hired specifically as a CNL. "I helped write our successful Beacon Gold application, I was very involved in our hospital's first Magnet designation, I am on the evidence based practice committee for the hospital, and the chair of our unit-based council as part of the shared governance structure of the MICU, so I am using this stuff all the time."

Next Steps

No matter where CNLs end up, they are sure to improve care coordination, communication and hospital-wide outcomes.

"You are basically in there improving care for nurses, patients, and physicians," Rankin said. "You are improving care delivery and the receiving of care for the patient population, so you are in there with your hands so much."

"Bring evidence based practice to your unit to show what the worth of the role is," Rankin advised nurses considering the CNL role. "In the end we are also taught that the clinical nurse leader is the guardian of the nursing profession, so we have to get in there and be the guardian. I would say, go for it, go hard, and be a guardian for the nursing profession."

Source: Advance for Nurses 

BY SEAN DENT

There is a lot of advice out there about how you should enter, develop and progress in nursing.

Do you get your feet wet by simply gaining some “field” experience before transferring to a specialty like Emergency, Critical Care, or the Operating Room?

What about pursuing an advanced degree? What are the qualities you should acquire and maintain to stay sharp? How do you avoid burnout? Where is the best place to work? What about workplace bullying? Nurses eat their young, right?

The list is long and the questions are never-ending  And, quite honestly, there is never a simple answer, or a single correct answer.

Over the years, I think I’ve finally figured it out: I found that “one thing” that matters. I found that “one thing” that can ensure you don’t get bogged down with the rhetoric and negativity. What is it?

Honesty.

Being honest is the key to success in this profession. And I’m talking global honesty across every facet of your job.

Be honest with your patients

• If you don’t know something, admit it. It’s okay to share stories with them. It’s okay to be human. It’s nurses’ genuine nature that keeps patients voting us the most trusted profession every year.

Be honest with your coworkers

• Don’t pull a fast one on the very people you’ll be relying on to pull you through that hellish shift. But don’t be a pushover. Be honest. Be genuine. You may be a little more vulnerable, but the reward you get always outweighs the risk.

Be honest with management

• This goes hand-in-hand with coworker honesty. Take care of those who will take care of you. Even if it’s the worst boss in the world, hate and evil just beget more hate and evil. I truly believe that honesty always wins out.

Be honest with your physician partners

• Respect has to be earned, not just expected. I have learned over the years to be honest about your skills, your knowledge and your performance with your physician partners–they will respect your honesty more than any lie you can tell. Don’t try to fool the very professionals who are your biggest supporters.

Be honest with yourself

• Not happy with your job? Change it. Not happy with your position? Change it. Don’t let anyone convince you that your situation is not in your control. We work in the greatest profession I know. You have an unlimited number of opportunities–you just have to be enough of a forward-thinker to go find them.

Be honest. Now, remember, I never said being honest was easy. Just because it’s the right thing to do doesn’t mean it’s popular. Be honest, but be strong. You will find that being honest is tough, so hang in there and don’t succumb to the pressure of dishonesty.

Do you agree?

Source: ScrubsMag

By Leah Thorsen

Margie Long was a 24-year-old nurse when she held the smallest baby she’d ever seen.

It was Jan. 31, 1947. Little Sharon Lynn Kaiser weighed just 1 pound, 14 ounces, measuring 12 inches long.

She had arrived more than two months early and was delivered by Caesarean section.

Doctors didn’t think she’d survive more than a day.

Long had become a nurse to help people. She knew that baby needed help, and she devoted herself to caring for the newborn during her 73-day stay at Suburban Hospital in South Gate, Calif.

“She looked like a rubber doll,” Long said Thursday as she and that grown baby — now a 66-year-old great-grandmother whose married name is Sharon Bolles — sat on the couch of Long’s home in De Soto.

In the decades since Bolles’ birth, the two have shared a bond experienced by few nurses and patients. They have corresponded by letter and phone while separated by thousands of miles, and have enjoyed the occasional face-to-face meeting.

“She never, ever missed my birthday or Christmas,” Bolles said of the cards from Long, whom she credits with saving her life. She has cherished those cards and letters. Now, they talk on the phone at least once a week.

Bolles drove from her home in Tulsa, Okla., to visit Long on Thursday. She brought mementos. They looked at old pictures, including one of Long cradling Bolles as her parents beamed, as well as photos of other visits through the years.

Bolles brought newspaper articles too, some from her time in the hospital and after. One headline read, “Tiny babe, given no hope to live, is a big girl now.”

And Long, now 89, told of Bolles’ tenuous first months, when that bond began.

“I got pretty attached to her,” Long said. “I kind of hated to see her go home.”

MEDICINE DROPPER FOR MILK

Long — who grew up in St. Patrick, Mo., and took the job in California while visiting a cousin there — remembers feeding Bolles a teaspoon of breast milk from a medicine dropper every hour.

A newspaper article reported Bolles gained three-quarters of an ounce each day during the first three months.

Long recalled that she cut a cloth diaper so it was small enough for the tiny baby. She constantly worried that Bolles wasn’t warm enough, and hurried to feed, bathe and dress her, keeping her wrapped in a blanket.

Bolles pulled out a newspaper story with the headline “30-ounce baby makes progress in incubator.”

Long remembers that incubator — it was a bassinet with a 5-gallon jar of water beneath it. Two 500-watt bulbs heated the water, and a sheet covered the top of the bassinet to keep Bolles warm. An oxygen tube ran beneath it so she could breathe.

Bolles said Thursday she had never heard that description.

Long remembers the two blood transfusions Bolles received, when she worried the baby wasn’t going to survive.

And she remembers Bolles’ twin sister, Augusta Lee, who died hours after birth.

“Respiratory distress,” Long said. “We couldn’t save her.”

The record for the lowest birth weight of a surviving infant is held by Rumaisa Rahman, who weighed 9.17 ounces — about a third of Bolles’ birth weight — when she was born in 2004, according to Guinness World Records.

Bolles weighed 5 pounds, 11 ounces when she was discharged from the hospital.

She kept the hospital bill from her stay. It was $597 — that included a $3 per-day charge for 73 days, another $256.50 for 19 oxygen tanks, and $55 for blood, plasma and transfusions.

The two reunited for the first time when Bolles was 1 year old.

“She was still on the tiny side,” Long said.

Bolles would never be big — she weighed 33 pounds at 5 years old, and was just 110 pounds when nine months pregnant with her own daughter, she said.

Long moved to De Soto in 1959 after being stationed with her husband, who was in the Navy, around the country and in Panama. She worked as a nurse for the Jefferson County Health Department for 18 years.

The two met again in 1969, when Bolles’ husband was stationed at Scott Air Force Base, and again in 2006 when Long passed through Oklahoma on her way home from a trip to Texas.

Thursday was their fourth get-together. Long told her grandson that “my preemie” was coming to visit. Bolles certainly wasn’t the only premature baby she’d cared for during her nursing career, but Long didn’t need to explain any further.

“He knew who I was talking about,” she said.

Still, neither can quite explain why their connection has endured.

“I know how special she is,” Bolles said. “I’ve always known that.”

Source: STL Today

By Chris Hoenig

When it comes to understanding the needs of diverse communities, including the LGBT community, not all hospitals are the same. Improving patient outcomes by providing culturally competent care is the focus of a DiversityInc healthcare summit this September, including presentations on equitable care and improved outreach to the LGBT community.

The Human Rights Campaign, which will present at the event, released its 2013 Healthcare Equality Index this month, a measurement of equality in care and employment for LGBT patients and practitioners. Seven of DiversityInc’s Top 10 Hospital Systems earned HRC’s highest rating.

To qualify as an HRC “Leader in LGBT Healthcare Equality,” facilities had to be able to provide documentation proving that they meet guidelines in four core criteria: patient nondiscrimination policy, equal visitation rights, employment nondiscrimination policy and training in LGBT-patient-centered care. The core criteria are further broken down into more specific actions, such as making sure that patient and employee nondiscrimination policies include both the term “sexual orientation” and “gender identity,” and that these policies are communicated to patients and visitors in “at least two readily accessible ways.” A hospital had to comply with every guideline to be designated as a Leader.

The DiversityInc Top 10 Hospital Systems

A total of 24 facilities owned and operated by companies in the DiversityInc Top 10 Hospital Systems achieved Leader status.

University Hospitals (No. 1 in the DiversityInc Top 10 Hospital Systems) has 10 facilities on the list. “We have made it a corporate priority and a strategic business process to nurture and strengthen a culture of diversity and inclusion, both within our system and across our community,” CEO Thomas Zenty III says. The system’s Ohio-based Leader facilities include: UH Ahuja Medical Center, UH Bedford Medical Center, UH Case Medical Center, UH Conneaut Medical Center, UH Geauga Medical Center, UH Geneva Medical Center, UH MacDonald Women’s Hospital, UH Rainbow Babies and Children’s Hospital, UH Richmond Medical Center and UH Seidman Cancer Center.

Henry Ford Health System (No. 2) has six Michigan-based Leader facilities. “Our rich diversity makes us a better company and helps us connect with the healthcare needs of our patients and their families,” CEO Nancy Schlichting says. Henry Ford Behavioral Health Services, Henry Ford Hospital, Henry Ford Macomb Hospital, Henry Ford Medical Group, Henry Ford West Bloomfield Hospital and Henry Ford Wyandotte Hospital all received Leader rankings.

Continuum Health Partners (No. 4) has two New York City hospitals on the list: Beth Israel Medical Center and St. Luke’s–Roosevelt Hospital Center. In addition to site diversity councils and subcommittees, Continuum also has an LGBT communities resource group.

North Shore–LIJ Health System (No. 9) is represented by three New York hospitals. On the DiversityInc rankings for the first time, North Shore–LIJ is known for its outreach to the LGBT community, which has also been recognized by the HRC. Lennox Hill Hospital, Southside Hospital and Staten Island University Hospital all achieved Leader designation in the HEI.

Massachusetts General Hospital (No. 7), Rush University Medical Center (No. 8) and University of New Mexico Hospitals (No. 10), all rated as single facilities, also achieved a perfect four-for-four and are therefore recognized as Leader hospitals by the HEI.

Two Cleveland Clinic (No. 3) facilities—its main campus in Ohio and Cleveland Clinic Florida—narrowly missed the HEI Leader list, gaining approved rankings in three of the four core criteria.

While not included in DiversityInc’s Top 10 Hospital Systems, Kaiser Permanente—a larger healthcare provider that ranks No. 3 in the DiversityInc Top 50—is well represented among HEI Leader facilities. Thirty-eight Kaiser properties in three states—California, Hawaii and Oregon—are recognized in the HEI.

More to Learn

A 2010 Lambda Legal study, quoted by the HEI, noted that 29 percent of lesbian, gay and bisexual patients fear they will be treated differently by medical personnel, while that number rose to 73 percent for transgender patients. More than half of transgender patients (and 9 percent of lesbian, gay and bisexual patients) fear they will be refused care because of their sexual orientation or gender identity.

These statistics highlight the need for improved patient experiences in the LGBT community at the times of greatest need. The Supreme Court’s ruling on the Defense of Marriage Act opens up spousal healthcare benefits for federal employees, but while some financial fears are eased, the care LGBT patients get for the money remains a concern.

The Human Rights Campaign and University Hospitals will offer more detail on the HEI and how to develop successful outreach programs for the LGBT community at Culturally Competent Healthcare: How Diversity Creates Better Outcomes , DiversityInc’s event on Sept.24 in Newark, N.J. Guest presenters include Donnie Perkins, Vice President, Diversity & Inclusion, University Hospitals, and Shane Snowdon, Director, Health and Aging Program, Human Rights Campaign.

Source: DiversityInc

by Angela Stevens

I’ve known a few ER nurses over the years, and all of them have told me that, no matter how much training they have had, how their teachers and textbooks tried to prepare them, and even how much experience in other fields of nursing…nothing prepared them for the reality of working in an emergency room. When choosing any nursing specialty, it is important to test drive the environment before making a final decision. This can easily be accomplished by taking a position as a traveling nurse and visiting different areas of the country as well as different nursing environments. In fact, one of the girls I went to high school with did this, and she found her great love was in pediatrics. Janey, the friend who became a pediatric nurse, actually did a stint in an emergency room for several months and told me some of the hardest things she had ever had to do occurred during that time. Don’t get me wrong, she said that the heartbreak in pediatrics could be excruciating, but that – more often than not – it was a happier place to be.

One of the difficulties she faced in the emergency room was not being able to make a personal connection with the patients. She was with them for only a brief period of time, usually a few hours, before they were discharged or sent to another floor of the hospital. She rarely found out what happened to the patients, even those she felt a connection to. Being able to move on to the next patient and distance yourself from previous patients is difficult. Another difficulty of being an emergency room nurse comes when there are more patients than there are people available to help them. At this point, the nurses, usually the first to see and evaluate a patient, have to decide who is in the most critical condition and get them to see a doctor. Making the decision of who gets medical treatment first was overwhelming for many of the nurses I knew, at least initially. One told me that she finally realized that, the more quickly she was able to make her assessment, the faster everyone would receive the care they needed. This is what stopped her from “hemming and hawing,” as she put it, and put on her decision making cap. While it was true she had to leave some patients in the waiting room who were miserable, they were seen as quickly as she could process those with more pressing conditions. Seeing it in this light made perfect sense to me, and it made me realize that, when I visit the emergency room as a patient, it isn’t that the nurses don’t care. Quite the opposite, really; sometimes they may care too much. I now know that if I’m waiting, there is usually someone with a much more serious problem who is receiving care.

Why did you, or do you want to, become an ER nurse? How has it changed your perspective?

Source: Sunbelt Staffing 

by Mark Downey

One of the questions that I frequently ask my students is, “Do you need to care to be a great nurse?” It’s always interesting to read the expressions on their faces and imagine what they must be thinking, because for the majority of my students it is the wanting to be a nurse and all that it entails that is a motivating factor in studying for their nursing degree.

From “Is he trying to trick me?” to “My teacher is an idiot!”, I can see the cogs and wheels ticking over in their brains. More often than not, I don’t give them an opportunity to answer. Instead, I tell them, “You don’t have to care about people to be a nurse. I consider myself an excellent nurse, but I’m not paid to care”.

Reactions to this vary. The two most common being dumbstruck, tongue tied and not knowing quite what to say or alternatively the hairs on the back of the neck bristle and I am challenged (often quite vigorously). Rarely, if ever, does anyone agree with me.

Let me explain with an example. If you’re a patient in an Accident and Emergency Room or perhaps lying unconscious in an Intensive care bed or on an operating table, is it really going to matter if the nurse gives two hoots about caring for you? Of course not! What is important is that the nurse is clinically competent and understands your health requirements so that every opportunity is afforded in generating a positive health outcome.

A steam train driver doesn’t have to care about his train to drive it, but he does need to understand how it works. As long as the gauges stay within the safe zones and coal is regularly fed to help generate steam to drive the engine, it doesn’t matter if he cares about the train or not. In fact, regardless of his care factor, the end result will never vary as long as he is good at his job. To be a good and great nurse is to know how to do your job right. I know everyone will agree.

Isn’t a nurse just like the train driver? Health outcomes will always be the same regardless of how much caring the nurse gives. It all boils down to the nurse trainings and the skills they have developed and how they are implemented. Nothing more, nothing less. A Cardiac Nurse needs to know about your heart, how it works, what the ECG squiggles mean and what the drugs that have been prescribed for you are going to do, but they don’t need to know your hearts desires or what’s in your heart. Isn’t that the job of the Chaplain?

Another important point is not to confuse advocating for the patient with caring. Advocacy is mandatory if the nurse’s training and experience lead them to believe that an alternative option may deliver a better health outcome for the patient. But really you don’t have to care to advocate as it’s just part of being a good nurse.

My argument is further proven when you consider the nursing process. Although it comes in many forms and guises, it is essentially:

• Assess the situation.
   
• Planning a course of action.
   
• Implement that action plan.
   
• Review the effectiveness of the plan and when necessary returning to step 1 and repeating. 

Nowhere, I repeat, nowhere, in any of the literature I have read, have I ever seen or mentioned that caring was required as part of the nursing process.

So do nurses care about their patients? Of course they do! Don’t be a goose! For the vast majority it’s an integral part of what makes them who they are. Nurses are looking after people, not machines. So, do I care for the people that I look after? I do and with a passion, but I don’t have to and, if couldn’t care for people, I couldn’t do my job.

Earlier on in this post I made the comment “I consider myself to be a great nurse, but I’m not paid to care.” This, I hold, as an absolute truth. When I am nursing, I am not paid to care.  You cannot pay me to care. I will not accept money to care! I choose to care because I want to care and you get that for free.

Source: NurseTogether

Bad Hospital Food: Coming to a Theater Near You

Whatever the paste-like substance is on the bottom right portion of the plate, the icky gravy coating certainly doesn't make it look any more appealing. The glop of green had better days in a Japanese horror flick.

Bad Hospital Food: Thank Goodness There's Dessert

Umm... at least there's caramel pudding! Even the wilted salad that hangs over the edge of its plate seems keen to escape this sad assembly.

Bad Hospital Food: Save Me From Savoury

Bad Hospital Food: Ham Tartare?

It's hard to mess up ham—but we think this plate deserves a medal for making it appear totally unappetizing. The lack of condensation on or around the food also points to another sad fact—this meal is completely cold and clammy. If you stare at the mashed potatoes(?) long enough you can almost see a face. A sad, sad face. 

Bad Hospital Food: The Dry to Try

Well, there's Remoulade sauce so we're guessing this is breakfast? Talk about a DRY looking meal. We're choking just looking at it. Additionally, we have no idea about those things opposite the slice of bread. Could be calamari, could be dog biscuits.

Bad Hospital Food: To Be Determined

There are just so many mysteries on this plate. It's certainly hard to discern the nutritional value of a meal like this when the four main food groups are Incognito, The Thing, Slime and Tan Unknown. 

Source: ScrubsMag