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DiversityNursing Blog

Nurse Association 'Zero Tolerance' On Workplace Bullying

Posted by Pat Magrath

Thu, Sep 24, 2015 @ 10:34 AM

mily Mongan via www.mcknights.com 

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This summer, the ANA (American Nurses Association) released a new position statement regarding Incivility, Bullying, and Workplace Violence. It clearly states that “All RNs and employers in all settings, including practice, academia, and research, must collaborate to create a culture of respect that is free of incivility, bullying, and workplace violence”. Any kind of workplace violence whether it be physical, verbal or psychological is not to be tolerated and should be reported immediately. This applies to bullying incidents/workplace violence from a co-worker, patient or patient’s family member. When these incidents are allowed to continue, there are many damaging consequences including psychological, financial and a toxic work environment.

A leading long-term care nurses group is praising a tough, new “zero tolerance” the American Nurses Association has adopted regarding violence and bullying in healthcare workplaces.

The ANA announced the new policy Monday, citing a survey of 3,765 RNs that found almost one-fourth of respondents had been physically assaulted at work by a patient or a patient's family member. The survey also found up to half of nurses had been bullied in some manner by a peer or a person in a higher level of authority. ANA's statement defines bullying as “repeated, unwanted harmful actions intended to humiliate, offend and cause distress.”

The ANA's new policy includes recommendations to prevent and handle violence like encouraging employees to report incidents of violence, avoiding blaming employees for violence perpetrated by non-employees and developing a violence prevention program aligned with federal health and safety guidelines.

“Taking this clear and strong position is critical to ensure the safety of patients, nurses and other healthcare workers,” wrote ANA President Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN, in a statement. “Enduring physical or verbal abuse must no longer be accepted as part of a nurse's job.”

Violence against healthcare workers, especially nursing assistants, should be handled with more scrutiny by long-term care providers, according to American Association for Long Term Care Nursing Executive Director Charlotte Eliopoulos, RN, MPH, PhD.

“Studies have shown that more than half of certified nursing assistants [CNAs] are victims of assault and battery at least once every week,” Eliopoulos told McKnight's. “Staff need to be better prepared to identify violence-prone individuals, prevent violent acts, and manage them should they occur.”

Take a stand against workplace bullying.

 

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This Medical ID App Could Save Your Life

Posted by Erica Bettencourt

Wed, Sep 23, 2015 @ 03:45 PM

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You don't know when an emergency is going to happen. You don't know if the emergency is going to happen to you. But you can prepare for a medical emergency by downloading the Apple Health app and creating a Medical ID. 

People should keep their information and medical history with them in case they cannot communicate during an emergency. We aren't saying you should carry your entire medical file to the grocery store. But what if we asked you to carry your smart phone?

Some people wear their information on jewelry like bracelets or dog tags. Other people have it written down and kept in their wallet. Now most people have a smart phone and can download apps like the Apple Health app. 

This health app allows you to store and update all your important medical information. Information including your name, date of birth, medical conditions, medical notes, allergies and reactions, medications, emergency contacts, blood type, organ donor status, weight, height, and photo can all be stored and accessed from a touch of a button on your lock screen.

Here's how to access Medical ID on a locked iPhone:

1. Swipe to unlock.

2. Tap Emergency.

3. Tap Medical ID, on the emergency call screen.

emergency_callmedical_emergency_call

Here's how to insert your information in the app:

1. From the iPhone home screen, choose the “Health” application. It is the white app with a pink heart in the top right corner.

2. You will notice a “Medical ID” option in the tool bar along the bottom of the screen.

3. An option to “Create Medical ID” will appear and display a screen with fields for you to enter your information.

As a patient, it can save your life. For medical professionals, try to make it a habit to always check a  patient's phone for a Medical ID. It could help you save their life.

Related Article:

How Health Apps Will Change Nursing

'She Saved My Life': Mother Is Awakened From A Coma By Her Newborn Baby

Posted by Pat Magrath

Mon, Sep 21, 2015 @ 12:11 PM

jdwz0-mom-daughter-2Many Nurses have a 6th sense when it comes to their patients. This story is about a Nurse who’s patient was in a coma after a C-section. Nothing was bringing the patient out of the coma. The Nurse’s actions changed the outcome of could have been a very tragic situation.

For Shelly and Jeremy Cawley, what should have been one of the happiest moments of their lives took a near fatal turn. 

Shelly went in for an emergency C-section and doctors had to put her under. After several hours, they were getting worried that Shelly hadn't woken up. 

The couple's newborn daughter, Rylan, was resting safely a few floors away in the same hospital. 

"I was a mess. I was numb. I didn't know what to think anymore," Jeremy told People. "The doctors had done all they could and it was clear, they absolutely thought they were losing her at this point." 

It wasn't until nurse Ashley Manus, a big proponent of skin-to-skin contact, stripped Rylan down and gently put her on her mother's chest that everything changed. 

"I was hoping somewhere deep down, Shelly was still there and could feel her baby, hear her baby and her mother's instincts would come out and she would realize, 'This is where I need to be.' " Manus said. 

Incredibly, it worked!

Jeremy says the bond for Ryland was instant, and she fell right asleep on her mom. She was so content the doctors had to make her cry so that Shelly would hear her baby. 

"We could see a spike in her vitals on the monitor. We knew that somewhere in there she was hearing her baby. Rylan saved her mom's life," Manus said. 

It would be another week before Shelly came out of the coma completely and could hold her baby for the first time. Both mom and baby were fine, with no complications from the ordeal. 

It's been a year since Shelly's miraculous recovery, and this past weekend, the family celebrated Rylan's first birthday. 

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Thank You, NICU Nurse

Posted by Pat Magrath

Fri, Sep 18, 2015 @ 02:22 PM

Natalie Romero via www.huffingtonpost.com 

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Grab the tissues because this article is a beautiful thank you note from the mother of an infant in the NICU. She refers to the Nurses in the NICU who took care of her baby as “background heroes”. Always there offering comfort to both her and her baby; translating the doctor’s language in to words she could understand; singing and reading to her baby; staying with him in the OR; and all the other important things the Nurses did to help her through it. She’s not sure if she ever properly thanked you so she wrote this letter. It’s beautiful and so are you for all you do for your patients and their families.

During our NICU stay, our son was seen by dozens of doctors -- surgeons, neonatologists, anesthesiologists, cardiologists, orthopedics and radiologists. He was treated by occupational therapists and physical therapists.

If you were to walk in the room during rounds on a typical day, you would have found five or six doctors huddled around his tiny body reviewing his charts. They discussed his numbers throughout the night, their opinions on his treatment, and how he was responding. The doctors didn't always turn to us to include us in the conversation. And to be honest, we didn't always understand their language.

If you were to look very closely at the scene, you may have noticed someone hovering in the background almost going unnoticed. If you looked hard enough, you would have noticed my son's NICU nurse who rarely left his side during rounds. His nurse stayed close by and tended to my son while the doctors tended to his illness. His nurse always helped us figure out the doctor language once they were gone.

Those nurses were our background heroes. They didn't get the same credit as the doctors and they never searched for praise, but they were such an important and necessary part of our NICU journey.

NICU nurse, I don't know if you know the impact you had on our family.

I don't think I thanked you.

I hope it's not too late.

Thank you for quietly closing the curtain to give me privacy when I couldn't stop the tears.

Thank you for rocking my baby when I couldn't be with him at night.

Thank you for knitting him hats and booties.

Thank you for reading to him.

Thank you for singing him lullabies.

Thank you for staying with him in the operating room.

Thank you for being gentle with him when he was battered and bruised after hours and hours of surgery.

Thank you for being his advocate and questioning everything, even the doctors, when you felt like he was being given unnecessary treatments.

Thank you for keeping the small bit of hair that was shaved off of his head when the only available vein was on his skull. "It was his first hair cut," you said when you handed it to us the following morning.

Thank you for teaching me how to bathe him without making all the alarms ring.

Thank you for teaching me how to read the machines he was attached to.

Thank you for helping me hold him without pulling out all his tubes.

Thank you for silently standing beside me while I cried tears of helplessness.

Thank you for helping me see the good I was doing by heading off to pump every three hours.

Thank you for making feel like a normal mother in the moments when I felt anything but normal.

Thank you for celebrating each ounce of milk consumed, each breath taken without the breathing tube, each time the number on the scale went up.

Thank you for celebrating when he was discharged.

Thank you for helping me get through one of the toughest experiences of my life. You were a part of the reason I survived it.

I don't know the half of what you have seen. I know that even though you always seemed to be smiling, behind closed doors you cried your own tears. I know that in the moments of chaos when alarms were sounding and codes were being called and my world seemed to be crashing down around me, you stayed calm and focused and you made sure that my world stayed upright.

I hope you know that I felt your hand of my shoulder. I hope you know that I was grateful to see your face every morning. I hope you know just how important you were to us.

I hope it's not too late to say thank you.

 

Minorities in Medicine: Diversifying Healthcare in the U.S.

Posted by Pat Magrath

Wed, Sep 16, 2015 @ 03:37 PM

By Denston Carey Jr. via www.wcuquad.com 

ThinkstockPhotos-160595730

While many of us are well aware of the disparities in healthcare, this article written by a medical student, makes some good points about the need for more diversity at all levels in the medical field. What would you add to his thoughts?

Increasing the presence of minority groups within the medical field is a pressing issue in healthcare today. When one walks into the average doctor’s office or hospital, one cannot help but realize that there is not enough diversity within the medical field. The sparingly present racial and ethnic groups in medicine are more formally referred to as the Underrepresented Minorities.

African-Americans comprise about 13 percent of the American population but, they make up only four percent of American physicians. – AAMC

Groups that are underrepresented in medicine are present, as physicians or other medical professionals, in small numbers relative to their presence in the population as a whole. For example, though African-Americans comprise about 13 percent of the American population, they make up only four percent of American physicians (AAMC). Furthermore, the 14 percent presence of Hispanics in the American population is hardly reflected by the mere six percent of Hispanics coming out of U.S. medical schools in recent years. It goes without saying that there are some negative side effects that stem from this lack of diversity within American healthcare. 

The medical professionals of the U.S. simply do not reflect the mosaic of racial and ethnic groups that comprise our population, and this indeed has social and cultural implications. Patients not only come with symptoms and disorders, but they also come with different social and cultural backgrounds. 

Being a medical professional is about more than just understanding how the human body works—medical professionals need to be able to relate to their patients on a personal level as well. When caring for such a diverse population, our medical professionals must be both culturally competent and reflective of the patient population. Understanding and relating to patients is an important part of medicine, and it can make a huge difference in the patients’ experience if their healthcare providers are able to do this. 

Beyond the social and cultural reasons that call for a diversified healthcare force lie the needs of underserved communities. Underserved communities are those which face economic, cultural, or linguistic barriers to healthcare (DOH). There have been studies that show underrepresented physicians (African-Americans, Latinos, American Indians, and Pacific Islanders) are far more likely to practice in underserved communities than their white counterparts. Because theseunderserved communities may benefit from a more accessible healthcare system, when underrepresented groups serve them, the healthcare disparities that afflict these communities are likely to be mitigated by an increase in the amount of underrepresented physicians.

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With this now in mind, it is apparent that increasing the prevalence of underrepresented minorities within the medical field can also decrease healthcare disparities. 

So, how can WCU help? The first thing we can do, as a university, is diversify our own pre-health programs. We can then work to support and embrace this diversified community of pre-health students. Lastly, we can reach out to the younger people of the West Chester community, encouraging them to pursue careers within the healthcare field as well. Through these three objectives, WCU can contribute to the national effort of diversifying the American healthcare force. 

Minorities in Medicine wishes you all the best this semester, and we look forward to seeing many of you pre-health students get involved with this organization. 

Register For The $5,000 Education Award!

Miss Colorado Wears Scrubs and Describes Passion for Nursing in Miss America Talent Portion

Posted by Pat Magrath

Mon, Sep 14, 2015 @ 02:48 PM

By Erin Powell via www.thedenverchannel.com 

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No matter how you feel about the Miss America Pageant, if you missed Colorado’s Kelly Johnson and her view about being a Nurse, you can see it here. Please let us know what you think about what she had to say.

Sunday's Miss America pageant will surely feature plenty of glitz, glam and glitter.

Miss Colorado didn't look like that in this week's preliminaries. During the talent competition, Kelly Johnson walked onto the stage with her hair in a ponytail, clothed in baggy scrubs with a stethoscope draped around her neck. Johnson didn't show off a talent, but she passionately explained hers: nursing.

After a deep breath, she said, "Every nurse has a patient that reminds them why they became a nurse in the first place. Mine was Joe."

Joe suffered from Alzheimer's disease and at night, screamed out because of night terrors. Miss Colorado would comfort him and stop him from screaming, but explains she couldn't change his treatments or medications because she was "just a nurse."

Instead, they'd talk about his grandchildren and laugh together. Until one day he was crying. She stopped and said to Joe, "You're not just Alzheimer's."

"Same goes for you. You're not 'just a nurse,'" he responded. "You have changed my life because you have cared about me."

Johnson graduated as the valedictorian from Grand View University in Des Moines.

"I am so grateful for the opportunity to share how passionate I am about this profession. Thank you to the Miss America Organization," Johnson wrote on Facebook.

This is why I did what I did. All in one message. This means so much to so many people. I love you, America. Thank you for reaching out to me. This is all for you! #NurseKelley

Do People Trust Telemedicine? [INFOGRAPHIC]

Posted by Erica Bettencourt

Tue, Sep 08, 2015 @ 02:11 PM

By Sara Seng via www.bartonassociates.com 

The telemedicine market isn't only effecting physicians and other healthcare professionals. Telemedicine has potentially great benefits for patients too. For example, regular office visit expenses will reduce and patients who have a difficult time traveling to appointments, don't have to worry about it anymore.

As the telemedicine market is expected to reach $34 billion by 2020, its impact in the healthcare industry is endless. Telemedicine refers to the use of telecommunication and information technologies in order to provide clinical health care at a distance. From reduced transportation expenses to increased cost efficiency, healthcare organizations are constantly searching for more ways to provide quality care and communication between providers and their patients.

However, do people ultimately trust telemedicine?

TechnologyAdvice recently conducted a nationwide survey of 504 U.S. adults to investigate the way people feel about telemedicine and its services. The infographic below highlights their findings.

will-patients-use-telemedicine-services-final-01

Empty Pill Bottles Desperately Needed (Take your meds & help others!)

Posted by Erica Bettencourt

Tue, Sep 08, 2015 @ 01:58 PM

Ginger Ail Blog post

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Not every patient gets their medication in a pill bottle. In other parts of the world these patients are handed their pills and must use whatever they have to keep the medication safe. In three easy steps you can make a difference for those patients.

Pill bottles: they are those translucent orange soldiers that pile up all around us… in our drawers, bags, cabinets… sometimes I wonder – if I had saved every empty pill bottle since I got sick, what would that look like?

One of the things I have always hated the most about being sick, is you often need more help than you can give. That’s not always true, but there are definitely days or weeks like that for even the most functioning among us. I see those specials on tv and think: I want to build a Habitat for Humanity house or dig wells in Africa (this might be a late night, insomnia induced thought but the general sentiment still stands).

Neither of those will be happening in my lifetime, but that’s okay. There really are other things we can do, all of us, to help other people no matter how sick we are. Here’s one idea that only requires a bit of energy…

“Medicine Bottles for Malawi” is a project with an idea so simple, it’s brilliant. I’ve tried this myself so I can vouch for how easy it is to do and how good it feels to pass on something you know will help others.

Imagine you’ve walked miles to a remote village or hospital to receive any form of medical care you can find. You are given the medication you desperately needed and now you have to start the journey back home. You don’t shake the pill bottle maraca as you walk because there is no pill bottle, heck there’s barely medicine. The pills you received are wrapped in a tiny scrap of newspaper.

A scrap of newspaper is all the protection your precious cargo has. The more I thought about this, the more I realized it’s a bigger problem than it sounds like: no safe way to carry the meds home when you are most likely walking miles, no way to really protect the meds from moisture, loss, damage once you get them home. Apparently those orange bottles do more than you think and so can you…

How to Help:

Step 1: Take your meds and when you finish the bottle, don’t throw it away! This includes bottles you might receive over the counter like for Advil, Motrin, vitamin bottles, supplements – as long as the bottles aren’t large, send them on! (Large bottles just cost too much to ship).

Step 2: Remove the label. I find it’s easiest just to peel them off, takes a few seconds, but you can also save up until you have a pile of the bottles and dump them into a bowl of boiling hot water.

Step 3: Snail Mail Send them off! I used a large flat manila envelope, it’s cheap & easy to mail.

Address it to: The Malawi Project, Inc.
3314 Van Tassel Drive
Indianapolis, IN 46240

Tip: Take a photo of that ^ address on your phone & save it as a contact! When you have enough bottles to send off, you won’t have to log back in here to find the address. I do this often and it definitely saves some energy to take photos of info.

Bonus Benefit: I saw someone online arguing that we shouldn’t send them to Malawi because they won’t be recycled when they are finished being used. I thought this question was silly since they are so desperately needed there but I like the answer all the same: Nothing goes to waste in Malawi. Your medicine bottle, when it’s empty, will be used in 100 other ways. Imagine you have very little and then think of all the ways a bottle with a sealed lid could be helpful.

Enhance your self-awareness to be an authentic leader

Posted by Erica Bettencourt

Thu, Sep 03, 2015 @ 10:34 AM

Contributors: Maria R. Shirey, PhD, MBA, RN, NEA-BC, ANEF, FACHE, FAAN via www.americannursetoday.com

Self-Awareness-2

For leadership to be authentic, programs should focus on both external programming and individual improvement. The most important factor of individual improvement is self-awareness. Authentic leadership on an individual level can be measured by an Authentic Leadership Questionnaire (ALQ).

In 2013 alone, U.S. organizations spent more than $15 billion on leadership development activities. Although much of these expenses focus on external programming, including face-to-face workshops, webinars, and e-learning, fewer resources target the internal development of leaders. To maximize sustainable leadership development, emphasis must be given to both external programming and individual improvement.

Experts in the field argue that organizations can more effectively redeploy billions of training resources by focusing on helping leaders mine their regularly scheduled lives for deep insights, feedback, strategies, and solutions. By investing in self-awareness and reflective practices, individuals have a better chance to grow as emotionally capable leaders. This article discusses self-awareness as a means to boost authentic leadership, an emotionally capable positive leadership style, and provides suggestions for enhancing self-awareness.

Self-awareness in authentic leadership

Authentic leadership is a pattern of leader behavior that draws upon and promotes both positive psychological capacities and a positive ethical climate. Elements of this definition are incorporated in the Authentic Leadership Questionnaire (ALQ) developed in 2007 and considered the definitive valid and reliable instrument to measure individual-level authentic leadership.

The ALQ uses four scales to evaluate key components of AL: self-awareness, relational transparency, balanced processing, and internalized moral perspective. (See Components of the ALQ, based on Walumbwa and colleagues.)

Components-of-the-ALQ

Self-awareness, the focus of this article, refers to an individual’s capacity to show an understanding of personal strengths, weaknesses, and impact on others. In addition to being a core element of authentic leadership, self-awareness is a key component of emotional intelligence that contributes to self-regulation and leader effectiveness.

Enhancing self-awareness

Authentic leadership can be developed. To become an authentic leader, however, requires that individuals pursue a journey of self-discovery, self-improvement, reflection, and renewal. The following recommendations offer direction for building self-awareness in your authentic leadership development journey.

Explore personal strengths and fatal flaws.
Understanding personal strengths helps to maximize potential. Although it’s your strengths that likely got you noticed as a leader, it may not be your strengths that will keep you on track. For this reason, it’s important to also recognize your major weaknesses or fatal flaws so you can minimize these and prevent them from derailing your leadership.

Completing the Strengths Finder instrument and reading about Goldsmith’s identified fatal flaws can help emphasize personal strengths without ignoring major weaknesses. Goldsmith defines fatal flaws as bad behaviors and cites examples of career derailing behaviors such as making destructive comments, withholding information, and claiming undeserved credit.

Understand your limitations and seek others to complement you and the team.
Self-awareness includes understanding personal limitations and acknowledging what still needs to be learned. Self-awareness also involves recognizing the strengths and fatal flaws in others to build a high performing team where all members complement each other and maximize the whole.

Examine emotional intelligence.
Emotional intelligence (EI) refers to people’s ability to recognize and understand their emotions and those of others. With EI, individuals can use their emotional awareness to manage personal behavior and relationships. EI has four distinctive components that need development: self-awareness, self-management, social awareness, and relationship management.

To better understand where you rate on the various EI scales, complete the simple and inexpensive Emotional Intelligence 2.0 instrument. Taking into account results of the assessment as well as suggestions for improvement can guide a personal AL development plan to develop EI.

Observe yourself and engage an observational partner.
Taking the time to record your major decisions along with the rationale for those decisions provides for personal analysis. In looking at the outcomes of decisions, you can establish a personal feedback loop that reveals what went well, what could be done better, and what patterns of behavior may be fruitful or counterproductive.

Including a trusted colleague or coach as an observational partner can offer just-in-time advice or retrospective validation with constructive direction. When leaders ask for input, it’s most beneficial for them to listen to feedback without justifying their actions or retaliating against the invited messenger.

Create down time for daily reflection.
Taking planned down time in the course of a busy schedule helps clear the mind and provide balanced perspective. This activity can involve taking a daily walk, engaging in mindfulness meditation, or reading daily scripture. Reflective down time is needed to enhance self-awareness and to cultivate authenticity.

Dig deep to gain insight.
It’s important for current and aspiring leaders to be able to ask and answer important questions such as: Who am I? What are my values? What is my purpose? What drives me? Are my actions consistent with what I value? How do others see me and is this consistent with how I wish to be seen?

Digging deep to honestly explore these questions requires time, dedication, and possibly validation from others. This type of deep reflection represents the inner work of leadership development that someone else cannot do for you.

Keep a reflective journal.
Keeping a journal helps to record personal thoughts that can lead to a higher degree of self-awareness and enhance both writing and emotional fluency. In recording daily reflections, this can help to recognize desirable as well as undesirable patterns of emotions and behavior that could either be repeated or modified for self-improvement.

A reflective journal also helps you begin to compose your individual life story, which can shed light on where you have come from, how you have learned from experiences, and provide direction for the future you wish to pursue.

Incorporate time for personal renewal and celebrate milestones.
Taking time to celebrate milestones is important for closure as well as for personal renewal. Pausing at regular intervals can be both inspiring and energizing for yourself and the team you lead.

Authentic leadership journey

Authentic leadership begins with self-awareness. Growing in self-awareness, however, entails individual responsibility, hard work, and devotion to reflective practices. You can use the suggestions in this article to build self-awareness that in turn enhances a personal authentic leadership development journey.

Ice Bucket Challenge Leads to ALS Breakthrough, Researchers Announce

Posted by Pat Magrath

Wed, Sep 02, 2015 @ 10:07 AM

Sheila Key via www.goodnewsnetwork.org 

ice-bucket-challenge-CC-Knox-County-Government

The Ice Bucket Challenge – you’ve all heard about it. Maybe even participated in it. Something that started last summer in Boston became a viral sensation across the country to raise awareness and money for ALS research. We’re happy to share this wonderful story with you. The money raised went to funding research that appears to slow down the disease and hopefully lead to a cure. This is great news!

It worked!

The Ice Bucket Challenge that flooded the Internet with videos of people getting drenched has led to a medical breakthrough.

Researchers have long known that a particular motor-neuron protein—named TDP-43—doesn’t function properly in 90 percent of ALS patients.

Now a grad student at Johns Hopkins Medical, in Baltimore, Maryland, is pretty sure he has figured out why. In experiments with mice, his team made a protein to mimic TDP-43, and after adding to the neurons, the cells came back to life.

“With any luck this could lead to the possibility of a cure or at least a slowing down of this terrible disease,” says pathobiology student Jonathan Ling. “We may soon be able to fix this in patients who have lots of accumulated TDP-43,” says Ling.

He published his discovery in the journal Science last week and credited funding from the ALS Association for making his team’s research possible–money raised through the viral Ice Bucket Challenge last year.

During the social-media sensation’s peak months of August and September, more than 17 million people—including many celebrities—uploaded wet, chilly videos of themselves and drove charitable giving to over $115 million, more than tripling what the organization had earned the year before.

Fixing the dysfunctional protein will take time, Ling and his professor, Philip C. Wong, Ph.D., said in a YouTube video announcing the breakthrough. Time and, undoubtedly, more research money.

Which is why the two are attempting to start the challenge anew.

“We want to… really push this work forward,” Wong says, as big orange buckets sneak into view on either side of the two men.

In the video, Ling and Wong each challenge three people to give more….your move, Bill Gates.

Although with the drought in California, they will probably need to drop glitter on themselves rather than buckets of water.

Related Articles:
The Origin of Lou Gehrig's Disease May Have Just Been Discovered

Have You Heard about the "Ice Bucket Challenge?"

 

 

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