Lorie A Brown, R.N., M.N., J.D., Author at Empowered Nurses

The Tale Of An Evil Nurse

October 26, 2023 11:54 am Leave a Comment

Lucy Letby, a 33-year-old NICU Nurse in the UK was recently found guilty of murdering 7 babies and trying to kill 6 others over a two-year period. She killed or injured the infants by injecting air or milk directly into the stomachs of some, 2 were slain with insulin and others had their breathing apparatuses compromised. And these are only the ones we know about! A question that remains is just how many other children were victims.

Police arrested Letby after authorities noticed a spike in infant deaths at the hospital and noticed Letby was on each shift where a questionable infant death occurred. She denied all the charges despite Police finding a personal note in her home reading “I am evil, I did this,” which police said was “literally a confession.”

The lengthy trial started in October 2022, and it took 145 days in the UK for the jury to go over all the evidence before deliberating for another 22 days to find Letby guilty of the seven murders and seven charges of attempted murder.

The convicted murderess was sentenced to life imprisonment with no possibility of parole. There is no death penalty in the UK, even for such horrific crimes as these.

Babies are the most vulnerable beings of the human race particularly when they become patients of healthcare providers. Yet we seem to be at a loss to account for just how this Nurse came to be allowed to care for these infants.

It is scary when a Nurse, put in a position of such high-level trust, goes off the deep end!

I guess we will never know why she chose to take these endangering and fatal actions, but the good nurses do protect our patients. Should there be a bad Nurse out there, we need to take any and every step to stop them so that these tragic and horrible events never happen again.

Who Is Maya Kowalski?

October 19, 2023 11:36 am Leave a Comment

Maya Kowalski, daughter of Registered Nurse Beata Kowalski, was 9 years old in 2015 and suffering debilitating pain. She was diagnosed with Complex Regional Pain Syndrome (“CRPS”), resulting in symptoms such as stiffness, spasms, and limited mobility.

Her mother was able to find a doctor who was able to properly diagnose her, and he prescribed ketamine treatments to block the pain receptors in Maya’s body, allowing her body to revise the sensitization process.

In October 2016, Maya had a horrific flare up of the CRPS and her mother took her to John Hopkins All Children’s Hospital in Florida. Unfortunately, the hospital concluded that Beata suffered from Munchausen syndrome by proxy in making up fake symptoms for her daughter and chose to report this case to Child Protective Services (“CPS”).

The hospital kept Maya for 90 days and was videotaping her for 48 hours. In addition, she was stripped down to her underwear without her family’s permission and photographed. I cannot imagine what it would be like to be a nine-year-old girl subjected to this and not being able to see or talk to her mother.

Beata, having been barred by CPS from seeing or speaking to Maya subsequently became depressed as it certainly caused her stress as well. Subsequently, after leaving two notes, Beata took her own life!

The family is suing John Hopkins Hospital for malpractice, asking for $220,000,000.00 and one physician from named in the suit has already settled.

Meanwhile, the judge has halted the ketamine treatments for Maya as the hospital staff disagreed with Beata’s insistence for the treatments.

This trial is currently underway in Tampa, Florida and can be followed on Court TV with excerpts available on YouTube. There is also a Netflix documentary available titled “Take Care of Maya”

There are always 2 sides to the story which is what makes a lawsuit. Johns Hopkins claims they had a mandatory duty to report a suspicion of child abuse and blames the state on making the final determination. The Kowalski’s claim there was a rush to judgment to report and did not contract Maya’s doctor who diagnosed her with CRPS and was treating her with ketamine.

I would love to hear any thoughts you might have on this matter and welcome you to please note them below.

The Coming Exodus of RN’s

October 12, 2023 8:22 pm Leave a Comment

I feel like I sound like a broken record continually harping on how many registered nurses are expected to leave their careers and how the path will affect mandatory state safe staffing. Along with previous research, another survey on this subject has been published by the National Council of State Boards of Nursing. In it, 335,000 registered nurses and licensed practical/vocational nurses surveyed in 2022.

That survey found that one in four nurses intended to leave the profession in the next four years. This is a staggering statistic, especially when we realize that since the COVID pandemic began, about 100,000 registered nurses have already said goodbye to their careers!

With 25% of our country’s 4.5 million registered nurses expected to quit by 2027 means a potential loss of approximately 1.1 million who will move on to other job opportunities or continue their education to become nurse practitioners.

The need for nurse practitioners is growing and, according to the U.S. Bureau of Labor Statistics, present projections call for a 38% increase in the need for nurse practitioners between now and 2032.

Interestingly, many nurses who leave to become nurse practitioners think it will be better for them. Some want scheduling freedom to do travel nursing or remote nursing. But the problems in healthcare exist no matter where you work.

The main culprit for nurses leaving is under staffing. For the first time ever, centers for Medicare and Medicaid services have proposed new staffing regulations for long term care facilities. Specifically, it would require facilities to always have a registered nurse on duty and that each patient receives at least 2.5 hours of direct care from a certified nursing assistant.

As pointed out to me by a colleague, I do not believe that this regulation took into consideration LPNs/LVNs which are the bulk of staffing in long-term care facilities. Many say that they would not be able to attract nurses to work in such facilities, which could mean they might be closing their doors.

The average nurse turnover is between 8.8% and 37%. It appears that the issue is not necessarily staffing alone but also how the nurses are treated, valued, and respected. If nurses are continually working short, that leads to burnout and frustration.

I’m not sure what the answer may be, if any. I initially tried to help nurses become empowered in their role working for corporate healthcare. However, I am seeing that I cannot do this alone. It’s going to take all nurses to stand together to make the needed changes we want to see in healthcare.

What If There Were No Nurses?

October 5, 2023 3:57 pm Leave a Comment

The main reason, or maybe the only reason hospitals exist is for nursing care. As an intricate tapestry of healthcare, nurses are the threads that bind all of health care together. They are compassionate caregivers and tireless advocates. Yes, they are unsung heroes who day and night work diligently to ensure every patient’s well-being.

Yet what if one day, every … nurse … in … the … world … vanished?

If all these angels of health disappeared at the same time, what would happen to the fragile balance of health care as we know it? Would health care even be possible?

It is questions like this that give me pause to reflect on the profound and unbelievable impact that nurses make every second of the day, all over the world.

When we enter a hospital, chances are that the first person we see is a nurse. They reach out, hold our hands when we’re scared, and they are the ones who make us feel human.

Amid all the medicines, devices, machinery and sterile environments, the essence of health care would change drastically without the presence of nurses. I know with AI apparently on its way to the forefront, many aspects of care by nurses eventually will be managed by these artificial means.

Although I believe AI can never replace a nurse’s judgment, its presence will become increasingly prominent. Nurses are the ones who can catch subtle changes in a patient’s condition; the ones who administer medications and treatment and the ones who tirelessly advocate for the best possible care. Consider that without nurses, who would be there to hold a patient’s hand both literally and figuratively, during their most vulnerable moments?

Will there ever come a time where we have a world without nurses? I certainly hope not. Yet it is a stark fact that nurses are leaving the profession in droves. The loss of nurses would have a profound economic consequence. Health care systems would face increased costs due to inefficiencies; they would pay higher salaries to attract doctors or other health care professionals to fill the voids. These costs would trickle down to the patients, making health care more expensive and less accessible.

Nurses play a vital role in preventative care and public health. If they were not available, what would happen? The emotional toll of losing nurses would be immeasurable. Beyond their clinical roles, nurses are the source of hope and comfort for almost everyone. I am hoping we will never come to that point.

Thank goodness nurses are the lifeblood of our health care system and the prospect of a world without nurses is incomprehensible. We must recognize the value of nurses as playing an indispensable role in health care. And nurses deserve, indeed they must be appreciated.

You Don’t Need to be Perfect

September 29, 2023 5:14 pm Leave a Comment

As nurses, the well-being of our patients depends on our precision and accuracy. However, when it comes to running our own business, the pursuit of perfection can be a double-edged sword.

First, is there really such a thing as perfection or are you setting yourself up for an unrealistic expectation? Remember when we first became nurses and hit the floor? We were neither competent nor perfect! We needed the assistance of the mentor to help us through everything.

The nice thing about being a business owner is that, unlike with nursing, patient lives are not at stake. Here is why perfectionism does not work as a business owner.

Perfectionism creates an overwhelming pressure, you’re no longer caring for patients but, instead, you are managing finances, marketing, operations and more. Trying to excel in every area simultaneously can lead to anxiety and a quick burnout.

You’re not going to be good at all these areas from the get-go. It takes time just like your first day as a nurse when you were acquiring your nursing “sea legs.”

Perfectionism does not work because it slows down your progress. When you are a perfectionist, you don’t readily take action because you want to make sure that it’s perfect! Perfectionism is a place to hide and keeps you small, so you never actually get your business off the ground.

As a perfectionist, there is a fear of failure where, “If I don’t get it perfect, I may fail!” Yet, there are no failures in business; there are only learning experiences. Setbacks along the way are valuable learning opportunities which help you grow and improve.

Perfectionism can stifle creativity and innovation. As nursing is an evidence-based practice, however, with business, many approaches may work with some may work better than others. But when you’re a perfectionist, your creativity can be repressed.

Being a perfectionist can blur the boundaries between work and personal life because you tend to overwork to make sure that it is perfect. This may lead to burnout and affect your health.

As perfectionists, we set unrealistic expectations not only for ourselves but also set high standards that can negatively impact our team and our customer relationships. You might appear unapproachable and overly critical. Clients need to know, like, and trust you before they hire you. Therefore, being authentic and transparent is much more endearing than trying to hold yourself to an unattainable standard of perfection.

As a perfectionist, you can also miss opportunities because as a business owner, there is some degree of risk and fear of imperfection holding you back. As a nurse business owner, we are always lifelong learners. Embracing imperfection encourages the mindset of continuous learning and adaptation.

It is profoundly important to find joy and fulfillment in your work. Perfectionism is “a thief of joy” and can adversely impact your journey as a nurse business owner. Therefore, while perfectionism may have its place in healthcare, it doesn’t necessarily translate to the world of nursing entrepreneurship.

Embracing imperfection does not mean compromising on quality or professionalism. Instead, it means allowing yourself the grace to learn, adapt and grow without the relentless pursuit of being perfect.

Strive to be perfectly imperfect. By doing so, you can build a successful nursing business that thrives while nurturing your own well-being and satisfaction along the way. Remember, you are not just a nurse, you are a nurse business owner.

And that journey is beautiful in its imperfection.

CEO Salaries Soar Into The Stratosphere

September 28, 2023 11:36 am Leave a Comment

Were you aware that the CEO of Children’s Hospital of Philadelphia was paid $7,700,000.00 in 2021? And got a bonus of $5,600,000.00 to boot? That’s more than the hospital had provided in all charity offerings over the previous three years!

That package averaged to over a quarter million ($256,000.00) a week; almost $6,400.00 an hour!

When I first heard of Madeline Bell’s mind blowing salary, I was like, “Oh my gosh, this is crazy!”

I was glad to learn that Ms. Bell is a nurse and as such would be able to command such a high salary, but I’m hoping she remembers where she came from and uses her position to support and honor her nurses.

Remember the days when healthcare was the responsibility of a community, and we took care of our own in those small community hospitals? Now healthcare has become “corporatized” with multiple facilities throughout the country.

Consider:

1. When CEOs command such huge salaries, it sends a message that profit is more important than patient care, eroding the ethical foundation of the healthcare system.

2. The staggering salaries of healthcare CEOs divert resources from where they’re needed to improve medical infrastructure, hire more healthcare professionals, invest in research, and make healthcare services more affordable and accessible to all.

3. With the escalating cost of health care, is it fair and just for CEOs to command such high salaries? These salaries trickle down to patients in the form of higher fees and insurance premiums.

4. If you know the salary of your CEO as a frontline healthcare worker, how do you feel? These huge salaries affect staff morale and retention.

5. The compensation structures for healthcare CEOs ties earnings to financial performance, again putting profits over patients.

6. When healthcare CEOs make such huge salaries, it can erode the public trust and raise questions about the facilities’ commitments to its admission to providing healthcare services for the community benefits.

7. When high CEO salaries can be seen as diverting resources away from initiatives that could address broader healthcare disparities and social determinants of health.

Therefore, while I am pleased that a nurse like Ms. Bell is at the helm at Children’s Hospital of Philadelphia, commanding such a fantastic salary, other CEOs, mostly male, are commanding even bigger payments!

It’s time to equalize the playing field between men and women and between CEOs and staff. I am not saying that CEOs don’t deserve to be compensated, but maybe put back $5,000,000.00 into the nurses’ pockets?

I’d love to hear your thoughts on this and invite you to please leave a comment below.

Nursing Pay Caps

September 21, 2023 11:33 am Leave a Comment

At the University of Wisconsin, the nurses are unionized. Unfortunately, a year ago Governor Tony Evers stepped in to negotiate a deal to avert a strike at the UW Health hospital in Madison.

The union for the nurses wants UW Health to provide greater pay transparency and to remove salary caps. One of Wisconsin’s US Senators will be speaking to the group to call for urgent progress toward retention and safe staffing in quality care.

The hospital administration announced a 3.5% annual pay increase for staff and a 2.2% increase to the pay scales. Regrettably, for nurses at the top of the pay scale, they will be given a lump sum payout which just gives them a check for roughly $500.

This is insulting and a slap in the face for nurses who have been faithfully serving patients, the community, and the hospital for the longest time.

We need seasoned nurses to mentor our new nurses. Having this cap on their salary is unwise as the nurses can go elsewhere for more pay and possibly even sign on bonuses. Last year the legislatures for the country were trying to cap travel nurses. This is not a way to attract nurses.

What the legislatures really wanted to do was cap the agencies who make money, who profit off the backs of nurses’ hard work by providing them with travel contracts. This is just another chink in the problems with the nursing profession.

If you are working at a place where you have reached the salary cap, I strongly encourage you to reach out to your state representative or senator to change this policy as nurses do deserve to make more.

While I think that there is an ultimate cap at some point, I don’t nurses have yet to reach it.

I would love to hear your thoughts in the comments. Please let me know your thoughts. Thank you.

Nurse’s Rant Goes Viral

September 14, 2023 4:25 pm Leave a Comment

Lex Hinkley, RN, BSN, a traveling nurse posted a video on TikTok that has gone viral. I don’t know her though we both live in San Diego. Regardless, she is very upset and concerned about the safety of our patients. Patients are being discharged from health care facilities with no place to go.

The nurse talked about how these patients are being placed in wheelchairs, taken from the emergency room, and dumped outside on the sidewalk. No need to say it twice but this is obviously very concerning. This is NOT the type of care we want to provide to patients, and it is disturbing to see health care facilities treating human beings like this. She also goes on to say how things will not change until corporate healthcare is dismantled.

While I agree with everything this nurse has said, I am concerned about her use of social media, especially using profanity, in hopes to make a change. I think for changes to be made in health care, we must band together and find solutions rather than hopping on social media and just condemning it.

Remember, social media platforms are not owned by you. Even if it’s a private group, it is possible for your information to still be discovered. I am concerned about this nurse and her future. The Board or current or future employers may consider this unprofessional conduct.

If this nurse is concerned to this level about what is happening in healthcare and it goes against her ethical beliefs, maybe either this isn’t the right fit for her or there are other ways to solve the problems. The other thing she did discuss is the EMTALA law, which is the anti-dumping legislation which requires healthcare facilities to take all patients, stabilize them and then release them.

As long as the patient is stable, the facilities have the right to release them. The problem is where can they be released? Our country is inundated with people that call the streets their home. The nurse called them, “unhoused.” But what do we do with them?

Here in San Diego, there is an anti-camping ordinance which prohibits tent encampments in all public spaces in the city. But they did build some tent cities in which people could camp, rest, shower and maybe even get a hot meal.

However, and unfortunately, the only remedy the police have is to enforce this anti-camping ban. Yet, how can they expect those people to go to court or to pay the fine when, after all, they are homeless?

This is a huge problem in our society, as well as healthcare, which needs to be tackled so that people can be treated humanely in our society.

I would love to hear your thoughts on this matter.

Finally! A Proposal For Mandatory Minimum Staffing Standards For Long-Term Care Facilities.

September 7, 2023 4:47 pm Leave a Comment

I was so excited to see that the Centers for Medicare and Medicaid Services (CMS) issued minimum staffing standards for long-term care facilities. This proposed rule seeks to establish comprehensive nursing staffing requirements. I love this initiative because residents in nursing homes are not always given the best care due to short staffing. Although there are requirements that facilities must provide sufficient levels of staffing pursuant to the OBRA regulations, chronic understaffing is prevalent in long-term care facilities.

The rule proposes 0.55 hours per resident day for nursing care and 2.45 hours per resident day for nurse aids. There is also a requirement to have an RN on site 24 hours a day, seven days a week. It will be so interesting to see if this rule passes. It is open for comment and if you support the rule, I highly recommend that you comment so that your voice can be heard.

I’m sure the long-term care facilities are going to balk at this proposed regulation, but one of our most vulnerable populations, our elderly, deserves to have minimum care. Even a nurse for 0.55 hours per resident day, which is basically less than one hour of care for the entire 24 hours is questionable but hopefully with more nurse aides on staff, patients will get the care that they need.

Residents in long-term care facilities are medically complex and can be high acuity patients. Creating consistent standards will hopefully reduce the risk of unsafe and low-quality care across long-term care facilities.

I also love the idea that an RN be on staff seven days a week to provide direct resident care. While I think LPNs are fantastic, the assessment skills of a registered nurse are definitely needed.

The rule also states that the CMS wants to hold nursing homes accountable to ensure that residents receive safe and high-quality care. I hope that there is some mechanism to hold responsible facilities that do not comply with the mandatory minimum standards. CMS is proposing that it will take away federal funding if the facility fails to implement these mandatory minimum staffing requirements.

The CMS does discuss good faith efforts to hire and retain staff through development and implementation of a recruitment and retention plan but trying isn’t good enough. These residents deserve consistent care.

The plan is to stagger implementation. Phase one would require facilities in urban areas to comply with facility assessment requirement 60 days after publication of the final rule. Phase two would be for urban areas to comply with the requirement for an RN to be on site 24 hours a day, seven days a week. And phase three would require facilities in urban areas to comply with mandatory minimum staffing.

These would be three years after the publication date of the final rule. Seriously, I don’t think we can wait three years! While I understand that the rulemaking process takes time, this needs to be implemented now!.

The CMS does acknowledge that rural long-term care facilities face difficulty providing safe staffing as well. This rule has different requirements.

Although I know staffing is difficult in rural areas, if the facility is competitive, has a great working environment and pays well, they should not have a problem with staffing.

Your comments to this proposed rule are invited through November 6, 2023. I truly hope that you will comment so that our elderly, who are the most deserving of safe staffing can get the care they need.

Will Money Help Solve The Problems In Nursing?

August 31, 2023 6:53 pm Leave a Comment

The Biden Administration announced that it is awarding more than $100,000,000.00 to train more nurses in growing the nursing workforce.

However, will adding more nurses solve the problems in nursing where nurses are leaving in droves?

I don’t think so. The problem is the context of nursing is practice and how nurses don’t feel valued and appreciated by administrations. Context means environment.

$8,700,000.00 is going to help LPNs become RNs; $34,800,000.00 will go towards advancing The Nursing Education Workforce Program; and $30,000,000.00 will go towards advancing nursing education – nurse practitioner residency fellowship programs and $26,500,000.00 will go to nurse faculty loan programs to provide low interest loans and loan cancellation to incentivize careers as nursing faculty.

While I am glad that this bill is addressing nursing faculty, I truly believe that nursing is in our DNA. You cannot pay enough to have people to do the things that nurses are required to do. Therefore, putting money into adding more nurses to the profession is, in my opinion, not going to help.

The system is broken and must be fixed or is going to continue to be a revolving door with people coming and going.

I would love to see more money being put toward nurses’ salaries but putting in more money is not going to solve the problem. Until healthcare facilities show how valuable and appreciated nurses are, listen to them and implement their feedback, things will not change.

At this time, nurses are treated like disposable workers, “we can always get another one!” Unfortunately, it is more difficult these days to get another nurse to replace those who leave.

Also, it takes a lot of money to orient a nurse to a new facility.

What are your thoughts about adding more money to nursing education? Will it solve or decrease the problems in nursing.

Give me your comments and post them below.

Author Archives: Lorie A Brown, R.N., M.N., J.D.