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

How Many?

April 9, 2020 7:00 pm Leave a Comment

In this international pandemic, can we fathom how many of our professional sisters and brothers we are going to lose?

I am appalled at hospitals which are requiring nurses to work without personal protective equipment (PPE). Prior to this outbreak, the CDC regulatory requirement was for a healthcare provider to wear an N95 mask which would be disposed every time the wearer left the patient’s room or treatment area and, if they needed to return, be required to don a new N95.

NOTHING HAS CHANGED! Therefore, the CDC guidelines should be enforced as stated and not be adjusted.

Maybe one thing has changed and that is “Where are all the masks?” We are not a third world country and we should have plenty of masks being manufactured to bolster a stockpile.

Allowing a nurse to enter a COVID positive patient’s room without a mask is totally unacceptable. Yet, that is what is happening. Click here.

Some deflectors say that our nurses signed up for this and took an oath. That is not true. Nurses do not take an oath and nurses do not sign up to put their lives on the line though, indeed, throughout history there are many incidences of those who did. Nurses signed up to care for others while protecting themselves. Should they not protect themselves, especially in this time, they eventually will be able to protect no one.

One would not expect a fireman to enter a burning building without proper protection to fight the blaze. It would not be reasonable to expect a soldier to go into battle without proper protection and weapons. Yet today’s nurses are often asked to forego PPE on this medical front line.

Some nurses are being fired for wearing their own masks, refusing to take care of COVID positive patients without a mask and other reasons involving PPE. Unacceptable. That’s the only word for it: unacceptable.

What is worse is considering how many healthcare professionals are we going to lose in this situation. According a recent article from the Center for Health Workforce Studies at the University of Washington, it is anticipated that the death rate for registered nurses will be between 6,809 to 19,125. Any death of a registered nurse from Covid is unacceptable. These nurses deserve to be protected and allowed to see tomorrow. When they become infected, they can infect their community, family and friends.

Another article recently showed that at a Detroit hospital system there were 700 healthcare workers who tested positive for the coronavirus. Is this test like MRSA where one may be a carrier while not showing any symptoms?

Yet another publication showed that healthcare providers from 15 hospitals in one area were going to walk out in demand of PPE.

Nurses! We need you!

PLEASE keep speaking up, don’t put yourself in jeopardy. What is your health care system doing to keep you safe? Please comment below.

It is OK to feel fear during Pandemic

April 2, 2020 5:50 pm Leave a Comment

The COVID-19 Global Pandemic has everyone, including Nurses, fearful. I want you to remember that it is ok to feel the fear and that you can manage your mind to manage the fear. I am creating a video series “COVID-19 Survival Guide for Nurses and Health Care Practitioners”, as a way to say Thank You and provide you with tools to get you through these trying times. I have interviewed the top experts on various topics to help you survive this pandemic. You will receive tips and strategies to keep yourself healthy, decrease stress and protect your license and livelihood. Please go to www.EmpoweredNurses.org/covid for more information. Please take care of yourself, be safe and remember we will get through this! Thank you!

You Are Not Alone

March 26, 2020 4:29 pm Leave a Comment

It’s okay to be afraid. It’s okay to be scared. It’s okay to be worried. It’s okay when you come home to wonder whether you will be carrying the virus on you to cause you or a family member to fall ill. These and many other concerns are all legitimate. You are not alone. We all think about these things.

In time of crisis, the best thing that you can do is to manage your own mind. It’s up to you to choose how you will respond to the situation. Are you going to respond in fear or are you going to respond in faith? You can still have fear and be in faith at the same time.

The reptilian brain in our mind gives us the option to respond with fight, flight or freeze. As nurses, we are conditioned to react in times of crisis. With this reptilian brain, it causes us fear which is real and puts our body into the stress response which lowers our immune system.

So, here are some suggestions to help you with managing your mind.

We’re all fascinated with the news. We get engrossed in it and can’t stop watching. But the news can be emotionally draining. I would suggest watching the news for only a short period of time and just to get the facts of what is happening so you can get to be in the know. However, being on the frontlines, you see everything firsthand.
Put yourself first. If you don’t put yourself first, you have nothing to offer to assist anyone else.
It is important in times of fear to calm your mind so that you can think rationally. When you’re in fear, you can’t think rationally and may make decisions that can hurt you.
Get plenty of sleep. Getting rest increases our immune system. This is particularly important at a time like this.
Don’t forget to exercise even after you are working and staying busy. Exercise allows you to let off some steam while helping to improve your immune system.
Be in gratitude. Think of all the good things that are happening like how nurses are working as a team even better than before.
To win this war, we have to be on top of our A game which can be done by managing our mind and not pushing the panic button by the things I mentioned above.

Nurse Heroes

March 19, 2020 9:32 pm 1 Comment

When the WHO (World Health Organization) determined that 2020 would be the Year of the Nurse, who knew that nurses would be at the epicenter of a pandemic? I am concerned that we are putting our nurses and frontline responders at risk.

On March 11, 2020, President Trump issued an Executive Order to boost the respirator mask supply. Because of the rapid spread of COVID-19, the N95 respirators are in demand. The Center for Disease Control (CDC) loosened its guidelines to allow healthcare workers to wear surgical masks because the supply or N95 respirators cannot meet the supply demands. Also, surgical masks don’t fit as tightly as the preferred N95 masks which can filter out airborne viruses that surgical masks cannot.

The president issued the Executive Order to increase the domestic manufacturing of these masks so that they can be readily available to supply chains.

In the COVID-19 pandemic relief legislation, it required shielding nurses from exposure to the coronavirus with N95 protective equipment. However, the hospital association lobbied against this bill claiming that the protective equipment is not available and that surgical masks are adequate substitutes when a supply of N95 respirators are not available.

The nursing unions are criticizing the physicians claiming, “It is unfortunate that the American Hospital Association is encouraging its member hospitals to adopt minimum rather than optimum standards to protect patients and the doctors, nurses and other staff who care for them. In the face of an exploding global pandemic, running backward is the worst approach the healthcare industry and the CDC should take.”

In addition, the unions say that not having rules mandating N95 masks could hasten the spread of the virus. It is important for Congress to mandate N95 masks because OSHA is unlikely to ask independently. Three TSA workers screening passengers at San Jose, CA contracted COVID-19 while on the job wearing surgical masks.

While N95 masks are more expensive, it should be the standard of care. I am hoping that money will not interfere with our ability to protect our most valuable asset: our healthcare workers. If healthcare workers are not protected and kept safe, then they will not be able to take care of the ever increasing number of patients.

In addition, the National Strategic Stockpile has 13,000,000 masks in stock and the federal government will soon purchase 50,000,000 more N95 respirators, but bids to supply them from companies will be due shortly.

Are you able to use N95 masks in your hospital or are you required to wear masks with face shields?

I would like to read your thoughts and solutions to this problem.

2020 Is The Year Of The Nurse And The Midwife

March 5, 2020 2:56 pm Leave a Comment

In celebration of the 200^th birth anniversary of Florence Nightingale, the World Health Organization has chosen 2020 as the Year of the Nurse and the Midwife. Recognition and awareness will be given due to the critical shortage of nurses around the world.

Frankly, I think every day should be the Day of the Nurse. Nurses deserve to be celebrated daily for all they do. Nurses are exposed to every type of germ known to man and even unknown to man. They are exposed to every bodily substance yet go to work every day with a smile on their face with an intent to do the best that they can for their patients.

Nurses are 80% of the work force but have 0% of the power. Nurses get to stick together to make the changes that we need in health care and nurses get to be celebrated every day for all that you do.

I understand there are celebrations around the world for nurses. But I declare every day should be the day of the nurse. Is your employer doing anything to celebrate the year of the nurse? I would love to hear your comments below.

Faith Or Fear

2:45 pm Leave a Comment

As a business owner, we can make decisions from faith or decisions from fear. Making decisions from fear will probably keep you stuck versus making decisions from faith knowing that your business will be successful and what you’re doing now is ultimately going to help it grow.

A lot of times I hear business owners make excuses that they don’t have money or don’t have time. They don’t have money or time to invest in the training that they need or the support staff they need or the equipment they need. Successful business owners make decisions from the top of the mountain, from their vision. If you make decisions from where you’re at, based on outside circumstances like I don’t have any money or time to do something, then you will stay stuck and your business will not grow.

Let me give you an example. 7½ years ago, my business was going well. I was making money and for a couple of years prior to that I had a part time assistant. My part time assistant gave notice and I was really depressed. What was I going to do?

I went to have breakfast at the place down the street where I visited occasionally. There was one server who always had a smile on her face. The customers at her tables were always happy. They always had their glasses full and she always got their order correct.

On this particular day, she asked me if I was okay because I must have looked sad. I said I was upset because my secretary just gave notice. I asked if she knew anyone who was looking for a job and she said she was.

I looked at this adorable 18-year-old who had just graduated high school wondering how she would fit in my business. She knew nothing about law or nursing. She came and interviewed, and I really liked her, and she liked the office, but she said she wanted to work full time.

My mind was, “how can I hire a full-time employee? It’s double the pay of what I’m paying now and if money doesn’t come in one week, I would still have to pay her salary.”

It was a very difficult decision but what I decided was first I’m going hire based on qualities instead of skills. I can always teach the skills but can’t teach the qualities. Her qualities were she was a very warm, caring, organized, patient person. I thought that’s exactly the type of qualities I need in my office.

And then the next decision was if I was going to take her on fulltime. And I said to myself, “I want to continue to grow and I am going to need to help.” So, I made a decision from where I want to be rather than from where I was.

By hiring her full time, it allowed me to be the CEO of my business rather than spending my time on administrative matters that didn’t need my level of expertise.

My time was better spent getting clients in the door and doing the work. That was the best decision I’ve ever made. Amanda has been with me 7½ years and my business is barely recognizable. We have grown so much and I am grateful she has stuck with me.

Therefore, the moral of the story is to make decisions from faith and where you want to be rather than from fear and where you are now based on circumstances.

I hope this helps you moving forward in your business.

Budget Cuts Could Impact Nursing Education

February 27, 2020 10:45 am Leave a Comment

The proposed budget cuts which would eliminate Title VIII Nursing Workforce Development Programs could significantly affect nursing education. These programs provide loans, grants, education and training to help professionals and connect them with underserved areas.

From 2016 to 2017, 575,000 future and current healthcare providers were working in 8,400 training sites.

This program also could affect the Nurse Corps Program which provides 85% of education reimbursement for RNs and APRNs in exchange for a 2-year service commitment at a critical shortage facility.

Lastly, this could affect the National Institute of Nursing Research as it would cut funding.

As the nursing shortage is rapidly increasing every day, by decreasing funding for education initiative, it can severely affect the nursing workforce. It is of great concern with the nursing shortage, lack of patient/nurse ratios and nurses being continually asked to do more with fewer resources, it’s no wonder that so many nurses are leaving the field and potential nurses are not even entering the profession.

I do have concerns about budget cuts and the impact on our profession.

Investing in education and resources to help nurses is one strategy that, if removed, will significantly affect our ability to provide care in this country.

I would love to read your comments below.

Health Systems Must Prioritize Nurses Now!

February 20, 2020 5:13 pm 1 Comment

A recent article on Becker’s Clinical Leadership & Infection Control, written by Patti Hart, DNP, MSN, RN, the Chief Nursing Officer of Medical University of South Carolina Health Charleston Division, discussed how taking care of her staff and ensuring quality and safety of care is so vitally important. You can check out the article here.

Ms. Hart believes, as do I, that since nurses are the largest work force in the country, they have the most direct influence on key indicators contributing to an organization’s success. Among those contributions are costs and safety but additionally would include patient outcomes and satisfaction.

She goes on to state, “If nurses start cutting corners, care quality and patient engagement automatically decrease.”

Ms. Hart also does studies to make sure her nurses are getting their lunch breaks. She believes it is important to create a healthy work environment for nurses to prevent burnout because it is difficult to re-engage an employee who is already burned out.

I love leaders like Ms. Hart and this should be the norm rather than the exception.

Do you work in a work environment where your organization values nurses? Does your organization help prevent burnout and create a healthy workforce? Does your facility take an active role in preventing violence by patients?

Please let me read your thoughts in the comments below.

How Committed Are You To Having A Successful Business?

February 1, 2020 12:31 pm Leave a Comment

I always joke I was an overnight success … and it only took me 5 years!

It actually did take me that long and it should not have. Part of the reason for the delay was commitment.

There are 5 levels of commitment:

LEVEL 1. YOU DON’T CARE – Obviously, you wouldn’t be reading this if you didn’t care.

LEVEL 2. WISHING, HOPING AND WANTING – If you’re wishing, hoping and wanting to have a successful business, you’ll continue to wish, hope and want without ever making it happen.

LEVEL 3. TRYING – If you’re trying to create a successful business, you will always be trying and not really achieve a successful business.

LEVEL 4. I’LL DO IT UNLESS – This was a place where I was stuck for a while. I kept thinking while wishing, wanting, hoping and trying that I would find a “real” job. Many will say, “Well, I’ll give it a year and I will stop if it doesn’t work out.” If you have any such thoughts in your head, you will not have a successful business. It wasn’t until I got to LEVEL 5 commitment that I could actually see success coming up the road.

LEVEL 5. DOING WHATEVER IT TAKES – Once I decided to jump all in, became 100% committed and willing to do whatever it took, that is when my business started growing into a success.

Are you LEVEL 5 committed to have the success in your business? If not … just what is stopping you? I would love to read your responses in the comments below.

Your Patients Are Listening

January 30, 2020 3:42 pm 1 Comment

Years ago, my mother was in a coma for several months. We practically moved to the state where she was hospitalized to be with her.

I admit it, we were the family from h—. The SICU nurses and physicians were trying to reign us in as we thought we were going to lose her. Fortunately, she recovered.

Though she does not remember much of what was going on around her, it was surprising some of the things that my mother did remember while in a coma.

However, now some patients are secretly recording the interactions of those around them while unconscious and such audio certainly can come back to haunt you.

In the summer of 2015, Ethel Easter secretly audio recorded her abdominal surgery at Lyndon B. Johnson Hospital (Harris Health) in Houston. Using a USB size tape recorder hidden in her hair extensions, she was shocked by what she heard on playback of the audio. Click here for full article.

She initially had been scheduled for surgery to be done two months later but, due to continued extreme pain, pleaded with the surgeon to move up her surgery date. He reluctantly agreed but, because of his dismissive attitude, she felt it was important to record the surgical proceedings.

She was shocked by what the doctors and nurses said about her in the surgery suite while she was unconscious.

The surgeon called her “Precious” in reference to an illiterate, obese and sexually abused character in a 2009 movie by that same name. One of the nurses made fun of her belly button, a subject on which she was very sensitive.

Although she was under anesthesia during the surgery, the conversations were recorded in their entirety. In fact, at one point the physician ordered penicillin knowing that the patient was allergic to that medication. Indeed, she suffered visibly adverse reactions as a result and experienced breathing difficulties for several days.

Ms. Easter sent a complaint letter along with a copy of the recording to the facility’s Director of Nurse Management who thereafter responded that “after carefully listening to the recording that you provided, Harris Health does not believe further action is warranted at this time.”

Apparently, the risk manager believed there was no wrongdoing because no one complained about the incident.

Ms. Easter may have filed suit against the hospital, but I don’t have any records of this.

If you believe that your coworkers are practicing unprofessionally, you have a duty to report it. If you are aware and do not report it, then you are part of the problem rather than part of the solution.

In addition, everyone should act as if they are being recorded. With today’s recording devices being so small and being a part of their phone, one never knows what is being recorded. In fact, it is legal to record a conversation in some states if only one person knows it is being recorded. If something is recorded, it could come back to haunt you.

In home health, it’s particularly common for family members to have a minicam in the room. Therefore, acting professionally at all times is of the utmost importance.

Of course, patients have an expectation of privacy. The staff also?

How do you feel about being recorded without your knowledge or consent? Should this be expected? Should people be required to let you know that you are being recorded?

I’d love to hear your comments below.

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