Social Networks & Personality & Behaviors

Can't remember where I found this. 

I thought this was a great way to illustrate the Social networks out there and link them to the various behaviors....

I do Facebook and that's about it. Looking at the chart.....I think I am more of a "stalker" than anything....

I like to keep track of my many nieces and nephews without them having to go to the "bother" of contacting me specifically with updates.  It's a great way to keep on top of events and milestones.

It has also proven to be a great way for my cousins and sundry to keep in touch since we live in all four corners of this continent.


I just don't understand the need to twitter.  I guess that is my age showing.  But really, on Facebook, I do get annoyed when every. last. little. move. is. recorded.    I don't want to know ABSOLUTELY EVERYTHING.

If you were to stumble upon my Facebook page (highly unlikely due to my security level settings) you wouldn't know that I was an RN.....as there is absolutely nothing on it that indicates that in any way. 

I keep my work very seperate from my social life, and except for the occasional phonecall from rellies that want to know what such-and-such a symptom means....... I keep a low profile.

Oh.  Except for the occasional comment on how *nice* someone's veins are.......

Agency Nursing & Needless C/Sections

Some nurses thrive in agency nurse assignments.  I usually didn't mind them. 

I was ok with it for approximately 2 years, but after working at several hospitals across the border, I threw in the towel and chose the one hospital that I really wanted to work at - and left the agency.

I wasn't allowed (by signed contract) to work for any hospital I had been contracted to work for at least 6 months so I waited the obligatory months - then applied at my favorite hospital.

What did I like about that particular hospital?  It offered women a little more freedom in labor and also the choice of midwives. The OBs were quite good and a little more relaxed than the other hospitals I worked at. "Epidural rules" were a little less stringent.  They didn't rush to the OR. The group of nurses I worked with were wonderful.

This wasn't the case with all the hospitals.

 There was one teaching hospital amongst my assignments that I found way too restrictive to the moms during labor. You would never see the mom's roaming the halls while laboring.   They had medical students and residents galore and it seemed to me that the patient hardly saw the actual OBs during their stay - which would have been ok if the decisions made about the patients were actually discussed with the patient and the nurse.   In fact, most of the time - from what I observed - in the OR - the OB didn't even scrub in - the one I saw just threw on a gown over top what he was wearing and yelled orders from the door holding a mask over his face.

Here is what I experienced:

I was part way through my orientation with an RN/Midwife (licensed from another state so not a practising midwife) and the woman was laboring in the tub with the waterproof fetal monitoring system.   The strip looked excellent. Mom was working hard.  Progressing.  Doing well. Coping well.  The strip was reassuring.... a couple of dips but nothing alarming.  Then - all of a sudden - a resident struts in - looks at the strip - then walks out.  Didn't say a thing to us. The next thing I knew, a STAT C/S was ordered.....

I looked at the other nurse I was orientating with in disbelief.  I could see she was puzzled.  I asked why -   but any discussion was overruled by the countless flow of people in and out -  the decision was made - and the poor mother was coerced into signing the consents with horrible scenarios as to what could happen to her baby - and she was whisked away to the OR on the unit and subjected to a c/s.

At the nurses' station I looked at the strip.  I swear - not ONE thing on that strip that warranted a C/S never mind a STAT C/S.  I showed the strip to another nurse I had met there - one from the same province as myself - one that I later would end up working with back in BC.......and told her - "Take a look at this strip. Do you see anything on here c/section worthy???"

She looked it over.....and shook her head.  "They sectioned her? What reason did they give?"

Me: "Fetal Distress"

She:  "Well - if they think that strip shows fetal distress - there are going to be a lot of sectioned women here"

Me: "I know.  Sad.  Know what?   If this is the way they operate....I don't think I can work here."

"Ya" she agreed. " I have another month and I am done too"

That same day I phoned up the Agency.  They tried to tell me that I had signed an agreement to work at that particular hospital for 3 months.   I told them I didn't care what was agreed to or signed.  I wasn't working anywhere where they would have me taking care of women that needless surgery was being performed on without proper discussion and explanation and reason.  It was a matter of principle.

I quit.

I just couldn't do it.  After working in a province that allowed so much freedom to the woman in labor, I just couldn't go back to the restrictive environment in that place.

AND - more Antlers....

So I am not the only one.....Catalogue Living also thinks antlers are blogworthy....  I love that website! I know I have mentioned them before....but their commentary just makes me laugh.

Visitors in the Fall......

We have a little visitor in our yard.  This dove seems tame - you can walk right up to it.  He doesn't even seem to mind the cat in the yard.  Not sure what he is up to, but he has been in our yard for a couple days now.  
Perhaps he likes the grapes we have growing on the fence.  Perhaps he's a little drunk.  

I like to think that he is just being friendly!

What you see Driving along the freeway....

 My husband and I drove down to Central Washington to visit his family.  Great scenery along the way...it reminded me of where I grew up in British Columbia.....desert terrain, dry climate, tumbleweeds, ponderosa pines and weird rock formations from ancient volcanos.   The California Desert sneaks up just over the 49th parallel into Canada and there you find much of the same scenery as you do in California's desert country.  No wonder I felt so "at home" when I lived in California.

Interestingly enough,  along the way.....we spotted 5 semi trucks on their way from Montana to Vancouver....  Brad Paisley's H2O tour on their way to Vancouver.....all with the same logo on the side.  I managed to catch two of them....but only the tail end!

I guess we weren't the only ones on the road that day!

Water Is such a Precious thing.

Emergency Room Blues has a video up on her blog - go and watch it...and participate.

I have had this blog entry sitting on my list-to-publish since mid August  - and was *just * thinking about going back to it again blogifying it.....when ERB posts her link.   So....a little earlier than October 15th - here is my blog post on water.   It's amazing that something as simple as this straw can save lives.

It's a good cause.  :)   We are luckier than we think we are........it really could be worse.  And the water from my tap is the best in the world.  My sister from the Philedelphia area told me so - when she was here this summer.

And this is what I am thankful for this Beautiful Canadian Thanksgiving Day Weekend......Water.  Clean, fresh, sparkling ..... water.

And the Book Goes to : Jo @ Head Nurse

Thank you all for your submissions!   By far, the most suggested name was Jo at "Head Nurse". ( Click on the book in the column to the right to read about the book)

So, Jo will be sent this book.  At first I had to ask her,  just in case.   I know she is newly diagnosed with cancer and not sure of how she would react to a book on the same topic....but she replied:  "Yes, I'd love to have that book. I love it even more that people thought of me.Thank them for me, will you?"

"I'm so freaking touched by everybody's love; I'm looking for a way to give it back"

Well, Jo, to tell you the truth,  I think you have given so much and more with your blog.   I really don't think you need to look for "a way to give back", unless you so choose to do even more.   You have given insight into the world of nursing for very many years, exposed your vulnerabilities and your foibles and imperfections, didn't hold back on your emotions - even when it means serious venting... and have been the inspiration for very many nurse bloggers.   You have been the shining example for newbie nurses,  an advocate for the patients/ the vulnerable out there who need it......I am thinking that you have already done more than simply "give it back".

So, thanks Jo....and here's to many more years of blogging! We all wish you Health and send out those Positive Vibes !   And more than that, we wish you Healing....and not just for the selfish reason of reading your blog for years to come....but simply because ... the world of nursing is a better place with you in it.  And that's not just ego-stroking! :)  It's the truth.

Enjoy your book! :)

ohhhh....another year, another day.......

Does this ever take me back.

One of the songs I sang on the beach...with my guitar....feet dug into the sand....breeze through my long blonde hair - parted in the middle as we did in those days.....psychadelic printed shirt.......boyfriend at the time driving up from Oregon in his little VW beetle........."the smell of maple leaves in fall"....

October 1960s......because I HAVE to~!

When I was just a little girl..mid 1960's - I couldn't have been any more than 8 or 9 yrs old - my older sister  HAD to learn a poem for school.....and she asked me to help her learn it - reciting it over and over...... in our little bedroom by the light of the Christmas lights hanging from the eaves outside our window.

My older sister and I shared a bedroom in our tiny 1000 sq ft, 3 bedroom house that was heated only by a little fireplace in the living room - and every cold night at bedtime we would hold our blankets up to the fire for a few minutes and then - RUN! to bed - blanket wrapped around us - and that is how we kept warm in those cold wintry nights.   Mom and Dad were in one bedroom the two boys in the second and us girls - three of us when my little sis came along - all in the third bedroom.
It was one of those types of evenings, by the light of the Christmas lights outside our window that I memorized this poem......

The Poet was Canadian: Bliss Carmen (1861-1929)

The poem: The Vagabond Song  (circa 1919)

I am not sure that my sister remembers it....but I certainly do, and recite it - with drama! - EVERY fall since then....usually every October 1st ....and remember.....

I will never forget it....the poem touches my soul....Bliss Carmen has a way with words....

THE VAGABOND SONG
There is something in the autumn that is native to my blood
Touch of manner, hint of mood
And my heart is like the rhyme
With the Yellow and the Purple and the Crimson keeping time.

The scarlet of the maples
Can shake me like the cry
of Bugles going by
And my lonely spirit thrills to see the frosty asters
Like smoke upon the hills...........

There is something in October that sets the gypsy blood astir
We must rise and follow her
when from every hill of flame
She calls and calls each vagabond by name.



the Leaves outside our house



Murder in the Hospital: Blaming Nurses

My last posting of May - May 29th. I thought since there have been a few deaths recently related to medication errors, I would repost this.  This is what happens when people jump to conclusions and investigations are not carried out properly.
It is easy to point fingers at the suspect, but what happens when you actually are innocent and everyone assumes you are guilty?  There but for the grace of god......
Here is a young nurse's story - the one that rocked our nursing world back in the early 1980s.


When I was a young nurse back in 1981-1982, a Canadian court case shocked the nursing community. It was enough to have every nurse in Canada take stock of their vulnerability.

It was discovered that there was a higher than average death rate in a certain Pediatric Cardiac Unit at Toronto's Sick Kids Hospital. Up to 46 babies died "suspiciously". An MD told his friends, then went to the police - "Someone's killing our kids" he claimed.

You can read all about it if you google "Susan Nelles nurse". She was accused of murdering 4 babies. All the evidence was circumstantial. Yet, she was arrested and hauled away by the police and incarcerated until the judge exonerated her due to insufficient evidence almost a year later. The biggest part of the prosecutors case rested on her close vicinity to the Unit plus the above MD's observation that she wasn't sufficiently grief stricken - according to his standards - while she was doing end of shift paperwork in the am on the deceased baby's chart.

Turns out that she wasn't even there for 3 out of the four suspected "homicides" ....and the MD had no clue what the RN was like, never having spent more than a few moments with her. Also, it was found that the test that detected digoxin - the suspected killer - was not only experimental, but flawed. Yet, because of the proceedings, her reputation was damaged and it caused stress to her family - enough stress that her father, an MD , died of cardiac arrest during the proceedings.

Her legal costs back then exceeded $200K which was the price of 3 average homes.

She lost almost a year of her life, spent under a microscope and denied a normal life. The newspapers reported extensively on it and people were ready to play judge and jury, calling for "justice" to be rendered on this nurse.

She was stripped of dignity, privacy and her reputation. You can still find her name in thesis', newspaper articles online and general hits.....1,710 google results for "Susan Nelles nurse"....her notoriety just won't die. In March 1991 the Halifax Chronicle Herald reported that she was still "haunted" by the accusations of murder that had been made against her.

Circumstantial Evidence.

Imagine - you could end up in Jail for a good chunk of time because coincidence sets you the wrong place at the wrong time ( although not as many times by a long shot as another  nurse who was later under suspicion but no charges laid).

Then, because you have a law student as a roommate, and she suggests you should see a nurse liability lawyer because of the "talk" about the unit and gives you a couple of phone numbers, and when the police come to question you - you mention that you wish to contact a lawyer first and you pull out those handy phone numbers - the police think you are exhibiting "suspicious behavior".

Then an MD that flies through your unit once in a while feels compelled to testify about your "lack of grief" and the "scene of the crime" has been disposed of due to hospital inattention despite all the suspicions.

Oh, but you say - that was almost 30 years ago.

Think it couldn't happen today?

Take a look at Lucy De Berk, the Dutch RN that was recently - in this past decade - incarcerated for 6 1/2 years, convicted of serial murders (7) with the "proof" based on incorrect statistical data, wrongly analysed and wrongly interpreted by a statistician.

There were no eyewitnesses or evidence found. Only the statistical improbability of babies dying on her shift. In the end, all the deaths were attributed to "natural" causes. No evidence whatsoever. Just stats and somebody's say-so.

But, the damage remains. It took a physical toll on De Berk. She suffered a stroke while incarcerated. It also took a toll on her personal life. As a newspaper reports: "On Wednesday the Arnhem court is expected to conclude the case by declaring her innocent of the murders, a course of action urged on the court by the public prosecutors.

 It should bring to an end one of the worst miscarriages of justice in Dutch history, but will it clear her name? Many Dutch people appear unpersuaded." The public don't see the injustice of it all. She will still have to deal with this - probably for the rest of her life.


The thought that a nurse that is innocent can be hauled up before the courts and judged by society, still gives me a chill. I am fairly careful in what I say out loud in the hospital. I might think some things......who doesn't.....but what comes out of my mouth in a hospital setting is fairly measured.

I am uber-careful with my charting, drugs and such. But how do you protect yourself when you have done nothing wrong?

Interestingly enough, through the whole process, who was the most to blame for the accusations?

Points to be pondered:

1. Although the deaths increased in the Cardiac unit, the overall deaths in the hospital did not. Why? Apparently babies were being moved out of the ICU before they should have been and put on the Cardiac Unit.

After Nelles arrest, the hospital changed the policy to keep the patients in ICU longer post operative. So, statistically speaking, post arrest - there was a dramatic decrease in the deaths on the Cardiac Unit itself, but overall - no change. The hospital had just redistributed the deaths to the ICU, but in the process- further incriminated Nelles.

2. The supposed presence of digoxin may well have never existed. In the Nelles case, the tests the courts relied on to detect digoxin in the deceased and exhumed babies were experimental and was proved to show false positives. It was actually impossible to test whether digoxin was even present.

Also, hospital policy dictated that bodies be cleaned off, IV tubing dumped and bedding around the baby sent to laundry etc....therefore perhaps critical evidence discarded - evidence that may have cleared Nelles immediately.

3. The Dutch Nurse? Statistics and psychology drove this case. De Berk's conviction - and even the 'proof' that there were any murders at all – let alone by whom – were almost entirely based on flawed data and flawed interpretation.

Apparently the traces of toxins found in the bodies of the deceased in this case could have been residual from treatments done. There was no evidence linking De Berk to any of the deaths except she was on shift at the time of expiration - and the stats showed that there were more deaths on her shift by chance than could be statistically proved possible.

4. Convinced she was guilty, the police and the managers of the Juliana Children's Hospital assembled a compendium of "data" in which it seemed every death became unnatural when it had occurred during, or after, a shift in which she had worked. For one of the alleged murders, it was established on appeal she had not even been in the hospital for three days around the time it occurred.


Their saving grace?:

1. The nurses working with Nelles all supported Nelles throughout, testifying opposite of what the MD did....which was a major factor in the judge dismissing all charges. Their solidarity in blaming hospital policy went far to exonerate Nelles. No thanks to the one
MD (Dr Fowler) who seemed insistent on pushing his theory of guilt by facial expression.

2. The determination of a statistical mathematician at a Leiden University that believed De Berk was innocent,  was the driving force behind clinching an overturn in De Berk's case. Finally an expert was brought in to debunk the theories in the prosecutors argument - the flawed testing.

Conclusion:
Sometimes, in the process of finding answers for the public, Management may use you as a scapegoat. You hope that your hospital will back you when the time comes, but don't count on it.
As both these nurses above found out - Nurses, in the eyes of the management, when under fire - are expendable.

This isn't the only conclusion you can draw from this .... but the obvious message seems pretty clear to me.

******************************************
A little post script here: Apparently, according to the published report in the Ottawa Citizen, the prosecutors stated that if the judge had found sufficient evidence to proceed to trial in the Susan Nelles case, they would have dropped the case because the outcome would not have been in their favor - and they didn't want to put Ms Nelles through the pain and suffering of a drawn out trial.

Does anyone really understand that kind of reasoning???......

Posted by Cartoon Characters at 7:25 PM 

3 comments salvaged:

nurseXY said...

Wow.

Just...wow.

May 30, 2010 5:48 PM  

newnurseinthehood said...

This is so messed up. Dr. Fowler sounds a massive douche. Wow, someone didn't cry at work? Yeah, sounds pretty heartless.

May 31, 2010 12:24 AM  

A NURSE said...

Definitely a travesty of justice.
And I agree about MD Fowler. If you clicked on the link and read the actual transcript of the questioning....he is majorly a douche. I tried to google his name but nothing comes up. Perhaps he is not "of this earth" at this time. It sure is quite the mark to leave on this earth...the only reference to him is that record of his statement.....his douchebagness on display for posterity.

June 02, 2010 10:38 PM