Whiskey Tango Foxtrot, RN - Lauren Bever

27/10/2023

Without Hesitation by Lauren Bever

I entered the room quietly, trying not to disturb the woman sleeping in the other bed.
She laid in hers, quiet as a mouse, eyes closed, breathing shallow.
I took one of her gnarled hands into mine; it was cold as ice, as it always was, prominent blue veins creating a roadmap pattern as if demonstrating her journey in the hundred-plus years she's spent on this Earth.

I knelt next to her and gently whispered, "Sarah."
Her watery blue eyes opened and met mine.
She smiled.
"Hello beautiful," I said, trying to simultaneously be loud enough for her to hear and quiet enough not to disturb Bertie in the next bed.
Her sparse white eyebrows raised, and she said, "Beautiful?"
She smiled.
I smiled.
She said, "I'm not beautiful anymore."
I said, "You are more beautiful than you know."
She chuckled and patted my hand as if to say, "Oh, child, one day you'll understand."

I said, "It's Lauren, the hospice nurse. I have to do your exam so we can keep you signed on to our service, okay?"
She nodded, absentmindedly looking over my head toward her window.
I always pulled up the shade when I came in, so she could look at the big oak tree outside.
I looked too, and saw that it's leaves were slowly turning from green to shades of orange and red.
Soon they would fall and carpet the ground, another cycle of seasons coming to a close.
I silently mused that this is the last time she'll witness that.
Over one hundred Fall seasons have come and gone in her life.
Seventy autumns that I haven't witnessed, yet I have the gift and honor of accompanying her through her last one.

I squeezed her hand and asked my first question: "What is your name?"
"My name?"
She mused for a moment.
"My name is Sarah."
"Very good," I responded, "now what about your last name?"
"My last name?"
She stared at me blankly.
Seconds ticked by as I patiently waited, giving her time to turn over the possibilities in her mind.
She looked perplexed.

She met my gaze.
"I... I don't remember," she said haltingly.
I smiled at her and squeezed her hand reassuringly.
"That's okay," I replied.
"Do you know where you are right now? What building are we in?"
She shook her head no.
"How about the state?"
She shook her head no again.
"Do you know what year it is?"
Her eyes met mine as she said blankly, "I don't remember."
I squeezed her hand again and said, "It's alright. It's a lot to remember."
She chuckled.

I told her where she is and what year it is, even though I know she won't remember.
I glanced over at her window and saw a bright red cardinal land on a lower branch of the oak.
As my gaze traveled back to her, it landed on the picture of the young man wearing dress blues on her windowsill.
I pointed to it and asked, "Who is the handsome young man in that picture?"
Her gaze followed my gesture, and she smiled.

She said, without hesitation, "That's my Adam. Adam Friel."

Her breakfast arrived, and she took great interest in the small muffin on her tray.
I encouraged her to eat and packed my things back into my bag.
She didn't notice as I slipped out of her room.
I glanced back to find her watching the cardinal in the oak outside her window.
It seemed like he was watching her, too.

- - - - - - - - -

Hours later, driving home, I call her son to give him an update.
I tell him that she couldn't remember her own last name but she remembered his dad.
He's choked up for a minute.
I swallow the lump in my own throat.
He regales me with anecdotes from his parent's long marriage.
I laugh and tell him what a special lady she is.
He agrees.
We hang up, and I am lost in thought.

I pull into the driveway and see you standing at the stove, nodding your head in time to whatever you're listening to.
I walk in, and the dogs dance around me, ecstatic that I've appeared.
You turn and smile at me.
I smile back as I look into your blue eyes.
You are also ecstatic that I've appeared.

You envelop me in a hug, and I smell everything that means I'm right where I'm supposed to be.
That I am Safe.
Loved.
Cherished.
Celebrated.
Encouraged.
That I am Home.

You ask me about my day, and I tell you all of the places I've been.
Then, I tell you about my interaction that morning.
You listen intently, spellbound.
Your blue eyes are watery now, too.
You pull me back in for another hug.
I close my eyes and listen to your heartbeat, my head pressed against your chest.

The next morning I drink my coffee and watch the dogs in the backyard.
A bright red cardinal lands on our bird feeder and seems to look right at me.
You come up behind me and put your arms around my waist, resting your chin on my head.
I close my eyes, perfectly content.

One day, when I am the old lady in the bed, and the hospice nurse is asking me all of the questions that I should know about myself...
One day, when I am the old lady in the bed, and I don't remember any of the answers to the questions that she has asked...
One day, when I am the old lady in the bed, and I have forgotten all but my first name...

I hope I will be like Sarah and remember you too.
I hope I will smile and say "That's my Sam."
Without hesitation.

Photo credit: https://commons.m.wikimedia.org/wiki/File:Cardinalis_cardinalis_in_Cercis_canadensis.jpg

Author's Note: while this poem is based on a real interaction, names and details have been changed to protect privacy.

11/05/2023

"Happy Nurses Week!" you say to me smiling.
Externally, I smile back.
Internally, I cringe.
I am a nurse, but I am not happy.

You ask me how long I've been doing this.
I say out loud "Six years."
I say inside "Not long enough to be this burnt out."

You ask me if I've always been in the ER.
I hear myself tell you that no, I haven't.
I tell you I started in cardiac nursing and then found my way to the ICU when COVID started.

"Oh wow!", you say.
"That must have been hard."
I smile sadly. It doesn't reach my eyes.
Hard describes video game levels and jigsaw puzzle difficulty.
Hard doesn’t come close to describing the nightmare that I’ve been through.
“Yes,” I say back, “It was really hard.”

- - - - - - - - - - - - - - - - - - - - - - - -

"Hi Nurse, I'm Lynn's mom. I want to go home and grab a change of clothes but I'm afraid to leave in case she seizes again and I'm not here. Her seizures are really bad. Do you think it's safe for me to leave her?"

I avert my eyes as I feel my stomach twist and drop.
The truth is that no. It's not safe for you to leave her.
I have five other ER patients that I'm currently taking care of, two of which are critically ill.
I have no patient care tech today.
Just me and one other nurse for 12 ER patients.
A safe ratio is 1 nurse for 3 patients with a tech to help.
I'm taking care of double that with no help.
I know there is no way I'll be able to watch Lynn closely enough to notice if she starts having another seizure.
So no. It’s not safe.
I feel your eyes searching my face in the silence.

I've always been taught never to tell a family that we're short staffed.
It's not their problem.
They shouldn't see the craziness that goes on behind the scenes as we do the delicately chaotic dance that is hospital nursing.
I look at Lynn and I see my baby sister Morgan.
I think of my own mother in a hospital ER the first time Morgan had a seizure.
I look you in the eye, but it's no longer you.
It’s my mom.
I take a deep breath and say "No. I'm sorry. It's not safe for you to leave her."
You're shocked.
I am too.
I can't hide it anymore.
I lift the curtain and show you behind the scenes.
You thank me for being honest.
For the first time I don't feel like I've failed.
I feel like I've appropriately placed blame where it should be.
It's not my fault that I'm so overburdened.
Lynn will be safe for now.
How many other Lynns are in other ERs right now that aren't?

- - - - - - - - - - - - - - - - - - - - - - - -

"This is Jim. Jim is coming from home, he's got a history of diabetes. Blood sugar on our machine said HIGH. Jim's been feeling bad for a few days now, but today was worse so he called us."
The medic finishes giving me report and says goodbye to you as he leaves.
It's easy to see that you're pretty sick.
Your skin is drier than leather, your breath smells fruity, and you tell me you've been doing nothing but drinking and peeing for the past week.
You've stepped right out of the pages of one of my nursing textbooks.
I know what is wrong with you without even drawing your blood.
Your labs come back and confirm that not only is your sugar high, but you're in ketoacidosis.
You need a lot of fluids, an ICU bed, and an insulin drip.
My heart sinks as I see the order.
An Insulin drip requires frequent blood sugar checks - sometimes as often as every 30 minutes.
I have six patients right now.
There is no way I’ll be able to monitor the drip appropriately.
Too little insulin and it won’t work effectively.
Too much and it could kill you.
You need it desperately, but if I start it now without being able to monitor you I'll be risking your life.
I hang your third liter of fluids and hope you get an ICU bed soon.

An hour later, I walk back to my desk and find the ICU doctor standing in front of me.
He’s questioning why I haven’t started the Insulin yet.
I look him in the eye and say “I have six patients. I can’t safely start an insulin drip.”
He incredulously looks back at me and says “But he needs it!”
I agree. You do need it.
I hear myself say out loud “What he really needs right now is an ICU nurse who can safely monitor him. I can either be an ICU nurse that can appropriately monitor an insulin drip or an ER nurse that can try to keep up with orders on six people. I can’t be both at once. Can you work on getting him an ICU bed ASAP?”
He stares at me, shocked.
I know he’s not used to being told no.
In the silence, the glaring inadequacy of our current healthcare system stares us both in the face.
Three rooms away, you lie in bed watching Pawn Stars, with no idea that you’re not receiving the level of treatment that you should.
Twenty minutes later an ICU bed is magically found and I drop everything to move you there immediately.
I feel the ICU nurse judging me for not starting your insulin four hours ago when it was ordered.
He doesn’t know that I’m an ICU nurse too.
I give him report and then apologize for not starting the drip sooner.
“I had six patients.” I say.
His face softens.
He understands.

- - - - - - - - - - - - - - - - - - - - - - - -

I think back to a nurse’s week five years ago.
I was brand new.
I was working on a cardiac step-down floor.
You were admitted with a rare diagnosis.
Takatsubo Cardiomyopathy.
Broken heart disease.
Your husband had died two months ago.
The stress and the pain and the grief had caused your heart structure to literally change enough that you were in heart failure.
You landed in my room after coming to the ER the night before with chest pain.
I stand next to the cardiologist as he explains the problem that your echocardiogram found.
He leaves the room.
The tears that had been welling up in your eyes spill onto your cheeks.
Your eyes search mine and I see the questions floating just under the surface.
I walk to the door.
I close it.
I pull a chair next to your bed and sit down.
I take your hand.
I spend the next thirty minutes answering your questions.
You’re not crying anymore.
You’re not scared anymore.
You understand.
You will heal.
This is not a death sentence.
I ask if you have any other questions and you say no.
I remind you that I’m only a call bell away if you think of anything else and that I’ll be back in to check on you in an hour or so.

I have three patients today.
I’m able to give good care today.
I’m young, and naive, and still feel like I can save the world in this profession that I love.
I don’t know what COVID is.
I don’t know what pandemic nursing is.
I don’t know what it’s like to work so short staffed that I’m risking my license and your life.
I have busy days, but they’re always manageable and I always have help when I need it.

I’m back in your room now, wishing you a good night and introducing your night shift nurse.
Your daughter is at the bedside.
I take your hand and you grasp mine tightly with both of yours.
You look into my eyes and I see yours shining brightly with unshed tears.
You take a moment to compose yourself before saying
“Thank you nurse. This has been such a hard time and I can’t thank you enough for what you did for me today.”
I squeeze your hand and then turn to walk towards the door.
As I’m crossing the threshold, your daughter speaks up from her chair.

“Happy Nurse’s Week.”

- - - - - - - - - - - - - - - - - - - - - - - -

Six years later I’m no longer that happy, young, naive nurse.
I’ve seen more death and trauma than most ever will.
I’ve seen the inadequacies of our healthcare system.
I’ve seen patients forgotten.
I’ve seen patients ignored.
I’ve seen patients die that didn’t have to.
I’ve seen thousands of patients blissfully unaware of how dangerous things have gotten.
I’ve seen politicians that seem like they want to help but aren’t sure how.
I’ve watched hospital administrators that haven’t touched a patient in twenty years convince politicians that things are fine.
Things are not fine.
Most hospitals are no longer safe.
Patients' lives are at risk.
Ratios matter.
Delays in care matter.
Attentive nursing care matters.

This nurses week, do more than just wish us a happy one.
We haven’t been happy in years.

Support us. Protect yourselves.
Reach out to your elected officials and demand safe staffing.
Demand safe patient ratios.
Demand adequate nursing care.

A year ago I marched on Washington to demonstrate how bad things have gotten.
Nothing has changed.
It won’t until the public demands it.

In my yesterdays it was Lynn, or Jim, or Shruti, or Terrence, or Wayne, or Shirley.
Tomorrow it could be you.
It could be your mom.
It could be your daughter.
We need help. We need change.
We need legislation.
Your life depends on it.

Happy Nurses’ Week.

- - - - - - - - - - - - - - - - - - - - - - - -

To learn more about safe staffing ratios and how you can help, you can visit the following:
https://www.nationalnursesunited.org/ratios
https://www.nysna.org/experience-and-research-show-safe-staffing-ratios-work-0 #.ZFzz7xDMKfA

Finally, because sources matter, here is a 2021 study of 87 hospitals in Illinois. The study found that for every patient added to a nurse’s caseload over what was considered safe (1:4), the 30 day mortality rate increased by 16% for all of those patients. Over 1,500 patients died due to inadequate staffing.
UNSAFE STAFFING IS KILLING AMERICANS.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8655582/

25/05/2022

TW: death and violence

"Attention Emergency Room. GSW five minutes out by police. Repeating. GSW five minutes out by police."

I finish taping down the IV that I just inserted and tell the patient that I am going to send of their lab work. I leave the room and make my way to the trauma bay with my colleagues.

The room is largely silent as we all don gowns, gloves, shoe covers, and masks with eye shields. You never know how bloody that a gunshot wound is going to be, so you try to be completely covered so that the blood doesn't get on you or your uniform.

I catch the designated trauma nurse's eye. "Do we know how many?"

Often there is more than one victim. When bullets start flying, there usually isn't a lot of thought put into where they are going to wind up.

She shakes her head as she ties her gown. "Nope, just one confirmed so far."

I walk look around the trauma bay and see my colleagues preparing themselves. Two attendings, three residents, four nurses, one respiratory therapist, and three ER techs all dressed in the same garb. Gowned and gloved. Silent. This is the calm before the storm. The silence is eerie.

I walk out to the ambulance bay and join the staff that are waiting. Three more nurses and two additional ER techs with a stretcher and a long-spine board between them stand facing the entrance to the ER driveway. We're flanked on both sides by the security staff and police officers that do their best to make sure that we are safe every day as we work in the chaos that is an inner-city level one trauma center.

We hear the sirens in the distance. They're almost here.

I get the same feeling of anticipation that I always get when something bad is coming. We never know what will be there when we open the doors. Sometimes it's screams of pain. More often it's silence and spattered blood.

The sirens grow louder until the police car flies around the corner, skidding to a stop at the bottom of the ramp. Why a police car and not an ambulance? Because in cases like this, the police don't wait for the ambulances to get there; they just scoop the victim and bring them to us. There's an infinitesimal increase in the chance that the patient may survive if they do it that way.

My colleagues rip open the door to the cruiser and are greeted with another lifeless body covered in blood. They maneuver to get them onto the stretcher and, since there is no pulse or breathing, begin doing CPR as they roll the victim towards the hospital as fast as they safely can. A tech runs ahead to update those waiting inside that this is a "trauma code". Our chances of saving this life have just plummeted to 2% - but we will still try.

We get them inside and immediately the horde descends upon them. Techs cut off their clothes while RNs hook them up to the heart monitor and defibrillator, getting IV access, running fluids wide open, pushing drugs in an attempt to restart a heart. Through it all, the trauma surgeons rush through an assessment, calling out bullet holes as they find them.

Six.

Six holes this time.

Nobody addresses the fact that as soon as we got the clothes off, it was easy to see that this victim is too young to legally buy ci******es.

The ER-resident quickly inserts a breathing tube and the respiratory therapist begins delivering breaths through the tube, trying to move oxygen to a heart and brain that desperately need it.

The trauma surgeons oversee the resuscitation, inserting chest tubes on both sides, and measuring the amount of blood pumping out with each compression of the chest. Two nurses rush to hang donated blood wide open in an attempt to replace what has already been lost. The trauma attending and fellow begin to cut into the chest - they've decided to try a last-ditch hail-Mary, the "clamshell" thoracotomy. They are performing open chest surgery in the trauma bay, trying to find what is bleeding, hoping that there will be something that they can fix. The trauma attending is now performing open cardiac massage - CPR on the inside of the chest - and the fellow has the internal defibrillator paddles, ready to deliver a jolt of electricity directly to the heart tissue.

I feel strange as I realize that I am watching this person's lungs inflate from the inside.

I stand against the back wall with the police officers that brought the patient in, awed by the efforts happening in front of me. Wondering how this poor soul came to be in my ER today. Wondering what life circumstances and poor choices led to this.

The team is silent now, waiting yet again. The only movement is coming from the trauma surgeons working feverishly and the respiratory therapist rhythmically squeezing the ambu-bag. The trauma resident has taken over the open-chest CPR so that the attending and fellow can find the source of the bleed. The attending calls out for a pause in CPR.

There is no heartbeat.

The attending calls the time of death and asks for a moment of silence.

We all bow our heads and close our eyes.

- - - - - - - - - - - - - - - - - - - - - - - - - - -

This is a scenario that happens in trauma centers like mine across the country daily.

Was it hard to read? Imagine witnessing it over and over. This is the harsh reality of gun violence.

It's really easy to sit in your living room and say that we don't have a problem when you aren't seeing the problem in front of you on a daily basis.

This was just one example in one ER on one shift.

My ER is used to this kind of trauma. We deal with trauma like this on a daily basis.

Do you know who isn't used to trauma like this?

A small critical access hospital in Texas that has 25 inpatient beds and an ER that likely doubles as the ICU.

I dread the day that I have to perform life-saving trauma care on a child. I dread the day that I have to work on a pediatric gunshot victim. I dread the day that my hospital is the one receiving body after body from a school shooting.

Seem macabre? It's not. We're at 27 school shootings so far in 2022. That's an average of 5 a month. If we keep going the way we're going, it seems like it's only a matter of time.

When will enough be enough?

https://www.bbc.com/news/world-us-canada-41488081

14/05/2022

Nothing is going to change until we change it ourselves... Where were you NBC News CBS News CNN Fox News MSNBC?

12/05/2022

U.S. Hospitals are NOT safe! Nurses are trying desperately to change that! Please stand with us! Demand safe ratios! Demand adequate staffing levels! Demand that your local hospitals try to actually RETAIN their experienced nurses.

Ask your reps to pass H.R. 3165/S. 1567 - The Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2021 and H.R. 1195 - The Workplace Violence Prevention for Health Care and Social Service Workers Act.

We need your help!

12/05/2022

Nurses march on Washington in t-minus 7 hours! 😬❤️

19/04/2022

31/03/2022

Please read. Please share. Please act.

If everyday Americans knew how close we are to a catastrophic complete collapse of the US healthcare system, would they care? Or would they continue to turn a blind eye?

If they knew how stretched thin nurses were, would they care? Or would they continue to criticize us for not being what they want us to be?

If they knew how frequently we were working at dangerously high ratios, would they care? Or would they continue to scream at us for taking too long to answer their call bell.

If they knew how close they come to being killed by the US healthcare system every time they walk into a hospital, would they care? Or would they just continue to die?

You see, this is out of our hands now. Nurses have been SCREAMING for YEARS that this is not sustainable. Nurses have been shouting from the rooftops that we are worried about ratios that we are worried about errors that we are concerned about people dying that shouldn't die.

Every single nurse I know has either cared for a patient that shouldn't have died or knows someone who has cared for a patient who shouldn't have died but DID because of a deficit in the US healthcare system. Every single nurse I know can tell you a story of a time that a patient was almost killed by a near-miss event. Every single nurse I know has been frustrated to the point of tears or rage because a patient was put in a situation that could have resulted in their death.

Every single nurse I know can tell you a story of a time that we were verbally, physically, or sexually assaulted by a patient. Every single nurse I know can tell you of a time that they or a colleague were held responsible by a patient for something that was completely out of their hands and due to facility policy or error.

What more needs to happen before Americans realize that the US healthcare system as it stands right now IS NOT SAFE? How many American lives will continue to be lost due to corporate greed and profit-driven standards and policies?

Yet still, the American public throws the blame on the nurses, the aides, the physicians, the respiratory therapists, the phlebotomists, the physical and occupational therapists, the speech language pathologists, the housekeepers... WE are the ones that get verbally accosted. WE are the ones that get blamed. WE are the ones getting convicted when care standards aren't met because we physically can't be everywhere at once.

Not a SINGLE nurse or healthcare worker that I know WANTS to practice below the current acceptable standards. Not a SINGLE nurse or healthcare worker that I know is ever WILLFULLY negligent of a patient. Not a SINGLE nurse or healthcare worker that I know would ever CHOOSE to put a patient in an unsafe situation. Yet we are FORCED TO by administrations that are so out of touch with reality that they expect us to be superhuman and have NO problem throwing us under the bus when we inevitably fall short.

"You should have checked again. You know better."

"You should have prioritized your time. You know better."

"You shouldn't be relying on the fail safes. You know better."

"You should have documented on time. You know better."

You should have. You should have. You should have.

Let me correct the phrase and say it to every single nurse, every single physician, every single healthcare worker in the country: You should have NEVER been put in that position in the first place.

You shouldn't be working short staffed as a rule. You shouldn't be working over ratio as a rule. You shouldn't be expected to circumvent best-practices as a rule. You shouldn't be expected to be super human as a rule. You shouldn't be expected to do the work of three people. You shouldn't be expected to pick up the duties of other specialties. You shouldn't be expected to put yourself or your patients in danger. You shouldn't be expected to break yourself for a system that won't even catch you as you fall. You shouldn't be expected to martyr yourself so that a corporation can make another hundred million dollars on the backs of sick and dying Americans.

So to the healthcare administrators who need to hear this. For the politicians that need to hear this. For the American citizens who need to hear this.

ENOUGH IS ENOUGH.

We are PAST our breaking point. We are considering EVERY SINGLE DAY if it is worth it to continue working in healthcare.

The ratios are ridiculous and obscene. 10 patients a single nurse on a med-surg floor? That gives her 6 minutes an hour per patient. Just over an hour a shift to pass all meds, provide all care, document everything (because God forbid we don't PROVE that we did everything), and address any emergencies that pop up. Sound ridiculous? That's because it is!

I started in Cardiac step-down. Our ratio was 3:1 which is manageable on most days. There are step-downs in this country with a 5:1 ratio. These nurses are taking care of patients that are one step away from being in the ICU. They are SICK. They need VIGILANT care. They aren't receiving it. They are dying because they aren't receiving it.

You want your nurses and healthcare providers to be proactive, not reactive. You want us to catch problems BEFORE they happen, not after they have already become unavoidable. Do you know how many lives could be saved if sepsis was caught before it became septic shock? Do you know how many lives could be saved if subtle changes in vital signs were noticed before they became glaringly obvious? We can't save your life if we are too busy to notice that you are getting sicker.

The US Healthcare system is collapsing and we are BEGGING for help. Everyone is going to need us at some point in their lives.

We NEED help.

Who is going to save US?

Your life literally depends on it.

- - - - - - - - - - - - - - - - - - - - -

PLEASE get involved and help us. There is national and local legislation that will help protect nurses and patients. Call your local and state politicians. Demand regulations that healthcare facilities must meet in order to provide a safer environment. Support safe staffing legislation.

National Legislation to review and consider supporting:

- Protecting the Right to Organize (PRO)
S. 420 and H.R. 842
This legislation would increase punishment for organizations that violate workers' rights and provide support for workers wishing to unionize. It would also enhance the right of workers to boycott, strike, and participate in other acts of solidarity. It would prevent employers from using loopholes in current federal labor laws to shortchange and exploit their employees.

- Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act
S. 1567 and H.R 3165
There are currently no standards federally to limit how many patients that a nurse can be made responsible for. This means that facilities can dictate their own "safe" ratios - which they have proven that they can't be trusted to do. For every patient that a nurse adds to their caseload above what is considered an acceptable ratio (1:4), the risk of mortality for ALL of their patients increases by 7%. A 2006 study showed that if RN staffing at each hospital matched the best-staffed hospitals in the country, 5,000 in-hospital patient deaths and 60,000 adverse outcomes could be avoided. For example: if Pennsylvania hospitals matched California's medical-surgical nurse to patient ratios, Pennsylvania residents would experience 10.6% fewer deaths - those numbers are from 2006 and I would bet money that they would be higher today ("Nurse Staffing in Hospitals: Is There a Business Case for Quality? J. Needleman, et al., 2006).

- The Workplace Violence Prevention for Health Care and Social Services Workers Act
H.R. 1195
Violence against healthcare workers has never been higher. A 2015 study found that 62% of hospital employees had been a victim of violence within the last year. This act would require employers to develop prevention plans that are unit specific (instead of one-size fits all) and to assess hazards and provide safer conditions. It would also mandate and prompt effective reporting processes that would track incidents and threats to monitor repeat offenders, helping to prevent future incidents.

Individual states may also have legislation that you can support. Pennsylvania currently has the Patient Safety Act (HB 106 and SB 240) which would define and set safe staffing standards for Pennsylvania nurses. PA House Committee Chair Representative Kathy Rapp, has stated that she will not push it forward for a vote because she "has not heard any real grievances" from PA nurses and does not find it necessary.

If you need help finding your elected officials, you can search here: https://www.commoncause.org/find-your-representative/

If you would like more information on other movements in the healthcare world, you can visit the following:
https://www.nationalnursesunited.org/national-legislation

https://www.aacn.org/policy-and-advocacy

Please help us. Our voices aren't enough. We need yours with us.

Image Description: A nurse sits on the ground underneath a rain cloud crying. She is surrounded by hands holding more for her to do. They contain a patient in a hospital bed, a boss yelling, a stack of education, a chart to review, a deceased patient to care for, and a virus spore.