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I'm so over it already! I just want Tuesday to be done so we can move on!


I really appreciated what you had to say Adam, it'd be great if your words could've been shared before every congegration six weeks ago!

That's crazy Adam! Sounds like an amazing alarm system, why do I feel like I need to get one of those all of a sudden now???
Glad everything's ok.

I'm so going out and buying that the first opportunity I have without the kids! That could be anywhere from one-eight days. Can't wait! I love Coldplay

What on earth Adam?!! I remember always thinking "I'd rather live in California and deal with earthquakes than the midwest and live through tornadoes!" Not fair to have both.

Who did you know that got you in??! That's amazing!

I'd be surprised. Traumatic injury triggers complex mechanisms in the body. There are all sorts of factors which go into the decision about whether a limb or body part is salvagable.

There are quality assurance (sometimes referred to as M&M conferences - morbidity and mortality) which look at the rates of complications and deaths, which look at optimal versus actual outcomes and which apply peer review processes. The military healthcare system has a pretty reliable track record around trauma care and stabilization. You should be able to get statistics about amputations at all types of military medical facilities (CSH versus Evac tertiary care hospitals (Germany) versus stateside military hospitals). That's where to start if you are so inclined as to investigate.

Except that salaries for nursing faculty run BELOW what novice two-year associate degree graduate nurses earn in their first clinical jobs! Prospective faculty can expect to earn between 1/3 and 1/2 less than their counterparts employed in service settings.

BTW - nurses are educated and are not trained. Training apprentice-like programs went out in the 1950s.

Shalala is probably one of the most informed influentials about nursing - as she exhibited during her time on the Dole/Shalala commission which investigated the military healthcare system failures uncovered by the Priest/Hull reportage at Walter Reed. But even then, the crux of the problem wasn't ever reported: the failure was that inpatient and intensive rehabilitation NURSING is not an offered service by the military healthcare system. The affected patients had been held by the military instead of being medically discharged and transferred to VA or civilian inpatient rehab settings. It was the absence of NURSING and nursing case management of patients was - and still is - at the root of the problem.

But who knew? No one was ever interested in looking at the missing pieces. And because you and your healthcare reporter colleagues don't know a great deal about nursing and how it's practiced, you never saw the gaping holes in the picture.

Thanks for your response and interest - it's appreciated (in spite of my crankiness and complaints otherwise).

The almost 3 million registered nurses provide about 95% of all reimbursed health care services (given the nature of the majority of nursing care which is a 24/7 endeavor versus the episodic appointment based care provided by physicians, therapists and other licensed providers). Yet nurses are not represented at all in any healthcare reportage, they don't have a seat at the policy table, nor are nursing experts and nursing research cited when addressing health system reform and patient quality.

Until this huge missing component is included and addressed throughout all of healthcare system design, delivery and reimbursement issues and policy, a fundamental change will not occur with enough breadth and depth to change the outcome.

I blog about professional nursing, patient advocacy/safety and healthcare at Universalhealth and at Home of the Brave. I'll be happy to serve as a resource for nursing issues and to provide contacts to expert nurses and nursing researchers across clinical specialties.

You made me so tired reading your blog! You need to do an Office or Arrested Development marathon to recoup a little bit before heading back out. That being said, you gotta post pictures of the yard, it must look amazing! Miss you guys

What is missing yet again is any mention and attention to the role and affect of professional nursing on infection rates (morbidity) and preventable death rates (mortality).



Professional nurses - those who are licensed to practice as a registered nurse, number just under 3 million in the US. Research by Aiken sponsored by the IOM demonstrates significant increases in morbidity and mortality rates when patients are not cared for by registered nurses who were educated at the baccalaureate level or above. Only about 1/3 of nurses are educated at this level.



Nurses have untenable work conditions, 70% or more have been bullied (including incidents which are defined as criminal attacks) at their places of work. The top two categories of people who bullied nurses are #1 physicians, and #2 fellow nurses, followed by patients, visitors and other healthcare workers.



Nurses often take care of too many patients, work with continual interruptions, have no proportional representation of their professional issues and interests as employees, and 90% do not enjoy collective bargaining or representation.



Yet nurses provide about 95% of all reimbursed professional health care services, largely attributable to the continuous around the clock nature of patient care and nursing care as opposed to the episodic, appointment-based nature of physician and therapy services.



Nurses are not adequately represented in the boardrooms, the policy table or in government. They get almost zero reportage across all forms of media (including the progressive blogosphere. Nursing research is almost never cites, yet the National Institute for Nursing Research is a full fledged NIH Institute with a robust research agenda which is providing new knowledge leading to improved patient care and advancing nursing theory and practice.



No presidential candidate has addressed the needs or issues of professional nurses, and patient advocacy is critically compromised when nurses - the key patient safety protectors and advocates - do not enjoy self-governance and the autonomy, authority and legitimacy needed to affect practices which protect patients.



When nurses have the authority and autonomy to practice nursing without suffering the external insults of employers, third party payers and non-nurse administrators, physicians and other stakeholders, patients and nurses will benefit.

All three kids and I stopped and watched the whole video together. It was great to have his story told in their own language. The Veggie Tales never age for me...

Unless there is a mass resignation effort by senior officers, it appears as though Bush/Cheney Corp. are going after huge third quarter profits - by the mil/industrial complex market share - next acquisition - Iran.



There is one surefire and quick way to stop it - Congress can defund and withhold funds for combat operations wherever and to the extent it chooses. As if that would happen with them in the thumbscrews of B/C Corp's surveillance sweep!

Bring it Adam! Very well put and humbly said. Can't wait to see you guys in a few weeks!

I have to wait till the episode comes up on the ABC web site. Do I stay up till 10pm to see if it comes up right away tonight or do I just wait to catch it tomorrow evening after the kiddies are in bed, it's hard to say. If I wait till tomorrow, I can't read your blog incase there's any spoilers! There's so much on the plate here.

I find that so disturbing. I'm so burdened that you have to read junk like that every week. It's sad, but I think you are receiving it in the right heart. People just don't know it's not about them, so they mistakenly voice their "opinions" or "orders" for the next musical worship set, thinking this is what they're entitled to. I think you're doing a fantastic job, and I hope the comment cards never weird you out.

I'm putting in my request for one!

You should be sorry. I love you.

You should be sorry. I love you.

I've been hit this Christmas season by truly acknowledging the words I'm singing in Christmas songs and not just "caroling" along by memory. Such a sad song, but I love that last cling of hope he gives at the end.
Looking forward to seeing you guys!

I always loved the view of the mountains with snow on top and the clear blue sky, it was what I sweated out summer for!

I'm not a redbook subscriber, fortunately after reading that garbage! Thanks for the heads up.
I bought a magazine years ago (JAnE) and was a little shocked by the content of that magazine too. I remember getting rid of it because I really didn't want my teenage daughter to read it. ever.

I somehow stumbled onto this post tonight, I understand your struggles. I have teenagers too, and then Izzy. I have wonderful friends who live in other towns and states, but not really any at church right now. We just actually changed churches after a lifetime at one particular church. Our faith has changed so much in the last few years that we no longer fit there. I am hoping and praying God connects me with some or even one woman in my age group that I can relate to. I noticed you were quick to say that it was probably your fault. I think part of it is just putting yourself out there and being involved. Although so far my attempts at this have brought me closer to the older ladies at this church. Don't get me wrong, I love the older group and think there is much to learn from them... but it is nice to have someone to relate to as well. I'm not sure where I'm going with this comment or even if I should hit the publish button, but I just wanted you to know you are not alone in your search and loneliness and that I will pray that it all works out.
blessings~
annie
(mylifeasannie)

So true!

I thank you for sharing this wonderful story of the resurrection. I belive that Jesus is sitting at the right hand of the father, and one day He will return to gather His Sheep. People who are not christian will never understand the true meaning of this story. Because if that can't except Christ as there personal savior they will never allow the Holy Spirit to lead them to Christ.