will soon be gone.

I have been writing here at since around 1999.
But everything has its time, and it is time to move on.

This site will shortly be removed1

I thank everyone for their support and amazing participation here over the years.

I am still actively writing, and you can now follow my journey here:


Take care,

  1. I would love to keep it active for  there is much of my nursing life recorded amongst its posts. But basically, I cannot afford to run 2 blogs.

less of me here, and more of me there.

Just to remind readers who may have not realised yet, that I have started a new site over at theNursePath and will be spending most of my energy writing over there for a while.

This is an experiment in getting out of my writing comfort zone.
I want to ramp theNursePath up to a new level of quality. The goal is to format it more as a magazine than a blog.

I will support you to:

  • Collect a kit of tools that enables you to provide excellence in clinical practice.
  • Build personal resilience.
  • Develop interpersonal and team fluency.
  • Practice with authenticity.
  • Discover what is really important to you as a nurse.
  • And finally, to (re)discover the joy in nursing.

I feel that some of this stuff I have some pretty good experience with. Other areas we will work through together.
This will be a community. A place for non-judgmental discussion, opinion and cross-pollination of our collective experience.

I really hope you will check it out and support my new project.

Much appreciation,




Nominate Now: Social Media Nurse of the Year.

Nominations are now open for the 2013 Social Media Nurse of the Year.

Last year there were a total of 16 finalists who received a total of 2,577 votes.
This year we have seen a huge increase in nurses leading the way in developing their online work.
Work that has inspired, informed, influenced, entertained and educated.

This is an opportunity for us to acknowledge those contributions from around the world who have helped in building an interconnected supportive, professional online nursing community.
It also gives pause to encourage and inspire others to become active and find their own social media voices.

So go check your bookmarks.
Nurses using Facebook, Twitter, blogs, websites, Podcasts or any other form of electronic means of social engagement are all eligible.

How do I nominate?

Simply provide the name of the nurse you wish to nominate in the comments field below.
Please include a short reason why you think they are worthy of the title SoMe Nurse of the Year.
Include a link to their social media stream(s).

Can I vote for myself?

Don’t be shy. You have put a lot of work into your online contributions no?….don’t hide your light under a bushel as they say.

Oh, and do not be discouraged if you think you only have a few followers right now….what we are searching for here is quality not quantity. And this is the perfect chance for you to get your work seen by a larger audience.

Are student nurses eligible?

Absolutely. As are nurses and midwives in every field of our profession.

How will I know who has been nominated?

I will provide a short post on each nominee, outlining their activities and a little about them as well as links to their work.
This will give you the opportunity to check out the online presence of other nurses you might not yet be familiar with.
I strongly urge you to explore the work of the nominees… might just stumble upon a NEW must-follow.

When will nominations close?

Nominations will close around mid November (depending on the response to this award).

How can I vote?

Once nominations are closed a list of finalists will be posted and you will have the chance to cast your vote.

Is the health system really a system at all?

We call it a health system, and there are times when it works with an incredible life changing, interconnected fluency.
But far too often what it is….is a complex bundle of separate silo-systems.

Every day there are hundreds of episodes of asynchrony within the patients journey as discrete silo-systems bump and scrape and snag up against each other. Some are minor annoyances that test a patients, well…..patience.
Others are truly exasperating experiences for everyone, demonstrating poor design, a lack of respect for our patients and a lack of advocacy by, well …….us.

Here is one very simple example of the health system at work

Mrs Fleck is a 45 yo female who presents to the emergency department after impaling her foot on a large 4cm splinter of wood whilst walking barefoot in her back garden.

She presents at around 7PM on a public holiday Monday.
The emergency department is experiencing access block, resulting in overcrowding and very long waiting times.

She is finally seen by an ED doctor at around 11PM.
The splinter is removed and the wound is cleaned and dressed.
There is however, some concern that a piece of wood has broken away and remains lodged in her foot.

The doctor books the Mrs Fleck in for an ultrasound, but as this service is not available this late, the patient is asked to present to the medical imaging department first thing in the morning.

Mrs Fleck leaves the ED at 1240 AM.

She presents as requested the next morning at 9 AM.
And gets her ultrasound at 1030.
Indeed, a piece of wood remains lodged in her foot.

Mrs Fleck is told to re-present to the emergency department for follow-up. There are no other management options available to her within the system at this point.
She presents to the Triage desk at 1145 AM.
Again the ED is extremely busy. Mrs Fleck is given a triage category 5 (non-urgent) and queued to be seen with other lower acuity patients in a Fast Track section of the department.

At 3.30PM Mrs Fleck angrily storms (well more of a hobble really) out of the department stating that “I’m sorry, but I cannot wait here any longer, I will sort out this problem myself”.

After presenting with a splinter of wood in her foot, she has spent well over eleven hours in the system. She has left the system with a splinter of wood in her foot.

Despite coming in contact with professional, hard-working staff she has been let down by the asynchrony of the system. It was a relatively minor outcome in the scheme of things. Mrs Fleck eventually went and saw her GP….who of course referred her straight to the emergency department, where it was eventually all sorted out.

As I said, this is an example of a simple problem that did not go smoothly.

How then, does the health system manage problems with more complexity and severity?
And how can we improve cross-links and flow design between the separate systems?

Book of Nurses: Chuck.

After a successful career as a software developer, I now find myself spending all my free time preparing to be a nurse. This wasn’t always my dream, but the older I get, the more I realized that I needed to do more than write code to develop the next somewhat useful application of which there are already ten available for purchase. So, I returned to nursing which I had abandoned 20 years ago because I thought it would take too long to finish. And now that I’m deep into my nursing education, I know this is the right career for me.

When I was in my fundamentals class, I was assigned to a patient who was very frail. As I went to care for this little-old-lady patient, I touched her and she startled awake. She looked up at me with pleading eyes and said that she was so glad I was there. So glad. She said that she loved me “with all her heart”… repeatedly. She grabbed my hand and held it as tight as her trembling grip could.

I think that’s the love that she needed back. From me. She was projecting it out because she needed it in return. That’s the degree of care that we need to be able to give. Our patients demand it; need it. And if you’re made for this, you’ll respond to it, and not run from it.

They need my strength and my skills. They need to feel confident that I will love them by giving them the best care possible. And by doing it, it fills me with a sense of purpose and reason to excel. That’s the source of my passion. I’ve never gotten that from money… that was always motivated from a position of fear (of lack). I’ve never felt that way from working on software… that was just for money; sometimes a thrill of solving a puzzle. But, never did it come close to moving me closer to who I really want to be: toward looking back on the story of my life and being happy with the content.

I want to help heal. I want to help people accept who they are, and if they want, improve on that. I love to answer questions (my kids could never ask “why” enough to satisfy my desire to teach them). Balance that with listening — otherwise, how will I know what to say?

Maybe I’ll be an ICU nurse where I can provide care to those in the most need of care. Maybe ER? They need quick thinking and a lot of understanding. Maybe something else… there are so many options.

It’s been said that “making progress on meaningful work” is the single greatest motivator in every workday. And, I believe caring for people is the most meaningful work we can aspire to.

I believe that nursing will help me become the person I now want to be.