Retaliation for voicing concern over unsafe pratices

panhandler · Dec 25, 2005

Have you lost sight of the big picture?

You forfeit your rights as a citizen when you work for the Medical-Industrial complex.

Without a written contract (which probably would pre-empt your getting a job offer....duh) you have no "rights" --- none at all, not even those espoused by law.

I have been burned badly by the M-I complex.

The corruption is evident to you (now!) but it is wide and deep throughout the industry. It is driven by MONEY. THe place that forced me to resign using a kangaroo court and fabrication has an ANNUAL LEGAL BUDGET of 400 Million dollars!! Business as usual.

Lobbyists work hard to preserve the MONEY flow to this corrupt system. This in turn corrupts our only protection, the LAW. There is only marginal gain at best using the LAW to expose the retaliations you have suffered.

The Medical Industry wants ICU nurses to be inexperienced, tractable lackeys of its corrupt system.

You can earn a great living there (sacrificing by prolapsing internal organs, galaxy-class headaches and varicosities) but you must be MOUSY. At any time (i.e. when your little 3% raise crosses the line they set) you can be fired for NO REASON.

Administrators of working nurses are excellent liars and/or completely delusional.

I have left the sandbox of callow fools, perhaps for the last time. I am accomplished in the art and science of clinical nursing, yet I have been tossed out on my keester.

Devalued? you bet! Overworked? you bet! Dehumanized? you bet! THe medical system as we know it treats NONHUMANS with far more compassion than its regular human clientele. We know when to put our animals down. We don't keep them alive to fatten the purses of our employers.

It's depressing, if you let it be -- My next "paying" job might be at hospice. However, my ex-employer has spread its poison to my future employers --- lying about their actions of course -- duh!... a few of my "girls" sent me notes, saying "sorry I didn't get to say goodbye..." -- Oh to be a fly on the wall....

The pendulum may not swing back in my lifetime. The hospital system here in the South (i.e., FL and TX) desperately needs a KILLING FROST....

Again, who has the cujones to take on this problem. Do you, TNN?:chair:

Keysnurse2008 · Dec 25, 2005

Panhandler,..

I am not really sure what you are asking? if you are asking if I intend to bring my case to a judge...you bet I am.If I am forced to...if this HCF does nothing.Am I getting more active in my Nsg association?yes! Yes I am....but...since I am so "new" to this type problem I dont know what else to do.What else can I do?Do you have any ideas?According to my atty I have to offer them a chance to "make right" a "wrong". When I receive the results of their internal investigation I can proceed.If they do nothing....and opt to stand behind their lying NM and her cohort.........then I will just set a court date and let them explain it to a judge.My case is very different than alot I have heard.I have written documentation from the NM that is a 180 from what the NM states on my exit interview tape.Along with many many other concrete lies that are easily proved by concrete evidence I have. So....there is no way to avoid the fact that she has lied many many times.It is a direct violation of their Code of Conduct and ethics...and Risk Managements policy on retaliation against employees also...in addition to state statutes/ and laws.So...if they do not remove that NM and Nurse...then it will be a fiasco for them in court....bc .....I am not going away.I didnt "ask" for this.....I did the right thing ethically , morally and legally and got illegally fired for it. Do you have a union in Florida?If so do they add additional protections for nurses? Do you have any ideas as to what we...as nurses....can do?

TsunamiKim · Dec 26, 2005

In answer to your question TNNURSE I think it would be helpful to clarify this Arbitration issue as I hope I may persuade those confronted by a similar option to be more cautious than I was. Arbitration can be either binding or non-binding. If it is binding then both parties agree to abide by the final decision as made by the Arbitrator; if non-binding then there are other recourses open to either side if they feel the final decision was unjust. I was told about this by my friend who is an Attorney, but if I had not known what to ask, no one bothered to tell me. If anyone reading this is about to go into an Arbitration hearing you must ascertain this first: is your Arbitration non-binding or is it binding? It is too late to discover this after the fact, but do not trust a regular Union rep to just tell you, you must see it in writing in your Union handbook or better still have it clarified by the Arbitrator at the beginning of your hearing. My knowledge of the rules one way or the other would have relied on my reading a Union employee handbook, knowing what to find and where to look for it. It would have also relied on my complete understanding of the relevance and implications of entering into binding Arbitration; I only hope other employees receive better information and support from their Union than I did. BE WARNED: if your Union employee handbook states that all of their Arbitration rulings are binding that means no legal recourse for wrongful termination if you do not succeed at your Arbitration hearing.

I had also presented written questions and suggestions regarding my case and how it would be handled to my Union Lawyer. It was pretty obvious from these notes to ascertain that I had every intention of bringing a case against the Hospital, but I doubt anyone bothered to read my notes so I was never informed that I was about to abandon all future options to legal recourse. The Lawyer appointed by the Union was so hostile towards me that I nearly backed out of the Arbitration. He tried to get me to agree to make a financial settlement without fighting for reinstatement. I said it was a matter of principal and told him that I was also aware of the example my case gave to other outspoken Hospital employees. He insisted that no one cared about my principals; I do, I live by them! He would not let me mention unresolved pay discrepancies that predated my removal and were just written off. He wouldn’t allow me to raise the issue of the times that I was left stranded in Surgery, the manipulation of my schedule to force me to take time off without pay, the ignored letters of appeal that predated the disciplinary process and multiple acts of retaliation that followed. I felt he was not really fighting for my reinstatement just the pay deal to silence me.

I literally had to tell my Union Lawyer that I was not prepared to lie under oath to cover up any of these relevant facts that obscured the real truth behind my wrongful termination. When he asked if I had any prior minor disciplines I truthfully said no I defiantly did not. But, there among the documents finally sent to us from HR were two violations I had never seen before; two minor rule violations I saw for the very first time 15months after I was fired. I have no idea when they were written and inserted into my file or who they had been shown to as there had been absolutely no mention of these disciplinary counseling incidents up until that point a few days before my hearing. There was no documentation beyond the basic charge on the minor violations so I had no idea what had been used to justify these violations, but that was quite normal for them. They did not have to bear my signature although I was supposed to have received counseling by my Manager; this disciplinary counseling couldn’t have happened without my knowledge. I demonstrated a consistent pattern of providing written explanations and challenges whenever false accusations were presented, but in 15months there was no mention of these incidents at all by Management or by me.

At my Arbitration the Union Lawyer barely even contested the validity of these late insertions telling me that they weren’t really relevant. Big mistake, they were a major part of the Arbitrator’s final decision to rule against me as they falsely supported the OR Manager’s contention that there was a “pattern of behavior” for which I had been warned in disciplinary counseling several times. They were also sighted by the Maryland Commission in justifying their decision to deny my case. I would have been so much better off representing myself at Arbitration without the Union Lawyer’s unpleasant, rude, obstructive interference. I know I asked the Union more than once about the binding/non-binding issue, but the Lawyer must have known from my notes that it was going to be a problem. He said nothing and let me walk straight into a trap. At the beginning of the hearing certain things were agreed to, tape recording of testimony, sequestration of witnesses, this is when we should all have been reminded that we were about to enter into binding Arbitration, but no one said a thing about it. I am sure the Hospital knew and they made excellent mileage out of it.

I was completely unaware and would also have assumed that if nothing was said and nothing was signed then what I had been told by my Union was obviously correct and it would not to be a binding decision. I need not have wasted money attempting to hire a Lawyer if I had only known the truth. The Lawyer insisted that before we could proceed I must first check the union rules handbook, if she hadn’t said this I wouldn’t have even known where to look! I was probably issued one of the handbooks when I began my job at the Hospital, but who reads through all that stuff? Because I had specifically asked about whether the Arbitration was binding, I felt deeply betrayed that they had given me incorrect information. I can understand some of the Union people not knowing about the rules of Arbitration, but the Union Lawyer must have known. I must stress, if a Union handbook clearly states that all of their Arbitration rulings are binding that means no legal recourse for wrongful termination if you do not succeed at your Arbitration hearing.

The only totally bizarre idea I have for fighting my case of injustice is so far out in left field that it is probable too obscure to work. My idea is to charge the Hospital with abuse of my human rights. I believe there is a possibility that I could bring such a charge from overseas where they are more likely to view what happened to me as a human rights abuse. As an active member of Amnesty International I am more familiar than most on issues of what does or does not constitute cruel and inhumane treatment and forcing someone to work without food on water for 12hours is in clear violation of the Geneva Convention on the treatment of POWs. It would be viewed by the public as absolutely obscene if America’s medical professionals at one of their top Hospital’s have fewer protections from abuse than POWs, but we must get them to draw this parallel. After all we aren’t helplessly imprisoned by some Despot forced to slave in a chain gang hauling rocks in a third world country; we are doing highly skilled intellectually demanding tasks that require absolute concentration as we take care of critically ill patients. In the US I honestly think that a Hospital employee would have to actually, physically drop down dead at work before they would ever consider it in the least bit significant.

Now here is the interesting thing, I do not think there is any statute of limitations on human rights abuse and the seriousness of making a charge of this kind would I think override the restrictions placed by a civil Arbitration hearing since human rights abuse is a criminal offence. It would be a real jolt for the “best Hospital in America” to face a charge like that and it would be a big wake up call for the entire medical establishment. I doubt that an American Attorney would touch it with a ten foot pole especially if they knew the name of the Hospital. However, a high profile case would create a landmark decision and the courts might start taking these excessive workplace abuse issues more seriously. We must insist that Hospitals rethink their dangerous understaffing strategies as they are unhealthy for staff and in turn increase the potential for patient error. We need to think about how forcing someone to go without water, food or urination for 12hours does qualify as an abuse of that person’s human rights. Scrubbed in the OR is just one circumstance where you are particularly isolated and trapped by the task at hand, completely dependant on your Manager to send in relief so that you do not abandon you patient in the middle of surgery. This makes it the perfect place to highlight what is rapidly becoming a Hospital wide abuse problem in institutions all across the country.

These acts of inhumanity to medical staff are condoned with simplistic references to the “Nursing Shortage;” in my case the “ER was busy,” I didn’t even work in the ER and how many ER patients come to the OR anyway? Then there was the outrageous statement: “she didn’t ask for a break.” Excuse me Your Honor she didn’t ask to be treated as a human being with basic physical needs to protect her own health, safety and well being while doing her highly skilled job! We figured if she screwed up and killed a patient she would take the rap for it, not the Hospital, because that’s what usually happens in these cases. In consideration of this we thought that the risk to her surgical patient was less of a priority than avoiding the expense of calling in a call person to relieve her. Although it says in our employee manual that “your Manager will schedule your break according to the acuity of the unit,” we don’t insist that abusive Managers support their staff by covering them during breaks and we never discipline them for negligence or abuse. My Hospital knew full well that this argument would not go down well in a court of law so they admitted to the abuse in a binding Arbitration hearing knowing that the standard of proof was lower and the issue would be dropped after that.

It is time Managers were held accountable for inflicting standards that constitute intolerable cruelty towards their subordinates not to mention serious health risks. On several occasions my blood sugar was so low I was on the point of collapse. On another occasion a Nurse jokingly offered to insert a Foley catheter so that I wouldn’t need to leave the field or commit the crime of “patient abandonment.” This was an incident I did not even complain about or document because we had 7 ORs running in the middle of the night and our call teams were there. However, looking back on it the OR Manager on call was not called in because they simply never called in a Manager. That night I bleed through my underwear and following that incident I always kept spare underwear in my locker at work. You are cautioned not to leave the same tampon in place for more than 6hours, but I condoned the danger to my health by doing what we are all being guilt tripped into doing: putting the patient first. Meanwhile my Hospital was too negligent to disturb an OR Manager earning call pay to answer questions and offer sympathies from the comfort of her home. I really have to wonder if they would be expected to come into the OR even for a mass casualty? Is it acceptable to put an employee at medical risk due to not calling in a staff member who is being paid to remain on standby to come into the Hospital?

Due to one of the multiple discrepancies in the final ruling on my Arbitration it states that the Hospital admitted leaving me scrubbed for 16hours without a break, an access even I have never tried to claim. To imagine that anyone functioning as an Arbitrator might consider such extremes acceptable just shows how morally bankrupt American society has become. What about my critically ill OR patient on bypass during transplant surgery? Simple if I screwed up they could have nailed me for it. That Arbitrator taped the proceedings, documented the facts on his laptop and then took over a year to come to a final decision. However, the standard of proof was so appalling that serious errors appear written into fact including harassing phone calls I was supposed to have made at times when I was on patient’s record as being scrubbed into surgery! No one has ever examined the facts, questioned the multiple inconsistencies or allowed me a decent standard of due process. From the outside this lack of proof issue isn’t taken into account and the credibility of this Arbitrators flawed decision may continue to sabotage my future medical career.

It is high time the courts examined the “patient abandonment” issue, stopped targeting individual exhausted medical professionals and focused on the real offenders: those whose deliberate understaffing represents the most serious ongoing case of “patient abandonment.” Why must we wait until an exhausted practitioner makes a mistake so that their preventable errors can be put under the microscope and they can be penalized for an act of negligence that was perfectly understandable considering the inhume circumstances they are forced to tolerate. Nurses have allowed themselves to become the medical establishment’s scapegoats for too long. We must put corporate greed on trial by exposing the highly questionable profiteering policies that are inhumane to staff and place patients at risk. Will the abuse ever end? I don’t know, but I am not going to stop fighting for justice. Stay strong and do not give up,

Fair Winds & Following Seas, Kim.

gauge14iv, MSN, APRN, NP · Dec 26, 2005

An excellent case that more fully explains why I personally am against unionization. You may get certain things by being unionized, but you lose certain other things.

Sheri257 · Dec 26, 2005

I have to disagree with a lot of what Gauge is saying on the union issue. Make no mistake ... there are good unions and bad unions. I've worked in jobs where unions did screw over their workers. I don't believe they are all saints. But, I happen to believe the California Nurses' Association is the best union I've ever seen. If you can find a good nurses' union, it's well worth it.

You talk about the AMA's lobbyists. Well ... CNA is very effective at lobbying. That's how they got the ratio law passed which benefits all nurses in California, not just union members, which are only 20 percent of the nurses working in this state. They also hired excellent lawyers who have successfully defended the ratios in court multiple times. Schwarzenegger had to withdraw his attacks on the ratios because the union was so effective.

As far as competency ... it is true that a union will sometimes protect incompetent nurses. But so does management. I've worked in union and non-union shops. The competency level, or lack thereof, doesn't change just because the union isn't around. If this thread demonstrates anything ... it's that incompetent nurses survive as long as they're favored by management.

Union RN's make, on average, $7,000 a year more than non-union RN's nationwide. In California, the difference is even bigger. I know of one hospital where the top pay scale was increased from $22 to $42 only because the RN's organized with the union.

But paying RN's more money is not going to break the healthcare system. A survey was recently published in my local newspaper comparing two hospitals in my area: one was unionized, the other was non-union.

The non-union hospital, which pays RN's less money charges, on average, double the amount that the union hospital charges ($10,000 a day versus $5,000 a day charged by the union facility). That extra $5,000 a day is going into management's pockets ... it's not going toward patient care. The non-union hospital has numerous patient care issues because they can't keep RN's with their lower pay, they refuse to invest in basic equipment like vitals machines, and they have recently lost three malpractice lawsuits due to patient care issues.

Maybe other organizations like the ANA would be a better alternative than unions but, until those organizations actually deliver better results, unions like CNA are the only ones who have delivered any significant benefits for RN's.

:cool:

AtlantaRN, RN · Dec 26, 2005

I hate that your nursemanager is being so petty...if this nurse who hasn't done nursing is hurting patients, that is a huge liability to your hospital.

hope it all works out well for you

linda

AtlantaRN, RN · Dec 26, 2005

you have to follow the chain of command, your direct nursing manager, and so on...

in fact if you bypass one person in the chain of command, it is grounds for dismissal

linda

AtlantaRN, RN · Dec 26, 2005

yes, but you will shine in the long run because you DO have such glowing reviews...I mean ANY lawyer worth their weight in SALT can use the glowing review email you received praising you of your value to your unit, then you are fired just a few hours later......

linda

Keysnurse2008 · Dec 26, 2005

atlanta rn,

in my facility you actually do not have to use the chain of command....most still do out of professionalism.so by passing doesnt really affect employees one way or the other.they posted that on their online web page.i hadnt thought of that till you mentioned it.so i printed a copy for my attorneys file.

i think alot of things will come into play in my case.my glowing reviews.the fact that my unit manager wrote letters to this hcf central committee asking/recommending me for a promotion only weeks prior to my termination.my numerous numerous patient safety issues that i brought forth to management, emails thanking me for my dedication like hours before she fired me-written by the same nm, and the fact that this nurse had not provided direct patient care for cc patients in years,the fact that even problem employees accused of the same "alledged event" were treated far differently than me-none was fired, the audiotapes of the nm blatantly lying , temporal proximity, etc etc.as i said ...this is just "some" of the proof i have...i will never list the majority of my proof on here.....but this is enough for you to get the message. as i have said before...

"any nurse can gain competency thru trial and error(no orientation) eventually but ...is that the correct ethical thing to allow that to occur? no...no it is not.it is not the correct ethical, morla or legal thing to allow that to occur.bc ..every patient lying in that icu bed is someones mother/brother/father/sister/spouse/child.they are "someone" to "somebody".allowing that to occur is a violation of that families trust.incompetence has to be resolved ...and resolved quickly and swiftly in a icu setting"

i will be very saddened if this hcf's final investigation does not lead them to do the correct thing.am i expecting them to?at this point...no...bc....they have lost all my trust.i believe you guys are right.that hcf would rather shell out the bucks in malpratice settlements to cover up for this tenured ex-administration nurse who has "friends" in all the right administrative places than truly do what is best ....remove that nurse..and the nm - the one they are going to have to be humiliated in front of a judge because of. they will have to say " well....yes judge....i know the nm said it alledgedly occured on "x" day...but.....uh...uh...that was a lie ...bc.....she documented it happened on "y" day.so please believe us when we say it occured on "y" day".its a slippery slope from the get go....so i am more than willing to go to court.i did the correct ethical thing.i followed their policies, their bylaws....and look what it got me and my family? for every action from this point on....that causes me more distress.....i am adding on the punitive damages. :madface: ..bc..its seems like thats the only thing they understand.they cant seem to grasp what i am saying about this patient....is a person...with a family...a life.i started this in the spirit of trying to ensure patient safety...and i am not going anywhere.if they want to back this nm.....then ...i am ready for my court date.

CseMgr1, ASN, RN · Dec 26, 2005

I just saw a news report on T.V. about a top government worker who got demoted after she blew the whistle on Haliburton. Her lawyer, who works for the Whistleblowers organization stated that the main reason government and businessness retailiate is to humilitate. He also said that while you may lose a lot during a retaliation lawsuit, it is well worth the effort.

Sheri257 · Dec 26, 2005

I just saw a news report on T.V. about a top government worker who got demoted after she blew the whistle on Haliburton. Her lawyer, who works for the Whistleblowers organization stated that the main reason government and businessness retailiate is to humilitate. He also said that while you may lose a lot during a retaliation lawsuit, it is well worth the effort.

Well ... that's easy for the lawyer to say. It's not his job or career on the line. I'm familiar with the whistleblower's organizations. I used to run one of those organizations myself. I also worked with many of them as a journalist in Washington D.C. The sad fact is: the vast majority of whistleblower cases are not successful.

Whistleblower organizations say these things in the press because they need to raise money from foundations. And they need to generate as many whistleblower cases as they can because the success rate in those cases is so small. Every once in a while a whistleblower qui tam litigation case -- where a whistleblower sues the government on behalf of taxpayers -- can bring in a few million in damages but ... those cases are few and far between.

For one thing ... the lawyers almost always have to convince the Justice Department to take the case because it's too expensive for them to litigate themselves, and that's no easy task. The Justice Department declines to prosecute in most cases and the matter usually ends there.

So ... people should probably take these kinds of statements with a grain of salt. The sad fact is: being a whistleblower is one of the hardest things you will ever do and, for many of them, it's not always worth it.

:cool:

TsunamiKim · Dec 27, 2005

I agree with regard to the statement about retaliation being for the purpose of humiliation. It is not just that the humiliation is painful to you as you experience being marched out in disgrace; it also serves a purpose as a deterrent to other potential whistleblowers. I can tell from your posts TNNURSE that you are strong and confident in your Nursing abilities and your professionalism. Others who have witnessed what has happened to you as a result of speaking up may not be as strong, not as courageous or determined; they might not be able to withstand the onslaught that lies ahead of you. The raw example of one is the deterrent to many.

They will isolate you and outnumber you to try to shake that faith you hold in your own convictions and destroy your belief that what you are doing is right. It is like enduring slow persistent brainwashing and it is relentless. Each experience is degrading and demoralizing, as outside help that you seek is easily convinced that you are the most serious problem that must be dealt with not the incompetence you reported. Now five years down the road I still want to go back and face each and every one of the people I was humiliated in front of and say: “see I was in the right.” Each humiliation is a scar and I will carry those scars for life. In the beginning I was so convinced that I would succeed because I was in the right. Each time they told new lies and subverted the truth I though they will never get away with this latest outrage, but they did. I was so confident I would finely be reinstated that I sank into debt trying to cover my mortgage in the belief that my back pay would settle this debt. Your strong conviction that the Hospital Management absolutely cannot get away with their retaliation against you mirrors exactly how I once felt. I am not saying give up, just be prepared to experience injustice that will shake you belief in everything you may currently think your country stands for.

How do you combat this? When going into a hearing try to bring back up witnesses, supporters or a lawyer. Try to maintain a strong support system like you have among the Nurses on this site; you will need to maintain your strength. As I said you are at the point I was at over four years ago, honestly believing that your Hospital cannot possibly succeed, but they know how to twist and warp the system to their advantage. They stall for time and try to outrun you in the hope you will just give up. If you do not give up, time and distance certainly help them to erode your potential recourse to justice from external sources. All too soon public agencies start saying: “well it has been a long time now, blah, blah, blah and things have probably changed; it is too late for us to investigate this.”

What can you do? Do not allow them to stall for time. Be very persistent and stress the dire urgency of correcting the problem. If they do not get back to you in a timely manner bug them with letters. Start the paper trail and keep it going. If they do not reply, which they probably will indulge in as little as possible, start the next letter by documenting the absence of a written reply from them. If the most you get from them is a comment over the phone put that quote in writing in your next letter to them: “during our last phone conversation you said x, y, z.” Do not just vent in your letters, ask questions that require a response. They will need to justify their reason for not answering your legitimate questions; this puts them on the spot. If you do not get results within a few weeks move on to the next stage without delay. My Hospital thinks they have squashed me, but my letters of warning about the negligence still linger like a time bomb waiting for an unfortunate occurrence to spark their resurrection in a malpractice suite. For some of us, all that we manage to accomplish is laying down part of the paper trail that will eventually lead to change.

Do not let them divert the focus to you. Sometimes it will seem like two completely separate hearing are going on at the same time with them focusing on your conduct and you talking right past them by insisting on keep bringing up the original incompetence issue. The incompetence issues you raised must stay on top so don’t give in to their browbeating and brainwashing. The more time passes the more your support among other Nurses will erode and the more vulnerable you are to their outnumber, bully and brainwash techniques. Don’t ever doubt yourself or the importance of you efforts; if it is the right thing to do at this time it will remain so if you manage to keep on track.

When this person from the Whistleblower organization says that you should persist because “it is worth it in the end,” I have doubts about that, but agree in some respects. If you expect financial compensation through legal action to make you “whole again” as if nothing happened, I doubt it. Even if it did, nothing can totally compensate for the mental and emotional toll it will take on you before this happens. However, if “worth it” is viewed as accomplishing something of lasting value with respect to being a catalyst for positive changes that protect patients from harm, then there is at least a possibility that you will be rewarded. The rewards may not seem tangible enough for some. They will almost certainly not include a complete reversal of the financial damage you and your family have sustained. In addition the private knowledge of what your actions have accomplished will likely not be mirrored by any public recognition of the part you have played. You may need to be satisfied with your own inner knowledge of personal accomplishments while still haunted by the powerful memories of sometimes very public humiliation.

For me the damage done is too irrevocable to be resolved by any settlement even if I hadn’t been cheated out of my day in court. It is too late now to get my house back and most of my possessions were probably consigned to a dumpster a long time ago. The debts remain and they are hefty; credit is no longer an option. But if I was at some point I was instrumental in forcing policy changes on my former Hospital that would be “worth it.”. Even if it requires shaming them into action I am determined to do this. Perhaps then, as they attempt to take control of the press spin, they might even be motivated to use their powerful and influential position to promote further expansion of those positive changes, then that definitely would be worthwhile. This really is a tangible possibility and I am pushing for it. This possibility, however remote, is “worth it;” worth the fight, worth the persistence, worth never giving up.

The dismal alternative is that the abuse in the workplace, the retaliation for exposing it, all the terrible losses I have sustained fighting the retaliation, the pain and misery that I and my family have endured for the past five years will have accomplished absolutely nothing. That is what continues to drive me the determination that it cannot be all for nothing; the patients need us to continue this fight on their behalf. I hope that when you come to terms with the concept of “worth it” you will reach this same conclusion: do not give up,

Fair Winds & Following Seas, Kim.