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That may be true on both counts. That doesn't lead to a very good resolution for nursing who are serious about their jobs and investment into nursing.

You have a good point and that area of the United States is high dollar living and overall expenses. They need to pay the person for the job! How can a dentist take the pay cut though?

Most colleges and universities have Ph.D. level nurses teaching research classes. They can't teach these classes unless they have some degree of knowledge of how to conduct research. I call foul on the decision and hope most if not all nurses send the letter. Please

After reading the article, and post, I came to the conclusion that most of nursing problems start with nursing. Nursing administration does not take up for nurses the way they need to because of their own issues of wanting 'to shine' for the bosses over them who are not nurses. Some of them do not have the confidence to step up to plate and stop inappropriate nurse to patient staffing. Some Nurse Leaders just want to collect the salary without any extra work. Some of them are excellent leaders but they may be the only leader in a field of really bad ones. That eventually will cause apathy when they try to do the correct thing. Nurses need to insist on leaders that are for patient and nurse 'bill of rights.'

I am sorry you feel that way. Helen

Thank you. I know you are a hard worker and try to stay up with with all the newest trends and knowledge regarding communicable infectious diseases. I receive a subscription from the CDC and HHS. It seems like one comes every month and the other one is weekly. I do not read everything but enough to get the gist of what is going on. We have made some gains in areas however, we are going backward if we let people come into the country without proper vetting. My comment is made because I am the wife of an immigrant. I know what it takes to get into the country legally and I know the difference in those that do not take the time to learn the language, culture, and people of the accepting country. Having traveled to Europe, and the Middle East, I can say that in those countries one does as the Romans do and not the other way around. It is the same in our country and it has a lot to do with respecting our laws and our values. TB vaccines were developed many years ago but they were not that effective and only given to people going to those countries for military purposes. My friend received a TB vaccine many years ago when going to Guam. Again, it is well documented they were not that effective. I have not been to Haiti but I have several Haitian friends that ask me why America allowed so many sick people come into the country when we do not take care of our own. I have no answer except to say we help who we can. These are the educated Haitians who came the correct way. In my opinion, the border wall is a good idea. I do not like spending the money on it but on the same note, it goes without saying that it will save lives. Border agents are getting shot on the border and sometimes it does not even make the news. I am very much against the financial and sexual exploitation of the people that come into our country. It makes me ill to think about the rapes, people used as 'mules' to carry drugs putting them at the great danger. The elites are for open borders because they are making money. It is dirty money. There is no doubt about that. Keep up your good work and I will too. Happy Labor Day! I appreciate your suggestion about the book. Most of the time I go to those places and see first hand what the issues are and how to deal with them. I have been to the border several times. My daughter has been on mission trips to Mexico and they are lovely people. Helen

That would assume they started with symptoms and is not necessarily the case. People can become infected over less time in a closed space such as the back of a van and over 2-3 days. Not only that if you are working in a border state as an Infection Control Nurse and collect data, then you know that many an individual is passing over without any contact with border control or health care provider contact. Laredo has a deep gully that you can walk from Larado, Mexico to the Larado, USA. It is not difficult. Larado is not the only place in Texas; a person can step over. In Arizona, some areas are wide open. Same in New Mexico. I have lived in all these states. My point is the numbers may show a decrease in TB because we are not collecting all the data. We do not check people coming over on planes or boats for TB or any other disease, but after the Ebola incident, they added some questions at doctor's offices in the U.S. We need to get a handle on who is coming into our country. The experience of having the Haitians coming into our country during the 1980s with so many cases of active TB left a sour note. They not only came with infectious diseases, but they also came with a high incidence of mental health problems. And later, during one of the National Conferences of the CDC, we were told that TB and other diseases often become resistant to antibiotics and other drugs. When people became resistant to antibiotics and developed MRSA, we had trouble with saving lives. Then we got hit with the crisis of AIDS/HIV in the 1990s and could not figure out how to stop it. The CDC informed everyone at a National Conference that they made a choice not to publically come out with a statement for fear that health care professionals would leave the medical field. Do you go to the National Conferences from the CDC? It looks like they had one in March of this year on HIV again. I learned a lot from them and some things I did not want to learn but the experience of having so many people with expertise in areas of a good experience. I often thought of working for the CDC in Atlanta, Georgia. I have much respect for you and know that you are doing what you can to pinpoint problem areas and make correct recommendations to those who will listen. My issue is that we need to start with the simple things like monitoring our border closer and finding out who is here. We have so many homeless people that are dying on our streets. Most of them are Americans. Helen

They don't have the health care professionals in the number to check that many people and there are quite a few coming through desert areas unmanned by border control. I am really not targeting legal immigrants. I am specifically looking at people coming illegally and without border control contact. I came into contact with that group of people when working. We have a problem and it needs to get corrected. Do you work in a border state? Helen

When reading articles like these, I always look at the numbers and when they are collected. Right now we are facing an increase in TB at the southern border because we have people coming in not just from South America but from Pakistan, Iran, China, etc. The CDC has not dealt with those stats and in fact, I do not believe they are actively surveilling. If I could go back in time, I would have been much more aware of TB during the 1980s when Haitian's were coming into the country. I would have insisted our ER nurses and doctors wore masks during any contact as many of us became infected. Please, nurses, 'due diligence' is a must. We must care for ourselves in spite of 'offending someone' when wearing a mask. Remember if you do not take care of yourself, you can not take care of others. Helen

Whoa, What a horrible situation.