Debi Fischer

Many RNs work in acute care and do not give insurance a second thought. Most people have Obama Care under the Affordable Care Act, right? As an RN in acute care you may not be aware of this growing trend. A new study in the Journal of Clinical Oncology showed that women with high deductibles put off initiating treatment for breast cancer. Once they found a lump, they did not go for imaging studies or biopsies to confirm the diagnosis right away. This was discovered after a retrospective review was done of claims. In fact, chemotherapy was delayed on average by seven months. Early Diagnosis and Treatment Many of us in the healthcare arena have learned through common knowledge and sometimes sad experience that early diagnosis is key with cancer. Oncologists are now sounding the alarm on this timeline. We have all heard anecdotal stories about women who delay treatment for breast cancer for various reasons. Some of this has to do with indecision, as well as denial. Many times, it has to do with family drama as well as lack of money. High Deductibles vs Lower Monthly Premiums Research shows that half of all people in this country have deductibles higher than $1000. Eleven percent of those insured have a deductible of at least $3000. This data was uncovered by the Kaiser Family Foundation. This non-profit group is concerned with explaining health policy that concerns all Americans. It also looks at this country's place in world healthcare. Many times, high deductible plans are the only choice in health care insurance options provided by employers. It doesn't end there. Besides a high deductible many times these plans require patients to pay part of their costs of bills before the plan's coverage begins. Difficult Choices Employees either pay high monthly premiums and have a lower deductible or the opposite. In the case of breast cancer, the consequences of choosing between high premiums or high deductibles can strike hard and fast. Between 2011 to 2016, research shows that 50 million people chose insurance plans with sky-high deductibles. Twenty-nine percent of those who had employer supplied coverage had these plans. High deductibles occur since insurance companies do not want patients to incur tests that may not be required, in their viewpoint. These are known as unnecessary tests in the lingo of the insurance company. A Car Wreck Breast cancer, according to this study is seen as an illness that strikes suddenly, many times without warning. This data is significant in that it examines the behavior of those faced with a life and death scenario. Breast cancer has been compared to a car wreck you didn't expect. How many of us have met breast cancer patients with little or no risk factors and the all too familiar phrase, "No one in my family ever had..."? This is in contrast to diabetes, according to one of the study's authors. This is known as a chronic illness, necessitating ongoing treatment. Breast cancer treatment is deemed "more straightforward". It does not have that many detours to take in the road to remission. Charity Care One of the largest breast cancer charity organizations, Susan G. Komen, deals with women who delay treatment frequently. Their staff field questions about the lack of money to treat newly diagnosed breast cancers on a routine basis. In fact, questions dealing with how patients will manage to pay for treatment comprise half of their calls despite Obama Care. They also dispense grants to needy women seeking care. These grants cover shortages when a woman's insurance will not kick in and pay for "unnecessary tests". They will also give women additional avenues to seek funding. Another charity known as the Samfund, helps younger patients with cancer pay their bills. The charity is named after its founder Samantha Eisenstein. New Reality in Healthcare Nurses should be aware of these trends when they see women entering the acute care hospital who may have delayed breast cancer treatment. The model of early diagnosis and treatment many of us learned in nursing school does not apply here. This is important when dealing with this new healthcare reality. References Women With Breast Cancer Delay Care When Faced With High Deductibles-The New York Times by Reed Abelson. Published May 4, 2018. Accessed May 4, 2018. About Us. Henry J. Kaiser Family Foundation website. About Us | The Henry J. Kaiser Family Foundation. Accessed August 30, 2018. Is High-Deductible Health Insurance Worth the Risk? -The New York Times by Reed Abelson. Published October 31, 2016. Accessed August 30, 2018.

We have all heard of 3 D printers. Some of us may even own one or will buy one in the future. In 2013, income generated from 3D printers was $3.07 billion. By 2020, less than two years away, this figure will skyrocket to an estimate of $21 billion. In the hospital setting, there are myriad uses. First, a definition is in order. 3D printing works on the concept of layers. A computer program is instructed to apply multiple layers of a product, which is usually plastic or metal until the finished design is complete. ORGANOIDS AND PEDIATRIC HEART SURGERYNow scientists are using this technology to create organs known as organoids made from stem cells. Think of the possibilities this will create for patients experiencing common ailments such as kidney and liver failure! This may prevent them from having to start and experience kidney dialysis. Down the line, they may also be able to delay death from kidney and liver failure. They can avoid risky transplant surgery. Since 2015, The Heart Program at Nicklaus Children's Hospital in Miami has been using 3D printing to formulate models of pediatric patients' hearts before surgery. Creating a 3D model before surgery allows the surgeons to look at the structure in a more in-depth fashion and to find the best surgical outcome. MELANOMA AND SKIN GRAFTSHow many of us have experienced a burn? That's where this technology also is useful. There is now 3D printed skin intended to be used for burn victims. Unfortunately, for those of us who have ever done a shift in a burn unit or even on a med-surg. floor, we have encountered people with burned skin. They usually need skin grafts as a replacement for their burned skin. In oncology units, for patients with melanoma, skin grafts are also used to close the skin in invasive surgeries, where the mole in question requires a deep excision. The results of skin grafts are not always aesthetically pleasing. Now thanks to breakthrough research in Spain, a 3D printer biotype that uses a biological ink composed of human plasma and material from skin biopsies has been revealed. One hundred square centimeters of human skin was printed in approximately 30 minutes. POLYPILL ANYONE?In nursing school, we all learn how to pass meds. We have gone from writing med cards, with the name and purpose of the drug and the patient's dose to using a WOW, Workstation on Wheels with the latest version of whatever program your facility uses like Epic or Meditech. A patient's wristband is required that you must scan and match with the patient demographics, that is, name and date of birth. Have you ever had to give a patient 20 or 30 pills throughout a shift? Think about this patient, taking multiple meds with and without food and all that this requires. Guess what? There is a new concept called a polypill which is being tested on diabetic patients. This format refers to a pill that has multiple medications contained inside it which has been programmed to open and release its' contents at staggered times. SAFETY ISSUESOf course, as nurses in the workplace, our safety is always an issue. If nurses are around the manufacture of 3-D medical devices, they must know the risks they face in using this technology. Safety data sheets which are used in healthcare facilities now will also be available with these printers. In addition, nurses and other healthcare workers should be informed of the materials being used in the printer. They must be able to access proper safety protective equipment such as rubber gloves that are capable of withstanding corrosion, goggles in case of splashes, proper masks, lab coats, face shields and rubber aprons. Sounds simple, but nurses should also be instructed not to eat or drink if 3D printing is done in their area. TOXIC FUMES3D printers emit chemicals. These are known as high volatile organic compounds or VOCs. An ER visit might be warranted to check out eye, nose, and throat irritations as well as headaches, nausea and loss of balance. Ultrafine particles or nanoparticles are also released during the 3D printing process. They can also cause health issues. If this technology is used, it is imperative to stay up to date on protective measures. The potential for lifesaving devices is limitless. Medical devices that will help patients will now be readily available. All technology has a risk-benefit ratio, and this is no different. Knowing the risks is necessary in this brave new world. REFERENCES How 3D printing is revolutionizing healthcare as we know it-TechCrunch. Reichental, A. How 3D printing is revolutionizing healthcare as we know it - TechCrunch. Published April 5, 2018. Accessed August 20, 2018.The Heart Program at Miami Children's Hospital Uses 3D Printing Technology | Nicklaus Children's Hospital. The Heart Program at Miami Children's Hospital Uses 3D Printing Technology Press Release. Printed January 14, 2015. Accessed August 21, 2018.Randolph, S.A., 3D Printing: What Are the Hazards? in Workplace Health & Safety: Promoting Environments Conducive to Well-Being and Productivity 2018 66(3), p.164.

Yes, there are men who are sexually harassed too. The show just didn't portray this story line. Actually, if you read the ending again, I said that the soap opera was leading the way to illuminate and educate nurses and empowering them. Not Nancy Lee Grahn.

This actress has been on the show for 20 years. She has very well thought out cogent answers. Thank you for your opinion. Nurses could have worse role models. Her character Alexis Davis has evolved on the show. In fact, the character is in therapy now to figure out her relationships with men and her family. She is a work in progress and very aware of the dynamics of the nurse-doctor relationships of the staff at the hospital.

You have a great sense of humor. Thanks for reading the interview.

Thank you for reading the interview.

Thank you for reading the article.

Thanks for reading this. This article is an interview with a well known soap opera star who happens to have an opinion about today's current events as it relates to women. This is relevant to nurses.

Thank you for reading this. Actually there are 4 GH related articles. Shelly Altman, the writer gave me a terrific interview. Plus don't forget the one on the transgender actress. Also, the first one on the #metoomovement. The nurses and characters on this show are very well fleshed out. This is a fictional town with a hospital as the main employer. This could happen anywhere! What is wrong with having a role model as a soap opera character? I can think of a lot of worse role models. Soap operas have given me countless hours of entertainment and inspiration. People go to the movies, read comic books, fiction, poetry. You can find hope and inspiration or comfort from all types of media. Nurses should empower themselves. If GH helps them do this, great!

Thank you for reading this. Actually there are 4 GH related articles. Shelly Altman, the writer gave me a terrific interview. Plus don't forget the one on the transgender actress. Also, the first one on the #metoomovement. The nurses and characters on this show are very well fleshed out. This is a fictional town with a hospital as the main employer. This could happen anywhere! What is wrong with having a role model as a soap opera character? I can think of a lot of worse role models. Soap operas have given me countless hours of entertainment and inspiration. People go to the movies, read comic books, fiction, poetry. You can find hope and inspiration or comfort from all types of media. Nurses should empower themselves. If GH helps them do this, great!

I recently interviewed General Hospital soap opera star Nancy Lee Grahn. One of the best known lawyers on daytime, her riveting performance as "Alexis Davis" the attorney for the two hospital staff members of the #metoomovement storyline on GH is worth exploring. She is drawn to bad boys like "Sonny Corinthos" (Maurice Benard), and "Julian Jerome" (William deVry). This year she was nominated for a daytime Emmy for outstanding lead actress in a drama series. Get into the mindset of this fascinating character who has been on the show since 1996. 1. This case exists in a fictional hospital. Do you think this case between Kiki and Dr. Bensch could have happened in a real hospital setting? Could happen? It does happen. In a hospital, a school, a law firm, a bank....anywhere and everywhere. This is a reality for many women to some degree at some point in their working lives. 2. Francesca the RN on the show. Do you think that her story line is credible, that she was coerced into sex with Dr. Bensch? Absolutely credible. This type of thing happens all the time. I've had friends that this has happened to sometimes expressly like here, sometimes by implication - I.e., women who don't cooperate with their harasser are systematically and insidiously destroyed. Suddenly, they aren't given opportunities, they are diminished and demeaned inside and outside of their presence, and often find themselves terminated for ridiculous reasons. Moreover, others who do give in, are seen to be advanced or at least survive in the workplace. Some women simply cannot afford the possibility of losing their jobs as they have children to feed or bills to pay and no other options. This is where the lines seem to blur as between a Francesca situation and Kiki one. But blaming Francesca for giving in to the threats ignores the bigger issue - nothing excuses someone threatening your livelihood unless you give them sex. It's not a real choice. That threat for many women is the same as holding a gun to her head and demanding sex - no one would consider blaming a woman for "giving in" under such circumstances. No one should blame Francesca either. Blaming Francesca for giving in to Dr. Bensch's threats and his abuse of power lets Dr. Bensch off the hook for his despicable and criminal behavior. 3. Given today's climate regarding sexual harassment how do you think she fell into this trap? Do you think it was due to her age? I think it's dangerous to see this as women "falling into a trap" because it makes it sound like Francesca, Kiki, or any woman could have avoided being in a harassment situation if only she'd done something different. These aren't traps - men like Dr. Bensch are going to harass regardless. You are right that there has been a climate change and no question that the "Me Too" movement has moved the line in a better direction. But it has not in any way eradicated sexual harassment or changed predators' behavior. While things are improved in terms of women at least being taken seriously when they complain, the facts are that men still have more positions of power in almost every workplace and some still harass and women still fear for their career future. These situations have not ended - they've just had a little more light shined on them. Even some of those who seemingly stood up for the Me Too movement and spoke out against Harvey Weinstein, like Les Moonves, has, it turns out, had a bunch of women come forward to say he'd done what Harvey Weinstein had to them - reputable women like Illeana Douglas. Things are improving but the problem has not ended. 4. As fictional attorney Alexis Davis do you think GH has enough emphasis on the medical side of things or more the legal side of things because of Sonny Corinthos and his organized crime ties? Let's just say, I would like a better balance of power between the mob and the law. It's a soap opera, so the hot bad boys rule. Television is complicated. However, when the heroes are killers, the stories are skewed in favor of the killers which puts those with a moral compass at a disadvantage. They do their best under the circumstances and I will say women do better on soaps than they do in primetime and kudos to the daytime network honchos for that. But I confess that I still have popped a vein or 2 over my 30 years in daytime wanting the playing field between men and women in soaps to be more equal. This is where Soaps and real life are similar. I and my coworkers, male and female, artistic and technical, keep trying to move the line and I feel, while we have farther to go, we have made measurable progress. 5. Are you surprised as Alexis Davis that Kiki decided to go after the case given her status as a nurse's aide and pre-med student, that is the low woman on the totem pole? Courage has no status. Often those who seem the weakest and most vulnerable have the most strength, courage, and fight in them. 6. How do you prepare to go into lawyer mode as Alexis Davis on the one hand versus being so insecure about your relationships with men (I can see the change when you speak to Julian for example) vs. when you prepare to do battle as the fierce attorney.? How do you reconcile the two sides of Alexis? It's an ongoing battle many women have and one that I hope the writers find interesting enough to pursue out loud. I know a lot of kick *** professional women who are fierce in the workplace, but go home to as many vulnerabilities and insecurities as Alexis. I love that dissonance in Alexis - it feels real to me. 7. Given that you have watched the show evolve over the past twenty years, do you think the #metooGH could have happened when your nemesis Helena Cassadine was on the show? She was such a strong willed woman? Helena would be an interesting case study, but probably not for the me too movement. I can only say that Frank and the network are very interested in doing right by the #metoo movement which is why this story was created, approved & written. 8. Will the #metooGH movement color how you portray Alexis in the future? I have and will always be a fighter for gender equality in real-life and in the character I play with the words I'm given. I'm a lovable (for the most part) pain in the *** about this, I fight each battle about the fair portrayal of women... and win some. I've learned to choose my battles. The PTB on GH are EXTREMELY fair about listening and supporting me, and I'm not just saying that because I work for them. I'm too old and too honest for that. They really walk the walk But I will never stop fighting. 9. Will Alexis back down even less? Become more ruthless like Scott Baldwin or does she have that intrinsic good core despite being a Cassadine? Well, It seems that bad behavior wins the day in this climate. Don't get me started. I'd direct you to my Twitter Account @nancyleegrahn and ask you to scroll through if you want to see me wound up! But I'd like to use a new friend of mine, Michael Avenetti, as an example of what I think is necessary right now and would defend my character to follow his lead. The game has changed. The high road was lovely and correct, but the rules have changed and we cannot play little league when the other team is playing hard pro ball. We must fight. And fight to win. Our democracy and liberty depend on it. I kind of hope Alexis comes to this conclusion as well - with some limits. 10. Where do you see Alexis in the next 5 years? I wish I could say The White House, but Alexis wasn't born in the USA so isn't constitutionally qualified. Wouldn't it be funny if she got deported now that the government is looking at past citizens who have already been naturalized? But seriously, I'd just like to see her hip deep in love, sex, family, friends, enemies, and legal battles. Or is that too greedy? I'll just take the sex! This show is leading the way to illuminate and educate nurses about the importance of the #metoomovement and how it affects them in the workplace environment. As nurses, we show our patients empathy 24/7. Nurses, empower yourselves like Kiki and Francesca on GH! What do you think of the GH storyline? Has this happened to you in the hospital setting?

I recently had the pleasure of interviewing Shelly Altman, the head writer of ABC's General Hospital. Shelly has been writing the #GHtoo storyline along with her co-writer Chris Van Etten. In the recent past, Shelley has also been the head writer for The Young and the Restless, and a writer for One Life to Live. Shelly is also responsible for the transgender and Alzheimer stories that have been recurring on GH. Note to the reader: Alexis Davis, the attorney for the health care staff in the #metoomovement is part of a wealthy, evil and at times lethal empire that came from Greece and settled in the fictional town of Port Charles, New York. Kick back and get into how the #metoomovement became part of this iconic soap. 9 Questions for Shelly Altman 1. What motivated you to start the #GHtoo storyline? Actually, that was a storyline that Jean Passanante (retired head writer on GH) and I had been planning to do about two and a half years ago. It was just something that as two women of our age we just were talking about having experienced harassment in a way that wasn't addressed when we were younger. Because of other driving stories we put it off, time passed. This was ironically before the whole #metoo movement became so prevalent. The timing just seemed right. We had the right characters poised in the right position and were able to tell a story that we know does happen in real life. So, we thought that it was an important story to tell now. 2. How did you decide to involve the characters of Kiki and Dr. Bensch, why those two? Again, going back even 2.5 years ago. They were the characters that we had in mind. We wanted a young woman in a workplace environment who would be facing the workplace harassment as well as sexual harassment. Again, the major focus, the major industry of our fictional town is the hospital. This character seems to be poised to be dealing with this situation with an older person in a more powerful position. 3. Adding Francesca to the mix, the RN, how far along in the story were you? I never saw the episodes of Dr. Bensch coercing her, and I didn't read online about them. Were they filmed? No, they weren't. Francesca was a new character who was only recently introduced into a different storyline. Because we deal in this kind of drama. We didn't want to show it on camera we wanted it to be a surprise both to Kiki and to the audience. Surprise to the character of Kiki. Again, we were trying to point out that the fact that often harassment is a hidden crime. We intentionally didn't show it because so many women go through this and do not feel comfortable talking about it. It was only through another young woman's struggle that Francesca felt emboldened to come forward. 4. How often do you turn to the news to get story ideas? I know there is a transgender one too now. Actually, we don't sit down and say what's current and how can we tell a story about that. Our stories almost always grow from the characters themselves but because we are dealing in the contemporary world and I work with such a wonderful team of writers who are very up on their current events. It just seems to happen organically that this is what's on our minds and therefore we put it into the characters' minds as well. 5. Using Alexis Davis to represent Kiki, why not tough as nails lawyer Dianne? Alexis as the mother of three daughters took this case quite personally. That as the mother of three daughters this case became quite personal for Alexis. 6. Do you think Alexis is more sympathetic given her background as a Cassadine outcast? Absolutely. That is another storyline that we are dealing with. That is something that Alexis herself is exploring. But I also do think that as a professional of her age. We dealt with this in a meeting that she had with other professional and working women that as a matter of course and as a matter of history she had to have faced some form of harassment in her career and in her ability to get where she was today. That's exactly the answer, this is a civil case and the District Attorney wouldn't get involved. She will get involved in her own thing. And again, I would imagine but we did not tell this story, Margaux as tough as she is would most likely have been sympathetic to Kiki's cause and as a prosecuting attorney she would have been going against Bensch and not for Bensch. I would say that Scott Baldwin remained true to character. 7. How far in advance is GH written? Is it a collaborative process between you and the other writer on the show, Chris van Etten? I am looking at a board right now right now we have written through Oct 25th. About 2.5 months plus close to three months ahead. Yes, he is my co-head writer. This is the most collaborative of all art forms I believe. We work with a team of writers who write outlines and then yet another team of writers who write dialogue in script form. I think it is extremely helpful to have people of different sexes writing this story because we can share different viewpoints. Although Chris and I are generally in agreement about almost everything, it still helps to share viewpoints. 8. Can you give me an idea of how your typical day goes? I see you are on the East Coast and GH is filmed on the west coast. How often do you visit the set? Every few months Chris and I get out there to California. It would be great if it were more often. The fact that we are in New York is simply an accident of location. We don't hire the writers out of NY. We happen to work with this executive producer before when he was located in New York on a different show. The typical day Monday through Wednesday Chris and I work with a team of outline writers to plot out a week's worth of shows. The remainder of the week I work on a projection for the future for the following week and months down the line. As I said then after the outlines are written and approved by the network and by everybody involved in the show they are then passed onto dialogue writers who write the actual script. Even in that last stage, we are channeling those characters and then we have a script editor who takes a final pass at the script and makes sure everything sounds right. She has been with the show for a very long time and she really has the characters voices in her head. 9. How long does it take you to decide to get rid of a character, either kill them or send them to prison? I know in soaps, no one ever really dies? Is it due to fan criticism? There are so many reasons those decisions can be made. Sometimes, it is simply because the actors chose to leave the show for other pursuits. Then, as a result, that will dictate the story for us if we know we are losing the actor it's an opportunity to perhaps write the character off in a dramatic way. Sometimes it was the way the story was always designed. There are certain characters brought in knowing well in advance they will be dying or they're here for only a certain amount of time. Those decisions really depend on story to story and actor to actor. There are different reasons fans do not like a character. Is it a character they love to hate like Nell? She is a character the audience loves to hate. Again, she is leaving the show of her own volition. She is such a wonderful actor that she is trying to pursue other things. That was a character we very specifically did not kill off. We hope she will have time to visit us again and we find her a very useful character. If we are getting a response that the audience just didn't like a character our first impulse isn't oh we've got to rid of him because the audience doesn't like him. The first thing we would do is find out why. The second thing we would do is either try to redeem the character or take the character in a direction the audience might respond more favorably to. Absolutely. Because of that, I love Dominic and we really wished him well. We intentionally did not kill that character (Dante). The character is very valuable, and the actor is wonderful. You want to leave your options open for the future. The #metoomovement is relevant to nurses because we do not exist in a bubble. Regardless of our age, or background, as nurses, we should expand our horizons and know what is going on in the world outside of the confines of the hospital or healthcare environment. Although this is a soap opera and a fictionalized version of events, it is still true to life and affects us all.

Sounds simple, but there comes a moment in the hospital when we all say, "I wish I had invented or thought of that. I could have retired by now." Looking at that concept, we find design thinking. This means that the person in the setting itself is responsible for creating the new product. In the hospital setting, this means that RNs and MDs are the ones coming up with innovative products1. Ideas for new products come from those in the thick of things or those working in the trenches instead of outside consultants. THE BEGINNING OF IT ALLDesign thinking was invented in a non-hospital setting. It refers to the designer being a part of a setting and figuring out what is needed in that venue to improve services.2 A large part of this is also marketing the product to the core audience, in this case the hospital. The hospital team members then move the product to designers, who provide the product with input from the members. A key concept to remember is that today's healthcare system is being stretched to full capacity. It is delivering products and services in a system that was never meant to take on such challenges when first invented.3 A Commonwealth Fund survey reveals that more than seven out of 10 adults are of the belief that this country's health system needs a complete overhaul.3 This just strengthens the need for design thinking. THREE PARTTo start from scratch, a definition of design thinking has three parts.3 They are as follows: it utilizes research and keeps the end users, in this case, the hospital staff in mind. It also uses a team approach to apply innovations from the team instead of obscure ideas. Keeping the end users in mind, refers to being empathetic to the players in the hospitals setting, that is, the doctors and nurses.3 THE ORANGE TRAUMA VESTOne example is the orange trauma team leader identification vest. No one knew who was running a trauma code which was a chaotic scene and had many responders giving orders. This concept especially works in crowded code situations, which many times in acute care settings is the norm nowadays. This vest is easily transferable to all types of codes in the hospital setting. This vest idea was invented by a nurse. By the way, reports from the trauma team where it originated are that wearing the vest has helped the members during these critical events.1 CARECUBEAnother idea generated by design thinking is the CareCube.1 At Thomas Jefferson University in Philadelphia, the Jefferson Health Design lab came up with the CareCube as a way for pediatric patients to score their pain level.1 It uses a cube, which has a drawing of a universally known expression such as a frown or grimace that the child can look at and identify with their hand. The nurse can then look at the pain scale that equals the expression and decide on the next course of action, which could mean administering pain medication or not. DIGITAL MAPPINGA new concept introduced by the team at Thomas Jefferson Health Design is a digital mapping tool.1 Again, the emergency room, is the setting. This time, medical students and architecture students were placed in a course to figure out how three groups, patients, nurses and physicians occupy the same space. How they speak to each other was considered and how all these factors influence waiting times in an emergency room where time can mean the difference between life and death. CLINICIANS for DESIGNFinally, since pretty much of us are online, there is a group for design thinkers! This online group brings architecture to the medical mix. Called, Clinicians for Design4 it was started by Dr. Diana Anderson, and Dr. Eve Edelstein. Dr. Anderson is a doctor who started out as an architect. She calls herself a "dochitect" and Dr. Edelstein calls herself a neuro-architect. Her background is neurology. This web-based community offers online discussions about the health care environment and how to improve it from architectural and medical viewpoints. In the hospital setting, there is always a need for new ideas and products. Just look around and see if you can become a design thinker! REFERENCES 1. Design Thinking for Doctors and Nurses Amitha Kalaichandran Aug. 3, 2017Design Thinking for Doctors and Nurses- The New York Times Accessed July 20, 201 2.Roberts, P., Fisher, T., Trowbridge, M., Bent, C., A design thinking framework for healthcare management and innovation Healthcare 2016(4): 11-14 doi.org/10.1016/j.hjdsi.2015.12.002 3. Design Thinking. Tim Brown June 2008 Design Thinking-Harvard Business Review June 2008 p. 85-92 4. Clinicians For Design Accessed July 30, 2018

I wonder how many other ER nurses feel this way. You pose a valid point.

Thank you for reading the article. I agree, you are "out there" so to speak.