Amanda Trujillo

Our prior post on the Amanda Trujillo case elicited many comments, on a variety of themes. There were also referrals and crosslinks to other sites supporting, analyzing, and weighing in on the situation, including statements from the Arizona Nurses Association and the ANA, and a post on a physician blog, “White Coat’s Call Room,” which has vowed to carry all the details once the case is decided.

One complaint raised by several people in response to our post was that the Arizona Board of Nursing wasn’t supporting Amanda. State nursing or medical boards are regulatory boards that exist to ensure the protection of the public and to regulate professional practice according to the law (in nursing’s case, according to nursing practice acts). They do not aim to protect the individual nurse, but to assure that all those who claim to be nurses are eligible to claim that title and practice within their scope of practice as defined by law.

Some historical context: Regulatory boards were set up back in the early 1900s, after nursing associations successfully lobbied for registration laws to keep out unqualified women who posed as nurses. In 1903, North Carolina was the first state to enact a nurse practice act; by the mid-1920s, all 48 states had laws regulating who could practice and who could use the title “registered nurse.”

Thus, boards of nursing are intended to protect the consumer and the standards of the profession.

While I agree with several comments saying that nurses should be able to practice within the full scope of their education and training, as recommended by the Institute of Medicine Report on the Future of Nursing, what’s also important to keep in mind is that we must do so in accordance with the law—which unfortunately may not always measure up to our ideals or accurately reflect actual professional practice.

Nurses and state associations need to work to change the law where it needs to be changed—and there are many people who devote themselves to making such change happen—but until the law does change, this is how nurses’ actions will be judged, whatever other motives may appear to be in play or not.

(Editor’s note: A few readers have misconstrued the last paragraph as implying a judgment in the Amanda Trujillo case. This is by no means the intended meaning. The focus here is a more general look at the roles of boards of nursing and the importance for all nurses of not leaving themselves vulnerable to accusations of going beyond their scope of practice, as it has been defined in a particular state’s practice acts. Further note: The Arizona Board of Nursing did subsequently release the Notice of Charges against Ms. Trujillo to those who requested a copy. It can be found via a link in this post from nurse/blogger Not Nurse Ratched.)

Addendum: January 10, 2013: The eventual outcome of this case can be seen in the “consent agreement” that Amanda Trujillo has signed with the Arizona Board of Nursing, which states that she “admits the Board’s Findings of Fact and Conclusions of Law” and agrees to fairly onerous terms for continuing to practice as an RN on probation. Thanks to blogger Not Nurse Ratched for providing a link to this document in her recent post about the case and its unfortunate history on the Web.

Executive Tower

1700 West Washington Street

Phoenix, AZ 85007

Greg Mercer, MSN

Governor Brewer,

You and your legislature are can make a strong improvement in the regulation of Arizona health care, at little cost, and set a positive precedent for the rest of our nation, building on your fine government reforms to date (I wish Massachusetts would follow your lead on transparency).

There is no regulatory function or group whose work will not benefit over time from the sunlight of public scrutiny.  Such accountability, as we have seen in the occasionally raucous debates over your BON and the case of Amanda Trujillo, can be messy at times, certainly inconvenient and irritating, but that is how a health democracy functions: involvement, and the willingness to form and express opinions, to speak and listen and do the hard work required to craft consensus.

“Many forms of Government have been tried, and will be tried in this world of sin and woe.  No one pretends that democracy is perfect or all-wise.  Indeed, it has been said that democracy is the worst form of government, except for all those other forms that have been tried…” – Churchill

This Nurse citizen agrees heartily.  I advocate for democracy often: without our participation and diligence, it withers and we pay a stiff price.  AZ BON may well need a dose: on the next renewal of its mandate, reforms should be considered, consistent with the fiercely and fearlessly innovative tradition of the  Western States.

Consider some mechanism to initially assess and screen complaints: a system to monitor and address potential abuses of this crucial system by those who file the complaints.  Courts have long had such mechanisms in place.  At the very least, provide a clear record of case evidence, findings, and the identities of all involved parties including complainants.  If need be, provide for a formal mechanism for record redaction by a disinterested party: protection of complainant anonymity is well-intentioned but provides a strong encouragement for abuse of the complaint process without culpability or public awareness.  Also, AZBON (every BON) must have adequate resources to process cases in a timely and effective manner: 1000 Nurses, or 1 in 35 of the total, suffering over 7 months of professional limbo (on average) each year is unacceptable.  It causes the innocent grievous harm, turns the presumption of innocence on its head, and has the potential to turn protection of the public into harassment and slander of those vulnerable individuals who have angered the powerful or ruthless.  It also delays accountability for those Nurses, and their patients, in need of it.  Both aspects harm Nursing and patients.  Arizona can do much better, at little cost.  Regulation without justice and accountability amounts to tyranny, much contrary to American and Arizonan values.

For some perspective, consider California, whose BON has seen far worse problems than has Arizona’s – see http://www.latimes.com/news/la-me-nursing-board14-2009jul14,0,1002564.story.

In 2009, in response to a private investigation showing an average of over 3 years per BON case, the CA Governor fired half of sitting board members: “Fred Aguiar, secretary of the State and Consumer Services Agency, said in an interview that the new board would be asked immediately to come up with a plan to eliminate the case backlog. ‘This plan needs to include how many more investigators are needed, how much that will cost. . . . I want to know now.’ “

Outside pressure does have its useful and necessary place in public affairs.  In America’s most deadly war, President Lincoln gave us the enduring precedent that we are one nation.  We Nurses, too, need to think more of the whole, of the big picture, and how precedent like the case of Amanda Trujillo, and the functioning of our BONs, affects that whole.

“No man, not even a doctor, ever gives any other definition of what a nurse should be  than this – ‘devoted and obedient.’  This definition would do just as well for a porter. It might even do for a horse.  It would not do for a policeman.”  Florence Nightingale, Notes on Nursing, 1860.

“Let us have faith that right makes might, and in that faith, let us, to the end, dare to do our duty as we understand it” – Abraham Lincoln, 1860.

“The nurse’s primary commitment is to the patient, whether an individual, family, group, or community… The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient… participates in establishing, maintaining, and improving healthcare environments and conditions of employment conducive to the provision of quality health care and consistent with the values of the profession through individual and collective action… The profession of nursing, as represented by associations and their members, is responsible for articulating nursing values, for maintaining the integrity of the profession and its practice, and for shaping social policy.” - American Nurses Association, Code of Ethics for Nurses with Interpretive Statements, © 2001 By American Nurses Association.

“Standards Related to Registered Nurse Scope of Practice:  A registered nurse (RN) shall… Demonstrate attentiveness by providing ongoing client surveillance and monitoring… Determine the clinical implications of client signs, symptoms, and changes, as either expected, unexpected, or emergent situations… Provide nursing care within the RN scope of practice in which the nurse… Intervenes on behalf of a client when problems are identified… Attends to client concerns or requests… Communicates client information to health team members including: Client concerns and special needs… Evaluate the… Need to communicate and consult with other health team members [and]

Need to revise the plan of care… Provide comprehensive nursing and health care education… Advocate on behalf of a client to promote the client’s best interest… Assesses and analyzes educational needs of learners… Unprofessional Conduct… includes one or more of the following… A pattern of failure to maintain minimum standards of acceptable and prevailing nursing practice… Abandoning or neglecting a patient… Failing to take appropriate action to safeguard a patient’s welfare or follow policies and procedures of the nurse’s employer designed to safeguard the patient… [or] Practicing in any other manner that gives the Board reasonable cause to believe the health of a patient or the public may be harmed.”  Rules of the State Board of Nursing, Issued by the Arizona State Board of Nursing

I am an ANA member with no leadership role, but I take ethics seriously.  Words and ideas are important, but they can also be used as empty pleasing sounds signifying nothing but hypocrisy, when they are used to project a pleasing image instead of as an honest guide for action.   When they are used to take more credit than one has earned.    What would Lincoln’s legacy be today, if he had merely spoken all his finely crafted eloquent words, without acting on them?

When a Nurse spends a year in professional limbo and unemployment, more should be alleged than actions to assess patient knowledge, provide education regarding available care options, advocate for the patient and communicate such in writing to the relevant treatment team and its Physician.   As AZ BON rules clearly state, not following employer policies or procedures qualifies as unprofessional conduct actionable by AZBON if and only if such rules are “designed to safeguard the patient.”  To request treatment team discussion of a care hardly seems to qualify, as it does nothing to necessarily change the care plan in any way: it merely makes a non-binding request for private discussion.  It is especially important to note: in Arizona, unprofessional Nurse conduct also includes failure to take the actions I describe, as quoted above.  Allegations of an improper “order” for consultation seem, in context, to amount to allegations of fully acting within the spirit and letter of BON standards on RN scope of practice.  If allegations of this nature require a year of consideration, what does it say about the state of health care regulation in Arizona?  I should also point out, that on a careful review of AZ BON rules, I have have been unable to find any suggestion that public discussion of a case by the accused violates any standard or has any relevance to BON’s decisions about the case.  These rules certainly do not suggest that such use of hallowed First Amendment rights somehow constitute evidence of mental illness: such an argument, historically, has typically been seen under Communist, not American governance.

One final note: just I write this note, I have learned that AZ BON has by its official rules a procedure for filing written requests for Board rule changes, open to use by “any person.”   As I imagine I qualify as such, I will consider using this option in future, as opposed to bothering such a busy official as yourself.  I apologize for not finding this option sooner, but in my defense it is buried in a 60 page legal document that, in of itself, was no small task to find and obtain.

Thank you for your consideration in these important matters.

I eagerly await any feedback you might offer.

Sincerely,

Greg Mercer, MSN

A little later in my nursing career one of those battle-axe nurses we all dislike decided she had an issue with me — which is to say, she was nearly shouting at me in front of every nurse in the department — over a triage record she thought was incomplete. When she finished, I asked her quietly asked her to step in our to step into our psych quiet room. I said her behaviour was unacceptable. I asked her to speak with me privately if she had a concern about my practice. I informed her if she ever tried taking me out again, I would speak to the manager. For that point on, until she left the department, this nurse avoided me like the plague. This was good. I deserved to work in a toxin-free workplace, right? More importantly, my patients deserved a nurse who wasn’t stressed out by harassment.

Somewhat after that, I began this blog. After writing some funny stories about strange patients and some sarcastic stories about irrational physicians I began to realize there was far more potential — and interest, if truth be told, because stupid patients stories on the Intertubes are as common as erectile dysfunction spam — in writing about how all the things I saw in the Emergency department related to larger issues surrounding the nursing profession and health care in general. To advocate, in other words. I think I have done this, in some small modest way.

This is how I see advocacy then, as a nurse: first for our patients (Jennifer Olin has some good elaboration here), then for ourselves personally, then for our profession. Needless to say, I’m a strong advocate for all of these. I believe most nurses are, if they think about it.

This brings me to my point. Whatever your perspective on the case of Amanda Trujillo, you might think the whole controversy would be a great opportunity for a thorough look at some hard issues related to advocacy.

There has been a lot of off-topic criticism directed at supporters of Amanda Trujillo — myself included —  for pushing the issue too hard. Mostly, this amounts to personal attacks on her advocates, or that her problems are merely a human resources issue, or that “people” are “tired” about hearing about the case, or that Trujillo is crazy or not credible or both, or that we’re all emotional, or that we’re engaging in bizarre conspiracy theories, or that we’re all drinking the Kool-Aid (because supporting Trujillo is like a cult and/or we’re mindless zombies) or that we all should just sit down and shut up, or that “real” advocates for the profession have advanced degrees and repose in legacy institutions like the American Nurses Association, or that we should trust Banner Health’s judgement (because health care corporations never screw up, I suppose), or we should wait for the disciplinary process at the Arizona Board of Nursing (because the Board investigates all cases correctly and without bias) or (my favourite) that we shouldn’t be “blowing up the Internet” because that will make things “worse” for Trujillo (God knows how, at this point) or lastly, that we don’t have all the facts. (I stipulate to the last, but I don’t think it’s all that relevant — an arguable point, I guess.)

What I am not hearing from the contras is any sustained discussion about what patient advocacy means in the context of a complex, conflicted health care environment, or what places nurses have in informing patients about treatment options, or how to effectively (and collectively) support nurses working in hostile environments, or what to do when hospital policy conflicts with basic nursing ethics, or what advocacy means for nurses in the age of social media.

What I am not hearing from the critics, to be precise, is why Trujillo was wrong to give her patient information on all treatment options, why Banner Health was right to fire Trujillo for what (at worst) could be construed as a minor practice issue, why nurse managers should always bow to angry physicians, why nurses advocating for patients is bad, why Banner Health reporting Trujillo to the state Board of Nursing — a one line complaint! — was necessary to protect the public from harm, why a group of us — including some blogging heavyweights like Emergiblog and Nurse Ratched — have utterly misplaced our passion in supporting Trujillo, and why, finally it is inappropriate to talk about this all over the Internet.

Instead all we get is a lot of fast talk, bloviation and (deliberate?) misinformation. I once hiked in the Guatemalan rainforest near the Mayan ruins at Tikal and a troop of howler monkeys followed us for a long time, flinging poo all the while. I’m having the same sensation now.

Nurses do to each other online exactly as we do to each other in real life. Fling poo. It’s sad, really, that for all our sophistication about social media and tech, things don’t really ever change.

I get that emotions are running high, on both sides. Even so, is it even possible have a serious conversation about Trujillo and what it means to be a nurse and advocate? Even me, secret Pollyanna I am, is beginning to doubt it.

***         ***         ***          ***          ***

Note of Clarification: The Arizona Nurses Association issued this statement on their Facebook page, which I am glad to reproduce:  ”When AzNA first became aware of this case, Teri Wicker, AzNA President identified a conflict of interest (between AzNA and her employer [Banner Health]) and voluntarily recused herself related to any AzNA discussions or decisions.”

[Cross-posted at NurseUp.com]

Giving all aid short of actual help. First, some words from the American Nurses Association on Amanda Trujillo. The ANA finallyissued a news release, in which they absolutely avoided, like nervous grannies dithering over an icy stretch of sidewalk, any position at all. However, they are watching the case “closely.” They advise “nurses and the public not to rush to judgments about complex cases based on social media postings or other media coverage.” They tell nurses in trouble to avail  themselves of the “many resources available on its website”. That’s pretty well it.  Three Tweets and they could have saved themselves 323 words and a news release. Would have been a more honest display of actual content, too.

That’s gonna leave a mark. Meanwhile Kim McAllister over at Emergiblog administers a very judicious flogging to the ANA over said news release above. Jennifer Olin does more dissection here.

Big and growing. More resources on Amanda Trujillo, including media contacts and how to contribute to her cause at NurseFriendly’s site.

Funky, interesting and fabulous New Blogs! New to me, anyway.

• Medical Ethics and Me has some great, relevant material on its collective blog. Deserves to have a much wider audience.

• RNAcademy.com: New grad on the ED offers a fresh perspective.

• Greg Mercer: a very new blog, and a strong advocate for nurses

• Comma to the Top declares war on those who would redesign grammar.

So what about Pinterest, anyway? Got my account, and am still puzzled by what exactly to do with it. (Though got a recipe for Olive Garden Alfredo Sauce.) HealthisSocial has some answers, but may also be mocking you.

So, what is the Mantrameds Insider Program?

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Sounds great, what do I need to do?

1. Apply here now http://www.mantrameds.com/insider-signup
2. Get Approved
3. Receive your Welcome Package
4. Enjoy the Benefits.

If you want to know the Guidelines Read moreInsider Program Guidelines

As a Mantrameds Insider you will have the privilege of all the Insider benefits listed above. Currently to establish a group of Insiders we are inviting individuals to join until the program is full. Insider status can be kept indefinitely but it must be earned yearly.  We don’t ask for much, keeping Insider status only requires your participation and brand support. Privilege does come with some responsibly but we do make responsibility fun.  We only ask you to use the tools we give you and interact with your community and ours.  That’s it give things away and help us spread the word about our brand and products, how cool is that for responsibility!

The Insider Program is currently limited annually.  The number of eligible Insiders per state is based on state population.
The Insider Program Coordinator will review ever Insiders participation yearly.   Keeping active status as and insider will be up to you and based on what you give away and how you interact with the brand and community via the program coordinator, social media, surveys, etc.

Apply here nowhttp://www.mantrameds.com/insider-signup

So, what is the Mantrameds Insider Program?

If you love our product the way we think you will, you’ll pass on the word!  It’s pretty simple.  The program is our way of saying thanks and asking for your help at the same time.  

As a Mantrameds Insider you will enjoy the following benefits:

• 30% Personal Use Discount
• Personalized Welcome Packet
• Free Scrub Top or Bottom Annually
• “Scrub Love” Cards To Introduce Your Friends To Mantrameds At A 30% Discount – (Recipients must be a new customer to be eligible)
• Participation in the Product Design And Review Process
• Ability To Host Your Own Income Generating Scrub Sale
• Fun SWAG for you and your friends
• Advanced ordering for new styles and colors

Sounds great, what do I need to do?

1. Apply here now http://www.mantrameds.com/insider-signup
2. Get Approved
3. Receive your Welcome Package
4. Enjoy the Benefits.

If you want to know the Guidelines Read moreInsider Program Guidelines

As a Mantrameds Insider you will have the privilege of all the Insider benefits listed above. Currently to establish a group of Insiders we are inviting individuals to join until the program is full. Insider status can be kept indefinitely but it must be earned yearly.  We don’t ask for much, keeping Insider status only requires your participation and brand support. Privilege does come with some responsibly but we do make responsibility fun.  We only ask you to use the tools we give you and interact with your community and ours.  That’s it give things away and help us spread the word about our brand and products, how cool is that for responsibility!

The Insider Program is currently limited annually.  The number of eligible Insiders per state is based on state population.
The Insider Program Coordinator will review ever Insiders participation yearly.   Keeping active status as and insider will be up to you and based on what you give away and how you interact with the brand and community via the program coordinator, social media, surveys, etc….

• Abuse of discount privileges will not be tolerated and can jeopardize your Insider status.
• Personal discounts are limited to the Insider themselves.
• Scrub Love Cards extending a 30% discount to friends and family will be provided on a limited basis to spread the love.
• Periodically Manrtameds may choose to allow your discount to be extended to others on a limited basis.

Apply here nowhttp://www.mantrameds.com/insider-signup

So, what is the Mantrameds Insider Program?

If you love our product the way we think you will, you’ll pass on the word!  It’s pretty simple.  The program is our way of saying thanks and asking for your help at the same time.  

As a Mantrameds Insider you will enjoy the following benefits:

• 30% Personal Use Discount
• Personalized Welcome Packet
• Free Scrub Top or Bottom Annually
• “Scrub Love” Cards To Introduce Your Friends To Mantrameds At A 30% Discount – (Recipients must be a new customer to be eligible)
• Participation in the Product Design And Review Process
• Ability To Host Your Own Income Generating Scrub Sale
• Fun SWAG for you and your friends
• Advanced ordering for new styles and colors

Sounds great, what do I need to do?

1. Apply here now http://www.mantrameds.com/insider-signup
2. Get Approved
3. Receive your Welcome Package
4. Enjoy the Benefits.

If you want to know the Guidelines Read moreInsider Program Guidelines

As a Mantrameds Insider you will have the privilege of all the Insider benefits listed above. Currently to establish a group of Insiders we are inviting individuals to join until the program is full. Insider status can be kept indefinitely but it must be earned yearly.  We don’t ask for much, keeping Insider status only requires your participation and brand support. Privilege does come with some responsibly but we do make responsibility fun.  We only ask you to use the tools we give you and interact with your community and ours.  That’s it give things away and help us spread the word about our brand and products, how cool is that for responsibility!

The Insider Program is currently limited annually.  The number of eligible Insiders per state is based on state population.
The Insider Program Coordinator will review ever Insiders participation yearly.   Keeping active status as and insider will be up to you and based on what you give away and how you interact with the brand and community via the program coordinator, social media, surveys, etc….

• Abuse of discount privileges will not be tolerated and can jeopardize your Insider status.
• Personal discounts are limited to the Insider themselves.
• Scrub Love Cards extending a 30% discount to friends and family will be provided on a limited basis to spread the love.
• Periodically Manrtameds may choose to allow your discount to be extended to others on a limited basis.

Apply here now http://www.mantrameds.com/insider-signup

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• Become a MantraMeds Insider and begin spreading the word about a truly different company. (mantrameds.wordpress.com)
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• MantraMeds is passionate about protecting our world. (mantrameds.wordpress.com)

Read more: http://www.care2.com/causes/why-is-it-impossible-to-find-an-organic-cotton-bra.html#ixzz1ZFY6tGzE

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Whenever you mention organic most people immediately think of food. Truth is that you can lead a very ‘organic lifestyle’ these days from food and clothes to beauty essentials. With September being Organic month, we’ve had a look at some of the many products out there which are produced according to organic principles. First up: bath and beauty.

Your skin is the largest organ of your body and whatever you put on it can be absorbed – much like you are what you eat. As people have become more interested in using more naturally sustainable products in their lives we’ve seen a growing number of organic skincare and beauty products hit the market – and they’re not too badly priced either! However, unlike food, there are no legal standards to follow for organic beauty products so if you’re really after living an organic lifestyle you should check each product before you buy it. Look out for brands that follow the COSMetics Organic Standard, or Cosmos-standard and will be labelled with one or more of the following:

Here are our four picks from the bunch that lets you introduce a bit more ‘naturalness’ into your bath and beauty regime:

Organic Surge Peach Passion Shower gel (£3.99/250ml)

An everyday essential – who doesn’t shower – the Organic Surge peach passion shower gel is packed with organic peach extract and almond essential oil that will calm and condition your skin.

The scent itself makes you want to eat this shower gel. Blended without the use of parabens, sodium lauryl/laureth sulphate and synthetic fragrances, it also contains Vitamin E so leaves your skin feeling smooth and soft and ready for the day. And if you are prone to irritated skin, the gel is clinically certified for sensitive skin so it is perfect for all skin types.

Available in Wholefoods, John Lewis, Ocado, Fresh & Wild and Waitrose.

OCS Aqua Boost Shampoo and Conditioner (£10.95)

A favourite of celebrities, OCS’s haircare and styling products are the ultimate choice for your tresses. Using Soil Association and ECOCERT certified organic ingredients (and carrying the Bunny Logo) the products use gentle, nourishing and natural ingredients like sunflower oil (a natural UV inhibitor), fennel seed, comfrey and wheat for conditioning and bergamot fruit oil for antiseptic properties.

We’ve been testing the Aqua Boost shampoo and conditioner on our over-treated, over-coloured locks for a few weeks now, and our hair is definitely feeling softer and looks more shiny! And the fact that it smelled like a sweet shop makes the experience even… well sweeter.

For stockist details call 01590 613 490 or visit the OCS website.

Aubrey Organics Collagen & Almond Enriching Moisturising Lotion (£11.72/237ml)

When you’re nice and clean, don’t forget to treat your body to some added protection against the harsh environment – especially important during winter – with a good body lotion. You can be certain you’re in safe hands by going with this one from Aubrey Organics. The brand was set up by US ecologist Aubrey Hampton and was the first brand in the world to receive organic accreditation.

Made with collagen and elastin, proteins found in your skin, plus rich moisturising almond oil, this replenishing body lotion promises to smooth and hydrate, leaving your skin soft, youthful and delicately fragrant.

Available online at www.aubreyorganicsuk.co.uk

Mádara Deep Moisture Cream (£24)

Add a bit of luxury to your daily organic skincare regime with Mádara’s moisturising cream. Part of a range of eco-friendly skincare products that is certified by ECOCERT, the Deep Moisture Cream promises to hydrate, firm and nourish the skin. It contains Baltic algae, oats, plantain, rosehip, sea bucktorn as well as rose water, avocado, cocoa and jojoba.

But ladies be aware: the sleek design and fresh fragrance makes it a favourite with men too, so don’t be surprised if you find you’re running out quickly!

Available in Wholefoods or online www.madara.co.uk

Read more http://www.hippyshopper.com/2011/09/organic_month_bath_beauty.html

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• Revitalize Your Skin With This Simple Organic Avocado Butter Mask! (organicjar.com)
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scampbell@salisburypost.com

SALISBURY — During a recent afternoon at Millbridge Elementary, school nurse Sharon Beck held a blood glucose monitor steady while second-grader Kayla Woods pricked her own finger.

The two chatted until the device beeped, an indication the results were ready.

Kayla’s blood sugar was high, so Beck asked the type-1 diabetic a few questions.

“What did you have for lunch?”

“Did you eat all of your lunch?”

“Wasn’t your blood sugar low this morning?”

It turns out Kayla ate almost every bite of her burrito lunch that day.

After Kayla returned to class, Beck called her father to give him a heads up.

During the call, she asked when the 7-year-old’s next appointment with a doctor was and suggested checking to see if her diet needed to be adjusted.

But most days Beck isn’t around to help Kayla with her blood sugar checks, leaving the school’s administrative assistants to handle the task.

Each week, Beck travels between Landis Elementary School, Millbridge Elementary and Knox Middle.

And she’s not the only one.

With 11 nurses to serve all 35 schools in the Rowan-Salisbury School System, the caregivers have to take on at least three schools, some even have four.

The school system is down one nurse this year due to state budget cuts, which leaves one nurse for every 1,800 students. The American Academy of Pediatrics recommends one nurse per 750 students.

“More students per nurse means we have to go around putting out fires and doesn’t leave as much time for preventative education,” lead school nurse Susan Thomas said.

And when they aren’t putting out fires, the nurses spend the majority of their time training staff how to properly administer and monitor procedures ranging from cauterizations to blood sugar checks.

“Our main job, since we cannot be in each school, is to train the staff to take care of the children,” Thomas said.

Getting ready

Beck said the start of the year is one of the most hectic times for school nurses.

“We may not be getting a classroom ready, but we are getting things ready so the classrooms can run smoothly,” she said.

The nurses schedule meetings with parents to get filled in on their children’s health needs. They also train primary and back-up staff to work with students who need care on a daily basis.

“There are a lot of health needs in school that sometimes people don’t realize,” school nurse Wendy Marchinko said.

Marchinko works with China Grove Elementary, China Grove Middle and Bostian Elementary.

“This time of year is so busy because we are doing a lot of training,” she said.

That training not only includes getting school staff prepared to care for students with chronic diseases, but also things like how to use an EpiPen in case of a severe allergic reaction, as well as bloodborne pathogens and CPR training.

The nurses also spend the first several months making sure students have the proper vaccinations before moving on to do vision and hearing screenings for elementary students.

The need for more

When Thomas began working for the school system in 1992, there was only one other school nurse, and both women spent most of their time working with exceptional children.

But today, Thomas said, there is more of a need for nurses in schools because the number of children with chronic illnesses, such as diabetes and asthma, has grown substantially.

“Back then we only had two insulin-dependent diabetics in the whole school system. We have at least 50 now,” she said.

Thomas said there is also a need for more nurses because of the severity of health conditions that require feeding tubes and catharizations.

“Because of those things, we need someone overseeing the health routines that children need, and that needs to be a registered nurse,” she said.

State law requires school nurses to be registered nurses and receive national certification within three years of their hire date.

At its peak in 2008, the district had 14 school nurses. That number has dwindled with the expiration of grant dollars and budget cuts, Thomas said.

School nurses perform a vital service to the health and well-being of students, according to Superintendent Dr. Judy Grissom. “The challenge for our district is that the medical problems for students have increased while at the same time funds have decreased,” she said.

Ideally, Marchinko said, there would be a nurse in every school.

“We work hard to do the best we can with what we have, but I do think we need more of us,” she said. “I could stay busy at every school every day.”

Marchinko said her role would be different if she was only assigned to one school.

“I would be the primary person that does the procedures,” she said. “My role now is making sure the staff can handle these situations when I’m not here.”

Beck said although staff members are trained to give insulin shots and change catheters, having a nurse at every school would remove that pressure.

“A lot of times they are given medical tasks and they feel overwhelmed, but they learn how to do them because they care about the kids,” she said.

A nurse in every school

Both the Kannapolis City and Cabarrus County school districts have a nurse at every school thanks to a partnership with the Cabarrus Health Alliance, the county’s health department.

Betty Braxton, community relations director for the Health Alliance, said the school health program is funded through the agency and allocations from both school systems.

She said the Cabarrus Medical Society Alliance, a nonprofit organization run by physicians’ spouses, has also raised more than $175,000 through an annual golf tournament in support of the program.

The Health Alliance originally started out with two nurses covering all the schools in both systems in 1988, but expanded to include a nurse at every school in 1999.

“We had a program where a school nurse visited a school once or twice a week, but we knew there were more demand and needs than we could meet with an occasional visit so the desire was to have a more comprehensive program,” Braxton said.

Braxton said the Health Alliance recognized that students perform best when they are healthy.

Cabarrus County is the only county in state to have developed a comprehensive school nurse program for each public school using a public-private partnership model.

Grissom said although the Rowan-Salisbury district doesn’t have a partnership with a local health care provider, that doesn’t mean it doesn’t want one.

“Our district has and will continue to have discussions with area health care providers to seek assistance during the economic downturn that is causing many areas in public education to be hit with critical losses,” she said.

What more nurses would mean

Thomas said if the Rowan-Salisbury School System had more nurses, there would be a greater continuity of care.

“I’d love to be able to just focus on one group of kids,” Beck said.

Beck said although most nurses dedicate one day per week to their assigned school, not having to travel between three would lend more time for health promotions including lessons about nutrition, the importance of physical actively and proper hand washing procedures.

“I think the whole level of wellness at the school would improve overall,” she said.

Marchinko agrees that increase preventative care practices would yield healthier students.

“Of course we want to help people when they are sick, but we want to help keep them from getting sick in the first place,” she said. “I feel strongly that we make a difference because if you don’t feel good you aren’t going to be ready to learn.”

Contact reporter Sarah Campbell at 704-797-7683.

Twitter: twitter.com/posteducation

Facebook: facebook.com/Sarah.SalisburyPost

See original post

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The best hospitals? The New York Times reports that “the country’s leading hospital accreditation board, the Joint Commission, released a list on Tuesday of 405 medical centers that have been the most diligent in following protocols to treat conditions like heart attack and pneumonia.” Many of the hospitals often considered among the “best” (including those in New York City) did not, however, make this list (though some came very close). While hospital representatives argue that there are several mitigating factors that might have influenced these findings, this is a reminder that reputation and the presence of famous specialists may not necessarily mean the best care.

Their own darn fault. Though some may laugh at letting sick people who can’t pay for care just die, many of us are able to imagine ourselves, a friend, or neighbor in such a situation. For those who believe America should be more like Victorian England in its division between the the haves and have-nots (bring back debtors’ prisons!), good news: such hilarious down-on-their-luck characters should be easier than ever to find:

Nearly one million more Americans went without health insurance in 2010 than in 2009. This distressing news is further evidence of the need for government safety net programs and the national health care reforms that will take effect mostly in 2014.

Social media guidance for nurses. Last, but not least, the American Nurses Association (ANA) has released new social networking principles (which, somewhat surprisingly, given the topic, you have to purchase!). Still, it’s good that these exist, since nurse blogger Megen Duffy recently noted in her September iNurse column in AJN, “Patient Privacy and Company Policy in Online Life”:

Social media is a newcomer to health care, and policies are still being formulated. Mistakes will occur, and policies will be revised. Nurses can rise to the challenge and make sure their voices are heard in the formulation of workable guidelines; we live and breathe the nursing process, and if something isn’t working, we reassess and implement another plan.

Leave us your comments. This is social media, after all.—Jacob Molyneux, senior editor 

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The American Nurses Association has announced its formal recognition of emergency nursing as a specialty practice.

The ANA defines emergency nursing as “the care of individuals across the lifespan with perceived or actual physical or emotional alterations of health that are undiagnosed or require further interventions. Emergency nursing care is episodic, primary, typically short-term and occurs in a variety of settings.”

The ANA also approved the Emergency Nurses Association’s scope of practice statement and acknowledged the standards of practice for emergency nursing. These documents, written by the ENA (www.ena.org/iqsip/nursingpractice/scopes/Pages/Default.aspx), form the foundation of emergency nursing and outline the expectations of the professional role within which emergency nurses must practice.

“The criteria for attaining specialty status are rigorous, so the recognition of emergency nursing as a specialty is a significant achievement,” ANA President Karen Daley, RN, PhD, MPH, FAAN, said in a news release. “ANA’s role in this process is to protect patients by ensuring high quality in nursing practice and performance. This recognition tells the public that emergency nurses are dedicated to meeting high standards of care and patient safety.”

ENA President AnnMarie Papa, RN, DNP, CEN, NE-BC, FAEN, said the recognition acknowledges the unique aspects of emergency nursing and gives emergency nurses a stronger voice in healthcare policy debates.

For more click HERE

See article http://www.clemson.edu/clemsonworld/2011/summer/

That’s what you’ll get in a superb new book called  Design for Growth: A Design Thinking Tool Kit for Managers, by Jeanne Liedtka and Tim Ogilvie.

Ogilvie is the CEO of Peer Insight, an innovation strategy consultancy. Jeanne Liedtka, a professor and former associate dean at the University of Virginia’s Darden School of Business, previously served as  chief learning officer for the United Technnologies Corporation.

Designing for Growth is an illustrated guide that shows how to translate “design thinking” into practical, everyday tools.  As the authors note, “Design thinking can do for organic growth and innovation what TQM did for quality – take something we always have cared about and put tools and processes into the hands of managers to make it happen.”  In reading the book, it struck me how useful their tool would be in the publishing industry where ebooks and handheld readers have blown up the publishing value proposition.

To unpack the process of good design and apply it to a business problem, the authors start with a process of four questions, What is, what if, what wows, and what works? Essentially, these are translated as:

1. Assess the marketplace, get close to consumers to understand their behavior, talk to users;
2. Brainstorm and write down hypotheses; dream up your optimal, best-case-ever outcomes to a challenge; set aside constraints and fears to loosen up creativity;
3. Cull options down to a manageable number that will “wow” the customer, combining upside value while presenting profit potential;
4. Go into the marketplace with options and test the solution, product, or service with consumers, invite customers to co-create, and integrate feedback.

The authors suggest a variety of tools to flesh out these answers.  Some examples include:

• Visualization: Use sketches, photographs, and other images to visualize a management problem.  At Kaiser Permanente, a nursing supervisor addressed problems with administering medications by having nurses sketch out their experiences.    The nurses at first denied they had issues, but when asked they drew amazing pictures showing nurses on roller skates with “hisor her arms full and all these other little stick figures asking them questions. So we took all that and started looking at themes coming out of this.”   Other techniques are storyboards that lay out a sequence of events with simple pictures, and creating fictional personas that visualize and represent typical customers.
• Customer journey mapping. As the authors observe, operations experts advise managers to “staple yourself to an order” to understand the flow of activities within a firm; a customer journey map means you “staple yourself to a customer” to empathize with a customer’s experience from beginning to end with your brand.   The authors cite how Darden Business School did a map with MBAs, beginning with their decision to join the school through 12 stages leading to graduation.  A book publisher could map a reader’s journey, beginning with reading about a book online and in a review, through further research, deciding whether to purchase a print or ebook, where to purchase it, the reading experience, and what happened when they finished the book (email the author, post Amazon review).
• Assumption testing: isolate and test key assumptions that will determine success or failure using thought experiments and simulations as you prepare to launch  your solution or product.  What assumptions are you making about your customers that need to be examined?  Assumptions about operational capacity of your firm? Assumptions about how your competitors will react?   Imagine if publishers had done more assumption testing years ago about the popularity of ebooks!
• Customer co-creation: engaging the customer in the development of new business offerings.  By putting prototypes in front of customers, you observe how they react, and integrate their responses to improve and change your offering.  As the authors write, in our “Six Sigma world, which values perfection and polish, we tend to get anxious about showing customers unfinished, unpolished “stuff.” Get over it. Innovation is about learning, and customers have the most to teach you.”    I’m sure publishers and editors are devouring survey and focus group data, as well as their own research, about how readers are changing habits, and what they want from the reading experience (for example, many readers are acutely concerned ebooks don’t allow you to share and pass along a book).
• Other tools include value chain analysis, mind mapping, brainstorming, rapid prototyping, and the learning launch.

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WASHINGTON–(BUSINESS WIRE)–The Bureau of Labor Statistics predicts the U.S. will need to add 580,000 nurses to the workforce by 2018. Moreover, these nurses will need higher skill levels than current nurses possess.

“Critical Conditions: Preparing the 21st-Century Nursing Workforce”

The Institute of Medicine recommends that 80% of registered nurses hold a bachelor’s degree or higher by 2020. Yet only half of nurses now have this credential. Experts say the nursing shortage and skills gap jeopardize our nation’s ability to provide care, especially for the aging population.

To explore these issues and possible solutions, on Tuesday, June 21, the University of Phoenix Research Institute sponsored the expert panel event, “Critical Conditions: Preparing the 21^st-Century Nursing Workforce,” at the National Press Club in Washington, DC. Hosted by The Chronicle of Higher Education, the event attracted academic and industry leaders with a wide range of expertise in nursing education, practice, and policy. Panelists included nursing school deans, healthcare executives, and technology experts. They addressed educational and policy strategies to advance a new generation of competent and compassionate nurses.

“Academia needs to partner with organizations employing nurses to ensure that students are learning the skills employers need today,” said panelist Dawn Bazarko, senior vice president for the Center for Nursing Advancement at UnitedHealth Group. She noted that the nation’s hotly debated nursing shortage is a “paradox” because “many graduates can’t find employment.”

Some educators believe the future of nursing depends on recruiting more men and minorities into the profession. Panelist May Wykle, nursing dean at Case Western Reserve University, described her institution’s community outreach program in which nursing students work with underserved schoolchildren and teenagers to get them interested in a nursing career.

Panelists discussed the role of technology in preparing nurses to be more efficient while not losing the “human touch.” One of the most important benefits that technology can provide nursing students, said Parvati Dev, president of Innovation in Learning, Inc., is a “library of virtual experiences that it would take years for them to acquire in real life.”

Moderator Tracey Wilen-Daugenti, vice president and managing director of the University of Phoenix Research Institute, presented preliminary findings from current research on nurses’ technology skills related to electronic health records. “The research shows that higher education must do more to help nurses develop technical skills to improve the quality and efficiency of care,” she said.

Educating the next-generation nursing workforce requires adaptable educational models, said Pamela Fuller, dean of the University of Phoenix College of Nursing. “Many nurses have heavy family and work obligations, and need education that fits their full schedules,” she said. “Educators need to provide flexible options for taking classes, whether on-campus or online.”

Other panelists included Carlton G. Brown, president of the Oncology Nursing Society; Maureen Swick, senior vice president and chief nurse executive, Inova Health System; Athena Palearas, corporate vice president of education, Fresenius Medical Care North America; and Kristy Chambers, cofounder and principal partner of Medical Simulation Design.

Drawing on current research related to nursing education, technology and workforce skills, panelists explained what actions today can ensure a healthier tomorrow for the nursing profession.

The University of Phoenix Research Institute will publish a special report on the event in fall 2011.

About University of Phoenix Research Institute

Affiliated with one of the largest providers of higher education for working adults, the University of Phoenix Research Institute conducts scholarly research on working learners, higher education, and industry to improve academic outcomes and promote a more prepared workforce. Visit www.phoenix.edu/institute.

About University of Phoenix

University of Phoenix is constantly innovating to help students balance education and life in a rapidly changing world. Through flexible schedules, challenging courses and interactive learning, students achieve personal and career aspirations without putting their lives on hold. University of Phoenix serves a diverse student population, offering associate, bachelor’s, master’s, and doctoral degree programs from campuses and learning centers across the U.S. as well as online throughout the world. For more information, visit www.phoenix.edu.

Contacts

for University of Phoenix Research Institute
Norma Kelly, 818-509-0575
norma@imindspr.com
Ellen Georgiou, 818-678-9659
ellen@imindspr.com

http://www.businesswire.com/news/home/20110621007160/en/Experts-Explore-Solutions-Nursing-Shortage-Skills-Gap

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This list provided by carenurse.com illuminates the day-to-day tasks and regulations pertaining to the life of a nurse in 1887—before routine charting was even invented.

1887 Nursing Job Description
In addition to caring for your 50 patients, each bedside nurse will follow these regulations:

1. Daily sweep and mop the floors of your ward, dust the patient’s furniture and window sills.

2. Maintain an even temperature in your ward by bringing in a scuttle of coal for the day’s business.

3. Light is important to observe the patient’s condition. Therefore, each day fill kerosene lamps, clean chimneys and trim wicks.

4. The nurse’s notes are important in aiding your physician’s work. Make your pens carefully; you may whittle nibs to your individual taste.

5. Each nurse on day duty will report every day at 7 a.m. and leave at 8 p.m., except on the Sabbath, on which day she will be off from 12 noon to 2 p.m.

6. Graduate nurses in good standing with the director of nurses will be given an evening off each week for courting purposes, or two evenings a week if you go regularly to church.

7. Each nurse should lay aside from each payday a goodly sum of her earnings for her benefits during her declining years, so that she will not become a burden. For example, if you earn $30 a month, you should set aside $15.

8. Any nurse who smokes, uses liquor in any form, gets her hair done at a beauty shop or frequents dance halls will give the director of nurses good reason to suspect her worth, intentions and integrity.

9. The nurse who performs her labors [and] serves her patients and doctors faithfully and without fault for a period of five years will be given an increase by the hospital administration of five cents per day.

http://scrubsmag.com/a-list-of-rules-for-nurses-from-1887/

Do you ever wonder where some of your fellow nurses find the time or energy to look so put together? Chances are they probably don’t have the time or the energy either, but it makes them feel better about themselves.

I am one of these people. Rarely do I leave the house without makeup. In a pinch, there are two items that must always be applied: mascara and, most importantly, lipstick. Mascara can make any sleepy eye look at least half opened. It gives a bright-eyed look that usually can last all day long. Lipstick takes only seconds to apply, and while it does make for a pretty face, it also enhances our smiles, which are a big part of who we are.

I feel better about myself if I look at least halfway presentable. I always keep my lipstick in the pocket of my scrubs and reapply it throughout the day. It just makes me feel good! Nothing is more frightening than a nurse who actually looks as if her intentions are to hurt you! Lipstick stat!!!

One day when I was working in the hospital, I was bathing a patient and his nurse came in to introduce herself. She was as sweet as could be and I didn’t think twice about her until the patient made a comment to me: “She could have at least dried her hair before she came to work!” Apparently the nurse’s hair was still wet from her morning shower.

This is just is example of how attentive patients are as to how we present ourselves. Some people may argue that beauty lies within. Very true, but our faces are the physical focal point for the patients we’re treating. If we can’t take time out to care for ourselves, how can we care for our patients?

http://scrubsmag.com/lipstick-stat/

Most nurses are juggling career, home and family responsibilities. One wonders why anyone would add graduate school to an already busy life. Classes, seminars, term papers and long clinical days fill the time that is left in their already-packed schedule.

About halfway through the semester of an online graduate class, I assign one “lighter” assignment to allow students to take a breath and relax. This year’s assignment was a Top 10 List.

In today’s world, so many of us hear nurses complain about how difficult and challenging our jobs have become and yet graduate students have obviously met that challenge and are seeking to continue in nursing. They clearly see something positive in what they do, so I asked them to identify the top 10 reasons they love being a nurse. Instead of giving you 40 top 10 lists, I have drawn from all of their entries and made a Top 40 list. I encourage you to take a minute and make your own top 10 list.

• 1. Nursing is a fulfilling career. I love that I make a difference in people’s lives most every day.
• 2. Nursing is a challenging career where I learn something new every day. It is never boring.
• 3. Nursing satisfies my need to comfort and care for others.
• 4. Nursing is being able to help someone if only by saying a kind word or providing a gentle touch.
• 5. One good day at work can make up for any of the bad days I have.
• 6. Nursing is being present for many of a patient’s most meaningful moments including the birth of a child and the death of a loved one.
• 7. It takes a special person to do what we do and I’m glad to be a part of it.
• 8. Nursing is educating, advocating and helping others strive for a better quality of life.
• 9. Nursing helps me organize my time efficiently.
• 10. Nursing has helped me to really listen to others.
• 11. I get to wear glorified pajamas (scrubs) to work.
• 12. Nursing is part of an interdisciplinary team.
• 13. Nursing has strengthened my spiritual faith.
• 14. Nursing has offered me the gratification in knowing I am “giving back to society.”
• 15. Nurses can help someone heal in mind, body and spirit.
• 16. I have a passion for what I do. I never wake up and dread going to work.
• 17. I love the challenge of my career. No 2 days are ever the same.
• 18. Nursing has made me a better person, husband, wife, son, daughter and friend. I am more patient, caring and open-minded because I’m a nurse.
• 19. Nursing helps me value my life and those who are in it. I see sudden, unfortunate death frequently and it gives me stronger resolve to stop and “smell the roses.”
• 20. Nursing allows me to be creative. Having a child forget he is in the hospital is the greatest by bringing in snow so he can make a snowman.
• 21. The goodbye hugs from the children who shouldn’t have made it but somehow did.
• 22. Nursing allows me to have a lot of autonomy.
• 23. There is always room for advancement in nursing.
• 24. Being a nurse means lifelong learning.
• 25. Nursing allows for a flexible schedule. When my sons were younger, I could work weekends or evenings when their father was home and, now that I am back in school, I can work around my school schedule.
• 26. Feeling trusted. There is nothing better than beginning your shift and having a parent leave because they know their child is in good hands.
• 27. Not having to do it all. If you can’t get everything done, there is always someone on the team that can help.
• 28. Most people don’t particularly like their jobs. I can honestly say that I am proud to a nurse.
• 29. I love the fast-paced, technologically advanced, critical-thinking environment of nursing. I am always challenged in new ways.
• 30. I love my amazing work family. Sometimes I spend more time with them than my real family!
• 31. I love all the people I have the opportunity to meet on a daily basis from all across the world. Understanding cultural differences is a real gift.
• 32. Nursing has humbled me. Many days, I hold a patient’s life in my hands.
• 33. Nursing has taught me to have empathy and compassion for others.
• 34. On most days I expend more calories at work than I take in. Nursing is definitely not sedentary!
• 35. If you don’t like one area of nursing, there is always something else to try.
• 36. Being able to work with a lot of smart people.
• 37. Achieving gratification is seeing patients thrive who were once ill and knowing I had a part in their recovery
• 38. Having 24/7 access to medical advice and education from trusted healthcare professionals.
• 39. There is such camaraderie among nurses in and out of the clinical environment. Once you discover another person is a nurse, you share a common bond and understanding.
• 40. I am allowed to see just a snapshot of strangers’ lives. Although they may not remember my name in 10 years, they will remember the way I made them feel.

http://community.advanceweb.com/blogs/nurses3/archive/2011/06/13/nursing-students-share-top-reasons-for-being-a-nurse.aspx

The Camp Recovery Center’s medical director is opening up a new range of treatment options for men and women suffering from drug or alcohol addiction.

Amy Solomon, M.D., is a board certified family physician with more than 10 years of experience practicing medicine. In addition to serving as medical director at The Camp, she has her own integrative medical practice in Ben Lomond, Calif.

Since joining The Camp Recovery Center, Dr. Solomon has expanded the drug rehab program’s treatment offerings to include complementary and alternative therapies, herbal remedies and amino acid therapy. Included in treatment are two yoga sessions per week, twice weekly detox acupuncture groups, and individualized recommendations to replenish the body’s natural amino acids and nutrients.

“One of my goals is to bring addiction treatment at The Camp into a more integrative space,” said Dr. Solomon. “Building on the highly effective program already in place, clients can now choose from a full range of conventional and alternative therapies until they find what works for them.”

In addition to new therapies, Dr. Solomon and the 24-hour nursing staff at The Camp offer natural remedies for the various aches and pains common in early addiction recovery. Rather than taking medication, clients may try lavender oil to aid with insomnia or a topical menthol patch to soothe minor aches and pains.

“We are moving away from the concept of taking a drug to change the way you feel, whether it is an illegal, prescription or over-the-counter drug,” said Dr. Solomon. “Our clients are really receptive to these safe, natural and non-habit-forming alternatives.”

Alternative therapies are just one aspect of The Camp’s approach to integrative addiction treatment. Clients also have access to an onsite gym and swimming pool and are encouraged to manage stress by taking a walk outdoors or spending time in nature. Surrounded by redwood trees in northern California, The Camp offers an ideal setting for people to reconnect with the world around them.

For some clients, alternative therapies are the most effective at helping them maintain sobriety, while others prefer conventional addiction treatments, which are also available at The Camp.
These include addiction counseling, 12-Step support groups, educational lectures and workshops, Suboxone and other medications, and relapse prevention planning. In all cases, clients are viewed as a key member of the treatment team, sharing their preferences and making decisions with guidance from a team of addiction specialists.

“When clients leave The Camp, their recovery toolbox is full,” said Dr. Solomon. “It includes art, poetry, journaling, yoga, acupuncture, nutrition, physical fitness, relaxation techniques and a wide range of activities they can use to support their recovery.”

About The Camp

The Camp Recovery Center provides comprehensive detoxification, residential, outpatient and aftercare treatment programs for adults and adolescents struggling with drug or alcohol addiction. For more than 25 years, The Camp has been one of the premier substance abuse treatment programs in the country, providing a uniquely effective combination of therapy, medication management, 12-Step work, and recreational and experiential therapies to build a firm foundation in recovery.

The Camp Recovery Center is a proud member of CRC Health Group, which offers the most comprehensive network of specialized behavioral healthcare services in the nation. With the largest array of personalized treatment options, individuals, families and professionals can choose the most appropriate setting for their behavioral, addiction, weight management and therapeutic education needs. CRC Health Group is deeply committed to making its services widely and easily available to those in need, while maintaining a passion for delivering the most advanced treatment available.

For more information, please call (866) 515-5253 or visit The Camp Recovery Center.

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