May you find the opportunity in every challenge.

The internet erupted on Saturday about something that Senator Walsh in Washington State said in a hearing about nurses. Her tone and underlying assumptions about our ability to play cards while at work were very disrespectful to the 4 million of us in the United States.

This is the second time in a few years where someone in the public eye made an uninformed statement about the most trusted profession in the United States for 17 years in a row.

I’ve learned over the years, through my own entrepreneurial endeavors, that assuming statements are often due to a lack of knowledge.

If we had to put a care plan together and form a nursing diagnosis for this situation, we’d likely use something similar to: “Knowledge deficit related to the reality of being a nurse.


Let me share some of my realities about being a nurse:

  • I never played cards while caring for patients. (I’ve never played cards in any of my nursing roles over the last 19 years).

Some things that I always did while caring for patients include:

  • I always felt as though despite all that I had done for my patients, there was more I could have done to care for them as I left each day over and above what was necessary. (Try carrying that around at the end of every shift and having it add up over time).
  • I always dreaded night shift because that first hour was the most anxiety provoking for me. Parents wanted to put their children to bed to get their rest (understandably so). I would be getting out of report around 7:30pm not even having prepared any of the 8 o’clock meds for my 4-5 patients all due at the same time.

 As nurses, we know we have to prioritize those patients that are in need first but try telling one parent that his or her child needs to wait while you care for another. That is REALLY hard to do. I often wouldn’t finish that first 8 o’clock med round until 11 o’clock at night.

(OF NOTE: Why do we expect nurses to deliver all of their patients’ meds in the same hour right after starting their shift and not having assessed any of them yet? Can someone find a new innovative solution to this system level problem?)

  • I always worried about whether or not one of my assigned patients would code on me during my shift. I often had palpitations before work each morning because of this concern.
  • I always wanted my patients to have a new clean bed or crib and bathed (if an infant) or have an opportunity to shower if possible. This wasn’t required but it was something I felt was important to do.
  • I always prioritized my patients and their families over my own personal needs for nourishment over 12 hours. Sometimes I wouldn’t eat anything until 8 or 9 hours into my 12-hour shift.


I say this about myself, but I know that I am not alone. Perhaps I had palpitations more than other nurses, but the other statements are likely transferable to most if not all other nurses.

Today, I spent a lot of time on my computer catching up on some things.  While working at my desk, I would occasionally open Twitter in seek of a distraction.  I could not open Twitter without a flurry of reactions to Senator Walsh’s remarks today.

Throughout the day, I continued to think of the Woodhull Report. In the most recent report, the results demonstrated that nurses are only cited in 2% of journalists’ stories.

If we are only in 2% of stories, how can we assume that the public knows the extent of our work? Well, one thing we can safely say going forward is that everyone will know we don’t play cards. :) 

Yet, this just scratches the surface. How do we use this unfortunate incident that set Twitter ablaze today as an indication that we can do more as a profession to educate others on what we do?

How do we proactively educate a nation on why we are the most trusted profession year after year at a level that abominates the possibility of such comments from happening in the future?

Honestly, it starts with us, the nursing professionals. If we each share our knowledgeable voices on a proactive and consistent basis in a consumable way, we can begin to make the positive change necessary to dispel misconceptions and assumptions.

Think about how you might be able to share something you know with others that might not know it.

We’re trained for this! We educate our patients every day about things they do not know but need to know for their own health and wellbeing.

How can you educate others through your spoken or written words in a way that can influence their perspective? How can you present the information in a way that opens the door for the reader or listener to want to know more and ask more questions?

If I can educate someone not in healthcare about the role of nurses in informatics, interoperability, and innovation, you can find your niche and do the same.






Nightingale’s November Newsletter

Did you catch our November Newsletter?

Here’s an excerpt:

While I get to share my story, I also get to offer a perspective that perhaps is new. Yet, I hope that perspective lights that initial spark that can be taken back to the workplace and think differently about how to solve some of the challenges faced in our health care environment. 

You can read the full newsletter here: Nightingale’s November Newsletter . To be added to our mailing list, email us at or sign up on the website!


The power of perseverance.

Perseverance is an essential characteristic when embarking on something new.

I was a PhD student for 4 years. Some students took 5 years to complete the degree. Yet, I knew I wouldn’t be able to sustain a fifth year. I needed to finish in 4 years. I spent the first two years of the program trying to demonstrate that there was value in studying nursing documentation. More specifically, I studied the information needs of nurses before and after an electronic nursing documentation system implementation. I remember being in a class one day and the professor looked at me and said, “no one cares about nursing documentation”. Ouch!

My first paper wasn’t accepted until I was in my 3rd year of the program. Yet, it was accepted with very little changes required to the Journal of Nursing Scholarship. That paper was what caught the attention of a publisher that led to them asking me to write my book, Electronic Health Records for Quality Nursing and Health Care. (So, it turns out MANY people care about nursing documentation… 😉 ). I applied for many external grants before finally figuring out the best way to present the case. I worked tirelessly every day. After that, I had several grants funded with a total of 7 by the end of my PhD program.

I remember thinking (often) ‘would it really happen, would I finally get this PhD degree?’ I also remember thinking it had to be preparing me for something else that would come. I couldn’t think of any other reason why it was so painful and difficult for that long of a time frame. That something else was entrepreneurship. Starting a business from an idea (e.g., Nightingale Apps) requires extensive perseverance (and many other characteristics). Instead of being in one academic setting, your ecosystem is much larger with greater variability in perspective. There aren’t set protocols and when you have something brand new, (e.g., Know My Patient), there isn’t a path already paved for you to follow. You need to be the one to figure it out. You also need to decide who and what to listen to as you go down this path. Everyone will have an opinion but you’ll need to decide which one(s) are aligned with your vision.

“The truth is, there is only so far ‘motivation’ can carry you and your vision when you are in the grind (especially in the early days). People watch you from afar, some half-expecting you to fail, and after all the good wishes and pep talks, you are only left with yourself — and your willingness to keep going.”

3 Secrets to Persevering (When All You Want to Do Is Give Up)

Post originally appeared on Dr. Tiffany Kelley RN on December 4th, 2017

Nurses aim to break innovation barriers

Thank you again MedTech Boston for the opportunity to share more insights on entrepreneurship in nursing.

“Nurses solve problems every day by the bedside, Kelley said, and the same problem might persist every day, only the nurses and the patients might be different.”

Nurses Aim to Break Innovation Barriers

Post originally appeared on Dr. Tiffany Kelley RN on November 16th, 2017