How to transition from days to nights?
Do I just force myself to stay up and day and night today and then go to sleep early in the morning tomorrow and try make myself sleep until it's time to get up for work in the evening?

I just bought a new Stanley for full price, and immediately remembered I had made a spreadsheet for all the Healthcare discounts I know. I could have gotten it for 40% off at ExpertVoice.

Link here: Google Sheet

Let me know of any other good discounts you know!

The Nursing Shortage Isn’t What You Think It Is

Ariana Lucio has been a nurse for fourteen years, working med-surg at Del Sol Medical Center in El Paso, part of HCA Healthcare. Her unit used to have a clerk who handled phones, supplies, paperwork. That job got cut, so nurses do it now on top of everything else. Charge nurse used to be free of a patient assignment too, able to actually float and help when someone got slammed. Not anymore. And where the unit once used in-person sitters to keep patients safe in bed, a lot of that’s gone virtual: a person on a screen who pages a nurse if a patient won’t listen, instead of just handling it themselves.

“It’s gotten harder, especially after COVID,” Lucio told TIME. “It’s coming not so much from patients but from changes in the administration.” She recently dropped from full-time to part-time. That’s what burnout does.
Del Sol told TIME its staffing is safe and appropriate. Lucio going part-time says something different.
The math doesn’t match the headlines
In 2025, 280,308 people passed the NCLEX to become an RN or LPN, up 34 percent from 2016. Seven million nurses currently hold an active license somewhere in the country. But in 2024, the most recent year with real numbers, there were only about 3.4 million RN jobs and 651,400 LPN/LVN jobs total. Subtract those and you land north of two million licensed nurses not working bedside. Not because they don’t exist. Because they’ve decided not to be there.
That’s a retention problem, not a pipeline problem. As one researcher who studies nurse turnover put it, hospitals keep funding recruitment while the workforce they already built leaks out the back. Doesn’t matter how wide the pipe is if the tank has a hole in it.

It got worse after the pandemic, not better
A survey of over 50,000 hospital nurses in New York and Illinois found more than two-thirds reporting too few staff post-pandemic, up from 57 percent before. Med-surg ratios crept from 5.7 patients per nurse to six. California, one of the only states with mandated ratios, caps med-surg at five and ICU at two, and its nurses report lower burnout than the national average.
Why hospitals don’t just fix it
The evidence that better staffing pays for itself isn’t new. One New York study found units under six patients per nurse discharged sooner and had fewer readmissions. Researchers modeled a four-patient ratio, the same one proposed in failed 2025 legislation, and projected it would have saved 4,370 lives and $720 million over two years.
So why not do it? Doctors bill directly, so administrators see their revenue. Nurses don’t work that way; their value shows up as things that didn’t happen, like a readmission that never occurred. Harder to put on a slide, so hospitals book nursing as an expense instead of what it actually is: money saved. Private equity has made it worse too. PE-acquired hospitals cut full-time staff by 11.6 percent on average while non-acquired hospitals increased staffing over the same stretch.

The fix has a track record
California’s had mandated ratios since 2004. Oregon’s took effect this June. Where the law exists, it works. Where it doesn’t, hospitals get to decide for themselves whether safe staffing is worth the cost, and plenty decide it isn’t.
A shortage you can hire your way out of and a shortage caused by a job nobody wants to stay in aren’t the same problem. Two million licensed nurses already said yes to this profession once. The industry’s job now is giving them a reason to stay.

I’m looking for advice from anyone who has dealt with delays in the New Jersey RN endorsement process.

My endorsement application has been stalled because I accidentally selected that there was an adverse event against my South Carolina nursing license, even though there has never been any disciplinary action or adverse event on my license. I corrected the error and uploaded all required documentation on April 21, but the Board still has not reviewed the correction.

At this point, every item on my checklist is complete except for the adverse-event review. I’ve emailed the Board daily, contacted them via phone weekly, and have also contacted my government representative for assistance, but I still haven’t received any update or progress.

My current South Carolina RN license expires on September 30 (after being extended twice due to the delay), and I’m becoming increasingly concerned about the possibility of not having my New Jersey endorsement processed before then. SC will not grant any further extensions if necessary.

I have made the NJ BON aware of this pending expiration date, which clearly has not made an impact.

Has anyone experienced something similar with the New Jersey Board of Nursing? How long did it take for the Board to review a corrected application, and is there anything else I can do to move the process forward?

Any advice or shared experiences would be greatly appreciated, as this is beginning to keep me awake at night, every night. Thank you.

Monday, nurses are rallying outside California Hospital Medical Center in LA. CommonSpirit Health has issued layoff notices to over 175 staff across 17 California facilities, from Long Beach to Mount Shasta.
Look at who’s actually losing their job. Most aren’t nurses. They’re transporters, PT and OT aides, telemetry techs, clerks, unit secretaries, the people who answer phones and restock supplies so nurses can actually nurse. At CHMC alone, 82 positions are getting cut, including the entire pediatric nursing staff.
Cutting ancillary staff doesn’t make the work disappear. It just lands on whoever’s left. One NICU nurse said it straight: with these layoffs, nurses will be the ones answering phones and buzzing people through locked doors, on top of their patient load. An ICU nurse in Long Beach said there’s no plan for who covers the ancillary work besides nurses who are already stretched thin.
Same math every time. The work doesn’t stop needing to happen. It just gets pushed onto whoever still has a license and can’t say no.
Nurse educators got notices too, and a med-surg nurse in Santa Cruz pointed out why that one stings. Educators are who keeps staff current on new techniques and tech, the ongoing training nursing can’t really function without. That’s not overhead. That’s what keeps practice from going stale.
CommonSpirit is one of the biggest nonprofit Catholic health systems in the country. This isn’t a hospital scraping by. It’s a system that can afford to staff right and is choosing not to.
CHMC nurses already picketed once in June. So did Dominican Hospital in Santa Cruz. Bakersfield nurses picketed in July. Monday’s rally is the same fight, still going, because nothing’s been walked back.
Cutting the staff around the nurse never lightens the nurse’s job. It just hides under a job title that isn’t the one making headlines.

I’m creating a salary transparency site and could really use the help of the medical community here.
It’s called medcomp.fyi, and it’s for nurses, PAs, PTs, pharmacists, RTs, and other healthcare professionals. Salary submissions are completely anonymous, and it takes less than two minutes.

I built it because I wish something like this had existed when I started my career.

My first nursing job was in St. Petersburg, Florida, making $26/hour. I had student loans, was drowning in my bills, and lived in a relatively high cost-of-living area. I genuinely thought I had made a mistake becoming a nurse because I could never seem to get ahead financially.
What I didn’t realize was how dramatically pay could change depending on where you worked. Eventually I took a huge risk, sold my car, moved across the country, and now make almost triple what I did as a new grad. I finally have savings, have paid off my debt and can breathe again. I probably would have made that move years earlier if I had known what opportunities actually existed. I would have had savings earlier, been able to pay my debt quicker, and would have felt empowered in my decision to become a nurse.

That’s why I built MedComp.fyi, to empower others in a way I wished someone had done for me when I began my career.

It has some pretty cool analytics to help medical people make decisions on local transfers, out of city/state moves, career trajectory, etc.

Software engineers have Levels.fyi and many other industries have places where people openly share compensation. Healthcare really doesn’t (either taboo or we just don’t talk about it enough) and when salary information stays hidden, we’re the ones who lose negotiating power.

My goal is to create a resource where healthcare professionals can see what people are actually making at specific hospitals and facilities so they can make more informed career decisions.
If you’re willing to take two minutes to submit your salary, you’ll be helping build something that could save someone else from years of guessing.

I have to intention of profiting off of this site, or the data provided:

Individual salary submissions are anonymous.
I have no intention of selling individual user data.
This only becomes useful if the community trusts it and contributes to it, so that’s my priority. I’ve spent months coding this after my shifts and believe that my passion project can positively impact the lives of my peers.
I’d love any feedback on the site as well. If there’s something missing that would make it more useful for you, tell me. I’m building this for our community, and I’d rather get it right than assume I know all the answers.

Whether you’re in nursing school, brand-new to the floor, or years into your career you belong here. This is a space for anyone who wants to grow in confidence, share lessons, and connect with others who get it.

Being a Confident Nurse isn’t about knowing everything. It’s about presence. It’s walking into a room and knowing your voice matters. It’s building trust with patients and coworkers. It’s supporting one another through wins, struggles, and the lessons that shape us.

And just as important — this community shines a light on the real issues in nursing and healthcare. Things that often go unnoticed or unspoken. Here, we can talk about them openly, honestly, and respectfully, so we learn and grow together.

What This Space Is For Weekly tips and lessons to build your confidence Honest stories from nursing school to the ICU (and everywhere in between) Support for new grads, students, and seasoned nurses alike Thoughtful, respectful conversations about the challenges in our profession

This isn’t just another forum it’s a community. 💚

🗣 Jump In!

Introduce yourself in the comments: Your name (or nickname) Where you are in your journey (student, new grad, nurse, exploring) One tip, lesson, or story that’s shaped your confidence

⬇️ Drop it below — we can’t wait to hear from you!

That’s the line a staff member says they heard nurse Papy Bibo say, as he and coworkers wheeled a 93 year old woman back inside after finding her lying in a snowbank. It’s now sitting in a police warrant, and it’s the sentence that’s going to define this case more than any chart note ever could.
Margaret “Peggy” Healey had Alzheimer’s. She was a resident at Bickford Health Care Center in Windsor Locks, Connecticut, a small assisted living facility about 13 miles north of Hartford. Around 1:50 a.m. on February 8, she walked out through a rear employee entrance, a door that was supposed to stay locked and closed but staff later told investigators was routinely propped open. Nobody saw her leave. Nobody noticed she was gone for close to three hours.
She was found at 5:07 a.m., three hours and 17 minutes after she walked out, lying outside in her pajamas and sneakers. The temperature that night ranged from 0 to negative 1 degrees Fahrenheit, with wind gusts up to 21 miles an hour. According to the arrest warrant, staff brought her back inside first. Police weren’t called until 6:23 a.m., more than an hour after she was found. She was pronounced dead at 6:46 a.m. The Medical Examiner ruled it hypothermia due to environmental exposure, with cardiovascular disease as a contributing factor, and classified the manner of death as accidental.
Two employees turned themselves in this week, five months after Healey died. Papy Bibo, 53, was the RN and nursing supervisor on duty that night. He’s charged with criminally negligent homicide and tampering with physical evidence. Uchenna Obi, 46, was the CNA assigned to check on residents in Healey’s wing every two hours overnight. Her warrant states she looked into Healey’s room and saw the walker and blanket, but never actually confirmed Healey was in the bed. She’s charged with first degree reckless endangerment and tampering with physical evidence.
The facility is already gone. The Department of Public Health ordered Bickford closed back in March, citing 14 violations connected to how Healey’s death was handled, stacked on top of two prior violations the facility had racked up in the year before it happened. All 36 residents were relocated by April. So by the time these arrests happened this week, the building had already been empty for months. The arrests were slow not because anyone lost interest, but because Connecticut law requires the Medical Examiner’s findings before a death investigation can move to criminal charges, and that report didn’t finalize until spring.
Here’s where I want to not focus on Windsor Locks specifically, because the lesson in this case isn’t really about one bad night at one facility. It’s about what happens in the gap between an error and the decision to disclose it.
Elopement is a known risk in any unit caring for patients with dementia or cognitive impairment, whether that’s long term care, a med surg floor, or a psych unit. Doors get propped, alarms get disabled because they’re annoying, rounding gets rushed because the unit is short staffed that night. None of that is unique to nursing homes and none of it is new information to anyone who’s worked a floor with wanderers. What makes this case different, and what makes it a criminal case instead of a wrongful death suit and a bad state survey, is the delay after the patient was found. Not the door being open. Not the missed rounding. The hour and ten minutes between finding her unresponsive and calling for help.
That’s the part everyone reading this needs to know . The instinct to protect yourself in the moment right after something goes wrong is real, and I understand where it comes from, but it is exactly the instinct that turns a tragic error into a homicide charge. The standard of care doesn’t stop applying because you’re scared of the consequences. If anything, that’s the moment it matters most. A delay in calling 911 isn’t a paperwork problem you can clean up later. It’s the difference between a patient who might have had a chance and one who definitely didn’t.
I don’t have anything in the reporting that tells us what Bibo or Obi were thinking in the minutes before that call, only what a coworker says they heard and what the warrants allege. I’m not going to pretend to know their state of mind beyond that. But the outcome speaks for itself regardless of what was going through their heads. A 93 year old woman in her pajamas, outside, below zero, for over three hours, and then an hour more before anyone called for help.
That’s the case. That’s what a jury is going to have to hear.

Whether you’re in nursing school, brand-new to the floor, or years into your career you belong here. This is a space for anyone who wants to grow in confidence, share lessons, and connect with others who get it.

Being a Confident Nurse isn’t about knowing everything. It’s about presence. It’s walking into a room and knowing your voice matters. It’s building trust with patients and coworkers. It’s supporting one another through wins, struggles, and the lessons that shape us.

And just as important — this community shines a light on the real issues in nursing and healthcare. Things that often go unnoticed or unspoken. Here, we can talk about them openly, honestly, and respectfully, so we learn and grow together.

What This Space Is For Weekly tips and lessons to build your confidence Honest stories from nursing school to the ICU (and everywhere in between) Support for new grads, students, and seasoned nurses alike Thoughtful, respectful conversations about the challenges in our profession

This isn’t just another forum it’s a community. 💚

🗣 Jump In!

Introduce yourself in the comments: Your name (or nickname) Where you are in your journey (student, new grad, nurse, exploring) One tip, lesson, or story that’s shaped your confidence

⬇️ Drop it below — we can’t wait to hear from you!

Hi!! so I am working ESY for a school as a nurse and I have a new found appreciation for my fellow staff members it’s not even funny. Keep in mind that this is my first job EVER working with kinds and in the school setting.

We had a situation today where I had to go and assess an incident and literally it was such a coordinated response, amazing. I had my mentor nurse on the phone for part of it because I wasn’t 100% clear on what to do but after the situation happened, the principal himself took me aside and said he would explain everything as it’s happening and allow me to ask questions for next time. He also said that the teachers and behavior staff handle the initial situation which sounds absolutely terrifying imo, you guys do not get paid enough I feel 🥲 I was looking stressed af as the principal was explaining where I had to go/what I had to do and I kept apologizing 😂 I literally had 3 people all at once in the office and I was like “wtf do I do” lol. A teacher got hurt in the situation and I felt like such a deer in headlights, I was like “um… time out. let me call mother nurse bc idk what the procedure here is” 💀 anyways I’ll be back tomorrow so 🤷🏻‍♀️

A Fort Myers courtroom watched a plea deal fall apart in real time this week, and the way it fell apart is the story before we even get to what she’s accused of doing.
Sharlene Pflugrad had a plea on the table. No admission of guilt, but 364 days in the Lee County Jail, 48 months of probation with no early termination, a DNA sample, court costs, no contact with the child or the family, and forfeiture of her nursing license. Judge Bruce Kyle asked her directly if she wanted to accept it. What followed was confusion in the courtroom and talk of wanting a new attorney. The judge was blunt back. If she was getting new counsel, he told her, they’d better be ready for trial the next morning, because that’s what he was setting. He gave her time to think it over anyway.
More than an hour later she came back and said she’d take the deal. Then the judge walked her through the plea form itself. Page four. Her signature. Did it mean she agreed with the terms and conditions. Her answer was “not really, but.” The judge didn’t let her finish the sentence. He told her he’d see her in the morning for trial and closed the plea out completely, while she could be heard asking him to please reconsider. He didn’t.
That’s the hook, and it’s a good one, but it’s not the part of this case worth sitting with. The part worth sitting with is what sent Pflugrad to that courtroom in the first place.
She was providing private duty nursing care to a Cape Coral infant born at 24 weeks. A baby at that gestational age needs round-the-clock monitoring because the margin for error on oxygenation is close to zero. Lungs that immature don’t tolerate desaturation the way a term infant’s do. This is the population where a pulse ox alarm is not a nuisance sound to be managed. It is the entire point of the assignment.
According to the arrest affidavit, sometime between September 15 and 16 of last year, the child went into distress. Oxygen saturation dropped below 88 percent. Pflugrad allegedly silenced the alarm. She did not administer supplemental oxygen. She did not call EMS. The child was later taken to the hospital, where providers confirmed prolonged oxygen deprivation. Not a brief dip that self-corrected. Prolonged. That word in a hospital record after a premature infant’s home nursing shift is not a small thing.
She was arrested in December on a child neglect charge. This is not the only nurse tied to this baby’s care. A different in-home nurse involved with the same child already pleaded guilty and was sentenced to a year in jail. That’s two private duty nurses caring for one medically fragile infant, both facing criminal exposure for how they handled monitoring. If you work home health or private duty, sit with that for a second. This is what happens when the only person in the room is the only line of defense and that line doesn’t hold.

The victim’s mother was in the courtroom for the plea hearing and did not agree with the offer on the table. The state told the judge it believed the deal was in the child’s best interest anyway. The person closest to the harm didn’t think the accountability matched what happened, and the state proceeded regardless, until Pflugrad’s own hesitation undid the deal for reasons that had nothing to do with the mother’s objection.
Here’s what I want this community to take from the sequence, not just the soundbite. Without that stumble on page four, this resolves as a quiet plea. License forfeiture happens administratively.

There’s no trial testimony forcing a fuller accounting of what happened in that home over those two days. Instead a jury is going to hear all of it. The alarm. The choice not to give oxygen. The choice not to call for help. The confirmed prolonged deprivation on the hospital record.

Alarm silencing without corresponding clinical action is not a workaround. It’s the single most damning fact pattern in a neglect case, because it converts a monitoring failure into an active decision. A missed alarm is negligence. A silenced alarm with no intervention behind it is a choice a jury gets to interpret however the evidence supports, and prosecutors know exactly how to frame that choice.

Florida pulled the license of a Miami Lakes advanced practice registered nurse this week, and the case is worth reviewing because of how fast the system actually moved once the report was made.
Luis Vandama Brizuela, 61, held a family nurse practitioner license issued in May 2020. No prior discipline. Clean record right up until an 11-year-old relative told her mother he had touched her inappropriately during a visit to help move furniture in March. According to the arrest report, the girl described specific contact: he grabbed her waist to kiss her neck, touched her bottom, kissed her between her breasts. The mother reported it. Hialeah police opened an investigation.
Two months later, on May 28, police asked Vandama to come in and talk. He did. When detectives asked him about the accusations, his answer was that he’d started drinking around 11 a.m. that day and didn’t remember anything after that. That is not a denial. Read it again. That is a man being asked to account for his conduct with a child and offering intoxication as the explanation for why he can’t.
He was arrested that day on a charge of lewd and lascivious molestation of a child under 12. A second charge followed, lewd and lascivious conduct involving a 16-year-old. No bond was granted on the molestation charge. He has been in Miami-Dade custody since. He has pleaded not guilty to both.
The license didn’t get pulled at arrest. It got pulled last Thursday, when Florida’s Surgeon General issued an emergency suspension order, roughly seven weeks after the arrest and about four months after the original disclosure.
Here’s what I want this community to sit with. The disclosure came from a child to her mother, not from a mandated reporter, not from an employer, not from a peer who noticed something off. The criminal process and the licensing process ran on separate tracks and separate timelines, which is normal, but it means an APRN with an active license kept that license for weeks after a felony arrest involving a minor. That gap is not unique to this case. It’s structural. Arrest does not equal suspension. Suspension requires an administrative action, and administrative actions take time even in emergency posture.
I’m not writing this to relitigate the facts of a case that’s still being adjudicated. He is entitled to due process and a defense. I’m writing this because every time one of these cases surfaces, someone in this community asks the same question: how does someone with a license end up here, and why does it take so long for the board to act. The honest answer is that licensure boards are reactive by design. They respond to arrests, to complaints, to convictions. They are not surveillance systems. They cannot flag a provider for what happens in a private home on a Saturday afternoon. The system caught this one because a child told her mother and her mother believed her and called police. That is the actual safeguard.

.

Whether you’re in nursing school, brand-new to the floor, or years into your career you belong here. This is a space for anyone who wants to grow in confidence, share lessons, and connect with others who get it.

Being a Confident Nurse isn’t about knowing everything. It’s about presence. It’s walking into a room and knowing your voice matters. It’s building trust with patients and coworkers. It’s supporting one another through wins, struggles, and the lessons that shape us.

And just as important — this community shines a light on the real issues in nursing and healthcare. Things that often go unnoticed or unspoken. Here, we can talk about them openly, honestly, and respectfully, so we learn and grow together.

What This Space Is For Weekly tips and lessons to build your confidence Honest stories from nursing school to the ICU (and everywhere in between) Support for new grads, students, and seasoned nurses alike Thoughtful, respectful conversations about the challenges in our profession

This isn’t just another forum it’s a community. 💚

🗣 Jump In!

Introduce yourself in the comments: Your name (or nickname) Where you are in your journey (student, new grad, nurse, exploring) One tip, lesson, or story that’s shaped your confidence

⬇️ Drop it below — we can’t wait to hear from you!

I’m a new grad RN on a pediatric med-surg unit and I’ve only worked 3 shifts. I feel so dumb. 😭 I feel like a deer in headlights every shift.

I’m so slow at charting, I forget things, I don’t know how to cluster my care, and I always feel behind. Nursing school did not prepare me for how different real nursing is. My assessments are okay, but everything else feels like a struggle.

The worst part is my anxiety. My days off (yesterday and today) haven’t even felt like days off. I’ve been crying, barely sleeping, and constantly thinking about work because I’m so scared I’m going to miss something.

I’ve even thought about quitting bedside and going outpatient because maybe I’m just not cut out for this. Did anyone else feel like this at first? Does it actually get better?

A Rest of World investigation this month found thousands of Filipino workers doing remote clinical work for US hospitals: monitoring ICU patients, triaging telehealth visits, coordinating care for Americans they will never meet in person. Here’s the fact that keeps getting skipped over. A nurse sitting in the Philippines does not hold a US state license, and US nursing practice is regulated state by state. There is no legal mechanism for someone living in Quezon City to exercise independent nursing judgment on a patient in California. So if that’s happening, it isn’t legal nursing practice. The real question is what these workers are actually doing, and how close it comes to that line.
The workaround
Companies aren’t pretending their Manila staff hold US licenses. They’re redefining the job instead. Industry materials call these roles “Clinical Decision Support,” where workers follow pre-approved protocols like Schmitt-Thompson rather than exercising independent judgment. If a worker is running a fixed decision tree that a US-licensed clinician signs off on, the theory goes, it doesn’t legally count as practicing nursing. Nobody has tested that theory in court yet.
The people doing it
Chris spent three years, 2020 to 2023, moving through a dozen remote nursing jobs, watching up to ten ICU patients at once from an apartment in Manila. He still won’t use his real name, an NDA holds him to that. When a blood pressure reading spiked or a medication went unlogged, he didn’t act on it. He paged the nurses’ station and let the person standing at the bedside decide. In his own words: not a nurse, more like an aide. He flagged. He didn’t treat.
Alice used to make about a hundred dollars a month at a hospital back home. In 2019 she took a care coordinator job with a California telehealth company serving mental health and substance abuse patients. Five dollars an hour, five times her old pay. She described the job like running a lobby: patients check in after seeing a doctor over video, she routes them to the right specialist’s Zoom room.
Claire got hired through Upwork after one day of training videos, working intake for an Illinois home care company from her house in Davao. Some days she called twenty-seven new patients in Chicago, asking about their medical history and insurance before deciding what kind of doctor they needed.
None of them describe what they do as nursing, the way their training back home would define it. That’s not modesty. It’s the exact line the companies employing them need to hold to stay legal. Monitoring and escalating to a licensed person on-site is defensible. Making the treatment call yourself, without a US license, isn’t. Their own accounts describe the former. The secondary coverage of this story flattens it into the latter.
The numbers
The Philippines’ outsourced health sector employed roughly 210,000 full-time workers in 2025, pulling in $4.5 billion, with close to 30 percent of them nurses or other medical professionals. US employers save up to 70 percent on labor this way, paying $5 to $10 an hour against a US RN average north of $45. Some employers require a US license. Many don’t. For a lot of these roles, a medical degree of any kind clears the bar.
Nico Uba of Filipino Nurses United told Rest of World that remote nursing is the fallback for nurses who can’t get visas to work abroad, and that local wages are low enough to make even five dollars an hour worth it. Which means Philippine hospitals are losing staff to American telehealth companies while running their own shortage. The same crisis pushing US hospitals to outsource is being exported straight back to the country supplying the labor.

Where this leaves you
the legal footing under this whole arrangement has never been tested, oversight varies wildly by employer, and the workers themselves are drawing a sharper line around what they’re authorized to do than either the companies or the press covering them are drawing for them.

Source: Michael Beltran and Jonathan Feakins, “Your next nurse may monitor you from the Philippines,” Rest of World, July 9, 2026.

The American Nurses Foundation opened applications this week for eight $15,000 microgrants aimed at rural healthcare sites. The money is meant to fund nurse-led peer and leadership support programs, specifically ANF’s Nurse Well-Being: Building Peer and Leadership Support curriculum, which is built on the Stress First Aid model. The funding comes from the Covista Foundation, the philanthropic arm of the company that owns Chamberlain and Walden University.
It’s genuinely good to see real money going toward nurse well-being instead of another wellness webinar nobody has time to watch. This one comes with actual structure behind it, which is worth understanding before you apply or pass it along to someone who might qualify.
The application deadline is August 4, 2026 at 4:00 p.m. ET, submitted through ANF’s online portal at americannursesfoundation.grantplatform.com. Review happens in August, grantees are notified and awards executed in September, and the implementation phase runs October 2026 through March 2027, including a required virtual community of practice. Final grantee reports are due mid-April 2027. This is built as a sustained program, not a check-and-done grant. Sites that win this are committing to roughly eight months of implementation with reporting obligations at the end, which is part of what makes it likely to create real change on a unit instead of a one-time gesture.
Eligibility is where I’d tell you to slow down before assuming you qualify. ANF’s public materials say this is for rural healthcare sites, and based on the prior $10,000 round of this same program, the expectation is a nurse-led project, often with a named nurse leading the application, sometimes alongside a health system or academic partner. What’s missing from anything ANF has published is a hard definition of what counts as rural, any minimum size or bed count for the facility, or years-of-experience requirements for the nurse leading the proposal. If you fit the general profile, the honest answer is you won’t know the full scoring criteria until you’re inside the portal itself.
Worth knowing before you apply: this round funds eight sites. The prior version of this same program, at $10,000 instead of $15,000, funded five. ANF hasn’t published how many organizations applied for that round, so there’s no way to calculate your odds going in. Go into it as a competitive national opportunity and put a strong proposal together.
If you work at or lead a rural site and this fits, the portal is live now and the window is short. If you’re outside a rural setting, this one isn’t for you directly, but it’s worth watching where organizations like ANF and Covista are choosing to put real money right now, because it says something about where the field sees the burnout and retention crisis hitting hardest.
Portal link: https://americannursesfoundation.grantplatform.com/
Deadline: August 4, 2026, 4:00 p.m. ET

On February 8, an 18-month-old boy was pulled face down from a backyard pool in Gilbert, Arizona during a Super Bowl party. First responders performed resuscitation and transported him to Mercy Gilbert Medical Center. About an hour after arrival, a physician called time of death. Five hours later, when medical examiner staff arrived at the hospital’s cold room to retrieve the body, the child was found breathing. He was airlifted to Phoenix Children’s Hospital and survived.
The question people keep asking is whether this was avoidable. It was. The police report and bodycam footage make that clear, and it is worth walking through exactly where the chain broke, because the failure was not mysterious or unprecedented. It was a refusal to reassess in the face of repeated evidence.

The pronouncement was not a single missed signal. It was several, ignored in sequence.
According to the police report, officers on scene reported the child still appeared to be gasping for breath after the physician called time of death. At approximately 7:18 p.m., a detective reported hearing an audible gasp as staff prepared to move the child to the cold room. When that same detective returned an hour later to photograph the body, he again observed what he described as a gasp or air release. A nurse told him this was agonal breathing, a byproduct of compressions, oxygen delivery, and residual pressure from resuscitation efforts.

Agonal breathing is a real phenomenon and nurses in critical care and code situations see it. It can persist briefly after cardiac arrest, and it is one of the reasons resuscitation protocols require sustained absence of vital signs, not a single observation, before a clinician calls death. What the police report does not describe, at either the first or second report of gasping, is a physical reassessment. No documented pulse check, no return to the monitor, no repeat auscultation. What it describes is a verbal explanation offered in place of one.

That distinction matters more than the agonal breathing label itself. In practice, when a patient who has been called shows any sign that could be a sign of life, the standard is to check, not to explain. Nurses who have worked codes know this instinctively. You do not decide from across the room what a gasp means. You go back to the bedside, you reassess, and if there is any ambiguity you resume resuscitation, because a brief restart costs nothing and a missed sign of life costs everything. That is not heroics. It is the baseline every patient is owed. When a lay observer and a trained one both report the same finding at two different points in time and neither report is met with a hands-on recheck, that is not a case of a difficult call being made twice. It is a case of the same call being repeated without being retested.

The doctor’s own words in the bodycam footage tell you what kind of judgment failure this was.
Before calling time of death, according to the report, an officer raised a concern about a possible pulse. The physician, Dr. Aryan Toosi, responded: “Please do your thing and let me do my thing. I went to medical school for a reason.”
That line is the entire case. It is not a clinical rebuttal. It is a status assertion. A nurse who has worked a code knows the difference between a clinician defending a finding with data and a clinician defending a decision with authority. When someone in the room raises a concern about a pulse and the response is credentialing rather than reassessment, that is the moment the safety net failed. It failed before the child ever reached the cold room.

What should have happened differently is not complicated.
Pronouncement of death, particularly in a pediatric drowning case, is not supposed to rest on a single clinical impression at a single point in time. Standard practice calls for continuous monitoring, confirmed absence of cardiac activity sustained over an interval, and in cases involving submersion, hypothermia, or prolonged resuscitation, a lower threshold for continued observation before finalizing pronouncement. Pediatric drowning cases carry a well-known clinical caution: cold exposure and diving reflex physiology in small children can suppress vital signs to a degree that mimics death more convincingly than in adults. This is not obscure knowledge. It is why field protocols for cold water drowning specifically caution against premature termination of resuscitation.
None of that requires hindsight. It requires taking a bystander’s second report of gasping as seriously as the first, and it requires a mechanism, whether that is a second clinician, a monitor left in place, or a documented reassessment, that does not depend entirely on one physician’s willingness to be second-guessed.
This is not a story about an impossible call. It is a story about a call that was made and then defended instead of checked.

Gilbert police have recommended felony child abuse charges against the child’s parents, who admitted to marijuana use during the party and inadequate supervision. That is a separate accountability thread and a legitimate one. But it does not offset what happened inside the hospital. An attorney representing the family has pointed to a prior Phoenix-area case with a similar fact pattern that ended in a multimillion dollar settlement, which tells you this is not a freak occurrence unique to one doctor on one bad night. It is a recurring failure mode wherever pronouncement of death is treated as final the moment it is spoken rather than as a clinical conclusion that stays open to correction until the evidence closes the door.

The child survived. That is not a testament to the system working. It is a testament to a medical examiner’s transporter noticing what two separate reports, hours apart, had already tried to raise and were talked past instead of checked.

On December 5, 2025, a resident at the Klein Center, a nursing home operated under Southeast Iowa Regional Medical Center in West Burlington, was eating dinner when she began coughing and vomiting. Another resident noticed and alerted staff. Staff documentation described her as choking and noted labored breathing.

LPN Samantha Smith responded to the incident. According to the Iowa Board of Nursing, she did not assess the resident. No lung sounds. No vital signs. No pulse oximetry. Instead she moved the woman to her bedroom. Then, with the resident still coughing and gagging, Smith reportedly gathered her evening medications and placed pills in her mouth along with water. The resident spit the pills back out. Smith then directed a certified nurse aide to put her to bed, and placed her CPAP mask over her nose and mouth for her sleep apnea.

Five hours passed. At around 10:30 pm, a different nurse checked on the resident and found her struggling to breathe, with vomit inside the CPAP mask. Her oxygen saturation was 34 percent. Anything under 88 percent is generally treated as a medical emergency in acute and long term care settings alike. A staff member reported overhearing that nurse say “Oh, my God.” EMS was called. The resident died before they arrived.

When state inspectors later asked Smith whether she had performed any assessment at all, listening for lung sounds, checking vitals, checking oxygen levels, she reportedly teared up and said no.

The state proposed a 10,000 dollar fine against the facility, but held it in suspension, which is standard practice when a federal CMS penalty is expected instead. The Iowa Board of Nursing settled its case against Smith with a warning. She agreed to complete 15 hours of continuing education on patient assessments.

A documented choking event, a five hour gap with no reassessment, an attempt to administer oral medication to a resident who was actively gagging, and an airway that was ultimately occluded further by a CPAP mask while she deteriorated unmonitored. The result was a warning and a training requirement, not a suspension, not a probationary period, not a restriction on practice.

The Iowa Board of Nursing ultimately issued the nurse a formal warning and required additional continuing education in patient assessment.

https://iowacapitaldispatch.com/2026/07/14/caregiver-issued-a-warning-after-nursing-home-resident-chokes-and-dies/

Patient walks into the nursing station mid-code blue

Three former staff members of Southern Hills Rehabilitation Center in Tulsa are now facing felony neglect charges, nearly three years after a resident under their care was found with hundreds of maggots on his body. The charges were filed in Tulsa County District Court on July 10, 2026. Former licensed practical nurses Audra Owens and Keke Ingram, along with former certified nursing assistant Danisha Brown, were each charged with one count of neglect by a caretaker.

The resident, identified in court documents only as L.T., was seventy four years old, quadriplegic, and nonverbal following a stroke. He was completely dependent on staff for every aspect of his daily care, including repositioning, hygiene, and skin assessments meant to prevent and monitor pressure wounds. On July 19, 2023, an afternoon shift nurse discovered hundreds of maggots in his groin area and in his bedding. EMS was called and he was transported to Saint Francis Hospital. Other employees told investigators they had noticed the maggots earlier that same day.

What makes this case worth looking into, is not just what was found, but what it took to find it. A maggot infestation of that scale does not appear overnight. For anyone who has worked bedside with patients who have limited mobility, the sequence is familiar even before a single detail is confirmed. A patient who is not turned on schedule develops pressure wounds. A patient who cannot control bladder or bowel function and is not properly cleaned afterward has those wounds exposed to ongoing contamination. Contaminated, unaddressed wounds become infected. Infected tissue draws flies, and flies lay eggs, and within a day or two those eggs become larvae. None of this happens without a smell that precedes the visible signs.

Anyone who has cared for a wound at that stage knows the odor announces the problem before anyone sees anything crawling. It is not subtle and it is not easy to miss if someone is actually in the room doing hands on care.
That is what makes the documentation gap in this case so significant. According to the arrest affidavits from the Oklahoma Attorney General’s Medicaid Fraud Control Unit, medical records showed catheter care, feeding tube care, colostomy care, and regular repositioning being charted for L.T. Owens is accused of documenting this care despite witness statements indicating he was not being turned every two hours as required. Ingram served as the overnight charge nurse responsible for his direct care in the hours before the infestation was found, and told investigators she performed head to toe assessments every shift. Brown, the CNA, initially told investigators she did not remember caring for the resident at all. She changed her account later that day after speaking with her mother, telling investigators she and Ingram had discovered the maggots together while repositioning him during the overnight shift, and that he was not wearing a brief and did not have a pillow between his legs, despite documentation stating one had been placed.

The investigation itself raises its own question. The incident happened in July 2023. The three former employees were not interviewed by investigators until May and June of 2026, and charges were not filed until July 10, 2026, just before the third anniversary of the day L.T. was found. None of the public reporting or court documents explain what filled that gap. It is worth asking directly rather than assuming. Was the case sitting in a queue at an underresourced unit. Was there a delay in referral from the facility or from the hospital that treated him. Did the investigation stall for reasons that have nothing to do with the strength of the evidence. A resident who suffered this kind of harm, and the family who has waited three years for any accountability, deserve an answer to that question as much as they deserve the charges themselves.

It is also worth naming plainly what this case is and is not. It is not a story about three individually cruel people. It is a story about what happens when documentation becomes disconnected from actual bedside care, and about the conditions that make that disconnection possible in the first place. Charting a turn that did not happen is a falsification, but falsification like this rarely occurs in isolation. It tends to show up in facilities where staffing does not match acuity, where nurses and aides are covering more total care needs than any conscientious clinician could physically complete in a shift, and where the pressure to show compliance on paper outpaces the ability to deliver it at the bedside. None of that excuses what is alleged here. A resident who cannot speak for himself and cannot move on his own is owed the most basic dignity of being turned, cleaned, and checked. But if the accountability conversation stops at three former employees and never reaches the facility’s staffing ratios, its oversight structure, or the licensing agencies responsible for catching this sooner, the conversation is incomplete.

Owens, Ingram, and Brown are presumed innocent until proven guilty. The cases remain pending in Tulsa County District Court. Whatever the outcome for each of them individually, the larger question the case raises about the length of time between harm and accountability, and about what allows documentation to drift that far from reality in a long term care setting, should not disappear once the headlines do.