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Showing posts from August, 2025

Would you consider returning? תוכלי לחזור?

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" "הנהלת __ התקשרה וביקשה אם יש אחות שגרה בעמנואל שיכולה להיות האחות המקומית כאן. האם תשקלי לחזור?" - מזכירת מרפאה בעמנואל, אוגוסט 2025.  לא ידעתי אם לצחוק או לבכות.    אז לקח כמעט שנתיים עד שהבינו שבקהילה קטנה של אנשים שנמצאים חברתית בשולי התרבות הישראלית, אחות מקומית עדיפה על פני שיחות טלפון קרות ואחיות נודדות מרובות שבני האוכלוסייה המקומית לא מכירים ואולי אפילו חוששים מהן.    זו לא הייתה צריכה להיות הבנה כל כך קשה להגיע אליה .     " the management of school nursing called to see if there is a nurse who lives in Imanuel who can be the local nurse here. Would you consider returning?" - Secretary of health clinic in Imanuel, August 2025. I did not know whether to laugh or to cry. So it took nearly two years before realization descended that in a small community of people who are socially in the margins of Israeli society that a local nurse is preferable over cold phone calls and itinerant multiple nurses who the members of the local population do not...

Have you had a good experience with a nurse? If so, ask the following questions:

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  אם פגשת אחות ששמה את הצרכים שלך במקום הראשון, שמקשיבה באופן פעיל, עם בסיס ידע רחב, זה לא מובן מאליו. שאל את השאלות הבאות: האם מקצוע סיעוד תומך במטופל, שם את המטופל במקום הראשון, שמקשיב באופן פעיל, אות בניגוד, כטכנאי המוחלף בקלות? הנה מאמר שדן בדיון המתמשך הזה. If you have had a good experience with a nurse, start asking the following questions: is the system in which she is working supporting her in patient advocacy, in spending time in active listening to patients' concerns, in looking at the whole picture and providing patient education with the patient as focus? The work that nurses do is shaped by are what they are taught in nursing programs, how the public views them, the management style that they are working under, and their own personal convictions. Or, in contrast, is the management style above her pressuring her to conform with parroted monologues, and even pressure patients into interventions that they do not want and may not even need? If you have met a nurse who care...

Parental consent for vaccines - how is this managed in school nursing in Israel?

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  Vaccines in Israel's schools: with most parents not attending vaccine administration when delivered in schools, how have parents granted permission for vaccines?   1 - From about 2002 until about 2007, the school nurse would send a notice to the parents of the upcoming vaccine day. Parents had to send the vaccine record ("pinkas chisunim") and the health declaration ("hatsharat briut") to the school to show their agreement to the vaccine.   2 - then, parents could either send the vaccine record, or the health declaration and a verbal agreement, or give a verbal agreement that included a health history that the nurse noted in the child's record.   3 - as of about year 2015, the health declaration was considered enough to grant permission, this was a hard copy that the parents would fill in and send to the school, but by year 2023, in non-Haredi school, this is is filled in by the parents on their computer or smart phone and automatically enters the child...

Is Nursing an Autonomous Profession?

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  Is nursing an autonomous profession? An autonomous profession is one run by the members of that profession. If nurses manage other nurses at the topmost levels of management, that would be an example of autonomy. But if nurses are being managed, ultimately, by lawyers and business models, then it is not autonomous. Imagine nurses working in the field. They see an issue with a policy or procedure that was imposed upon them by management. These nurses give feedback that this policy or procedure is incongruent with patient needs and safe care. An autonomous organization would welcome and value feedback.     But if nurses are ultimately beholden to "the bottom line", that is, the profits of the company for which they work, then their feedback is not likely to be welcomed, their job satisfaction is likely to suffer, and patient care is likely to decline.   Feminist theory can be used to empower any disenfranchised group. Traditionalists and conservatives need not write ...

Who is listening to the school nurse?

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  School nurses used to perform height and weight measurements in the following grades: 1,3,5,7. Since about 2005, height and weight is only performed in grades 1 and 7. By the time the child is in the 7th grade, if there is a growth problem, it can be too late to fix. In I srael there is often a six month wait to see an endocrinologist. --- In Japan, management meets with the workers, hears their feedback, and makes adjustments accordingly. That boosts productivity and morale. Where is the feedback mechanism for the community nurse in Israel?   We are learning about communication and building trust with patients in my rehabilitation nursing course. This means ensuring that patients fully understand instructions, and feel a sense of autonomy and partnership with clinicians. Gone are the days when patients expect to follow orders and not bother doctors and nurses with questions. This comes from the fruition of generations X, Y, and Z, who held by the concept of what they have...
  In nursing school, we learned about "nursing judgement". In the field, if a nurse is told by her boss, "follow the policies and procedures and no one can sue you and you should not care if people yell at you" it feels like a real contradiction.

Patient-centered care, or business? first English, then Hebrew

 עברית אחרי: The nursing literature reflects the importance of patient centered care. You advocate for the patient.   Evidence-based practice means that nurses should cull evidence from their field of work to evaluate the policies and procedures, putting the patient as the center of what works for them.    In Israel, a signature on a health form differs in its legal weight than a signature on say a mortgage agreement. If the person signing the mortgage agreement claims he did not know what he was signing, that carries no weight, but if a patient signs a medical consent form and then claims that he did not understand what he was signing, the patient can claim wrongful action on the part of the health-care worker.   Since about 2016, school nurses in Israel were told that the health declaration that parents sign, which contains a clause regarding vaccines, is sufficient permission to vaccinate the child. Some critical thinking questions could be brought forth rega...