Bass Report

" הנהלת פמי 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 .     "Femi 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 culture that a local nurse is preferable over cold phone calls and itinerant multiple nurses who the members of the local population do no...

  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...

  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? 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 off feminist th...

  Those who hold by authentic feminism, in which the voice and agency of woman is valued, would do well to pay attention to what is happening in the nursing profession, which tends to downgrade its history and proclaim its "new" professional aims. Drawing from our history can only strengthen the contribution of nursing, and of Womankind. sciencedirect.com The rhetoric of rupture: Nursing as a practice with a history? In this paper we argue that nursing is consistently presented as a practice without a history, constantly reinventing itself within new professional a…

  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 "al basisi" 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 rights to...

  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.

  The nursing literature reflects the importance of patient centered care. 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 the equation 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 regarding the health declaration: 1 - after eight years ...

  We need wide vaccine availability in Israel. Vaccines should not be compartmentalized under various private businesses. Evidence-Based Practice would beg the following question: how many times have parents signed the school health declaration, say in September of the school year, but when it actually comes to vaccine day, say in March, changed their mind and refuse some or all vaccines? Plenty. So school nurses should assess parents' wishes, right? Seems obvious. But the business model is taking over and demanding high volume and low patient contact, as is happening to #SchoolNursing in #Israel . So, two weeks before vaccine day, a notice is sent to parents, vaccines are ordered. The parents got the notice, if they do not respond, and had signed the health declaration ( months ago), case is closed. The health declaration includes a description of vaccines, but the title is misleading - it only says "health declaration" and not "health and consent to vaccines decl...

  The school nurse in Israel used to be present once a week in a school . This means, if she vaccinated on a Thursday, the following Thursday she could check in with the pupils to see if they experienced any side effects form the vaccine.   I was a schoolnurse in Israel for 21 years. In about 2005, we started traveling among more schools, and were not present weekly to check on the children, instead, we were told to tell the school if their teachers noticed any side effects. How can teachers be the ones to report side effects? What happened was that we only heard about side effects if there was a crisis, such as many children absent, or many complaining of pain, fever, rash, etc. Teachers in turn became more stressed. They were under increasing pressure to complete their curriculum, they had little time for vaccines and I doubt if they were able to recognize subtle side effects of vaccines. One way to run a business is to overwork the employees until they cannot think obje...

      A signature on the Health Declaration is legally enough in order to vaccinate school children, even though many parents have expressed disagreement and even anger at this. The rationale? Wide vaccination coverage.   But if the goal is wide vaccine coverage, then why are vaccines not widely available in both schools and health clinics?  Health clinics have late afternoon hours, which are more convenient for parents should they need to complete vaccines, considering that school nurses' hours at each school are scarce.   Vaccines should be widely available in Israel , and they used to be.   If a school age child missed a vaccine on one of the very few vaccine days, their parents could bring them to a local clinic in the evening and have it completed.   Then, in about 2005, vaccines that were given in schools could only be completed in schools, and this led to less availability.   Stop the compartmentalization, bring vaccines b...

  The school health declaration in Israel is considered enough allowance for vaccinations. This is evidently to get more vaccines performed with fewer hours spent by nurses checking the true intents of the parents.       This policy does not work, it has angered parents. If the goal is wide vaccine coverage, then why are vaccines not widely available in both schools and health clinics? Health clinics have late afternoon hours, which are more convenient for parents should they need to complete vaccines, considering that school nurses' hours at each school are scarce.   So in both areas, the needs of parents are secondary.    My request to Israel , to Israelis : question the loss of services, stop watching minute by minute updates on whatever current war or scandal is looming.

      My son attends a Chassidic elementary school, in Israel, called "Talmud Torah" or "Cheidar". Today he brought home a half a piece of paper stating, "the standard vaccines for first and eighth grades will be given next Tuesday, send your child's vaccine record to school". No explanation of what the vaccines are, no explanation of possible side effects. During my tenure as school nurse, I built trust with parents over a long time and in many one on one informative conversations. I encouraged some Haredi (ultra-orthodox) families who were opposed to vaccines to complete at least some of them. This meant increased coverage in large families, causing a positive ripple effect. And during my tenure, there were no outbreaks of contagious disease preventable by vaccines in Imanuel. But trust building and the time it takes is not of interest, evidently, to those running vaccine administration in Israel. I have been replaced by a half a page note, implyin...

  Someone mentioned to me that government ministries are resistant to change. I responded:   The ministry of health certainly allowed the change of privatizing school nurses.    They allowed the change of one nurse for two schools to one nurse to 16 schools.   They allowed the change from a nurse who performs much follow up to the nurse who gives one or two chances a year for vaccination and then blames the parents for not keeping up their vaccines. "Let's give responsibility to the parents" the current head nurse said. How are overstressed parents supposed to know what vaccines need completing?   Thus, plenty of change has conspired   They allowed the change from a nurse who has some free time each day to speak with the school children to the school nurse who has a minimum amount of work to do in a day then move on to another school.    They allowed the change from performing heights and weights in first, third, fifth and seventh grades to...

Imagine what is it like to work for an organization that ignores your colleague's plight? Imagine that he was hit by a car while riding his motorcycle, rendered comatose for months, yet management said absolutely nothing to  the coworkers.   Nothing.  No email of sympathy, no gathering to share feelings. Imagine that a nursing supervisor fought for recognition that this cannot go unnoticed, so upper management agreed to one meeting between his coworkers and a psychologist.  That is all. Imagine that this leads to a level of anxiety bordering on the codependent, working even harder to serve the parents and students and shield them from an organization that could ignore such pain so ruthlessly.