May 12th is International Nurses Day!

National Nurses Week runs May 6th through May 12th. The celebratory week culminates on Florence Nightingale’s birthday. May 12th is recognized as International Nurses Day by the International Council of Nurses. This year marks the 30th year of celebrating National Nurses Week.

I have been a nurse for 24 years this June. I still remember the day I took my NCLEX exam. I also remember my first job as a nurse tech, as a new graduate registered nurse, as a travel nurse, and every other nursing role that has led me to where I am today.

I believe that the education, training, preparation and experience of becoming and being a nurse prepares you with the ability to not only assess someone but also something. Your nursing knowledge, skills, and abilities are necessary not just in your day to day work but in your life as well.

Additionally, being a nurse holds so many opportunities for you. Whether you opt to change direct care areas of focus, choose to travel, choose to pursue an advanced practice role, choose leadership, education, informatics, or any other role, there is that possibility for you to explore.

Nursing as a profession has a long history of evolving and advancing through the determination, intelligence, and forward thinking nature of other nurses.

Today in 2024, we continue to extend the boundaries of where nurses can and do have an impact on the delivery of quality care to others.

You may be inspired by Florence Nightingale, Mary Seacole, Clara Barton, Anita Dorr, Mary Mahoney, or any other nurse in the world who has advocated for better.

Now consider that someone may be inspired by you and your nursing abilities, your role, your education, your accomplishments and/or any other characteristic or attribute that differentiates you from the nurse next to you.

Happy International Nurses Day to you! May you have a year that provides you with continued inspiration and meaningful moments as a nurse.

~ Dr. Kelley

Documentation burden continues to be an issue.

“If it is not documented, then it is not done.” This expression is one that is commonly known amongst nurses working in direct care roles. Beyond this expression, is a need to recognize the value that documentation provides in care delivery.

As a nurse and/or healthcare professional, the responsibility one has is to provide the highest quality care. To do so requires accurate and accessible data and information about the patient.

Data and information about the patient needs to be entered into the record. That data and information must also be retrievable for effective use.

Two weeks ago, AMIA (American Medical Informatics Association) released results from a survey, TrendBurden, taken during the month of April 2024 with over 1200 respondents. In addition to nurses, physicians, social workers, educators, and other healthcare professionals participated in the survey. Details of the survey questions can be found at the above link. The responses were reported on a 3 point likert scale (Agree/Strongly Agree, Neither Agree nor Disagree, Disagree/Strongly Disagree).

Documentation burden may be seen initially as a health information technology issue. However, there are larger implications for the workforce. The questions asked in the survey include:

  1. The amount of time and effort I spend documenting patient care is appropriate. The majority disagreed that the necessary time to document patient care was appropriate.
  2. I finish work later than desired or need to do work at home because of excessive documentation tasks. The majority agreed that they work later or do work at home because of documentation needs.
  3. Recently, there has been a noticeable decrease in the time or effort or both needed for me to complete my documentation tasks. The majority disagreed that there has been a noticeable decrease to complete documentation.
  4. The effort or time required for me to complete documentation tasks impedes patient care. The majority agreed that documentation time or effort impedes patient care.
  5. I find it easy to document patient care using the electronic health record. The majority of physicians disagreed that documentation is easy while nurses’ responses were split between agree (38%) and disagree (38.5%).

Surveys are self-reported data from the users. Having their voices heard in this manner opens the door for exploration into finding ways to address these documentation burdens that continue to persist.

It takes years to become a healthcare professional and even more years to become an experienced to expert care provider. Those years cannot easily be replaced. However, technology can be created to support the workflows and the people who use them and disseminate those at scale.

I would encourage you to explore the responses for yourself here. The responses are broken into three categories of responses: All, Physicians, and Nurses. What I appreciate about this particular survey is the side by side comparison of responses between nurses and physicians (and then an aggregate).

~ Dr. Kelley

Tiffany Kelley PhD MBA RN NI-BC FNAP

Know My Nurse Life 2.0

Nightingale Apps is re-releasing Know My Nurse Life, our iMessage digital sticker app with 21 nurse and medical themed emoji-like images to enhance your SMS messages. Soon to be available in Apple’s App store for a nominal purchase.

Below is Nightingale Apps’ Privacy Policy

Privacy Policy

Your privacy is important to us. It is Nightingale Apps’ policy to respect your privacy regarding any information we may collect from you across our application, Know My Nurse Life, and other sites we own and operate.

Nightingale Apps does not ask for any personal information in Know My Nurse Life. Nightingale Apps does not share any personally identifiable information publicly or with any third parties, except when required by law.

Know My Nurse Life is a sticker app and is intended for enhancing your communications through SMS messages. Please be aware that we have no control over the content sent or received through SMS messages that use Know My Nurse Life stickers. Nightingale Apps cannot accept responsibility or liability for their respective privacy policies.

Your continued use of Know My Nurse Life will be acknowledged as acceptance of our privacy practices and policies. For any questions, please reach out to us.

Effective September 21st 2023





Patient-Centeredness & the Persistent Fax Machine

Patient-centered care is one of the six factors of quality in healthcare. Yet, there are many opportunities for improved patient-centered care.

To anyone that has had to fill out a form or receive a form from a healthcare provider or practice, there is a great likelihood of being told to ‘fax it back’.

Yet, how many have access to a fax machine at home?

Next, you are working to find a way to get the information back to or from the healthcare facility or organization that is not through a fax machine.

Knowing most do not have a fax machine, and encountering this issue, this is one example of an opportunity to improve patient-centered care.

In the bigger picture, healthcare has opportunities to explore the healthcare experience through the eyes of patients and unveil the blind spots to truly address patient-centeredness.

This is just one example but there are many others.

The article here provides several factors that contribute to the persistent challenge however, at some point, we will not be using fax machines….

In the meantime, one area of impact is on quality through that patient experience.


~ Dr. Kelley

The Administrative Burden of Being a Patient

Last week I had two once-a-year visits back to back. One was with my Primary Care Provider (PCP) and the second was with a new dermatologist. Both visits were booked out 9 months or longer in advance which initially surprised me.

As someone who is a healthcare professional of over 20 years and actively working in the space of innovation, I cannot help but notice some of the challenges of being a patient. My reflections are not intended to critique any particular provider, practice, clinic, facility or other healthcare organization. Instead, I see the challenges reflective of unmet needs faced by patients that could largely go unnoticed by healthcare professionals.

Patient-centered care is one of the 6 quality outcome metrics. However, I often wonder how we are defining patient-centered care. Is it defined by the perspective of healthcare professionals as to what we think patient-centered care means OR are patients involved in the process of defining what patient-centered means to them?

I had a couple of snafus trying to get to both appointments. The address for both offices was incorrect from the reality. Luckily, I was able speak to someone in the buildings, completely unrelated to my provider’s practice, who shared with me the correct locations. In both instances, I heard, “You are not the only one.”

Imagine if I was running late or my mobility was compromised so additional walking would be potentially burdensome to make it to the correct location. I would miss that appointment due to an administrative error. That appointment scheduled 9 months in advance and requiring my day to be arranged around it. The healthcare practice may see it as a no-show when that was not at all the intention.

The second administrative burden that I ran into was obtaining a detailed receipt for the charge paid upon leaving the dermatology visit. I used my Health Savings Account (HSA) card for the payment and the next day received an email requesting a detailed receipt for the payment. The receipt I received from the office only provided the location, date and amount. The reason for the payment was not included in the receipt.

When I called a few days later, I was surprised to hear how difficult it would be to obtain the detailed information. I asked if it is possible to receive a receipt with information as to details on the charge for the payment. The response was, “I don’t know.” She worked to investigate on her end and then said that someone would call me back. I did receive a call back and need to call another department to get the requested information. My question to her was why is it not on the receipt that I received the day I paid? The answer I received was HIPAA in the event I lost the receipt.

The phone calls, time, and effort to get the detailed receipt is an expense of its own as a patient that extends far beyond the 20 minute appointment. I often wonder how many patients go through the efforts to address the details requested for proof of purchase and/or reimbursement of rendered services.

Being a patient, even for a visit once a year, presents challenges that I am not sure are often recognized or considered as healthcare professionals. Without integrating patients into the process, these burdens will continue and lead to the same challenges over and over again.

Users are at the greatest advantage of identifying opportunities for change. In healthcare, change tends to require an ability to demonstrate quality outcomes. In this category, I envision patient-centeredness as the primary focal area.  To fully reach the utopia of patient-centeredness, we need to understand the areas where being a patient presents challenges beyond the healthcare visit itself. To a patient, the entire process is seen as one experience.

Have a lovely evening,


Dr. Tiffany Kelley PhD MBA RN-BC